Secondhand Drinking/Drugging (SHDD): Understand It, Prevent It and We Can Go a Long Ways to Reducing Underage Substance Abuse; A
Posted Sep 20 2011 8:07pm
by Lisa Frederiksen
WHAT THIS MEANS
There are several entry points to the disease of addiction (whether it’s an addiction to alcohol or drugs) and the condition of alcohol or drug abuse. They are called risk factors. Many of them are the result of secondhand drinking/drugging – in other words, the impacts a person experiences as the result of a someone else’s abusive drinking/drugging and/or alcoholism/drug addiction. There are five key risk factors and they include:
Genetics – persons whose parent or sibling have the brain disease of addiction may have a genetic predisposition towards the disease as well. This does not mean there’s an addition gene, rather it may be lower levels of dopamine or dopamine receptors or lower levels of the liver enzyme that breaks down alcohol, for example.
Early use – because of the critical brain development that occurs from ages 12–25, an adolescent can become an alcoholic or drug addict in as little as 6 to 18 months; persons who begin drinking before the age of 15 are four times more likely to develop alcoholism than those who wait until 21, for example.
Social environment – people who live, work or go to school in an environment in which the heavy use of alcohol or drugs is common – such as growing up in a home where heavy drinking is seen as ‘normal’ or in a school setting where it is viewed as an important way to bond with fellow students – are more likely to abuse alcohol and/or drugs themselves.
Mental illness – just over one-half of persons diagnosed as alcoholics or alcohol abusers have also experienced a mental illness (e.g., depression, PTSD, ADHD, bipolar) at some time in their lives; mental illness causes chemical and structural changes in the brain, as does repeated alcohol/drug abuse or alcoholism/drug addiction. It can also cause a person to “self-medicate” with alcohol or drugs in an attempt to make the feelings caused by the mental illness go away.
Childhood trauma – verbal, physical or emotional abuse or neglect of children, persistent conflict in the family (such as that surrounding a family member’s alcohol/drug abuse or alcoholism/drug addiction), sexual abuse and other traumatic childhood experiences can shape a child’s brain chemistry and subsequent vulnerability to substance abuse and/or addiction.
HOW THIS CONNECTS
The more risk factors – entry points – a person has, the more likely they are to develop a problem with alcohol/drug abuse and/or alcoholism/drug addiction. Take a young person who has grown up in a family where there is untreated alcohol abuse and/or alcoholism, for example. That young person potentially experiences three of these risk factors: Genetics, Childhood Trauma and Social Environment. That young person may also experience depression or anxiety as a consequence of the craziness that can exist in a family with untreated alcohol abuse and/or alcoholism, which presents a fourth risk factor – Mental Illness. If that same young person decides to experiment with alcohol in middle school or high school because that’s what their peer group is into or they are provided alcohol by a drinking parent who has a skewed view of drinking, anyway, and finds that drinking helps to relieve their sad and anxious feelings (at least while drinking), that young person now is faced with a fifth risk factor, Early Use. Each of these risk factors is a secondhand drinking impact — a ripple effect of someone else’s alcohol abuse and/or alcoholism.
WHAT UNDERSTANDING, TREATING and/or PREVENTION CAN DO Preventing or mitigating the entry points reduces the secondhand drinking/drugging impacts, which in turn, reduces the likelihood of a young person engaging in underage drinking or drug use/abuse and/or developing the disease of addiction. A bold claim, I realize, but we have a very successful model to follow for this approach — secondhand smoke.
When we were focused on trying to get the smoker to stop smoking, it was easy for those in their sphere to dismiss the problem as, “I don’t care if she smokes. Doesn’t bother me.” Once new research proved the impacts of a person’s smoke on the health of others (i.e., secondhand smoke), there was a whole new appreciation for the far-reaching harm caused by an individual’s decision to smoke, and a whole new shift in society’s view and tolerance for secondhand smoke.
It is my opinion that if more of us understand the new brain research (see “What’s Changed” below) and secondhand drinking/drugging, we will have a key to reducing alcohol/drug abuse, underage drinking/drug use and addiction – much the same way secondhand smoking campaigns changed America’s smoking culture. Yes, this is a bold claim, but think about that same young person, again.
If his (or her) elementary school’s substance abuse education program had a piece on the new brain research that explains alcoholism as a chronic relapsing brain disease and just what that means, that young person may have been able to separate his parent (whom I’ll now refer to as his father) from his father’s drinking behaviors. He might have understood that the very nature of a brain disease means the disease changes the way a person thinks, acts, feels and therefore their behaviors because the brain controls everything we think, feel, say and do. That young person may have been able to understand it was his father under the influence of alcohol, not his father doing and saying the crazy, mean things. He may have been able to understand his mother’s behaviors (some of them just as crazy as his father’s) were the result of her reactions to his father’s drinking behaviors, not because he hadn’t cleaned his room or gotten all A’s or was always forgetting to put the toilet seat down.
In other words, he may have understood it was not him causing his parents’ behaviors — it was his father’s chronic relapsing brain disease – alcoholism – and his mother’s reactions to it. He would have also learned his mother’s reactions were ‘normal’ when a person does not understand the disease of alcoholism or the condition of alcohol abuse, but they are not healthy or productive. He’d have understood his mother’s behaviors were the result of her desperate attempts to do something — anything — to make it stop; an impossible task that left her feeling angry, sad and frustrated every time she failed to do so.
All of this knowledge might have reduced that young person’s depression and anxiety because he would have understood early on that as long as his father drank and his mother did not understand a healthier way of coping with it, his father would continue those drinking behaviors and his mother would continue her reactions (some even more hurtful than his father’s behaviors!). Knowing this would have helped that young person understand that the only thing he could do was to get help with developing healthy coping skills himself, which his teacher and school counselor would have been aware of, given the enhanced substance abuse education programs that would have incorporated those, as well.
Or if that young person’s pediatrician had received this new addiction education in medical school (something that does not occur, in most cases, by the way) and insurance companies covered the cost of a pediatrician taking an extra 15 minutes beyond a covered visit, the pediatrician would have been able to use brief assessment tools to gently probe substance use in the child’s family. If the child opened up about what was going on, the pediatrician could have helped the child understand what alcohol abuse and/or alcoholism is and is not, thereby helping the child recognize their anxious and sad feelings were likely the consequences of his father’s drinking behaviors and his mother’s reactions to them.
The pediatrician would also have been able to explain to the child the idea of genetic predisposition and thus the need for the child to be wary of early use of alcohol, because – you guessed it – the pediatrician could have explained the critical brain development that occurs from ages 12-25 and why alcohol abuse during that time is especially problematic — especially for a child whose parent is an alcoholic. And, like the teacher and school counselor, the pediatrician would have known resources that could have helped their young patient learn healthier coping skills.
Armed with all of this new information, that child may have overcome and/or avoided entirely the risk factors he was facing as the consequence of secondhand drinking. And, who knows…that child’s teacher sending home some of the education materials may have helped a parent or two think about their own drinking patterns enough to change them or helped another parent or two better understand what alcoholism and/or alcohol abuse were really all about and what they could or could not do to help their spouse stop drinking. (Okay, okay, YES, this is an oversimplification… but you get the idea.)
WHAT HAS CHANGED — WHY HASN’T THIS BEEN DONE BEFORE?
It is being done. It’s just very, very new. Thanks to new brain imaging technologies of the past 10-15 years, neuroscientists and medical professionals can now study the live human brain like never before. Some of the resulting discoveries and research findings (many in just the past decade) are:
shedding new light on brain functioning and development, explaining how a person can become an alcoholic before age 21 and why a person who abuses alcohol ‘thinks’ and behaves the way they do
providing the visual evidence of the chemical and structural changes that occur in the brain as a result of alcohol/drug abuse and/or alcoholism/drug addiction (check out the brain scan blogs under the “Brain Scans” category to the right)
radically altering our understanding and/or treatments of
- addiction (to drugs or alcohol — now understood to be a chronic relapsing brain disease),
- alcohol / drug abuse (now understood to cause chemical and structural changes in the brain that can make a person more vulnerable to his/her risk factors), and
- secondhand drinking/drugging, a term used to describe the impacts of a person’s alcohol or drug misuse on families, friends, co-workers, fellow students and society at large.
So, I urge all of us to be open to this new research and this new approach. Over one-half of American adults report having a loved one who drinks too much, for example. Think about this — that’s an average of 1 out of every 2 adults. One in four children in America will be exposed to a family member’s alcohol abuse, alcoholism or both before the age of 18. I urge all of us to learn as much as we can and to share this new brain and addiction-related research with others. Because the most important thing about ALL of THIS is that we’d be talking about it.
We’d be taking the disease of addiction (whether to drugs or alcohol) out of the closet and exposing it for what it is — a chronic, often relapsing brain disease. We’d be talking about alcohol/drug abuse for what it really is — a condition that changes the chemical and structural make-up of the brain, which in turn causes some pretty nasty drinking/drugging behaviors, regardless of whether the person develops addiction. We would be pealing away the secrecy and shame that surrounds this disease — a disease that affects the entire family and through them, fellow students, co-workers, friends and society at large. We would be tackling the disease at its entry points — early use, mental illness, childhood trauma, social environment and genetics — where it could be arrested — before the person experiencing or exposed to the entry points suffered the consequences.
Who knows, with this approach, together we just may be able to cause a sea change in much the same way as tackling secondhand smoke changed the smoking culture in America. Now wouldn’t that be something…