Father John A. Hardon, S.J. Archives

Moral Theology

Chapter V
Drinking and Temperance

by John A. Hardon, S.J.

The morality of drinking is unique, at least in a country like the United States which spends about twelve billion dollars annually for alcoholic beverages. Unlike other ethical decisions that people are called to make, drinking involves more than one option. It may be the choice to drink or not to drink. If the decision is to drink, another choice has to be made about the amount that is moderate for the person himself, because in this matter no two people are alike. And if alcohol has given trouble, there may be the need to abstain from drink altogether as the only practical way of solving the problem.

Another factor complicates the issue. Some religious groups look upon the consumption and sale of alcoholic beverages as sinful in itself, and therefore absolutely forbidden to anyone under any circumstances. Others consider drinking morally indifferent but potentially dangerous if taken to excess or indulged beyond one's capacity to stand the effects of alcohol.

Furthermore drinking is a thriving business, with vested interests in the advertizing field, supported by distillers, entertainers, and a variety of financial enterprises that make it difficult for the average person to decide unemotionally what his practice ought to be.

On one thing, however, everyone is agreed: alcohol and the drinking habits of the country are a major problem that for almost a generation was built into the American Constitution. The eighteenth amendment, adopted in 1920, declared that "the manufacture, sale or transportation of intoxicating liquors within, the importation thereof into, or the exportation thereof from the United States and all territory subject to the jurisdiction thereof for beverage purposes is hereby prohibited." It cost the government a billion dollars a year to enforce the Volstead Act, with scant success, until in 1933 the twenty-first amendment repealed the eighteenth. This about-face in less than fifteen years, in twice revising the highest law of the land, only highlights the magnitude of the issue and the need for clarity in handling a question that personally affects more than eighty million Americans who are known to consume alcoholic beverages.

Scientific Facts About Alcohol

Alcohol comes in many different forms, but in general may be classified as fermented or distilled. Wine and beer are the main types of fermented drinks; whiskey, rum, brandy, gin, cordials and liqueurs are the principal kinds of distilled beverages.

Process of Fermentation and Distillation. The fermentation of wine is a simple chemical reaction. When fruit juices of various kinds, like grape juice, have yeast plants added to them, the sugar is changed to alcohol while carbon dioxide is formed and bubbles off as a gas. The resulting product is wine, containing anywhere from six to sixteen per cent alcohol. Wines that are less sweet, like claret and burgundy, have a lower alcoholic content and are called dry; whereas others, such as port and muscatel, have more alcohol both naturally and because they may be fortified, up to twenty and more per cent. They are called sweet wines.

If wines are bottled before their fermentation is complete, the carbon dioxide may keep forming and the contents are called sparkling wines (sometimes imitated by artificially adding carbon dioxide). But if the product is bottled after complete fermentation it is called still wine. Further names refer to color, place of origin or special process of manufacture.

Beer is also fermented, but from grain, in three stages: malt (generally barley, softened by steeping in water and allowed to germinate) is used to make sugar out of the starch in the grain; then yeast is added to induce fermentation, i.e., changing sugar into alcohol with escaping carbon dioxide; and finally hops are put in for flavor.

Beer has a lower alcoholic content than wine because fermentation is not allowed to go to completion, giving American beer about four to five per cent alcohol by volume. Similar to sparkling wines, some of the carbon dioxide is retained when the beer is bottled or kegged, which gives it the familiar fizz.

Ales are a type of heavier brewed malt drink, with higher alcoholic percentage; stouts or porters are merely beers which were made with larger amounts of cereals and extracts. Their strength depends on the amount of fermentation.

There is an essential difference between fermented and distilled beverages, because the per cent of alcohol that naturally accumulates under fermentation seldom goes above sixteen. Anything above this amount must come from distillation, where a fermented mash is heated to allow the more volatile alcohol to be released as a vapor and condensed. Normally distilled spirits are about fifty per cent alcohol, or 100 proof, since the term "proof" in the United States means one half of its quantity by volume. Technically, "proof spirit" is a mixture of alcohol and water, containing a standard amount of alcohol of a specific gravity 0.7939 at 60 degrees temperature.

Distilled beverages made from grain are called whiskey, which in the United States is generally made from rye and maize or corn; in Scotland and Ireland, from malted barley. Rum is manufactured from fermented molasses or any other cane product, brandy comes from distilled wines or other fruit juices. Gin is a strong liquor made by distilling a grain mash, especially rye, in pot stills with juniper berries; although the name is also applied to a similar drink made from plain spirit flavored with a suitable aromatic. Cordials and liqueurs are aromatized and sweetened spirits.

There are extant records to show that beer and wine had been in common use centuries before the Christian era. The Egyptians, Babylonians, Greeks and Romans used these beverages; and wine figures so often in the Old Testament that its use appears at almost every stage of Jewish history. The process of distillation, however, is a recent discovery, with brandy having been first produced in France from wine some time in the thirteenth century, and the art applied to other forms of beverage was not commonly known in Europe until about the sixteenth century.

By chemical definition, alcohol is a colorless, volatile, inflammable liquid, which has numerous molecular forms, but only one, ethyl alcohol, is meant when speaking of alcoholic drinks. Pure ethyl alcohol, or straight alcohol, is not a beverage; it is unpleasant to the taste, and causes a harsh, burning sensation when taken internally. Yet, it is the alcohol in intoxicating drinks which makes them desirable, not the taste to the palate or flavoring. In other words, alcohol produces an effect on most people which they find pleasant, up to a point; it is also the alcohol that gives rise to whatever problems are inherent in the use of fermented and distilled beverages.

Measurable Effects of Alcohol. Scientific analysis has established some facts about how the body handles ethyl alcohol. Scientists can measure the rate of absorption, distribution, and oxidation of alcohol in the body.

Alcohol is absorbed directly into the blood stream by the blood vessels in the stomach and the small intestine and is carried to all parts of the body. It requires no digestion. The absorption occurs more rapidly if the stomach is empty. While part of the absorbed alcohol is eliminated in the breath, sweat and urine, most of it is oxidized in the body and the energy is released as heat.

In one sense, alcohol may be classified as a food, in that its oxidation in the body is accompanied by a release of energy. Yet this fact increases one danger from its continued excessive use. A person who drinks his meals in the form of alcohol is not getting the proteins, vitamins and minerals that his body absolutely needs for nourishment.

In a man who weighs approximately one hundred fifty pounds, the liver will oxidize (destroy) about three-fourths of an ounce of ethyl alcohol an hour. There is no known way of speeding up the oxidation process, with the result that drinking of a larger quantity of alcohol in any less time results in an accumulation in the blood.

Four factors are known measurably to affect the concentration of alcohol at any moment in the blood stream: 1) the amount of actual alcohol in the drink consumed is most important, since an ounce of whiskey contains about ten times as much ethyl alcohol as an ounce of beer, though naturally beer is not taken in one ounce quantities, 2) the time span during which the drinking goes on, so that nursing a small drink for an hour or more may practically coincide with its rate of oxidation and simply remove its presence from the blood stream, 3) how much food is in the stomach has a pronounced effect on absorption, since the more food elements present the slower the rate of absorption; moreover the beverage itself, like wine and beer, may have food contest which slows down the absorption factor, and 4) the person's weight has a direct connection with his ability to consume alcohol, since theoretically a man who weighs two hundred pounds can drink twice as much as someone who weighs a hundred pounds, before his concentration of alcohol in the blood is the same.

Since human blood is about ninety per cent water, the alcohol consumed is diluted immediately. Although the alcoholic concentration in drinks varies from four (and less) to fifty (and more), the concentration of alcohol in the blood practically never goes up to more than one half of one per cent at the most. During a period of continued drinking, the drinker goes from a stage of slight intoxication to a coma-like condition that may endanger his life. Any higher concentration than .50 per cent results in paralysis of the higher nerve centers that control breathing and the heartbeat, and causes death.

If the range is small within which alcohol may safely accumulate in the blood, the variety of effects on drinkers is very broad. No two people are alike in this respect. Most people would show definite signs of intoxication at three-tenths of one percent (.30%), and anyone will lose consciousness at a concentration of four-tenths of one per cent (.40%) . Some drinkers show evidence of tipsiness with a low blood alcohol concentration, while others can seem to carry a high load with no outward signs of drunkenness. Experts suggest this shows that intoxication depends on many psychological elements besides the physical factor of alcohol in the blood stream. Experience teaches some people to keep from showing a heavy intake, but beyond a certain point no psychological restraint is effective.

In popular language, excessive drinkers show signs of intoxication by being high, tight, and dunk in that sequence; but some can manage to hold back these manifestations until they collapse in a stupor. These distinctions are useful to keep in mind when describing the morality of drinking in terms of losing one's reason or the control of emotions, because there is no exact correspondence between the amount of alcohol consumed (or in the blood) and the external marks of drunken behavior. And even the same person does not always react in the same way to a given amount of drink.

A remarkable fact is that doctors cannot find a tolerance for alcohol of the kind produced by the regular use of drugs. Drug addicts are known to build up an ability to absorb ever larger amount of the same narcotic, to produce the same physiological effect on the body. But nothing really similar is found with alcohol. In fact, the opposite is true. No doubt some drinkers can develop a psychological tolerance (explained above), but in the later stages of alcoholism even a small drink will produce effects that formerly came only from larger quantities.

The most pronounced effect of alcohol is on the brain. As the concentration of alcohol increases, reasoning power, inhibitions, and memory go. Repeated tests have shown that skills and dexterity are affected by even a few drinks. Judgment of time and distance is impaired, and one who has been drinking even a little is handicapped for the operation of tasks that require excellent judgment, like driving a car.

The effects of alcohol on the nerve centers are similar to those of other anesthetics. They disappear when the alcohol is oxidized and do not usually cause immediate organic damage, since the alcohol that comes into contact with body tissues is a very weak solution. Continued drinking, however, may lead to cirrhosis of the liver, nutritional diseases like beriberi, pellagra, and degeneration of the brain or the nerves. Other organic difficulties may arise either directly from the alcohol, or indirectly from the side effects of drinking.

The end-point of alcoholic degeneracy is a type of seizure, delirium tremens (trembling delirium), which no one but drinkers experience. If death seldom results directly from over-indulgence, it is only because nature causes the drinker to lose consciousness before a lethal quantity is consumed; though men have been known to die if they quickly took a large amount just before they reached the passing-out stage. Another dangerous practice is to take alcoholic beverages together with certain kinds of sleeping pills, e.g., barbiturates.

The Virtue of Temperance

The word temperance is derived from the Latin temperantia, which was used by Cicero to translate Plato's sophrosune, which meant restraint of the appetites and passions in accordance with right reason. As seen before, temperance is one of the four cardinal virtues, that moralists consider the most fundamental because it is the one on which the other three depend.

In the New Testament, the Greek noun sophrosune, is variously translated as "soberness" or "sobriety" when it occurs in the Acts of the Apostles and St. Paul. (1) The adjective sophron, translated indiscriminately as "sober... temperate...discreet," is listed among the attributes proper to people of mature age and to leaders in society.

For Christians, temperance in its physical aspects is related to the need for self-control of the body, regarded as a temple of the Holy Spirit. The teaching of the ancient Fathers of the Church, notably Origen, Ambrose, and Augustine, was synthesized in the Summa Theologica of Thomas Aquinas, whose treatment of the moral virtues remains the classic theological work on the subject. He places temperance into context as the virtue that controls our unruly desires, including the appetite for food and drink.

As fortitude controls rashness and fear in the face of the major pains which threaten to unbalance human nature, so temperance controls desire for major pleasures. And because pleasure follows from connatural activity, so therefore are pleasures the more vehement when they attend our most natural activities. They are those which serve the individual through food and drink, and the species through intercourse of male and female, and it is with them that temperance is properly engaged. They come from the sense of touch; hence we conclude that temperance, in its most precise sense, is concerned with tactile pleasures. (2)

In its broader aspect, therefore, temperance spans the control of all pleasures, but by common usage the word is applied to restraint in the taking of food, and mainly of drink. A familiar synonym is sobriety, in the reference to a person being "sober" when he is not under the influence of intoxicants.

Moral theology teaches there are two ways of practicing temperance in the use of alcohol, either by moderation or by total abstinence. Both are approved by centuries of Christian practice, much as the practice of chastity is sanctioned by Christian morality, either by total abstinence, as with those who vow themselves to a life of celibacy, or by moderation, among the millions who marry and confine the enjoyment of sex pleasure to the married state.

Moderation in the use of alcohol cannot be measured in size or frequency. It is different for different people, conditioned by their known capacity for absorption of intoxicants without deleterious effects on the body, emotions, or the mind. It is also different, according to a person's station in life, financial condition, duties to support family or dependents, and a host of other factors that are never the same for two people. It is also different, depending on the circumstances under which a person drinks, the good or bad example he gives, the occasions of sin to which drink may expose him, and in general, his ability to drink without interference with his personal, social and religious obligations. Americans who travel in Europe, for example, are astounded at the Europeans' regular use of such things as wine without anything resembling the alcoholic problems that we have in the United States.

Many families of good repute serve wine at dinner as part of the ordinary meal and, in Europe, at lunch and dinner every day. Even children may receive a bit of wine mixed with water. Working men often are accustomed to take a bottle or two of beer every day, at dinner and perhaps again before retiring. Social gatherings in our country normally include, for example, a cocktail before dinner; and maybe a highball or two in the course of the evening. These would be examples of moderate drinking, where the motive is a satisfying pleasure in the sense of taste, or a mild relaxation that coincides with the Biblical observation that "wine was created from the beginning to make men joyful, not to make them drunk." (3)

There is nothing wrong with the enjoyment of pleasure, which is the normal accompaniment to the right use of a faculty, and nature's (or God's) way of compensating men for the effort which the faculty expends and to insure that the appetite in question is used. Unless pleasure accompanied eating and drinking, men would soon starve for lack of incentive to nourish themselves, and the same with the pleasures of sexual intercourse, without which the human race would die out.

A more subtle question is the personal one of what is moderate drinking for me. This question must be answered by each person for himself, on the principles of faith and Christian morals, keeping in mind that the operative word "moderate" is not a quantitative but qualitative function. What matters is the effect of alcohol on my life and on those with whom I live and deal. First we may review some general rules on attachment and then apply the norms specifically to drink.

Assuming that drinking is not sinful in itself, I can still be unduly attached to it, as may be recognized by certain signs. Some of these are external and others can be experienced only internally.

If an object occupies my mind at times that should be free of such pre-occupation, like work or necessary duties; or if the amount of attention I give to a thing is out of all proportion to its objective value or importance – I should suspect attachment. The standard hierarchy of values: spiritual, intellectual, and material may be applied here. So that if I am more concerned with an intellectual project than with my spiritual obligations to the evident detriment of the latter, or with material things than with studies or my profession, I ought to admit undue affection.

If I find myself habitually losing peace of mind from definable or undefinable causes, on account of what I have or do, I am too attached to the object, person, or practice, since ordinate affection, being orderly, produces tranquility of mind which is the essence of peace.

If I am always afraid of losing or being hindered in the use of something, or if I feel dissatisfied with what I have, whether its amount, quality or perfection, I am too enamored of the object because the right kind of affection precludes such anxiety.

Applying these and similar norms to the problem of drink, a person can discover on his own – without being told by someone else – whether his drinking habits are moderate or not. Dr. Seliger of Johns Hopkins University Hospital drew up a handy check list of twenty items that a drinker should ask himself. If he answers affirmatively to any one question, his drinking is immoderate; if he says, yes, to any two questions, the chances are he may be alcoholic; and if three questions are answered positively, the person is a confirmed addict.

Do you lose time from work due to your drinking? – Is drinking making your home life unhappy? – Do you drink because you are shy with other people? – Is drinking affecting your reputation? – Have you ever felt remorse after drinking? – Have you ever got into financial difficulties because of drinking? – Do you turn to lower companions and inferior environment when drinking? – Does your drinking make you careless of your family's welfare? – Has your ambition decreased since drinking? – Do you crave a drink at a definite time daily? – Do you want a drink the next morning? – Does your drinking cause you to have difficulty in sleeping? – Has your efficiency decreased since drinking? – Is drinking jeopardizing your job or business? – Do you drink to escape from worries and trouble? – Do you drink alone? – Have you ever had a complete loss of memory due to drinking? – Has your physician ever treated you for drinking? – Do you drink to build up your self-confidence? – Have you ever been to a hospital or institution on account of drinking? (4)

Understanding that we are not here speaking of the true alcoholic, what attitude should a person adopt if he finds that his drinking is nevertheless immoderate? There are those who claim that all drinking is immoderate and that everyone should be a total abstainer. The evidence they have of the evil effects of alcohol, and the damage it does to personalities and families, makes them insist that nothing short of complete abstinence is right and that any drinking is sinful.

The traditional Methodist reform position on alcohol goes back to John Wesley, founder of Methodism, who wrote in his sermon on "The Use of Money" that, "neither may we gain by hurting our neighbor in his body. Therefore we may not sell anything which tends to impair health; such is evidently all that liquid fire, commonly called drams or spirituous liquors." (5) In accordance with this principle, the Doctrine and Discipline of the Methodist Church declares in forthright language what is the official stand on the sale and use of intoxicating drinks, not only among Methodists but among many Protestant denominations.

Our Church reasserts its long-established conviction that intoxicating liquor cannot be legalized without sin. The Church of Jesus Christ from its very nature stands at variance with the liquor traffic. For it to be silent in its opposition would be to be disloyal in its function. Therefore, to be true to itself the Church must be militant in opposition to the liquor traffic ...Adequate relief can come only through total abstinence for the individual, and effective prohibition for the state. (6)

These norms are given positive expression in the Methodist Board of Temperance, with headquarters in Washington, D.C., whose duty it is "to promote by an intensive educational program...voluntary total abstinence... to promote observance and enforcement of constitutional provisions and statutory enactments which suppress the traffic in alcoholic liquors and in narcotic drugs; and to aid and promote such legislation." (7) Since the General Conference of 1872, American Methodists have steadily advocated the need of "total legal prohibition." They were the most influential group in securing the passage of the eighteenth amendment, and in 1932, just before the amendment was repealed, the General Conference stated that, "As a church we can follow no course except the one that will reduce the consumption of beverage alcohol to the minimum. We are convinced that national prohibition is that method." (8)

Catholic moralists are less rigorous in their response to the drink question. They first of all distinguish between a counsel and a precept; the latter binding under sin, but the former an ascetical option. Total abstinence is promoted and practiced in Catholic circles, and for many people it may be the only effective solution even for immoderate drinking. But complete abstention is never advocated as a universal obligation. Among the extant writings of Leo XIII (1878-1903) is a remarkable letter the Pope wrote to Archbishop John Ireland of St. Paul, Minnesota, commending the prelate on his temperance movement among Catholics who voluntarily pledged themselves to abstain from alcoholic beverages. "We have rejoiced to learn," the Pontiff said, "with what energy and zeal, by means of various associations, and especially through the Catholic Total Abstinence Union, you combat the destructive vice of intemperance. For we know well how ruinous and deplorable is the injury to faith and morals that comes from overindulgence in drink." (9)

Total abstinence, then, by Catholic standards is commendable to anyone and may be necessary for some, but it is not mandatory on all. It is in the nature of a counsel, whereby a person freely gives up the use of an otherwise legitimate right (the use of drink) in order better to equip himself spiritually and offer a good example to his neighbor.

By the same token, Catholic theology does not favor prohibition by legal statute as happened during the short-lived Volstead Act. Such intrusion by the government in restricting the use of something which, in itself, is morally indifferent carries too many dangers and places the state in the role of custos morum, for which it is neither juridically established nor divinely authorized. History has shown that if National Prohibition somewhat reduced the consumption of alcohol (though even this might be questioned), it brought in a host of other evils like bootlegging, gangsterism and disrespect for the law meddling in morals that America will continue to experience for generations to come.

For the person who has some trouble with drink, but is not an alcoholic, total abstinence may be a simple, if not easy, solution. A good approach to the question is the ascetical one. Suppose a man recognizes that his drinking habits are getting slightly out of hand. What should he do? The essential thing for him is to arrive at the conviction that unless he is willing to give up drink his protest of sincerity about detachment from alcohol remains questionable. Why should this be so? Why is it necessary to be ready physically to relinquish something (here drink) as a guarantee that I am truly detached from the object? Why is it not enough to remove the attachment (psychologically), yet so wish to remove it as to remain (physically united) with the thing which causes me trouble? The reason lies deep in the psychology of Christian asceticism.

Any creature I possess outside of my own mind and will, and to which I am strongly attached, marries with it beneficial effects that I enjoy when and in so far as the creature is used. Money is a ready example, drink is another. My will may become more or less bound to any of these because I have learned from experience what comfort, pleasure and joy they afford me when I use them. But when on reflection I discover that my attachment is inordinate, I am faced with the decision of either compromising or going "all out" in ridding myself of the disorderly affection. Indeed, unless I am ready to be rid of the thing itself, I am not really sincere in the desire to correct the malaffection. Why so?

Whenever a creature produces an undue attraction, the fault or defect must not be sought in the object as such, but rather in me. Evidently, because the same thing may be safely used to someone else without detriment or even with positive benefit to his moral life. Perhaps I have not received the grace necessary both to use physically and to profit spiritually from the disturbing item. Or I may be lacking, culpably or otherwise, in those qualities of mind and temperament needed to overcome the natural seductiveness of what disturbs my peace of mind. Or most certainly, the state of life to which God has called me makes demands on my generosity and self-sacrifice which cannot be properly fulfilled except at the cost of being freed of certain inordinate affections. In any case, there is no objective assurance of becoming volitionally detached unless I remove what stimulates the attachment, namely, the object itself. There is a limit to my ability to be exposed to the stimulus, say, of drink, and to remain ordinately attached. And even this limit is unpredictable, undefinable and uncertain. To make sure I am delivered from a troublesome taste for liquor, I must remove its stimulating source. The degree of my readiness to do this determines my sincerity.

Yet, while saying all this, we should not infer that total abstinence is therefore necessary, even for those who admit to some immoderation in drink. Maybe the only thing for them to do realistically is to give up drinking altogether; but it may be just as likely that, all things considered, this would be unfeasible and unnecessary. Nevertheless their willingness to abstain totally is a good index of now seriously they look upon the issue.

Alcoholism

The drinking habits of America are a new wonder of the world, both in the amount of alcohol consumed and in the effects which excessive drinking have brought upon the nation. An estimated five million Americans are confirmed alcoholics, who create disastrous problems for themselves and for the millions of others who live or work with them. Visitors to the States seldom fail to point out what they consider a tragic national malady, that an affluent society like ours should be the victim of its own prosperity.

It is not easy to define an alcoholic, except to say he is a person who keeps drinking to excess, even when he sees the havoc that indulgence causes in his life. He is also generally one who cannot give up drinking entirely without some outside help. Experts in dealing with drink addicts have traced what they call the phases of alcoholism; they illustrate the process of becoming addicted and explain concretely what alcoholics are.

In the first phase, the pre-alcoholic stage, drinking gets beyond the social plane. Alcohol begins to take a definite part in the living pattern and needs of the drinker. It begins to mean more to him or her than to other people. He finds psychological relief in drinking and starts to seek out this experience. Various symptoms are commonly recognized: the drinker takes more and more often; a kind of amnesia occurs in which he has gaps in memory; he slips extra drinks and carries a private supply; he has feelings of remorse and guilt over his drinking habits. Yet in this stage, the person has not lost control of his drinking to the extent that it is compulsive.

Next come the early stages of alcoholism. The tempo of drinking increases, so that a person's ability to stop is leaving him, of which the symptoms are again characteristic: loss of control is the first mark of an alcoholic, at which point he can refuse to start drinking, but after he once starts he cannot stop, so that a single drink acts as a trigger that leads to complete intoxication. Soon the man develops an alibi system, whereby he tries to justify his drinking to his family, friends, employer and himself. Then come the "eye-openers," because there is need for a morning drink to kill painful hangovers and feelings of moral guilt.

Next starts a change of pattern, due to pressure from family or employer. A drinker tries to break the hold that alcohol has on him by changing the type of beverage; he makes rules about his drinking - when and how much - and goes "on the wagon" for various periods.

In the same period, a drinker develops anti-social behavior patterns, He broods over imagined wrongs; begins drinking alone or with other alcoholics, regardless of social level; he becomes highly critical of others (self defense) and may become destructive or violent; he thinks people are staring at him or talking about him. This conduct leads to the loss of jobs and friends, or the drinker may "jump the gun" and quit his job before he gets fired or drop his friends first. Under further pressure, he may go to a doctor or hospital, but is seldom helped because at this stage he refuses to cooperate.

In the third or later stages of alcoholism, a person drinks to live. He gave up his problems to alcohol; now alcohol demands the surrender of his personality. In the previous stages the victim could still choose to drink or abstain; but no-choice is left now - he must drink however and whenever he can. Typical traits of this phase of alcoholism are first the "benders." A man drinks around the clock, becoming blindly and helplessly drunk; he disregards everything - family, friends, job, religion, even food and shelter. He drinks to escape problems created by drinking; he drinks against his will. Then he develops tremors or the "shakes," which is a serious nervous condition. Alcoholic sickness, brought on by prolonged malnutrition, can begin at this point. In some cases, the alcoholic has delirium tremens, a mental disorder characterized by extreme nervousness and hallucinations.

Still in the penultimate stage, the alcoholic may refrain from drinking for short periods, but goes back to the bottle sooner or later. He will, in fact, do or sell anything to buy liquor; he will hide it or do anything else to protect it. Solitary drinking is often brought on by fears of running out of alcohol, so that having a supply becomes the most important thing in life. At the same time, the drinker shows hostility towards others, both as a protection to his supply and as a manifestation of an unconscious desire to punish himself. He hears things that he cannot definitely pin down or put into words; he develops a sense of impending doom or destruction; nervous and shaky, he is unable to face life without alcohol.

The end of the journey is the beginning of the turn. After so many alibis, the system breaks down and the drinker no longer can make excuses or put the blame on others. He realizes that drinking is beyond his control and admits he is defeated. This may also happen during earlier stages and be repeated many times.

He must give up the idea of ever taking another drink of alcohol in any form. This follows collapse of the alibi device and must come to an end to self-deception if recovery is expected. The surrender process means that a man had to admit to himself that he is an alcoholic, and even more important, he must accept his alcoholism as incurable by his own powers. He must seek help and accept it when offered.

Not all addicts follow the precise order outlined above. But regardless of order of occurrence, the symptoms that alcoholics experience are definite and visible. Each of the symptoms may not appear in each alcoholic, because people differ widely, but these stages will be recognized by any problem drinker.

Medical historians have found that already in 1990, Dr. Benjamin Rush, an American physician, said, "inebriety is a disease and should be studied as such, a physiological not a moral condition." This is an oversimplification because intemperance has a definite moral dimension, at least in its earlier stages, and always during periods of lucidity when a man's conscience is alert and his moral sense alive. Nevertheless, once a person becomes an alcoholic, medical evidence and the judgment of social and moral specialists concur in holding that an alcoholic is a sick person, those condition needs more than strength of will or even religious motivation.

It was not until 1956, however, that the American Medical Association openly declared alcoholism a disease. This pronouncement changed the classification of the alcoholic from a willful moral degenerate to that of a sick person. Yet, while admitting the fact, a number of qualifications should also be made. In favor of considering alcoholism as partially moral are two palpable facts: that the drinker began to drink of his own free will, and therefore may have foreseen the eventual condition to which his continued drinking would bring him; and that between states of unconscious stupor there have been not a few times when the alcoholic might see himself in a desperate situation from which the only escape was to take effective measures against a relapse. Failure to check the first beginnings of over-indulgence and failure to use necessary means once addiction was induced may be morally culpable; and in this sense alcoholism is not simply a physiological disease.

Having said this, however, the findings of medicine and psychology confirm the belief that alcoholism itself is a malady that requires expert help to be cured. Those who specialize in alcohol problems state that the most telling reason for looking at alcoholism as a sickness is the simple fact that an alcoholic can never learn to drink normally, no matter how hard he tries. On this point students of the subject are unanimous, and it is absolutely agreed that the practical goal of treatment must be complete abstinence. After years of temperance, an alcoholic will react abnormally the moment he starts drinking. Why should this be so unless there is something wrong with him, i. e., physiologically and/or psychologically? That unknown factor is properly called pathological.

On the physiological side, researchers have not come to an agreement on a clear and definite pathology which affects all or most alcoholics. Some of them think that the abnormal drinking of certain alcoholics comes partly from an organic pathology; others claim that in most cases, once alcoholics became addicts, changes take place in their physiology which prevent them from ever again being normal drinkers.

Psychologically, the causation is also not certain, although explanations from this area are currently more common. At any rate it is often easier to discover a neurotic trait than to identify a specific bodily pathology. Biologically, it is true, alcoholism shows evident chemical changes in the living cells of the body. Many psychiatrists, on the other hand, insist that alcoholism is a symptom of emotional disorder. Freud held that a penchant for drink was the sign of suppressed urges to homosexuality. Several investigators have tried to reconcile these points of view. A summary of their findings concludes that what starts as a symptom develops into a disease and is treatable as an independent illness.

To repeat for the sake of emphasis: the concept of alcoholism being a symptom, growing into a sickness, is supported by the almost universal observation that once alcoholic addiction has been developed, a return to normal drinking is impossible, even if the underlying emotional problem has been solved.

Women alcoholics are in a class by themselves, especially because they are protected by the privacy of home. Typical cases of addiction among women run the whole spectrum of personal tragedy, to which are added factors that make alcoholism more disastrous than ever in a wife or mother.

In West Virginia the wife of a traveling salesman is reported as spending Friday afternoon cooking samples of various foods and putting them in the refrigerator. She would just grope her way out of four days of heavy drinking. She would fabricate the leftovers to make her husband think she had eaten something during the week. In California a young mother came out of a blackout during a weekend of drinking when her husband was away. She found herself at an upstairs window, an empty box of crackers beside her. In the yard below, her two children could be seen crying in their playpen, with bits of cracker littering – the lawn – her aim was not so good. She had no idea how long it was since the babies had been fed properly.

In upper New York a young wife was brought from Manhattan with their small son in the hope of curing her of heavy drinking. For several years she managed to carry on the pretense of being normal, from morning until late afternoon, when she suddenly went on a drinking spree. "I always tried to wait until five," she said, "And people say alcoholics don't have will power! Then began the business of getting the bottle, hiding the bottle and getting rid of the bottle. By the time your husband has started marking the bottles, this becomes a life work. You drive across town to get new ones, and you're always scared of being caught. In New York (City) I had always looked for 'occasions' for drinking, but now I wasn't bothering with that. Mostly I drank alone. I drank until I passed out." (10)

Statistics on the prevalence of alcoholism varies, but the accepted ratio is that there are two women alcoholics for every eleven men - thus some three quarter of a million women addicts in the United States. Yet there are some who suspect that the proportion women is really much higher. They point out, for example, that in big cities meetings of Alcoholics Anonymous show there are just about the same number of either sex. Dr. Ruth Fox, medical director of the National Council on Alcoholism, says, "in the past decade I have seen 1292 alcoholics - 789 males and 503 females. I think this means that the figures around the country are way off." Dr. Fox is also a psychiatrist in private practice.

Helping women get over addiction involves difficulties that are not present or not so grave with men. Above all women must be convinced that alcoholism is a common, treatable disease, not (necessarily) a guilty sin. If the burden of shame could be lifted from the word "alcoholism," more women might face their drinking patterns honestly. Their sense of shame and moral depression are deterrents to cure because they block the intelligent use of existing media of rehabilitation.

Shy women will take a drink or two at parties to warm up to the company. Without realizing it, they may develop compulsive habits more easily than men because women's emotional systems are more sensitive and therefore more rapidly thrown off balance by over-indulgence.

Intemperance

In spite of its recognized physiological and psychological aspects, alcoholism has clear moral implications. The virtue of temperance is violated by the sin of intoxication or drunkenness. Moralists commonly admit that intemperance in drink is more serious than gluttony in the matter of food, mainly because of the more serious effects that follow. As a general norm, intoxication that results in a partial loss of reason is a venial sin, although it can become a mortal sin by reason of the scandal given, injury to health, harm to one's family or the neighbor. Drunkenness that ends in complete loss of the rational faculty is a grave sin if brought on without a sufficient reason and with some advertence to what a person was doing.

How to estimate complete loss of reason? A good sign would be when a man can no longer distinguish moral good from evil, or if he cannot remember what he said or did while in the drunken stupor, or if he does something he would never do when sober. Moral theologians suggest that a sufficient reason to deprive oneself of the temporary rational powers would be to cure a disease or counteract a toxic condition in the body – if this were prescribed by doctors. Partial intoxication corresponds to being high or tight; complete intoxication is commonly the same as being drunk or actually passing out. A careful distinction should be made between experiencing a pleasurable feeling, mild relaxation, or a sense of cheerfulness, and actual intoxication. The latter is sinful, the former is not. In practice, one may not be able easily to tell the difference, except by the sense of guilt following a drinking experience

An important factor in rehabilitating drinkers is to have them realize the sinfulness of what they are doing. Why should drunkenness be morally wrong? Without this ethical dimension, alcoholism will never be looked upon with the seriousness it deserves.

Following the injunction of St. Paul, that "drunkards shall not possess the kingdom of God," Christian tradition has universally condemned intoxication as a sin. Its sinfulness is manifold, but principally derives from four sources; Because it abuses the human faculty of taste by overindulgence, deprives a person of the use of his reason and free will, causes damage to the drinker in body and mind, and brings a train of evil effects on every person or institution that enters the drunkard's life.

No one has ever seen a drunk lying in the gutter along skid-row, or heard witnessed language and conduct in public, without feeling that here was a human being who lowered himself to the level of a beast, in fact below the animal because his irrational condition was self-induced.

Our faculties of reason and freedom are God-given powers that may not be lost or suspended without just cause. To extinguish them deliberately for the sake of indulging the palate is a kind of self-mutilation that nature instinctively tells us is wrong. We are no more masters of our minds than of our bodies; they are gifts from God to be used according to His will. Frustrating their function without adequate cause is to assume prerogatives that belong exclusively to God.

There is no limit to the evil that a man or woman under the influence of liquor cannot perpetrate: impurity and dishonesty, blasphemy and injustice, loss of money and reputation, hatred and even self-destruction are typical effects on the drunkard himself. An intolerable situation is imposed on husband, wife or children; family and friends are lost and disgraced; quarreling and violence to bloodshed are common; scandal to the young, especially one's children, and the loss of their love and respect; broken homes and the loss of faith – are all well known in families where alcohol dominates.

Medical experts also warn that while characteristics acquired by the individual in the course of his life are not transmuted to his descendants, yet germplasm is not immutable. It may change under the influence of the organic medium. It can be altered by disease, poison, food, and secretions of endocrine glands. Syphilis in parents may cause profound disorders in the body and consciousness of their children. For this reason, it is claimed, the descent of men of genius sometimes consists of inferior beings, weak and unbalanced. Trepomnema pallidum has exterminated more great families than have all the wars of history. Likewise alcoholics, morphino-maniacs, and cocaine addicts may beget defectives, who thus pay during their whole life for the vices of their fathers and mothers.

Driving while under the influence of alcohol, statistics show, is one of the main causes for what has been aptly called "massacre on the roads." Experts differ on the degree to which intoxicants affect the competence of drivers, but they agree that nothing is more responsible for traffic and highway accidents, resulting in a total casualty list of many thousands every year in the United States. Some people can be truly said to be under the influence of liquor and morally incapable of driving a car safely with concentrations over five hundredths of one per cent, or one part in two thousand, ratio in the blood. Legal and medical advisors favor setting standards for testing drivers. People whose blood shows less than .05 per cent are presumed to be sober, from .05 to .15 per cent may be intoxicated, and over .15 per cent are certainly drunk. Two high balls or two cocktails on an empty stomach are enough to slow up the reaction of many people, and depress their faculty response to the point where driving an automobile becomes a poorer risk.

The sinfulness of driving while under the spell of alcohol is dealt with severely by moralists. It is obvious, then, that a person who is drunk (though still conscious) could not get into a car and attempt to drive it without grave sin. Likewise a man who has indulged too freely sins venially by his excessive drink, but his culpability increases the moment he gets into a car.

One who by alcoholic drink has notably dulled his reflexes or diminished his judgment so as to render him an unsafe driver would grievously sin by driving in that condition. In that state of nervous and judicial instability a driver is in serious danger of becoming involved in an accident, and thus violating the fifth or the seventh commandment as a result of his own intemperance. One is never justified in placing one's self in a situation like that, even though in a particular case one should happen to escape unscathed.

We are dealing here with the objective morality of a befuddled driver taking the wheel. In many cases it seems to happen that the driver himself does not realize that he is incapable of safe driving. Mild intoxication often makes men more self-confident and reckless than they would be when they are perfectly sober. (11)

Comparable studies on the breakdown of family life place drinking at the top of contributing factors which lead to separation and legal divorce. The reason is that drunkenness has a satellite of other evils, from infidelity to mental cruelty, which make married life difficult or practically unlivable.

One aspect of alcohol that is too often overlooked is the extent of drinking by high school and college students in the United States. A large percentage of young people use beverage alcohol, some experimentally and some with regularity. The heaviest drinking is being done between the ages of 18 and 24, according to available information. Boys and girls are beginning to drink at an earlier age, just as they date at an earlier age than they did a few decades ago.

Recognizing the fact that young people drink, and often heavily, many states have made provision for instruction about alcohol and alcoholism.

Studies have shown that a strictly objective presentation of facts about alcohol will not be enough to cause a change in the thinking or behavior of students. They must be made aware of the social and psychological implications of the practice. An approach in which the teacher presents the facts and aids in interpretation of these facts is considered the best. Student participation and discussion help immeasurably.

Among the important objectives of such an education program would be to present factual, scientific information about alcohol and its effects on the body, as the basis for further instruction.

1. To encourage students to examine and analyze their attitudes toward the use of beverage alcohol. Few young people stop to ask themselves why they took to drink in the first place, and why they continue the practice.
   
   
2. To help students realize that alcoholism is an illness and that the alcoholic is a sick person who can be helped. They have heard about allergy, and can be made to see that for some persons alcohol is a lethal drug from whose addiction they can be saved only by total abstention.
   
   
3. To aid students understand that the alcohol problem is a complex one, with physiological, sociological, psychological and moral implications. Those who take to drink may be avoiding real problems that need solution, and always they are creating new problems that may become insoluble.
   
   
4. To assist students to see that social acceptance can be built on activities more valuable than drinking with the crowd. While the urge to conformity is strong in all people, and specially so in young persons, it destroys character and defeats the very purpose of social agreement when the basis of friendship is a common indulgence of the palate.
   
   
5. To educate each student to a sense of responsibility for himself and others in regard to drinking intoxicating beverages. Not many understand that no two people are alike in this respect. One person can take it, another cannot. If my indulgence (which perhaps I control) becomes an occasion of sin to someone else whose system cannot take alcohol without inducing alcoholism, I am responsible for his or her falling into the vice and therefore I share in the tragic consequences that always follow such addiction.
   
   
6. To make students aware of the results of excessive use of alcohol. A single instance of seeing a parent or relative drunk has been enough to cause some children to swear off drink for life. They know from firsthand experience the evil effects of intoxication. But unless drunkenness is shown to be what it is, a moral disgrace that may cause disease, young people can become alcoholically involved and then find it is too late to "either take it or leave it alone."

Another phase of intemperance that has only recently come to light is the mass program of subtle advertising that seeks to extend the alcohol market to consumers not traditionally interested in drink, notably women and the young. Vance Packard showed that until the fifties, whisky, gin and beer had commonly be garbed in two-fisted male vestments in keeping with the assumed sex of the buyer. Vogue, a fashion magazine for ladies, became suspicious of this fact and surveyed four hundred liquor stores. It found thirty-eight per cent of the dealers reporting that more than half of their liquor customers were women. The women were obviously ignoring the old taboos about liquor, probably because liquor stores were starting to be grouped in shopping centers.

A nationally famous advertising writer took her male colleagues to task for being outdated. If one were to judge American drinking habits from advertising, he would assume that whisky, gin, and the rest are taken solely by men. Ads showed clubmen, sportsmen, men in evening clothes ...but women never. Why not re-examine the field and try to sell more liquor to women? Many hostesses prefer it to candy, the writer said, and she exhorted the industry to do something to make the average liquor store a more attractive place to shop, with festive windows and well-styled interiors. In catering only to men, the stores had neglected decor so that the average liquor shop had no appeal to women customers.

About the same time a new trend began in liquor merchandising. Labels changed from staid male-directed items to graceful, multi-colored formulas. It was also found that women like nice decorative bottles. Beer brewers, too had been caught unawares. The United States Brewers' Foundation told its members to stop assuming that the average beer buyer was an older man. The average beer buyer, it was discovered after research, was a woman between twenty-five and thirty-six, who buys beer out of her weekly food budget and is specially prone to female- oriented ads, nice packaging, and display.

Within the last ten years, therefore, the liquor and beer industries have revolutionized their sales methods, featuring more women and young people in the ads and directing appeals to a still untapped drinking market that experts tell them numbers tens of millions. Sales results are confirming the validity of this campaign.

Agencies for Treating Alcoholics

Recognizing that alcoholism is a moral and physical malady that cannot be cured by the addict himself, various agencies have arisen to help the victim of his own excess and restore him, if possible, to a normal life in the world.

The best known of these is the Alcoholics Anonymous, which describes itself as a fellowship of man and women who share their experience, strength and hope with each other, that they may solve their common problem and help others to recover from alcoholism. It was founded in Akron, Ohio, in June, 1935. The founders, both chronic alcoholics, were an ex-stock broker from New York City (Bill W.) and a local surgeon (Dr. Bob S.). The physician died in 1950 after fifteen years of uninterrupted sobriety.

Alcoholics Anonymous' services are supported wholly by voluntary contributions from members. Gifts, contributions or bequests from non-members are not accepted. The Society maintains no hospitals, convalescent homes, rest farms or similar facilities. In some communities hospitals now have programs whereby all admissions of alcoholic patients are handled in cooperation with an Alcoholics Anonymous committee or service office. So-called A.A. rest homes or farms are totally unrelated to the society, except that elements of A.A. therapy may be available to patients.

Many professional people – doctors, institutional administrators and others in the field of medicine, law and public health – are familiar with the Alcoholics Anonymous and its program for personal recovery from alcoholism. The organization today comprises an estimated 250,000 recovered alcoholics. Most of them are affiliated with approximately 7,500 local groups in the United States, Canada, and about seventy other countries. Women constitute approximately one-fifth of the membership.

The Society does not keep statistics on recoveries. Observers have suggested, however, that fifty percent of the chronic alcoholics who seek help voluntarily through Alcoholics Anonymous attain stable sobriety immediately, while another twenty-five per cent arrest their compulsive drinking after a period of further "experimentation" with alcohol.

From its earliest days, A.A. has been accorded the support and cooperation of leaders in the field of medicine and psychiatry. Its use in the rehabilitation programs of noted penal institutions dates from 1944. Religious leaders and churchmen are equally in favor of Alcoholics Anonymous, which they praise for its strictly non-denominational basis and sound moral principles that recognize the existence of God and man's dependence on divine help through prayer.

The sole purpose of the Society's members is to preserve their own sobriety by sharing it with other interested alcoholics. As a Society, A.A. has therefore avoided affiliation with other programs in the field of alcoholism. Individual members, local groups and special service committees do, however, contribute their experience freely to assist doctors, institutional administrators, law enforcement officials and community agencies who seek to help problem drinkers. There is only one requirement for membership, namely a desire to stop drinking. No dues are collected and no fees. Alcoholics Anonymous is not allied with any sect, church, politics, organization or institution. "Our primary purpose," the Society declares, "is to stay sober and help other alcoholics to achieve sobriety." Its success in achieving this purpose has been due mainly to the twelve-point program, called the twelve steps of the Alcoholics Anonymous. Their combined philosophy is a commentary on the effectiveness of religion and charity for others to accomplish what people have found impossible to do alone, after years of solitary effort.

1. We admitted we were powerless over alcohol--that our lives had become unmanageable.
   
   
2. Came to believe that a Power greater than ourselves could restore us to sanity.
   
   
3. Made a decision to turn our will and our lives to the care of God as we understood Him.
   
   
4. Made a searching and fearless moral inventory of ourselves.
   
   
5. Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
   
   
6. Were entirely ready to have God remove all these defects of character.
   
   
7. Humbly asked Him to remove our shortcomings.
   
   
8. Made a list of all persons we had harmed, and became willing to make amends to them all.
   
   
9. Made direct amends to such people wherever possible, except when to do so would injure them or others.
   
   
10. Continued to take personal inventory and when we were wrong, promptly admitted it.
    
    
11. Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.
    
    
12. Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics and practice these principles in all our affairs.

No city of any size is without at least one group of Alcoholics Anonymous, which are often so listed in the telephone directory. Otherwise discrete inquiry will easily show where they can be reached. Their national headquarters are at P.O. Box 459, Grand Central Annex, New York 17, New York.

On a different level is the National Council on Alcoholism, which acts as a clearing house for information and ideas on work and research in the field of alcoholism. It distributes the latest data from scientists and doctors, and also directs the establishment of community programs on alcoholism. Local groups become affiliated on request from the national office, which is at 2 East 103rd Street, New York 29, New York.

One of the main functions of the National Council is to furnish advice to individual members of the family on how to deal with an alcoholic. It is well known that mistakes by imprudent or uninformed persons may only retard the drinker's rehabilitation. He cannot be preached to or rebuked, and generally he resents any pressure from the family, doctor, clergyman or psychiatrist. Unless those who are nearest to the alcoholic come to see his condition as pathological, and treat him accordingly, their efforts may aggravate the malady. Hence the value of knowing what to do and what to avoid doing, if the victim of alcoholism is ever to begin his recovery.

An outgrowth of the Alcoholics Anonymous are the Al-Anon Family Groups, which describe themselves as "a fellowship of wives, husbands, relatives and friends of members of Alcoholics Anonymous and of problem drinkers generally." Members of the A1-Anon are banded together to solve their common problems of fear, insecurity, lack of understanding of the alcoholic, and of the warped family relationships associated with alcoholism.

In their own words, "the message of the A1-Anon Family Groups is the story of hope. It is the story of men and women who once felt helpless and powerless to deal with the alcoholism of their loved ones. Today these men and women no longer feel lost or lonely. They have learned that there are simple things that they can do directly to help themselves and indirectly to help their alcoholic partners." Many members have already seen their relatives and friends achieve sobriety, but they have also found that living with a sober alcoholic presents not a few problems of readjustment. Others still have problem drinkers in their home or family circle. Both kinds have discovered that sharing of needs and experience has strengthened their moral stamina and given them a new lease on life.

Among the Al-Anon tenets is the recitation of the Serenity Prayer: "God grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference." It is a fair summary of the Christian outlook on one of the gravest problems in affluent America, where millions of "sober victims of alcoholism" look forward to being delivered from a heavy trial, while they accept the cross in their lives as a means of sanctification.

Chapter V

Drinking and Temperance References

1. Acts 26:25; I Timothy 2:9, 15.
   
   
2. St. Thomas Aquinas, Summa Theologica, II-II, 141, 4.
   
   
3. Ecclesiasticus 31:35.
   
   
4. "Medical-psychological Aspects of Alcoholism," Journal of Clinical Psychopathology, vol. VIII, pp 577-586.
   
   
5. John Wesley, in Methodism (W.G. Muelder, edit.), Nashville, 1945, p. 194.
   
   
6. Doctrine and Discipline of the Methodist Church, 1952. p. 639.
   
   
7. Ibid., p. 385.
   
   
8. William W. Sweet, Methodism in American History, New York, p. 389.
   
   
9. Life and Lifework of Leo XIII (James J. McGovern), New York, pp. 392-394.
   
   
10. Neal G. Stuart, "Women Drink Too Much," Ladies' Home Journal, March, 1961.
    
    
11. Annual Social Justice Statement of the Australian Heirarchy, September 7, 1958.

Copyright © 2004 by Inter Mirifica