By Richard R. Peabody
Scribner’s
Magazine, 1936
What
are the signs which indicate that liquor is "getting" a
man? Is it the "hair of the dog" as salutary as it is
supposed to be? Here are five rules by which to judge whether the
road to alcoholism is open.
Well-groomed,
erect, clear of voice and eye, certainly he did not look the part of
the man who had been "got" by whiskey. Yet he told me that
during the first year of the depression, when his business fell off
seriously, he had been resorting to alcohol to buck up his spirits
and relieve his worry. There came a time, he said, when he took a
drink in the morning because he was jittery, and these jitters he
knew were different from business worries because they seemed to come
from the previous night’s indulgence. One day, even though his
business had begun to pick up, he found he could not stop.
"If
a fire gets big enough," he explained, "it creates its own
draft."
Though
he had no idea of it, that man had stepped over the danger line when
he took his first morning drink. He called it an "eye opener,"
but it would be more exact to describe it as a drug to soothe his
nerves.
Let
me state once and for all that I have no prejudice against alcohol as
a beverage, and little sympathy for the well-meaning reformers who
run around with sharp sticks chasing Demon Rum. I recognize that "the
cup that cheers" has advantages of social value. It relieves
self-consciousness, promotes good fellowship, and in general
contributes to the gaiety of many occasions. What I would like to do
here is to indicate to those who are accustomed to drink, and who
know how to handle alcohol (or believe they do), certain signs by
which they may be warned when they are entering the twilight zone of
danger. These signs I have learned from long observation. It is an
old story for me to hear; "If only I had known ten years ago as
much about the effects of drinking on nervous systems like mine as I
do now, I certainly would have saved myself and my family an enormous
amount of suffering."
Most
everybody knows of some person, too often an intimate friend or
relative, who has "gone to hell" from drink, and they may
know more than one; yet how many people stop to think of this danger
in connection with their own conduct?
Of
course the great majority are so relatively abstemious that this
reflection is not necessary, but there are nevertheless a great many
men who might profitably pause to consider whether or not drink has
become a potential danger to them. Certain ways of drinking indicate
a morbid interest in it. Sometimes small parties, and even small
drinks taken during certain states of mind are not as innocent as
they may seem.
Unfortunately,
there is no clear—cut difference between what might be called
normal drinking and alcoholism, the way there is between a broken Leg
and a whole one. In dealing with mental states it is not nearly so
easy to make a definite diagnosis s it is in the physical field when
the organs can be examined by various mechanical methods. So to avoid
wasting our time in hairsplitting we will have to make certain
statements, and then discuss the exceptions.
Despite
the opinion of prohibitionists the man who is somewhat under the
influence of liquor every evening is by no means an alcoholic
problem, provided he goes about his business soberly in the day time
and is reasonably sensible while drinking, he may be a drunkard in
the making but he is not one at the moment.
At
what time then in a man’s drinking career does he show definite
signs of alcoholism, either in process or in fact? One answer is when
he begins in the morning. This is an unmistakable danger signal. When
he needs "the hair of the dog that bit him" to restore his
nerves so that he can get on with the day’s work without "going
crazy" from an indescribable state of depression and jitters,
then he is a drunkard real or potential, the latter depending on how
much the alcohol that he consumed on the following day after affects
him. In other words, at this point drink has become a drug, and a
major drug at that. A man who cannot go out with the boys in the
evening and return with them to their work the next day because he is
drunk again is a drug-addict, and if he is returning with the help of
a pick-me-up he is a drug-addict just the same.
Normal
drinkers, no matter how much they may have imbibed the night before,
carry on the day without "eye-openers," and they do this
not because of will power but because the idea physically disgusts
them. Their unhappy friend is going to have a drink because he is
suffering from a painful mental reaction which they know nothing
about, for if they felt the way he did they would have one too.
While
my work is confined to treating those who are disturbed by their
excessive indulgence I make it a point to go into the matter with
normal drinkers from time to time in order that I may be informed as
to how, when, and in what manner they drink. They invariably tell me
that, no matter how intoxicated they may have been the night before,
the last thing in the world they want is a drink the next morning.
When
I asked a certain patient how he started to drink in the morning he
replied, "About four years ago I went on a party with a man who
was in somewhat the condition that I am now. The next morning we
awoke very much the worst for wear nervously. This was extremely
unfortunate for me as I had an important and difficult engagement
which I seemed absolutely incapable of keeping. When I told my friend
of my predicament he said, "A hair of the dog that bit you is
all that you need," and forthwith set the example by having one
himself. I had one too, though the idea was distasteful to me, and in
the course of a few minutes I felt all right. "Now," I said
to myself, "I have found a way to beat hangovers!" And I
had for a while; but as my nerves got worse I had to keep increasing
the dose, until I found I was more or less drunk all the next day."
Those
then who wish to enjoy moderation, interspersed with occasional,
parties, would do well to avoid drinking anything until lunch time,
and if they can wait until after dinner so much the better.
At
this point I realize that certain readers are reflecting on the
exceptions that they know of, and as a result are wondering whether I
am an extremist who does not know his business. Are there any
exceptions to these somewhat dogmatic statements? Yes, there are. In
fact I once had a patient whose father took only one drink a day and
that was before breakfast. Nevertheless none of these exceptions is
strong enough to vitiate the fundamental symptoms of chronic
alcoholism as set forth here. However we will take up the most common
for consideration.
For
instance, there are a relatively few older men who can and do take a
pick-me-up in the morning, not habitually, but after particularly big
parties. These men, because of their age, cannot be considered
alcoholics, past, present or future. If a man under thirty-five or
forty is doing this he’d better look out, but if he is fifty or
sixty and is not increasing the dose then his habits have
unquestionably crystallized and such ills as result from drinking
will be those of the body. Men who could drink slowly all day long
(and still be a success in the office and home) without doubt existed
a century ago; but high speed business and high speed pleasure have
made such demands on the nervous system that it can no longer
withstand an all-day-every-day ration of alcohol. Drinking does not
help under any condition; but in this era of keen social as well as
economic competition, the nerves must have frequent respites or we
may expect alcoholic breakdowns on the part of those who persist in
abusing it.
Another
exception is the reunion common to college men, business associates,
and war veterans, to mention just three groups. Here large bodies of
respected men may set out to become intoxicated for the better part
of two or three days or longer. Conservative people may question the
good taste of these performances, but those who indulge in them
cannot be considered abnormal by any stretch of the imagination. The
obvious reason is that too many normal men do it.
Now
the discouraging part of this change from normal social drinking to
abnormal drug addiction which wrecks so many lives is that its onset
is often insidious. A man may have a full-blown case of alcoholism
before he is really aware that he is the victim of a dangerous
narcotic. He is drinking the same beverage that he always drank and
that his friends are still drinking with impunity. If he had to
retire to the privacy of his room in order to give himself a
hypodermic injection he would realize that he was doing a thoroughly
abnormal and dangerous thing the first time he did it. But when he is
only drinking a little more of the same old stuff for a little longer
period of time, he fails to, realize that he too is a "hophead,"
and it sometimes takes what might be termed a prolonged catastrophe
to educate him.
Taking
a drink in the morning as a relief from the excesses of the night
before is only one danger signal. Another one is using alcohol as a
means of escape from a disagreeable reality’. Life itself,
particularly’ in these days, provides a good many reasons for
nervousness and depression and so the desire to escape into a
pleasanter world of fancy is pretty strong for many people. But
alcohol is intended to be used for purposes of celebration and not
consolation, for in the long run it makes a poor if not disastrous
nerve medicine. Drink if you like to make a good time better but
never to make a bad time good. Boring social functions may be
excepted from the latter part of this statement. It may be all right
to blow off steam on Saturday night, but the person who deliberately
and with increasing frequency seeks refuge in the bottle is headed
for serious trouble. The cause may seem justified, but that does not
prevent the end from being tragic. Drinking to escape from the
hardships of life then is the second danger signal.
Incidentally
if it is true that a great many people are worried and unhappy more
or less because of the depression, why is it that alcoholism has not
increased by leaps and bounds? The answer is that the average man,
while he may be unhappy, while he may be none too strong of will, and
while he certainly knows the temporary soothing effects of a drink,
simply does not choose this way out of his troubles. He instinctively
knows that it will not work, and furthermore that, except for a brief
period, it will make matters much worse. It is not a question of will
power so much as a lack of desire. In this he is fortunately
diametrically opposed to the person whose nerves have become poisoned
by alcohol.
I
don’t want to weaken the truth of my statements by being
misunderstood and hence considered fanatical. Any sound theory can be
made ridiculous by carrying it to an absurd degree. Plenty of normal
drinkers do seek a party with their friends because they are "fed
up," but they do not make a habit of it because they know from
experience that it will work satisfactorily only once in a while.
They go to the great majority of their parties because their friends
are going also, and not because they are unhappy or worried.
This
brings us to the third point in our consideration of what signs
indicate that the danger line of drinking has been or is about to be
passed. Is the monthly or yearly dosage being steadily increased even
if slowly? Most men’s habits, certainly their drinking habits, have
more or less crystallized by thirty. So if a man’s drinking
increases after that he may easily be concerned without being accused
of morbid introspection. A man who is steadily drinking more at
thirty-five than he was at thirty, and more at forty than he was at
thirty-five, has cause for worry, unless of course drinking has
always been a matter of negligible importance in his life. This
increase is often subtle, and it is generally accompanied by a series
of plausible excuses. But the fact remains that the normal man tends
to do most of his drinking when he is young, and his nerves and body
can stand it. As he advances in age, and responsibilities develop, he
drinks less. In other words he restricts his consumption of alcohol
to that amount which does not injure his health, his reputation, or
his efficiency. Still another danger signal to bear in mind is how
much more, as time goes on, a person depends on alcohol for
enjoyment. Has he the same enthusiasm (with due regard for advancing
age) as he had five or ten years ago, or is he leaning more and more
on alcohol in his attempt to get happiness out of life? I do not mean
he is depending on it in the same quantity, to enjoy those social
functions where it is habitually used, but is his drinking slowly
becoming a necessary accompaniment in the gaining of pleasure from
those things which used to be spontaneous hobbies and which should be
still? Has the "nineteenth hole" become the most
interesting one to the golfer, and is the flask as important to the
fisherman as his bait? If so, be careful.
As
a final symptom to be watched we will add insane conduct, that is,
behavior extremes beyond the point of drunkenness. Most men who drink
to excess at all do something sooner or later which causes them much
chagrin, but the man who frequently and without cause fights, insults
ladies, or in any way conducts himself in ,a dangerous, crazy, or
indecent manner, shows an abnormal mental deterioration. I am not
concerned here with the moral or esthetic effects of alcohol, but
such behavior as has been mentioned denotes mental, sickness, and
thus it is a danger signal of serious trouble ahead.
Just
as we have qualified our statements in the direction of leniency
toward drinking - that is breaking rules without danger-so in the
other direction too much should not be made of technicalities to
bolster up oneself in the belief that one is indulging in a safe and
sane manner. For instance, the man who waits until lunch time to
begin drinking, but who from that time habitually keeps on for the
rest of the day, need not pride himself that his use of alcohol is
safe and sane. He may have one of those very rare old-fashioned
nervous systems, but the chances are that unless his consumption and
his reactions to it have become fixed for a considerable period of
time he is a semi— alcoholic in process of becoming a full-fledged
one.
To
sum the matter up, we may say that the danger line of drink has been
reached under the following conditions:
(1)
Drinking to get over effects of previous drinking, particularly when
it is done in the morning.
(2)
Using alcohol as a means of escape from a disagreeable reality.
(3)
Slowly but surely increasing the monthly or yearly dosage.
(4)
Depending more on alcohol for enjoyment, particularly in connection
with those things to which it is not a normal accompaniment.
(5)
Extreme conduct while under the influence of drink, that can only be
described as "crazy."
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