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Winter 2008/09 | Vol 12 No 2

Myth busters

Distilling fact from fiction

The truth about alcohol

With Dr. Peter Selby & Wayne Skinner

Dr. Peter Selby, clinical director of Addiction Programs at the Centre for Addiction and Mental Health in Toronto, and Wayne Skinner, deputy clinical director of the
program, challenge common myths about alcohol treatment and recovery.

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MYTH: Alcohol has the same chemical and physiological effect on everyone.

FACT: Alcohol, like any drug, affects different people in different ways. Many factors affect a person’s reaction to alcohol,
including body weight, metabolism, sex and body chemistry. Even the social setting, a person’s mood or whether one is tired or hungry have an effect.

MYTH: Drinking reveals a person’s true personality.

FACT: Heavy drinking, either binge or chronic, can have significant effects on behaviour, perception and personality. Intoxication or withdrawing from alcohol may also exaggerate emotions, such as anger, fear and sadness.

MYTH: Anyone who drinks long and hard enough will become alcohol dependent.

FACT: Alcohol abuse and alcohol dependence are two different points on the
continuum. In many individuals, dependence is preceded by abuse, but some develop dependence without progressing through drug use and abuse to dependence. In addition, many people abuse alcohol for many years without developing dependence. A complex of factors, including genetics and childhood development, shape the risk of developing alcohol dependence.

Unlike alcohol abuse, alcohol dependence is measured by tolerance and withdrawal, as well as other factors. For both conditions, the negative consequences of excessive drinking can occur on the biological level (from hangover to liver disease to cancer), the psychological level (from depression to cognitive impairment to sleep disturbance) and the social level (from relationship problems to work problems to legal involvement).

MYTH: A person who can abstain from alcohol for weeks or months or who only drinks on weekends does not have a drinking problem.

FACT: A person does not have to drink every day or every week to have a problem with alcohol. And not all people who drink daily are alcohol dependent. Alcohol dependence is not characterized solely by how often a person drinks. It is important to consider whether alcohol use affects the person’s functioning in areas such as work, relationships and school, and whether the alcohol use has medical, legal and financial consequences.

Even people who drink infrequently but who binge when they do (five drinks for men, per occasion, four for women) are at risk for health problems and other consequences from drinking.

MYTH: Drinking is higher among Aboriginal people than in the general population.

FACT: Research indicates that the prevalence of drinking among Aboriginal people is approximately the same as in the general population. However, it is drinking patterns that are different. Among those Aboriginal people who drink, more engage in binge drinking than social drinking.

MYTH: People who are alcohol dependent have no will power. If they were stronger they could just stop drinking.

FACT: Alcohol dependence affects brain chemistry, which makes the person feel compelled to drink alcohol. Addressing the problem usually requires treatment and ongoing support to minimize relapse risk.

MYTH: All someone has to do to overcome alcohol dependence is go to Alcoholics Anonymous.

FACT: AA doesn’t work for everyone. When it does work, people use AA to stay abstinent, reorganize their lives, draw on peer support and find deeper meaning.

MYTH: Tranquilizers and sedatives are useful in treating alcohol dependence.

FACT: Tranquilizers and sedatives can be useful during the acute withdrawal period. After that, these drugs are risky and can become a source of abuse and dependence.

MYTH: Alcohol detox is the same thing as treatment for alcohol dependence.

FACT: Alcohol detoxification, or withdrawal management, addresses the physical component of addiction by giving the body time to readjust to the lack of alcohol in the body. It does not in itself constitute treatment, but it may be the first step in the process of change, which includes the psychological and social components of alcohol dependence.

MYTH: Residential alcohol treatment is more effective than outpatient treatment.

FACT: While there are advantages to residential care, including round-the-clock attention and having a safe place to focus on recovery, the actual programs in residential and day treatment services are similar and outcomes are comparable. What is important is for treatment plans to be personalized for each situation and person.

MYTH: Relapse is an inevitable part of recovery from alcohol dependence.

FACT: Alcohol relapse is not inevitable, but it is common among individuals in recovery. Many people who try to stop using alcohol on their first attempt do not succeed. However, this does not mean that they will never succeed. It is also not true that high relapse rates mean that treatment does not work. Although relapse is often a part of the recovery process, it is treatable. And even if a person does not achieve abstinence, treatment can reduce the number and duration of relapses, lower the incidence of related problems such as crime and poor overall health and improve the individual’s overall functioning and ability to cope better with the next temptation or craving.

MYTH: If people with alcohol dependence eat three balanced meals a day, their nutritional problems will disappear.

FACT: Alcohol depletes the body of important vitamins and minerals and affects major body organs like the liver. During and after treatment, vitamin and mineral supplements help to correct deficiencies and maintain nutritional balance.