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Dr. E.M. Jellinek, a native of Brooklyn, NY is recognized as one of the premier researchers in the field of alcoholism. He was one of the strongest proponents of alcoholism as a disease. He even went on to typify drinkers into four classes, with the two most severe classes being alcoholics. His writings and descriptions did more for the acceptance of the disease concept of alcoholism and of A.A. as a respectable therapeutic modality than any other medical force of the time. Most every patient in A.A.-based recovery centers in this country encounters the "Jellinek Curve", which describes the progression of the disease. Although, in the Chemical Recovery ministry, we do not concur with all of Dr Jellineks theories, his chart is very useful in better understanding the stages of addiction.
Prodromal (Early Warning) Phase
This should not be confused with passing out. Blackouts are a type of amnesia that occurs when we are unable to remember certain things about our drinking. As the old joke ironically says, "I must have had a great night, because I don't remember a thing".
When a person does not have a drinking problem, sneaking a drink would seem ludicrous to them. However the person who has a drinking problem does not want people to really see how much they use so on the outside they appear to be drinking the same amount as anyone else but really have to drink much more. This person would be the one to go to the bar to get the "rounds" or would always be the "bartender" at parties. This way he can get more drink without being noticed.
A person becomes preoccupied with drinking when their thoughts become mainly about when they will drink, what they will drink and how soon they will be drinking. People may talk about alcohol a lot. They may carry it with them, in a flask, for example. They may even start brewing it themselves, thus allowing them to drink cheap and often.
When a person gulps their drink, it would imply that he is trying to reach a state of inebriation faster. He probably feels that he cannot be as bold or as confident, sober, as he can be after a few drinks.
At this point, other people see that the drinker has a problem. He avoids talking about it and quickly changes the subject when it arises, avoiding people who give him grief about it.
At this point, the drinker is frequently forgetting what happens when he starts drinking. He constantly has to apologize for his actions. More and more, people are noticing his problems and bringing it to his attention thus causing him to retreat further into himself.
Here, the addict is unable to predict, with absolute certainty, what will happen when he uses. This is a true loss of control. He will start using, maybe wake up on a bus or in the street, not knowing how he got there. He has crossed the line from abuse to addiction.
Now the addict is using more of his drug to get him to the point he wants to be. As his body relies on the drug more and more, he will reach a stage where he must drink just to be normal.
Acute (Middle) Phase
The addict will make excuses to drink. "It's my birthday" "It's the weekend" "I deserve this after the week I had". To him these are all valid reasons and deflect the fact that he has a problem.
Even though the addict feels that his drinking affects only him, this is never the case. His family, friends and co-workers will now be affected and will let him know by their anger and frustration.
Here, in order to deflect criticism and anger, the addict will act generous in order to manipulate those who feel this way. He will buy expensive things to look good, while the rent money gets spent on drink and drugs.
The addict gets angry, even violent, whenever his choice of lifestyle is questioned. Again, this is simply a defense to avoid seeing that he has a problem, thus allowing him to continue drinking.
The addict, seeing the damage he is causing, comes to temporary sanity and feels remorse at the hurt he has caused. He relates it to drink and agrees with his persecutors that he needs to change.
Because the addict still does not truly see his powerlessness, he will try to stop on his "own". He will tell his friends, with a sad face, that he is "on the wagon". Due to a lack of surrender, this way never works.
Here an addict will blame his drinking problem on something he is not doing right. For example, he may feel that if he only sticks to beer or wine he will not have a problem. An addict never succeeds at controlled drinking. If he could, he wouldn't be where he is.
The addict has now swapped his social circle and replaced it with one filled with people just like him. These people will not judge him or get upset at him when he is drunk. He no longer feels comfortable around non-or social drinkers.
The addict is now unable to function properly or hide his problem on the job. At this time, he could be in danger of losing his job or at least attending a drug program.
The family of an addict adjusts in very unhealthy ways. They can become co-dependant and will protect and enable the addict to continue their lifestyle. They may also become bitter and resentful, venting frustrations on each other instead of dealing with the problem. The negative impact is progressive and works to break down the family entirely.
The addict will look for help for all the wrong reasons. He will seek marital advice to fix his marriage, financial advice for his money woes but not deal with the real issue - his drinking.
The addict feels that he has done all he can possibly can to fix his problems but people are still upset at him. He now starts to resent those around him and blame them for his drinking and drugging.
The addict may, at this point, attempt to cure himself by moving, a "geographic cure", figuring that his problems are a result of his surroundings. This will not work because he takes himself with him and still does not deal with his drinking.
Afraid of being without, and resigned to his addiction, the addict will ensure that he has a steady supply of his drug.
At this point the addict is drinking constantly. There are no more hangovers and alcohol is needed just to feel normal.
As his body is being poisoned due to the excesses of drugs and alcohol, his overall health deteriorates and his conscience and ability to reason breaks down.
His life is now given over to the drug. It is not unusual for him to spend days or weeks doing nothing but drinking.
Chronic (Late) Phase
The addict has very little tolerance for his drug. Just a small amount will get him high. At this point, everything he does, he does while high.
The addict loses his grip on right and wrong. He will do things for drugs or money that would, if sober, appall him.
The addicts thinking will no longer run a logical course. He will find it difficult to tell reality from illusion.
He will become jealous of people in his life for no reason. He may accuse his spouse of cheating on him without rationale.
He will suffer from paranoia, unable to overcome a sense of fear and dread he feels. He will hide from things that are not there.
These physical symptoms are a result of him poisoning himself with alcohol and drugs.
His ability to do simple tasks is greatly diminished. He will be unable to coordinate lifting his foot to step up on a sidewalk.
The addict is so desperate at this point, he will try to "quick fix" his problem with religion. He will not be willing to put a plan into action that can really help him recover. He still wants to do it the easy, painless way.
Chronic Alcohol Addict
At this point the addict's situation is chronic. His body cannot process the alcohol as well as it could before. The only possible outcomes here are recovery, insanity or death.
Monday, February 07, 2005 - 18:55:32 Comments (0)