You may wonder why some but not all drinkers become alcoholics. Alcoholism is a disease and can be determined by predisposing factors, such as heredity, ethnic susceptibility, and abnormal metabolism.
Untreated alcoholics can expect to pass through the following three progressive stages:
- The early, adaptive stage is characterized by Adaptation, Tolerance, and Improved Performance
- The middle, dependent stage is characterized by Physical Dependence, Craving, and Loss of Control
- The late, deteriorative stage is characterized by Malnutrition, Secondary Disease, and Death
Following are excerpts from James R. Milam’s seminal breakthrough on alcoholism, UNDER THE INFLUENCE.
The Early, Adaptive Stage of Alcoholism
One of the first symptoms of alcoholism is, ironically and tragically, an ability to increase alcohol intake and still function "normally." It is ironic because most diseases incur immediate and obvious penalties, not benefits, and result in reduced functioning rather than improvement in functioning. But in the early stages of alcoholism, the alcoholic is not sick, in pain, or visibly abnormal. In fact, the early, adaptive stage of alcoholism appears to be marked by the opposite of disease, for the alcoholic is "blessed" with a supernormal ability to tolerate alcohol and enjoy its euphoric and stimulating effects. This improvement in functioning is tragic because the alcoholic has little or no warning of the deterioration inevitably to follow.
In the early stage, the disease is subtle and difficult to recognize. It is characterized by adaptations in the liver and central nervous system, increased tolerance to alcohol, and improved performance when drinking.
Adaptation: A general biological rule holds that when any bodily system is under stress it either adapts of suffers damage. Adaptation is actually a tool of survival, helping the body endure stressful changes in internal or external environments. Adaptational responses occur rapidly, spontaneously, and in most cases, without the person’s conscious knowledge.
The adaptations which occur in the early stage of alcoholism
are of two kinds: those affecting the metabolism of alcohol,
and those taking place in the central nervous system and
contributing to addiction. Both types of adaptation have
direct effects on the alcoholic’s ability to drink
large amounts of alcohol without becoming intoxicated
(tolerance) and actually to function better when he is
drinking than when he is not drinking (improved performance).
