Men & AlcoholismMen & Alcoholism

John Blattner, Ph.D., SCADC

June 11, 2010

John Blattner, Ph.D., SCADC

June 11, 2010

Alcohol StatisticsAlcohol Statistics

• Alcohol Abuse statistics tells us that 23 million Americans suffer from substance abuse

• 18 Million is alcohol related

• Untreated addiction is more expensive than three of the nation’s 10 killers

• Shortfalls in productivity & employment cost $80.9 billion in 1992!!

• Alcohol Abuse statistics tells us that 23 million Americans suffer from substance abuse

• 18 Million is alcohol related

• Untreated addiction is more expensive than three of the nation’s 10 killers

• Shortfalls in productivity & employment cost $80.9 billion in 1992!!

Alcohol StatisticsAlcohol Statistics

• 62% of high school seniors report they have been drunk

• 31% say that they have had five or more drinks in a row during the last two weeks.

• Between 20 and 30 percent of male psychiatric admissions are alcohol dependent or have alcohol-related problems.

• 62% of high school seniors report they have been drunk

• 31% say that they have had five or more drinks in a row during the last two weeks.

• Between 20 and 30 percent of male psychiatric admissions are alcohol dependent or have alcohol-related problems.

Alcohol StatisticsAlcohol Statistics

• 47 % of seniors admitted to using alcohol in the past month

• Higher percentage of males (50.7%) than females (43.3%)

• About a third male tenth graders used alcohol in the past month

• 16.2% of eighth grade males used alcohol in the past month

• 47 % of seniors admitted to using alcohol in the past month

• Higher percentage of males (50.7%) than females (43.3%)

• About a third male tenth graders used alcohol in the past month

• 16.2% of eighth grade males used alcohol in the past month

Alcohol StatisticsAlcohol Statistics

• Men are three times more likely than women to become dependent on alcohol

• 40% of people who begin to drink before age 15 will likely become an alcoholic

• Early drinkers are four times more likely to become an alcoholic than those who don’t start drinking until the age of 21

• Men are three times more likely than women to become dependent on alcohol

• 40% of people who begin to drink before age 15 will likely become an alcoholic

• Early drinkers are four times more likely to become an alcoholic than those who don’t start drinking until the age of 21

Alcohol TheoriesAlcohol Theories

• Freudian perspective: interpreted the consumption of alcohol to be the result of a childhood fixation at the oral stage caused by frustration with oral development needs due to a unloving mother who denied pleasure by withholding food or because of an overly protective mother

• Social Learning: suggested drinking as a purposeful choice that is goal directed and extends the basic conditioning theories and sees the development and maintenance of individuals different drinking related behaviors as being guided by common learning principles

• Freudian perspective: interpreted the consumption of alcohol to be the result of a childhood fixation at the oral stage caused by frustration with oral development needs due to a unloving mother who denied pleasure by withholding food or because of an overly protective mother

• Social Learning: suggested drinking as a purposeful choice that is goal directed and extends the basic conditioning theories and sees the development and maintenance of individuals different drinking related behaviors as being guided by common learning principles

Alcohol: Prevalence of Use for Total U.S. PopulationAlcohol: Prevalence of Use for Total U.S. Population

Used Used At 12 or 51 or

Ever Past Past Least MoreMoreAge Used Year Month Once Days Days

12-17 39.7% 34.0% 20.5% 34.0% 11.7% 4.4%

Male 38.8 32.7 21.0 32.7 13.0 5.2

Female 40.7 35.3 19.9 35.5 10.3 3.5

18-25 83.5 75.1 58.4 75.1 46.5 23.2

Male 86.0 78.9 65.9 78.9 57.2 33.6

Female 81.0 71.2 50.8 71.2 35.6 12.6

26-34 89.9 74.6 60.2 74.6 48.9 24.6

Male 93.1 80.4 67.9 80.4 60.1 35.0

Female 84.7 69.0 52.6 69.0 38.0 14.5

Alcohol: Prevalence of Use for Total U.S. PopulationAlcohol: Prevalence of Use for Total U.S. Population

Used Used At 12 or 51 or

Ever Past Past Least MoreMoreAge Used Year Month Once Days Days

35+ 87.0 64.1 52.8 64.1 39.7 24.8

Male 93.9 69.8 60.6 69.8 52.2 33.9

Female 80.9 59.0 46.0 59.0 28.7 16.8

TOTAL 81.9 64.1 51.4 64.1 39.2 22.4

Male 86.6 68.7 58.2 68.7 49.9 30.9

Female 77.5 59.8 45.1 59.8 29.2 14.6

What Alcohol Does to the BrainWhat Alcohol Does to the Brain

Part of the BrainBlood AlcoholLevel (BAL) Effect on Behavior

Frontal Lobe .01 - .10% Removal of inhibitionsLoss of self controlWeakening of willpowerFeeling of well beingFalse confidenceImpaired judgement

Parietal Lobe .10 - .30% Dulled and distorted sensesUnsteadiness of movementInability to writeSpeech disturbancesLoss of technical skill

Occipital Lobe .20 - .30% Loss of color perceptionDistorted visionDouble visionLoss of distance perception

Cerebellum .15 - .35% Disturbed equilibrium andcoordination

Thalamus and Medulla .25 - .50% ApathyDepressed respirationCirculation failureSubnormal temperatureStupor, Shock, Death

What Alcohol Does to the BrainWhat Alcohol Does to the Brain

Frontal Lobe(reason and self-control)Affected by .01 - .10%

alcohol• Removal of inhibitions• Loss of self control• Weakening of willpower• Feeling of well-being• False confidence• Impaired judgment• Loquaciousness• Dulling of attention

Parietal Lobe(sensor control) Affected by .10-.30% alcohol• Dulled or distorted sensibilities• Unsteadiness of movement• Inability to write • Speech disturbance • Loss of technical skills

Cerebellum(coordination enter)

Affected by .15-.35% alcohol

• Disturbance of equilibrium and coordination

Thalamus and Medulla(respiration and circulation control)

Affected by .25-.50% alcohol• Apathy• Depression of respiration and other automatic

movements• Failure of circulation, subnormal temperature,

Stupor, shock, death

Occipital Lobe(visual sensations)

Affected by .10-.30% alcohol• Loss of color perception• Distortion• Seeing double• Loss of distance perception

Symptoms and Phases of AlcoholismSymptoms and Phases of AlcoholismOut of 90 million drinkers 15 yrs. and over, 200,000 become alcoholics annuallyOut of 90 million drinkers 15 yrs. and over, 200,000 become alcoholics annually

Acute Alcohol Addict

Alibis

Alibis

Repro

of

Extra

vagan

ce

Aggress

ion

Remors

e

Wat

er-W

agon

Social

Dec

ay

Proble

ms

on Job

Family

Changes

Seeks

Hel

p

Resen

tmen

ts

Attem

pts E

scap

e

Mainta

ins

Supply

Chain D

rinki

ng

Gross

Physi

cal

and

Psych

ologic

al

Changes

Prolo

nged

Ben

ders

Acute Phase 8th 15th year

Contact Phase 6 mo. - 5 yr.

First B

lack

out

Sneaks

Drin

ks

Preocc

upied

Drinki

ng

Gulps

Drinks

Avoid

Ref

eren

ce

Frequen

t

Black

outs

Loss o

f Contro

l

Increased Tolerance

Prodromal Phase 5th 8th yr.

Ethic

al

Deter

iora

tion

Paral

ogic

Thinkin

g

Chronic Alcohol Addict

Alcoholic

Jealo

usies

Decreased Tolerance

Indef

inable

Fea

rs

Trem

ors &

Shak

es

Psych

o-Moto

r

Inhib

itions

Relig

ious

Need

Recove

ry

Death

Insanity

Vicious Circle

Chronic Phase 15th 25th yr

Myths about AlcoholismMyths about Alcoholism

Myth:But he’s too nice to be an alcoholic.

Myth:But he only drinks beer.

Fact:Lots of alcoholics are nice guys. Alcoholism has nothing to do with personality.

Fact:Alcohol is alcohol. It’s not the type of beverage that matters, it’s the alcohol in it.

Myth:But he only drinks after work.

Fact:Many Alcoholics schedule their drinking for weekend and after work.

Myths about AlcoholismMyths about Alcoholism

Myth:But alcoholics are all bums.

Fact:Most alcoholics are ordinary, respectable people. Only about 3% are skid row bums.

Myth:But he seldom misses work.

Fact:Many alcoholics rarely miss work. They may feel terrible but still show up.

Myth:But he’s not always drunk.

Fact:Few alcoholics are. It’s what happens when they drink that counts.

Myths about AlcoholismMyths about Alcoholism

Myth:But women can’t be alcoholics.

Myth:But she’s got too good a job to be an alcoholic.

Fact:Alcoholism doesn’t discriminate on the basis of sex. Many alcoholics are women.

Fact:Many alcoholics have good jobs. Many are professionals and executives.

Myth:But she’s too young to be an alcoholic.

Fact:Alcoholism can happen at any age. Even children can be alcoholics.

How Alcoholic Employee BehavesHow Alcoholic Employee Behaves

25%

50%

75%

90%

Behavior Crisis Points During DeteriorationRelieve tension

Alcohol tolerance increases

BlackoutsLies about drinking habits

Eff

icie

ncy

Early Phase

Middle Phase

Late Middle Phase

Late Phase

Surreptitious drinks

Guilt about drinking

Tremors during hangovers

Loss of interest

Avoids discussion of problem

Neglects food

Fails in efforts at control

Prefers to drink alone

Believes that other activities interfere with his drinking

Criticism from boss

Family problems

Loss of job advancement

Financial problems

Warning from boss In trouble

with law

Supervisor’s Evaluation

Punitive disciplinary action

Serious family problems-separation

Serious financial problems

Final Warning from Boss

Area of greatest cover-up

Termination

Hospitalization

TYPICAL CRISIS

Visible SignsAttendance Late (after Lunch) Leaves job earlyGeneral Behavior Fellow workers complain Overacts to criticismJob Performance Misses deadlines, Decreased efficiency,

Attendance Frequent days offGeneral Behavior Begins to avoid associates borrows money from workersJob Performance General deterioration Spasmodic work pace

Attendance Fails to return to workGeneral Behavior Grandiose, aggressive Trouble with lawJob Performance General deterioration Spasmodic work pace

Attendance Prolonged unpredictable

absencesGeneral Behavior Drinking on Job, undependableJob Performance Uneven and generally

incompetent

Ethnic MinoritiesEthnic Minorities

• 29% of US Population is an ethnic minority (Census, 2001)

• Patterns of alcohol consumption have been found to vary across ethnic groups.

• Patterns for 18 and older between 1984 and 1995 were examined

• Alcohol consumption remained stable among White men but increased among Black and Hispanic men

• 29% of US Population is an ethnic minority (Census, 2001)

• Patterns of alcohol consumption have been found to vary across ethnic groups.

• Patterns for 18 and older between 1984 and 1995 were examined

• Alcohol consumption remained stable among White men but increased among Black and Hispanic men

Ethnic MinoritiesEthnic Minorities

• Studies among these three groups defined frequent heavy drinking as five or more drinks at least once a week.

• Another study found reported 6.6% of whites, 4.5% for Blacks and 4.75 for Hispanics for frequent heavy drinking (SAMSA, 2001)

• Studies among these three groups defined frequent heavy drinking as five or more drinks at least once a week.

• Another study found reported 6.6% of whites, 4.5% for Blacks and 4.75 for Hispanics for frequent heavy drinking (SAMSA, 2001)

Risk Factors Risk Factors

• Risk factors for white men and frequent heavy drinking were lower educational attainment, being separated, divorced or never married

• No specific factors were found for Black men – though protective factors included being retired and defining religion as important in their lives

• Among Hispanic men unemployment was the only identified risk factor

• Drinking patterns for Native Americans appeared to be similar to Blacks and Hispanics

• Risk factors for white men and frequent heavy drinking were lower educational attainment, being separated, divorced or never married

• No specific factors were found for Black men – though protective factors included being retired and defining religion as important in their lives

• Among Hispanic men unemployment was the only identified risk factor

• Drinking patterns for Native Americans appeared to be similar to Blacks and Hispanics

Alcohol-Related problemsAlcohol-Related problems

• White and Black men reporting one to three or more alcohol-related problems remained relatively stable from 1984 -1995

• Hispanic men reporting one to three or more alcohol-related problems doubled from those two time periods from 9% to 16%

• For all groups older people were less likely to report alcohol-related problems than younger people

• For all groups the amount consumed was positively associated with the likelihood of having alcohol-related problems

• White and Black men reporting one to three or more alcohol-related problems remained relatively stable from 1984 -1995

• Hispanic men reporting one to three or more alcohol-related problems doubled from those two time periods from 9% to 16%

• For all groups older people were less likely to report alcohol-related problems than younger people

• For all groups the amount consumed was positively associated with the likelihood of having alcohol-related problems

Alcohol-Related problemsAlcohol-Related problems

• Black men being widowed was associated with lower risk for alcohol-related problems

• Hispanic men who were unemployed had a higher likelihood for alcohol-related problems

• Among Hispanics - Mexican American men have been found to have more alcohol-related problems than those of Cuban or Puerto Rican origins

• Black and Hispanics are more likely than Whites to continue their alcohol dependence once it begins

• Black men being widowed was associated with lower risk for alcohol-related problems

• Hispanic men who were unemployed had a higher likelihood for alcohol-related problems

• Among Hispanics - Mexican American men have been found to have more alcohol-related problems than those of Cuban or Puerto Rican origins

• Black and Hispanics are more likely than Whites to continue their alcohol dependence once it begins

Alcohol-Related ProblemsAlcohol-Related Problems

• White (22%) and Hispanic men (21%) had higher rates of driving after drinking compared to Blacks (14%)

• Hispanic men born in the US were three times more likely to engage in drinking an driving than those born elsewhere

• Hispanic men had higher rates of being arrested for DUI (19%) compared to White (13%) and Black (11%) men

• Compared with other ethnic groups in Alaska, Alaska Natives had higher rates of car crashes resulting from a DUI

• White (22%) and Hispanic men (21%) had higher rates of driving after drinking compared to Blacks (14%)

• Hispanic men born in the US were three times more likely to engage in drinking an driving than those born elsewhere

• Hispanic men had higher rates of being arrested for DUI (19%) compared to White (13%) and Black (11%) men

• Compared with other ethnic groups in Alaska, Alaska Natives had higher rates of car crashes resulting from a DUI

Alcohol-Related ProblemsAlcohol-Related Problems

• Alcohol Abuse and dependence are associated with several medical problems

• Chronic Liver disease and cirrhosis is one of those medical problems

• Age ranging from 55 to 64 per 1000,000 men were:

• 34.7% for White men

• 45.3% for Black men

• 100.6% for Native American men

• 11.5% for Asians and pacific islanders

• 61.8% for Hispanics

• Alcohol Abuse and dependence are associated with several medical problems

• Chronic Liver disease and cirrhosis is one of those medical problems

• Age ranging from 55 to 64 per 1000,000 men were:

• 34.7% for White men

• 45.3% for Black men

• 100.6% for Native American men

• 11.5% for Asians and pacific islanders

• 61.8% for Hispanics

Ethnic Differences Cultural FactorsEthnic Differences Cultural Factors

• Alcohol norms and attitudes have been found to be strong predictors of drinking

• Both Blacks and Hispanics have reported more conservative alcohol norms and attitudes than Whites

• Drinking patterns of Hispanic men who are more acculturated more closely resemble the general US Population

• Japanese Americans report drinking patterns more similar to those of whites than those of Japanese living in Japan

• Difference between Japanese men and Japanese American men likely reflect the influence of acculturation

• Alcohol norms and attitudes have been found to be strong predictors of drinking

• Both Blacks and Hispanics have reported more conservative alcohol norms and attitudes than Whites

• Drinking patterns of Hispanic men who are more acculturated more closely resemble the general US Population

• Japanese Americans report drinking patterns more similar to those of whites than those of Japanese living in Japan

• Difference between Japanese men and Japanese American men likely reflect the influence of acculturation

Ethnic Differences Cultural FactorsEthnic Differences Cultural Factors

• Acculturation to US drinking patterns however may not be the same across different ethnic groups or even for subcategories

• Americans of Irish heritage report a higher frequency of heavy drinking

• English/Scottish, Austrian, Italian and Greek backgrounds all report lower frequencies of heavy drinking than do White Americans in general

• Different regions in the US have their own drinking norms and people who acculturate to different cultural environments influences drinking patterns

• Acculturation to US drinking patterns however may not be the same across different ethnic groups or even for subcategories

• Americans of Irish heritage report a higher frequency of heavy drinking

• English/Scottish, Austrian, Italian and Greek backgrounds all report lower frequencies of heavy drinking than do White Americans in general

• Different regions in the US have their own drinking norms and people who acculturate to different cultural environments influences drinking patterns

Alcohol TreatmentAlcohol Treatment

• Research on alcoholism treatment with these ethnic groups is very limited

• Blacks are more likely to have gone to inpatient programs

• Whites have gone to driving under DUI programs

• Blacks twice as likely as Whites to have gone to AA

• Hispanics in treatment attend significantly more formal alcoholism therapy sessions and fewer AA meetings than Whites

• AA may be more appropriate for Native Americans and needs to be modified to meet their particular needs.

• Research on alcoholism treatment with these ethnic groups is very limited

• Blacks are more likely to have gone to inpatient programs

• Whites have gone to driving under DUI programs

• Blacks twice as likely as Whites to have gone to AA

• Hispanics in treatment attend significantly more formal alcoholism therapy sessions and fewer AA meetings than Whites

• AA may be more appropriate for Native Americans and needs to be modified to meet their particular needs.

Alcoholism TreatmentAlcoholism Treatment

• Variation exists in alcohol consumption, alcohol-related problems and other issues among and within specific ethnic groups

• There is a need for culturally sensitive/specific programs

• Cultural sensitive programs incorporate elements from a given culture, such as language, cultural symbols and so on

• The advantage of culturally specific programs is not so much based on effectiveness but on the fact that they are better than generic programs at and attracting and retaining ethnic groups

• Variation exists in alcohol consumption, alcohol-related problems and other issues among and within specific ethnic groups

• There is a need for culturally sensitive/specific programs

• Cultural sensitive programs incorporate elements from a given culture, such as language, cultural symbols and so on

• The advantage of culturally specific programs is not so much based on effectiveness but on the fact that they are better than generic programs at and attracting and retaining ethnic groups

John F. Blattner, Ph.D., SCADCJohn F. Blattner, Ph.D., SCADC

P-A-S International, Inc.

1000 Maple Ave.

Downers Grove, IL 60515

630-968-5454

P-A-S International, Inc.

1000 Maple Ave.

Downers Grove, IL 60515

630-968-5454