The cultural context of psychological approaches to alcoholism: Can we control the effects of alcohol?

Abstract

Argues that the unique history of alcohol use in the US has led to the ascendance of disease theory as the dominant conception of alcoholism. Social-scientific research has consistently conflicted with disease theory, but psychological and other nondisease conceptions of alcoholism are not well-represented in the public consciousness, in treatment programs, or in policies for affecting nationwide drinking practices. Conflict in the field has intensified in the last decade, most notably surrounding the issue of controlled drinking in alcoholism treatment. It is suggested that the current cultural attitude toward alcoholism in the US, one strongly influenced by disease notions, has not led to an improvement in society's drinking problems and that there continues to be a need for psychologists to present alternative views of alcoholism. The concepts of dependence and addiction as related to alcohol and to drugs are discussed. (3 p ref)

Asians, Asian-Americans and Alcohol

“…Descriptions of historical changes in alcohol use and abuse in Asia 1987) and in the United States (Peele 1984) suggest complex set of economic and political factors can result in major shifts in mean alcohol consumption and prousage, with changes in norms for alcohol use as precede as to follow such shifts.…”

“…Analyses of large samples on levels of and problems with alcohol use (Hilton & Clark 1987;Foch et al 1984) suggest that the single distribution theory may adequately account for the alcohol consumption data. It should also be noted that there is compelling evidence for the influence of social/cultural factors on group definitions of what constitutes problem alcohol use and alcoholism (Peele 1987a(Peele , 1984, a topic that will also be addressed in the present article. While it is possible that the development of alcholism for small subsets of individuals within groups in largely determined by specific genetic factors, the present authors believe that most of the variance of alcoholism is accounted forby the more general genetic and environmental influences that determine normal alcohol use.…”

Toward a preliminary macro theory of drug addiction

“…Individual moral and value-oriented themes have reappeared in the sociological literature on drug addiction as an attempt to counter the influential disease model of addiction (Peele 1984(Peele ,1985(Peele ,1988a(Peele , 1988b. Currently, microsociological models of addiction-namely social learning theory, social control theory, and the adaptive model of addiction-offer important insights into such individual or smallgroup factors as loss of self-control, lack of conformity and social maturity, and depraved values.…”

Literature review: connections between trauma and substance abuse

“…This model attributes the use of alcohol to personal choice, with dependence resulting from weak moral character. In this model, character building, personal will power and removal of temptations overcome dependency [117].…”

“…Withdrawal symptoms vary according to the level of physical dependency and the previous numbers of detoxification but may include the following: hyperarousal, tremor, tachycardia, anxiety, fever, anorexia, diaphoresis, disorientation, hallucinations, and seizures [115]. It has been argued that a heavy reliance on the presence of tolerance and withdrawal symptoms may lead to a failure to diagnose serious dependence [116][117][118][119][120]. Therefore, clinicians should not rely too heavily on the presence of tolerance and withdrawal symptoms before they make the diagnosis of physical dependence.…”