Question

Alcohol as a public health problem in the community. What factors contribute to the problem?

What are the possible interventions that can be carried out by community health agents?

Answer 1

Any kind of addiction has deeper roots and issues that need to be resolved before the person is completely ready to give up their addiction.

Factors that contribute to alcoholism in an individual

1) Poverty- One of the most common reasons people turn to alcohol is to numb their pain. Many a time, people who have poor finances struggle and have a lot of problems that can easily overwhelm them. This leads them to turn to a relatively cheaper means of "Dealing" with the problem and that is alcohol.

2) Genetic predisposition to Alcoholism - If the person's parents were alcoholics then the person has a 50% increased risk for developing alcoholism. But ultimately the risk is diminished or augmented by the environment. A high-stress environment would drive the person towards alcohol and thus create an alcoholic.

3) Social factors - This has a lot to do with the dominance hierarchy. It is a well-established fact that organisms (not only humans) way down on the dominance hierarchy possess lower serotonin levels, and this makes them more susceptible to anxiety, stress, overt sexual behaviors, and Alcoholism. Millions of years of evolution has established a mechanism in our brain which is constantly validating our position in the dominance hierarchy. In the current societal context, people who work low-end jobs, or haven't seen much success in life, or aren't well excepted by society or the ones at the bottom of the dominance hierarchy. One might argue that success is relative and one can't pigeonhole success, but the sad truth is that the communal definition of success is the one that ultimately decides your position in the hierarchy.

4) Childhood trauma - Childhood abuse, neglect, loneliness, school bullying all can increase the individual's risk for alcoholism, and couple that with a genetic predisposition and voila! you have yourself an addict.

Possible interventions that can be carried out by community health professionals.

1) Proper Rehab facilities - Rehab is one of the toughest things, and if the facilities aren't on par then it makes it almost impossible for an addict to recover. I think this is the first and the most important step in reducing the number of addicts in the community. And there should be proper funding for these centers. The major issue with the current rehab centres are that the best ones are very expensive, and the majority of the population that is addicted to alcohol is poor and hence they can't afford the best facilities which makes them either choose a sub-par facility or not go to one at all, which means that there is a great likelihood that they are never going to recover.

2) Destigmatizing Rehab and addiction - Addicts are the people that need trust, love, and support the most. Due to the current stigma, many feel ashamed to reach out to their loved ones. One of the biggest fears an alcoholic has is if he comes out in the open about his addiction, will he be accepted or not. Society looks down on addicts and considers them a burden. This would just perpetuate the downward spiral that got the person addicted in the first place. Programs that help make an addicts family aware about addiction, and how it's not entirely a person's fault will be greatly helpful. Awareness programs done at the school level would be effective too, as children are more impressionable.

3) Community outreach programs for addicts and the general public - This step can help in preventing alcoholism and help recovering addicts. Children enrolled in a community outreach program will be surrounded by people. Helping people out is an excellent source of pleasure and satisfaction. This would also help fight off any loneliness in the person. Recovering addicts would benefit from this because a) they are around people and thus are less likely to grab a bottle. b) Showing them that their life is making a difference will be a huge boost in self-esteem. c) having the community see the alcoholic as a member of the community, that helps, and does good to the community, will make it easier for the alcoholic to be accepted by the community, thus reducing the chance of a further relapse.