Addiction and Alcoholics

Is addiction new? No. It is thought that one of our ancestors may have discovered the effects of fermented fruit or grain by accident, or inadvertently inhaled smoke from herb leaves tossed on a fire. As a result, getting high or intoxicated-getting out of oneself in an artificial way-has been a goal or at least part of every culture. "Drunkenness" has been seen as a problem in various societies for a long time, and when it gets out of hand, it has been punished. Until fairly recently, however, most psychoactive drugs were legal. Nineteenth-century America has been called a "dope paradise," and it was only in the early 20th century that drugs began to be seen as sources of "abuse" that needed to be regulated by laws. Even alcohol was outlawed in the United States in the early 20th century. But laws have not stopped people from using alcohol or drugs.

When these substances were declared illegal, the whole process went underground and got otherwise complicated, with, for example, more people pointing fingers at the evils of drink and fewer potential professional hands available to help. In the second half of the 20th century, the drug scene got even more dramatic. In the 1960s, due partly to the "hippie" culture and partly to addictions fostered overseas during the Vietnam War, the use of drugs became more socially acceptable or at least widespread. During the same period, the pharmaceutical industry developed increasingly sophisticated prescription drugs, which started to be abused. Those scared away from criminally connected illegal drugs devised creative ways to use prescription drugs and other substances to alter their consciousness.

Statistics show that teens' use of such substances has grown as use of other substances has declined, but pharmaceuticals are potentially just as dangerous as other drugs. Though potions for "curing" drunkenness were on the market hundreds of years ago, the primary approach to dealing with alcoholism and addiction has historically been to make it illegal or shameful or both. Even with the advent of serious research in the 1930s, people addicted to drugs were thought to have a moral failing rather than a health problem, so approaches stressed punishment rather than prevention or therapy. The idea that alcoholism might be a disease spread in this country only around 1940, in part because of the popularization of Alcoholics Anonymous, and later by the acceptance of the disease concept by the American Medical Association. Today, thanks to scientific breakthroughs in brain studies, the approach to addiction has changed dramatically, showing that it is a disease that affects both the brain and behavior.

The path of nicotine illustrates the process by which substances move from popular fad to social outcast. Cigarettes were once used just by a small segment of society, but then they were marketed as a sign of sophistication and reached a wider slice of the population. As time passed, the facts about nicotine came to light, and people of all ages found ways to stop lighting up. The same can be true of any substance of abuse.

With new knowledge of how addiction works, you and your generation have the power to change the future, to take actions that will stop the history of addiction and alcoholism from repeating itself. Because the good news about substance use disorders is that they can be successfully treated, and the more that is known about the addictive properties of each substance, the more effectively they can be treated. The process of addiction is quite similar for most kinds of addictive drugs, but each type has its own characteristics. Though substances of abuse act on the dopamine pathway in the brain, alcohol and drugs can each affect different neurological circuits. Abuse of alcohol, for instance, may create changes in the brain that result in increased feelings of stress that may trigger further compulsive drinking.

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