How It Works
Knock on wood. I am, in general, for the most part, relatively speaking (stop me before I modify again) a healthy person. My blood pressure tends to be high normal, but then that's only when I have it taken. I don't get sick a lot, and I have a reasonable exercise endurance considering I don't really, you know, exercise. And the last time I had a physical (don't ask), my blood chemistries were in great shape. Excellent cholesterol (good and bad), blood sugar, electrolytes, etc.
In fact, the only thing I really have to watch out for are enzymes. Two in particular -- ADH and ALDH. They're a little goofy; not as functional as they should be. But other than that, I'm doing OK.
Enzymes, as I'm sure you all remember from high school biology, are complex proteins that are involved in catalyzing specific biochemical reactions. We've got lots of enzymes, working away, that we don't even pay attention to unless someone gives us a heads up.
And I can live with my limp enzymes. I just have to be careful with what I ingest. Sort of like a diabetic, although different. Because with those ADH and ALDH enzymes taking a snooze, I can develop unusual levels of acetaldehyde, which we all know is a bad thing. It can lead to the development of tetrohydroisoquinolines (TIQs), which is never good. TIQs can soup up the brain, meaning you can start talking a lot and just get generally hyper. There might even be personality changes. And seizures are a distinct possibility.
So I have to watch my TIQs, as it were, and be aware of my enzymatic situation and try to keep the acetaldehyde in a fairly normal range. I can do this by simply watching my diet and what I put into my body. That means, in my case, avoiding EtOH, which is the chemical term. The medical term is booze.
Sorry for the biology lesson, but I thought it was important.
I have an abnormal reaction, in other words, to a chemical substance. Which is not a bad definition of an allergy, a model that's sometimes used to explain alcoholism, particularly an allergy to strawberries (I have no idea why; I would prefer eggs. I don't really like eggs).
Let's say you're allergic to strawberries. You break out in hives and have trouble breathing. What do you do? You stop eating strawberries. Problem solved.
But suppose there was a nutrient found only in strawberries, something your body needed and craved when it wasn't available. Pretty soon all you can think about is strawberries. Maybe if you just have one. And so on.
It's not a great analogy, but it's useful. Here's how it's put in recoveryspeak: Allergy of the body/obsession of the mind.
The allergic reaction in the case of the alcoholic is loss of control. In fact, that's damn near the definition. And loss of control has been directly linked to TIQs. Isn't this easy now? Don't you feel bad about being judgmental about Jeff at the Christmas party? When you should have just been sympathetic and said, "Poor guy. He must have TIQs coming out the wazoo."
Ah. Well. Biology is just biology. There are lots more factors in play here.
For example, you can have a cholesterol of 600, weigh 380 pounds and smoke three packs a day, but if you have a stroke while driving your car and hit somebody, you're not going to jail. Kill a fifth and get behind the wheel and it's a different story.
And it should be. I can't tell you how many times I've heard, in a film or during a lecture, the words "It's not your fault." And it's not. Nobody dreams of being a drunk when they grow up. Alcoholism is a familial-genetic disease, and some of those genes have already been identified. Four, in fact, which may account for the differences in alcoholics.
There is also no relationship between psychiatric disorders and alcoholism. None. Sorry to shoot that down, but it ain't there. Depression may point you toward a bottle, but it doesn't make you an alcoholic. God does (sorry again).
But there are choices, and personal responsibility. No one forces you into the car, or puts the gun in your hand, or clenches your fist for you. Those pesky TIQs lead to incredible cravings, and eventually some find themselves powerless over even the first drink, but there's always a first one and a moment before. Even the Wolfman, who probably had some serious chemical imbalance stuff going on, begged to be locked up during a full moon. Alcoholism is not an excuse for bad behavior. An explanation, sometimes, but tell it to the judge.
There are two things I want to add here. Obviously, we can infer that there are plenty of biological alcoholics who never have problems because they never drink alcohol, for religious or cultural reasons or whatever. And, also obviously, it would be great if anyone with a family history of alcoholism were aware of the fact and abstained just for safety's sake.
Secondly, the term "alcoholic" is tossed around a lot. There's a difference between alcohol abuse and alcoholism. You can drink every day of your life, drink yourself to death, and still not be an alcoholic, by definition -- i.e., you could stop if you wanted to. Alcoholics can't. Or not without, usually, some help.
So we have a problem: a progressive, primary, incurable and ultimately fatal disease that costs million of lives and billions of dollars, and it can be halted simply by not taking a drink of alcohol. What's a TIQ-loaded guy to do?
It turns out there is a solution. More later.
5:21:31 PM 
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