Search for mental health; Alcoholism

We are a Forest Hospital located in displaying the Illinois presents the search for mental health and exploration of the newest advances in psychiatry. During this series physicians and other professional personnel working in the area of mental health at Forest Hospital a hundred bed facility will discuss the latest advances in mental health care research and education. Such topics as alcoholism adolescent behavior marital problems problems of the aged suicide emotional problems and others will be presented on the search for mental health. Your host for this series is Mr. Morris Squire administrators of Forest Hospital. This is more squire a special guest for today's mass. Heyman of Los Angeles California who's a research psychiatrist in the alcoholism research clinic the

UCLA School of Medicine. He's director of Education Research at the Compton Foundation Hospital which is a member of the mystical foundation. He's an analyst and a Fellow of the EPA and Reese and the editor of the book called alcoholism. Is that correct Dr. Heymann. Alcohol is a mechanism in management. It's not an edited book on writing. Sounds like an interesting thesis in a study of a very very real problem. To what extent is the drinking of alcoholism a real problem in our country. It's the third greatest problem in the country at the present time. Probably five million there five million alcoholics in this country at the present time officially. But as will develop later I think that people dependent on drinking three or four times that.

When we consider that for every alcoholic There are four people who suffered because of his alcoholism. We can see that here there are about 20 million people involved. Wrong force the adult population are abstainers and the rest drink to varying amounts. Even even affects doctors and one in 100 doctors are lost to the profession and an unknown number have their efficiency decreased on account of drinking. Do you drink dr. I want to take the Fifth Amendment on that. I declined to answer primarily because I'd like what I say to be considered on its merits and not on the basis of whether I'm foolish enough to become an alcoholic or drink or whatever. Well you made the assertion there is a myth about social drinking. You mean by that.

Well I use myths in the sense that a statement or proposition is believed without adequate evidence to support it. But. The business about social drinking I will come back to you right directly to the question. If a physician Granger if a person drinks he's a social drinker What does that mean. It doesn't mean very much actually because social drinking can mean anything from a convivial drink once a year at Christmas to a state of alcoholic coma whenever two or more people get together. Is alcohol a Comac the right kind of thing to say about a person who gets stoned once a year. Well when you ask that person or ask the person who gets stoned daily whether he's an alcoholic and I need to tell you that he isn't. We can post from Alice in Wonderland Humpty Dumpty says. Social drinking is whatever I choose it to mean neither more or less.

I see so really it within the eyes of the beholder it's depends upon how he feels whether he's a social drinker and that's right. The World Health Organization gives a definition of alcoholism as any drinking that goes beyond the traditional customary dietary use or ordinary compliance with social customs of the community. Well that's so broad and so vague that it's useless for us and when we consider social drinking which is even more vague than that it's used as a concept. But there are communities that drink every meal I think that if you if you're French you drink. Wine every meal instead of water because water is a sort of a second everything and I suspect the water's as good as the line always as pure as the wine as clinging is the wine and certainly doesn't taste as well. And I might mention that is that France has the highest incidence of complications of the effects of alcohol of any country in the world. Well why is it there's a wine industry in this country that says that wine is therapeutic.

Well I'll consider that in more detail if you wish to later on. But I don't think that anyone can make a case for social drinking being helpful. As a matter of fact that's one of the myths that I have catalogued. Well would you discuss the myths that you do have cataloged doctor. And what are these myths. First of all let me mention that social drinking and moderate drinking are equated. But moderation in this context is the greatest example of contemporary undefined ambiguity. And I'm quoting King social drinking a normal drinking I really value judgements rather than capable of any definition. You know I joke to the concept of social drinking too because it is rationalization. It leads the person to it individual and sometimes

cultural denial of a problem till the magnitude is so great that to deny it would be to utterly dissipate reality. For example you see an alcoholic lying in the street. That's something real. There is one definition of alcoholism that we find clinically satisfactory and that is the loss of the power of choice. Now if we use this as a definition I would suggest to you or to anyone who does social drinking that they try to stop and observe the feelings that they have the feeling of loss and dependency and that's often followed by rationalizations and they go back to their old drinking habits. I think you can gauge a person's dependence on alcohol by stopping to drink for a short period of time. I think most people believe consciously or unconsciously that there's a qualitative difference between social and pathological drinking. That is that alcoholics drink for different reasons than the ordinary person. But I don't think that's true. Drinking really is a reflection of a universal desire.

Our aggression if you will for the infant pleasure that's present in all of us. The difference may be in the corner Terry necessary to achieve that state. The alcoholic can do it on quite a date and someone else can do it on say two or three drinks. Also alcohol provides relief of anxiety and depression both to the problem and the non problem drinker. OK let's hit that for a second. What about this business about the relief of anxiety and anxiety stricken world fast as the American goes. Why doesn't he have a right to respond from this particular anxiety and this anxiety state why shouldn't he have a little bit of something to relax and go out and take up a tranquilizer. Couldn't he just as well do it with a beer. Well in that context we have to call it a tranquilizer. I have no objection to his taking it as long as he recognizes the potentialities for harm that it has. What kind of harm does a beer have.

Well. I can go into this in more detail and I can bring in various publications in recent years to bear on this. There is a group of doctors who believe that that alcohol in one form or another is beneficial. This I'm aware of this group and that they are the group of people who have been writing recently that alcohol is a beneficial agent should be used for some kinds of diseases and so also sometimes people a particular prescribe or for older people people who have it and don't have enough of an appetite. People who require stimulants people who are anxious. Well I can add a few other statements they make they say it's valuable as a source of food and energy and appetite stimulant at the jest of aid. They say it's helpful in cardiovascular disease and it's a useful sedative and so on. Doc

even says that it's useful in psychiatry as cathartic and so on. But I know of no psychiatrist who uses it in that way. The only thing is that the claims that are made are vague. There are very few controlled studies of most of these things are impressionistic and they often say that Well alcohol is existed for thousands of years it must have something good in it. But in actuality as an appetite stimulant for example recent evidence shows that both appetite and olfactory acuity which is a part of appetite is reduced by alcohol. And this has been measured by actual food intake and this was a terribly controlled study. Cardiac benefits have not been established and recently there is a study of not Topsy of over 700 cases where alcohol had no relevance. There was no difference in the coronary arteries in the

alcoholic in the non alcoholic people are. On the other hand if you'd like to go into the harm that alcoholism does I had a talk on that for a moment. Well I'm going to let you talk on my bike that as soon as you tell me it's releasing Xyzzy. Yes it does relieve anxiety. Now this is true with most people. It relieves anxiety and relieves depression at first. But we find that after about three or four ounces instead of relieving anxiety and depression it creates it so that you get a worse situation afterwards. I see so an overdose of alcohol is as bad as an overdose of any other kind of stimulant cation. Well you say overdose. How do you know what is an overdose. Well I don't know. Maybe one drink is an overdose. Well how does a physician know when a dose of medication is sufficient as compared to overdose. Bicep area side effects. Well then I suspect he could very well prescribe alcohol in the same way.

Yes but suppose he prescribes. I don't drink or two of alcohol before meals. Yes and then he finds that his patient gets a little excited. Drives down to the store for cigarettes or whatever and has an accident. I see now this is a deleterious effect of alcohol which is too little CONSIDERED. Well I wanted you to answer that question because you know you can go too far the ones you can go too far to the other side and sometimes there is a need to expound on a subject like alcohol for various reasons I believe that many alcoholics who need to be helped but and I'll follow them is a real severe problem. The question is out of usage and also you know if it's therapeutic if it's anxiety relieving. If it has some positive merits those people who are now prescribing it probably have a medical rationale for doing this and I'm wondering how you as a psychiatrist feel

about this. Well I don't see the medical rationale of using it yet I see. I've mentioned Dave the things that are claimed the benefits that are claimed from alcohol. But I think that every one of these points can be controverted. I see so that in actuality alcohol. It doesn't seem to have any benefits whatever. And if there are certain benefits claimed for alcohol we have better medications now that are not addicting for example. Some of the newer and minor and major tranquilizers are much more satisfactory than alcohol already. Now how do you feel about it as something that pleases people like candy does like food does. Yes if there were no harmful effects from alcohol it would be no reason why they shouldn't use it. But there are an awful Thanks Candy and also for food. And you can take too much candy can affect your teeth. You can take certain kinds of

food and probably affect other kinds of things. Well Callie's is alcohol food. It has a food value. The only thing is if you need food why do you use alcohol. We have much finer foods and alcohol and it's a quick source of calories but carbohydrates are too high for him and I wonder if you could give us some statistics on alcohol problems in our country. Well I would like to talk about. The levels of alcohol which are presumably healthy I put that in quotes most of the writers emphasize that alcohol isn't harmful in moderate doses. That is a blood alcohol level of point 0 5 milligrams percent. That amounts to let's say one or two drinks. But it's illegal to go over this tenuous line and it's a rare social drinker who doesn't occasionally and innumerable

social drinkers do so frequently erect and regularly. Now there have been drinkers in the California drinking practices study and in Mumford's group have much higher blood alcohol levels and this and they represent 20 percent of the adult drinkers. We could use selective drinking group as I would 20 percent of drinkers are these people who are habitual drinkers or social drinkers what I think these are the upper or let's say 5 percent are probably alcoholics but we consider that 20 percent are heavy drinkers. That is they would drink two to five times a week and they'll drink four drinks or more at a sitting. Now the frequent is not the normal population. It is a sample of the normal population is 20. This is opposition running through the whole population. Presumably this includes every stratum 20 percent of our people trying to be president of the adult population. Ok fine I just don't identify that the frequent moderate group drinks one to four times a week

with over two drinks at a sitting. And I think they can be included in this group so that really 36 percent of the population are fairly heavy drinkers so it is their doing so week. What's a moderate drinker. Frequent moderate drinker is a person who drinks one to four times a week but drink two drinks or more at each setting one to four so that if a person had two martinis before supper he would be considerate of my frequent moderate rank. These are frequency doses. Now this includes 36 percent of the California sample. Presumably 36 percent of the whole population. So we have to conclude that the range between the toxic and the therapeutic doses of alcohol if there is such a thing is a very slender one as a matter of fact I think that if the present active Food and Drug administrator were confronted

with a new drug called alcohol he would rule it out and he wouldn't even permitted for experimentation as a dangerous drug. Now there if you ever asked him that question. The Food and Drug Administration as a matter of fact Abraham Myers and 25 years ago did not but I know where that one is with the snow. I would like to mention it as far as drunken driving arrest is concerned for example and in California there are 50000 of these a year. Let's see high figure would be 50 percent alcoholics 50000 arrests for alcohol or drunken driving. And in California and 50 percent of these are let's assume that 50 percent are alcoholics. We know the danger comes from them. No question that 50 percent of them are social drinkers goal just an assumption. This is an assumption based on

Seltzer's figures. The 36 percent of the population drink that much. No no wait a minute wait we're getting a little mixed up here. There are 50000 drunk driving arrests in California. Selzer in a study found that 50 percent of drunk drivers were alcoholics. Now this means that 50 percent are non alcoholics or at least social drinkers. So you see that there's a great deal of damage which is caused by the social drinker. No question. Now I want to mention an experiment that Moskowitz and depressed they had done at UCLA alcoholism research clinic. They found that first of all driving is a very complex thing. And one of the defects that alcohol produces is that it prevents the person from paying attention to more than one stimulus at a time. Now in driving you have to pay attention to three or four more stimuli at a time right. And even one drink interferes with the attention of the driver.

I'd like to mention too that in driving the simulated driving experiments Drew noted that there was a detectable error score with the lowest possible amount of alcohol measurable in the blood. That's point one to point out two milligrams percent that disturbs the chemistry of the whole body. That's right it makes a person drunk let's say one way makes you drunk that's right. So you shouldn't drink even if you had one Greg. You shouldn't drive if you've had one drink on sea shouldn't drink if you drive. Now let me mention an experiment with a group of college students. There were 90 fraternity men in a social setting. There was a party and they were given as much liquor as they wanted to drink out of the liquor was free. But in one hour they consumed 11 ounces of 86 proof alcohol. Now this is this is called social drinking. These people weren't alcoholic. Each person consumed the 11 ounces I was free. It was

but can you imagine what this would do to the driving skills of a person. How long does it take for alcohol to be dissipated so it doesn't have any problems in the body. It takes about two hours to drink one and a half ounce drink two hours per one and a half ounce drinks so a person who drink has a drink before. If he wants to drive should not drive for at least an hour and a half. That's right I see. So he would be out of trouble then. As a matter of fact one definition of alcoholism is the person who takes one drink. This is the second drink before the first is metabolized. This is going to abolition is one and a half hours after a drink that approximately has two drinks is at three hours right now. Right or you can go to a cocktail party and have two drinks in three hours. That's right. One I think there are many accidents people coming home from comp their party crashing. That's a good point.

I would like to mention the suicide the homicide has cancer of the esophagus and mouth the varicose veins the complications of venereal disease and many other disorders that occur in social drinkers as well as alcoholics. Now do you have any more time to have a little more time. All right. I'd like to mention some of the life insurance statistics because I think they're extremely meaningful. With minimal criticism on alcohol habits in an investigation we find that the actual mortality is double the expected mortality of alcoholism. Now in three classes of social drinkers the ratio was three to one. Three actual mortality to one expected Martin. And this varied according to the degree of drinking for speeding drinkers and I think we can call these alcoholics the ratio of actual To expected mortality was five and a half to one. Now going back to a nine hundred

twenty nine study Incidentally these are very little publicized. It showed that there was using one and a half or more ounces of alcohol a day without intoxication had two and a half times the mortality rate. And for periodic intoxication it was double the mortality rate. Another long term study indicated to us that if a person became intoxicated six times a year the mortality was three times that expected. A person gets drunk three times a year he's going to reduce the times a year six times you know reduces lifespan by over two thirds his mortality will be three times that expected. Well now I haven't figured this into the normal about 70 years now. If we score 10 or so get strung six times a year being on a list but 25 years well I hadn't figured that out in years but he had three times the liability of dying before that time.

I'd like to mention is that even former drinkers who have stopped drinking still had three times excess mortality five years late. What are they what do they die from. Various things. What a neoplasm for malignant neoplasm arteriosclerosis and generate of heart disease cardiovascular renal disease diseases of the digestive system and this includes liver cirrhosis. Motor vehicle and other accidents homicides and suicides. I see so people who have been drinking at some time during their life are more prone to die at an earlier age. Really what you're saying. That's right and if we consider this a value then alcohol decreases that. Yeah well you know if you consider the alternative to aging. Now there there are a few situations for the exam. An example the elderly that say about our age.

Who you might give alcohol to because their expectation expectations for the future are M.. Nice. Well we appreciate very much this conversation on alcoholism. Dr. Max Heyman who is a research psychiatrist in the alcoholic research clinic at the UCLA School of Medicine and this is more a squire for further information regarding this program. Please write to this station or to Forest Hospital this plane's online. You have just turned another in the series the search for a mental health produced by Forest Hospital in this plains Illinois in cooperation with this station. During this series of decisions and other professional personnel working in the area of mental health at Forest Hospital a hundred bed treatment facility will discuss the latest advances in mental health care research and education. The other topics such as alcoholism the adolescent behavior and marital problems problems of the aged and

others will be presented on the search for mental health. The host for this series is Mr. Morris Squire administrator of Forest Hospital. This program was distributed by national educational radio. This is the national educational radio network.