The Malta Independent 11 June 2025, Wednesday
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From Abstinence to alcoholism: the continuum of alcohol abuse

Malta Independent Wednesday, 20 June 2007, 00:00 Last update: about 12 years ago

Alcohol, a legal substance that is highly consumed nowadays and by earlier societies, is not regarded from the same perspective as illegal substances tend to be perceived. However, this concept is paradoxical in itself, especially if one had to reflect about the consequences that could possibly come on board in one’s life because of drinking abusively.

The aim of this article is to explain what constitutes a dependency on alcohol, mention some of its consequences, as well as raise awareness about the process through which one usually passes in order to reach the chronic stage of a dependency.

What is alcohol?

Some fruits, vegetables and grains are made up of certain sugars which, under a process which is usually referred to as “fermentation”, can be transformed into ethyl alcohol. This is the basic process by which alcoholic beverages, such as beer and wine, are produced. On the other hand, spirits are made through a process of distillation.

Alcohol is a depressant and it acts specifically on the nervous system, hence explaining why individuals who consume alcohol tend to feel relaxed and less inhibited. Moreover, one’s capacity to concentrate and maintain proper judgment is reduced as a result of the same drug. Furthermore, as a depressant, alcohol slows down certain coordination processes within the brain and one’s nervous system, including the rapidity of one’s reflexes, which is why individuals are strongly encouraged not to operate heavy machinery or drive while under the influence of alcohol.

The continuum of alcohol abuse

Even though one is not born an alcoholic, it is important to point out that there are certain individuals who are born with a genetic predisposition that puts them even more at risk of developing a dependency on alcohol once they start abusing of it. Therefore, if one makes a simple exercise of having a good look at one’s family history and manages to identify quite a few relatives who are reported to have suffered from alcoholism, then it is advisable to consume alcohol in a cautious manner.

One may find it difficult to understand how a person ends up being dependent on alcohol if one is not born as such. The following is a brief description of the different phases of the classic drinking pattern which one passes through to reach the point of alcoholism. While this process shall be referred to as the “continuum of alcohol abuse”, the time frame spent in one phase before progressing to the other varies from one person to another.

Phase 1: Abstinence

Except for in the case of pregnant drinking mothers, human beings commence their initial trail of life completely abstinent from alcohol. Hence, this is a phase where no alcohol is consumed at all.

On the other hand, many individuals opt to abstain from alcohol as a result of several different circumstances, such as pregnant women, people on medication, individuals suffering from depression, anxiety or other mental illnesses, as well as persons who have a history of alcohol abuse.

Phase 2: Social drinking

Since alcohol is welcomed very warmly by many different cultures, it is a well-known fact that the majority would consume alcohol without any hesitancy as soon as the first opportunity comes along the way. For instance, it is not a rare scenario for one to see children, even less than 10 years old, whining at their parents during a typical family meal to allow them to have a sip from their glass of wine or beer.

Obviously, this is not the best way of introducing social drinking to this young generation. In fact, it has always been advisable that individuals below the age of 21 years (and above 16 years) should ideally consume not more than two units of alcohol per week. However, this is far from reality and, unfortunately, today’s youth are nearly skipping the phase of social drinking by introducing a completely new phenomenon which is that of binge drinking (more than four units on one occasion).

On the other hand, if alcohol is consumed appropriately (not more than four units during a single occasion), then no serious negative consequences are to be expected. In fact, this is the most common form of drinking and many manage to keep up with this drinking pattern with no related problems whatsoever.

Phase 3: Problem drinking

This form of drinking is no longer within the healthy range, as in social drinking. When drinking problematically, one starts experiencing several negative consequences, such as aggressive behaviour and an increased risk of getting involved in accidents, including those involving drink driving. If this drinking pattern persists, one is also likely to start experiencing a negative impact at one’s place of work, while in the case of bingeing among the youth, their school performance may also start to deteriorate. Since at this stage, dependency has not yet been developed, such drinking behaviour may vary in its frequency from a one-off incident, to every weekend, and so on.

Phase 4: Habitual drinking

If the previous drinking pattern persists throughout a substantial length of time, one’s tolerance to alcohol starts increasing, and later, a psychological and physical dependency on alcohol may develop. This means that one starts seeking places and occasions to have an “excuse” to drink alcohol rather than drinking during appropriate occasions.

Moreover, this repeated alcohol abuse keeps on persisting, even if one is experiencing a whole range of problems as a direct consequence of the abusive drinking. Such problems may vary from physiological and psychiatric consequences to psychological, social and legal ones (Refer to Chart – The Effects of Alcohol Misuse).

Phase 5: Alcohol dependency

If one fails to address the habitual drinking pattern, either on his or her own or through professional help, then one would be risking to proceed to the final and most serious stage of the continuum of alcohol abuse, that is of developing a dependency on alcohol. Once an individual reaches this point, drinking is no longer pleasurable; to the contrary its effect becomes, to mention the least, very depressing. Family, work and friends are given little attention compared to the importance given to alcohol. Even though one might have reached a decision to stop drinking, this is often not possible without the necessary medical attention.

One sign of this problem is that one would not be able to function normally without consuming the usual necessary daily dose of alcohol. If this is not available, the alcohol-dependent person starts experiencing withdrawal symptoms within a few hours or days after one’s attempt to abstain from the substance. Moreover, loss of control is a frequent symptom of one’s dependency on alcohol. Even if one’s intention might be to drink only a couple of glasses of wine, the alcohol consumption will continue until the individual would have reached a clear state of drunkenness.

The only solution to get rid of this vicious cycle is to revert to the very first stage, which is that of abstaining completely from alcohol. This can only be done by seeking necessary medical and other related professional help, including relapse prevention therapy and psychological support on a regular basis. It is important to point out that, once an individual reaches the point of dependency on alcohol, there is no realistic possibility of reverting to social drinking.

If a person, who would have reached this stage, manages to abstain from alcohol for, say, a whole year, and then feels tempted to re-introduce oneself to the lifestyle of “social drinking”, one would soon realise that this is not quite possible.

The reason behind this is that, once developed, alcoholism is a life-long condition, and hence, one’s alcohol consumption would eventually follow the same pattern prior to abstaining from alcohol and therefore the cycle re-starts all over again.

Where to get help

• Your family doctor

• Sedqa Helpline 151

• Alcohol Community Team – 2142-1814/2142-1815

Theresa Borg is Team Leader, sedqa’s Alcohol and Gambling Community Services

Agenzija Sedqa forms part of the Foundation for Social Welfare Services, which also incorporates Agenzija Sapport and Agenzija Appogg

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