Men & Alcoholism

1. Men & Alcoholism John Blattner, Ph.D., SCADC June 11, 2010

2. Alcohol 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!!

3. Alcohol 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.

4. Alcohol 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

5. Alcohol 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

6. Alcohol 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

7. Alcohol: Prevalence of Use for Total U.S. Population Used Used At 12 or 51 or Ever Past Past Least More MoreAge 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

8. Alcohol: Prevalence of Use for Total U.S. Population Used Used At 12 or 51 or Ever Past Past Least More MoreAge 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 TOTAL81.9 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

9. What Alcohol Does to the Brain

10. Occipital Lobe • (visual sensations) Affected by .10-.30% alcohol • Loss of color perception • Distortion • Seeing double • Loss of distance perception • 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 • 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 • 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 What Alcohol Does to the Brain

11. Frequent Blackouts Preoccupied Drinking First Blackout Sneaks Drinks Gulps Drinks Avoid Reference Increased Tolerance Loss of Control Contact Phase 6 mo. - 5 yr. Prodromal Phase 5th 8th yr. and Psychological Changes Acute Alcohol Addict Gross Physical Problems on Job Family Changes Seeks Help Resentments Attempts Escape Maintains Supply Chain Drinking Alibis Alibis Reproof Extravagance Aggression Remorse Water-Wagon Social Decay Acute Phase 8th 15th year Prolonged Benders Chronic Alcohol Addict Paralogic Thinking Ethical Deterioration Alcoholic Jealousies Recovery Vicious Circle Psycho-Motor Inhibitions Indefinable Fears Tremors & Shakes Religious Need Chronic Phase 15th 25th yr Insanity Decreased Tolerance Death Symptoms and Phases of Alcoholism Out of 90 million drinkers 15 yrs. and over, 200,000 become alcoholics annually

12. Myths about Alcoholism Myth: But he’s too nice to be an alcoholic. Myth: But he only drinks beer. Fact: Alcohol is alcohol. It’s not the type of beverage that matters, it’s the alcohol in it. Fact: Lots of alcoholics are nice guys. Alcoholism has nothing to do with personality. Myth: But he only drinks after work. Fact: Many Alcoholics schedule their drinking for weekend and after work.

13. Myths about Alcoholism Myth: But alcoholics are all bums. Myth: But he seldom misses work. Fact: Most alcoholics are ordinary, respectable people. Only about 3% are skid row bums. 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.

14. Myths about Alcoholism Myth: But she’s got too good a job to be an alcoholic. Myth: But women can’t be alcoholics. Fact: Many alcoholics have good jobs. Many are professionals and executives. Fact: Alcoholism doesn’t discriminate on the basis of sex. Many alcoholics are women. Myth: But she’s too young to be an alcoholic. Fact: Alcoholism can happen at any age. Even children can be alcoholics.

15. How Alcoholic Employee Behaves Visible Signs Crisis Points During Deterioration Behavior Attendance Late (after Lunch) Leaves job early General Behavior Fellow workers complain Overacts to criticism Job Performance Misses deadlines, Decreased efficiency, Relieve tension Efficiency Early Phase Alcohol tolerance increases Supervisor’s Evaluation 90% Blackouts Lies about drinking habits Criticism from boss 75% Attendance Frequent days off General Behavior Begins to avoid associates borrows money from workers Job Performance General deterioration Spasmodic work pace Family problems Surreptitious drinks Middle Phase Loss of job advancement Guilt about drinking Financial problems Tremors during hangovers Warning from boss Loss of interest In trouble with law 50% Attendance Fails to return to work General Behavior Grandiose, aggressive Trouble with law Job Performance General deterioration Spasmodic work pace Avoids discussion of problem TYPICAL CRISIS Punitive disciplinary action Late Middle Phase Fails in efforts at control Serious family problems-separation Neglects food Prefers to drink alone 25% Serious financial problems Attendance Prolonged unpredictable absences General Behavior Drinking on Job, undependable Job Performance Uneven and generally incompetent Final Warning from Boss Late Phase Believes that other activities interfere with his drinking Area of greatest cover-up Termination Hospitalization

16. Ethnic 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

17. Ethnic 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)

18. 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

19. 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

20. Alcohol-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

21. Alcohol-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

22. Alcohol-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

23. Ethnic 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

24. Ethnic 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

25. Alcohol 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.

26. Alcoholism 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

27. John F. Blattner, Ph.D., SCADC P-A-S International, Inc. 1000 Maple Ave. Downers Grove, IL 60515 630-968-5454