The Four Factors of Alcoholism

I have been attending Alcoholics Anonymous (AA) meetings for more than a year now. I had my last drink of alcohol on 10-31-2009. It has been a great relief for me to simply remove alcohol (mostly beer) from my life. I was spending great amounts of energy to control my desire for more beer; it was much easier to just give it up altogether. One thing that puzzled me for the last year is this: why now? Why did I suddenly find myself wanting to drink everyday? Why did my tolerance for booze go up? After drinking modestly for almost 40 years, something changed.

The one striking thing I've discovered over this last year is this: there are many faces to this disease. I always knew I could become an alcoholic someday, given my family history. But the theoretical possibility and the actual reality of it happening, in the way that it did happen, was surprising, even shocking to me. The manifestation of this crippling disease in me did not look like the alcoholism of my Dad or my siblings. In fact, the desire to drink and to drink more & more crept in gradually into my life over 3 or 4 years. I've been wondering how this happened and what triggered the change in me. I heard a fascinating AA talk recorded in 1957 by a man named Inor Hansen in Monterey, California on "The Four Factors of Alcoholism". He lists these factors as 1) Absorption, 2) Distribution, 3) Combustion, and 4) Body Chemistry.

Before describing each factor, he asks the question : what is an alcoholic ? He answers "a person whose body processes do not give him the protections that enable him to maintain sensible control of himself when he drinks alcohol". We do not make ourselves an alcoholic even if we drink excessively. Alcoholism is a real disease. You cannot change the way your body works by willpower, morals, good judgment, character, etc. This disease is not really a compulsion but an obsession of the mind, that is an idea that comes to me with a power of its own. Your childhood and upbringing make no difference to the body processes you have. The alcoholic reaches for a drink to get relief from powerful negative emotions. This is not really "stinking thinking" as much as it is the "squealing feelings" of fear, guilt, and shame. Alcoholics "over respond" to their feelings. We drink to suppress our internal pain, not to escape reality.

1. Absorption A slow rate of absorption is one of the body's defenses against alcoholism. Two men at a bar drink 4 beers in an hour. Both have promised the wives they would be home by 6 pm. One man's body absorbs alcohol rapidly into the bloodstream; the other has a slow rate of absorption. The man with this normal, slower rate has most of the alcohol still in his stomach and at 5:55 recalls he must leave now to get home but the other man is already impaired by the amount of alcohol in his bloodstream, which has hit the brain's higher functions (like judgment). The impaired man is not morally inferior; his body has "betrayed" him by absorbing alcohol's anesthetic power more rapidly. He cannot "see" what is happening to him. This man is in the "unlucky 10%" that lack one of the body's normal protections against consuming too much alcohol.

2. Distribution For some people, 10% to 50% of consumed alcohol is deposited in the heavy, fleshy parts of the body, resulting in less alcohol reaching the brain. That means the higher levels of brain function (like good judgment) remain active. This is considered "favorable distribution". People with this natural protection against overconsumption of alcohol find that their muscles and respiration relax and they have less energy to do stupid things, including more drinking; often they simply go to sleep. (note: going to sleep is not the same thing as having an alcoholic "black out" when the person remains conscious but is not recording his actions or activities). Poor distribution allows more alcohol to reach the brain and to effect the higher brain functions. Changes in weight may affect the body's ability to handle alcohol.

3. Combustion This breaks down the alcohol and converts it to energy, which is part of the body's metabolism. Most people have a high rate of combustion : 75%, 85%, or even 100%. This is the social drinker with a natural protection against overdoing the drinks. These people recover from too much alcohol more quickly than alcoholics because the booze is burned off. They may suffer from a hangover the next day but still remain able to function well and go to work. A small minority of alcohol consumers have a combustion rate of 25%, 15% or lower. These people remain under the anesthetic influence of alcohol for a longer period of time, often waking up the next day with high levels of alcohol still in the blood stream. He is unable to care about his work or other responsibilities because the brain is still compromised.

4. Body Chemistry For most social drinkers, the consumption of alcohol causes the body to release adrenalin, which can actually stimulate the higher functions of the brain, which makes the individual more cautious and wary than he was before drinking. This adrenalin is another defense against drinking too much. Alcohol is not a stimulant itself, but the release of adrenalin acts like an internal "fire department" to keep one from danger. Do not let the social drinker tell you that they possess superior morals than you; they only have a different body reaction to alcohol.

Every person has feelings of inferiority or of not being wanted to some degree. We all have feelings of fear, shame, guilt, etc. The alcoholic is influenced by these powerful emotions to a much greater degree. This is why they are so vulnerable to "anesthetic excess". They are seeking relief! They find relief rather immediately with drugs and / or alcohol. But at what price?