Saturday, October 30, 2010

If Alcohol Were Invented Today

[Originally posted on 29 Sept 2010]

The word 'alcohol' was coined around 1540 by an Arabic chemist to describe the fine powder, or 'kohl,' used to stain or paint the eyelids.  Two centuries later, British writers borrowed the word to describe the intoxicating essence of wine -- an ironic twist, since the original Arabic chemist was very likely a Muslim and, as such, forbidden to drink it.  

If alcohol were invented today, international law would class it with the controlled substances, alongside opium, heroin, cocaine and the like.  The World Health Organization (WHO), in its most recent comprehensive report, writes:
Alcohol is a psychoactive substance with a known liability to produce dependence in humans and animals. If considered in the frame of the 1971 Convention on Psychotropic Substances, alcohol would qualify for scheduling as a substance that “has the capacity to produce a state of dependence, and central nervous system stimulation or depression, resulting in hallucinations or disturbances in motor function or thinking or behaviour or perception or mood”, and for which “there is suffi cient evidence that the substance is being … abused so as to constitute a public health and social problem warranting the placing of the substance under international control.”

The propensity to produce "dependence" -- a bland synonym, in this context, for the more controversial term "addiction" -- is the red flag that sets apart this relatively small class of drugs, including alcohol, from the millions of other known chemical compounds.  They are addictogenic.

The exact molecular mechanism of addictogenesis is still the focus of scientific investigation in several countries.  But the fact of its occurrence is beyond dispute.  The WHO report says, "The direct actions of alcohol on the brain and sustained alcohol exposure lead to longer–term molecular changes in the brain known as neuroadaptation."  That is, a number of neural pathways in the brain are altered to form a strongly self-reinforcing habitual behavior pattern that leads to adverse consequences for the organism.  

Among the pathways by which alcohol enters the brain is the brain's indigenous opioid system -- the same doorway by which the opiates such as heroin and codeine pass into the neural network.  

Wherever alcohol is introduced into a country on a large scale, there one finds the rise of alcohol addiction (alcoholism).  The WHO world surveys find a strong correlation between the level of alcohol consumption in a country, and its prevalence of alcohol dependence.  Statistically, more than three quarters of the dependence rate is correlated with the level of consumption, and this trend is even stronger in "developing" countries, among which the WHO report specifically names India.  

Alcohol marketing generates alcohol use.  Alcohol use generates alcohol addiction.  Alcohol addiction then sustains the alcohol market. 

In any country where alcohol use has become established, writes the WHO, a small minority of drinkers consume the bulk of the alcohol sold.  "A typical finding is that half of the alcohol consumed is consumed by 10% of the drinkers."  In the U.S., some reports indicate that 10 per cent of the drinkers drink 80 per cent of the alcohol.

Imagine, then, that by some magic pill you could  convert the 10 per cent into non-drinkers.  The alcoholic beverage market would crash more profoundly and disastrously than the mortgage and financial markets in our recent meltdown.  

The alcoholic beverage industry worldwide is absolutely built on alcohol addiction.  One has to say it; there is no way to sugarcoat it.  

Recently, after I outlined these economic facts to a person newly in recovery from alcoholism, she exclaimed, "But that's so illogical!"  

Of course, it's utterly illogical.  We have grandfathered alcohol and tobacco into the category of legal substances, even though the combined death toll from these two drugs is perhaps 15 times greater than the toll from all of the drugs proscribed as illegal.  

So, we have prisons full of people caught using or selling negligible quantities of drugs whose total impact on society is relatively small, while the pushers of mega-quantities of lethal addictive substances that kill as many people each year as die in major wars, floods and earthquakes sit in luxurious offices with princes, prime ministers, and police chiefs on their speed dials.  

Meditation can provide lucidity at times of mental turmoil.  My friend who exclaimed at the illogicality of current addiction policy became agitated and, for a while, I feared that the mental stress would tilt her toward relapse.  I suggested meditation, and she calmed down.  The next day we met and I asked for her thoughts.  

She said that after thinking it through, she was more determined to remain free of addictive substances than ever.  Said she, "I don't like being used."

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