Doctor: Genetics responsible for about 60 percent of center’s alcoholics

It's the standard sitcom character: the alcoholic friend whose pratfalls signal the laugh track. But alcoholism is no laughing matter for those affected. The U.S. Department of Health and Human Services reports that alcohol-related disorders cut across gender, race and other demographic lines. The National Institute on Alcohol Abuse and Alcoholism says that 17.6 million Americans — or about one in every 12 adults — abuse alcohol or are alcohol-dependent.

Drug use at age 12 eventually led to alcohol abuse

Brett (not his real name) shared his story. His dad was a veterinarian, and both of his parents were rock-solid citizens. But at a young age, Brett said, he didn't like who he was.

"No normal 12-year-old steals a 30cc vial of Demerol and starts giving himself shots," he said. "My parents didn't drink, so I didn't have alcohol available. But I had his pharmacology available."

That led to codeine and pot. But the drinking was legal, and alcohol easy to obtain. When drinking with friends, he said he was the last guy standing.

"I would drink, and everybody else would pass out," he said. "I (know now) it's proof that I have this disease. Alcohol is a depressant for people; you get mellow. With me, it's a stimulant."

His parents took him to his first Alcoholics Anonymous meeting when he was 20. But he couldn't quit.

Brett managed his drinking enough so that he didn't lose his job. But he had to have alcohol, he said — had to.

He told of a man he met who had gone blind. Why? Because the man had resorted to drinking the only thing he had available: rubbing alcohol.

While training race dogs, Brett had access to plenty of rubbing alcohol. One day, he had the shakes as his body's craving for alcohol kicked in. He said he was willing to drink it and risk blindness except that a dog fight broke out, requiring his immediate attention. The man who helped him quash the fight, a fellow trainer, said he had booze and invited Brett to his place for a drink.

Brett ended up drinking so much, he got alcohol poisoning and had to undergo dialysis the next day. He was 27.

He returned to AA. It was June 1987. He was sober for 17 years. Then he stopped going. From 2004 to 2011, Brett said, he "could not stop." He got divorced, got DUI tickets and was fired from his job.

On Jan. 27, 2011, he decided to get sober. What triggered that?

Brett was arrested for a DUI, and while locked up, he decided to try to kill himself by breaking a glass pane and cutting his throat on the shards. But it was shatterproof glass, and he knocked himself out. When he awoke, he was in a padded cell, feeling, he said, like such a failure, he resorted to ripping off one of his toenails and trying to cut his throat with it.

He ended up at a psychiatric hospital and realized he truly didn't want to die. Brett returned to AA meetings.

Now, he mentors those new to the program. That's a big part of AA, being there for others. It helps to keep the long-term AA member sober as well.

"If we don't work with a new person, we forget where we come from," Brett said. "The meetings aren't the program; the steps are the program. If I take somebody through the steps, I'm taking them with him. Nothing assured permanent sobriety as much as working with new people to the program."

These days, Brett helps host meetings for AA. As of 2013, it had more than 2.1 million members and 100,766 groups in 150 countries.

According to the Mayo Clinic, alcohol use disorder can be mild, moderate or severe. Signs and symptoms may include: being unable to limit the amount of alcohol you drink; wanting to cut down on how much you drink and/or making unsuccessful attempts to do so; and using alcohol in situations where it's not safe, such as while operating machinery, driving or swimming.

Las Vegas Recovery Center works to help alcoholics detox

Dr. Mel Pohl, medical director for the Las Vegas Recovery Center, 3371 N. Buffalo Drive, said 30 percent of the patients who come to the recovery center are there for alcohol issues.

"Often, that's combined with a drug dependency," he said. "That number is actually down in the last 10 years. It's evolved. Now, there's less straight alcoholism and more in combination with drugs or where drugs are primary."

Still, the facility sees hundreds of clients for alcohol in any given year.

"There are a variety of factors that influence whether someone develops alcoholism," Pohl said. "Genetics is (responsible) for about 60 percent of cases ... call it a vulnerability, and exposure to alcohol over time leads to addictions."

The doctor said trauma and stress are factors that can lead one to drinking, as alcohol allows someone to "self-soothe."

"So, where some people might be able to relax on their own or meditate, or go to therapy to ease their discomfort, people who have alcoholism can't do that — and this is key — the alcohol works (to soothe them). It fits into the brain almost like a key into a lock," Pohl said.

How does the alcohol affect the brain? It works on a receptor system and affects the chemical that flows between the nerve cells. When one is ready for sleep, the brain turns off the activation from the chemicals. Alcohol interrupts that message. It also affects the dopamine system, which is associated with pleasure.

"For those with alcoholism, they take a couple of drinks, and they get taller and smarter and are a good dancer, and they have a real sense of comfortable well-being," Pohl said. He said tolerance is developed over time, requiring more and more alcohol to achieve the same state of mind.

"They develop a physical dependence," Pohl said. "They can't stop if they wanted to, and alcohol is one of the more dangerous drugs to discontinue abruptly. Complications from withdrawal from alcohol are potentially life-threatening."

Withdrawal can lead to losing consciousness, and aspiration is the main cause of death in such cases.

Cravings will still haunt the alcoholic even after they stop drinking.

To detox, various medications are available.

"We use sedating drugs to help people get through the worst of it," Pohl said.

It can take three days to a week for someone to detox from alcohol. They'll spend another two to four weeks after detox at the center. More is preferable, Pohl said, but longer stays are not always covered by medical insurance.

"Studies show that 90 days of treatment correlates with the best outcome," he said. "So, it really takes that long for the brain to start to change, to heal, if you will."

Treatment involves learning to live without alcohol and how to deal with the cravings. The patient also learns the reasons that underscored his alcoholism.

"About 60 to 80 percent had some significant trauma in their life," Pohl said.

After detox, physicians may prescribe short-term medications, such as Naltrexone, which blocks part of the brain where cravings occur. Other medications are Antabuse, which causes one to regurgitate if they drink, and Vivitrol, which is an injectable that lasts a month.

"If medications are used, they're a small percentage of the battle. They help people manage, but it's really managing the stressors, depression and anxiety that have to be dealt with," Pohl said.

Establishments have policies in place for dealing with overdrinking

Casinos and taverns have policies in place regarding alcohol use. Tim Etter, whose family owns Tenaya Creek Brewery, said his employees keep an eye out for those who imbibe too freely.

"It used to be called TAM, Techniques of Alcohol Management," he said. "It's called TIPS (Training for Intervention Procedures) now, but it's a certification required and something we encourage. The last thing you want to see is somebody intoxicated to the point where you have to cut them off."

The National Institute on Alcohol Abuse and Alcoholism defines one standard drink as any one of these: 12 ounces of regular beer (about 5 percent alcohol); 8 to 9 ounces of malt liquor (about 7 percent alcohol); 5 ounces of unfortified wine (about 12 percent alcohol); and 1.5 ounces of 80-proof hard liquor (about 40 percent alcohol).

Etter said his bartenders follow the "green light, yellow light, green light, red light" guidelines for drinking. Yellow means to have caution, that maybe the person can handle only one or two drinks. Red means they can have no more alcohol. In those cases, they tell the patron that they're not OK to drive.

"All the cab companies, we have their numbers behind the bar so if you need them for a customer," Etter said. "We don't hesitate to call them."

AA provides roadmap for way out of cycle

Many battling the disease turn to AA like Brett did.

View visited an open discussion AA meeting held at the Serenity Club, 8990 Schiff Drive, in September. The site also offers a more involved meeting, a book study of the best-seller "Alcoholics Anonymous." The books helps people understand the steps and how the program, which started in 1935 after the book's release, works.

There, attendees spoke on the condition of anonymity. They introduced themselves by first name only and shared their experience as it related to Step Two of the 12-step program. Step Two was that day's topic. It reads: Came to believe that a Power greater than ourselves could restore us to sanity. AA doesn't specify identifying that higher power with a name, leaving it up to the person to view it according to their own belief system.

The meetings at the Serenity Club see anywhere from 10 to 60 people. This day, about 20 showed up.

One man told how coming to believe in a higher power led to "knowing" that higher power.

"God is internal, in every cell of our being," he said. "You just have to learn how to get out of the way. When I came out of 'victim' mode, I could see it clearly."

Another man said it took a long time for him to admit he was an alcoholic.

"But once I conceded that, the rest (of the healing) started to come," he said. "I knew that no matter what promises I'd made, once I took that first drink, all bets were off. ... I used to have a spiritual connection. Alcohol took that away from me."

One man in his 30s said he'd been an alcoholic for 10 years, with the last two being "really bad." He told of being desperate to keep custody of his son, but he ended up appearing before a judge while high on pills and alcohol.

"It's insane," he said of the hold alcohol had on him. "I live with my mother now. She doesn't allow drinking in her house, so I go outside and sit on the curb to drink. I'm out there in the cold, next to a trash dumpster. ... I think about drinking all the time. But I believe in God, so I know I have a chance."

Another man said he had never been to church. When he entered AA, he was told to choose a higher power.

"I had no idea what they were talking about," he said. "Then I began to read the book, and it opened my mind to the possibilities. My life is so much better now."

Al-Anon meetings give friends, family members place to heal

The issue of alcoholism takes on a new dimension when one considers the impact on family members.

Every year, the Center for Behavioral Health Statistics and Quality, part of the U.S. Department of Health and Human Services, estimates that 7.5 million (approximately 10 percent of all U.S. children) reside in families where one or both parents have an alcohol use disorder. It notes that these children are at higher risk of depression, anxiety disorders and problems with cognitive and verbal skills. The offspring are four times more likely than other children to develop alcohol problems themselves.

View also visited an Al-Anon meeting, which provides support for families and friends of problem drinkers, where eight people who had been affected by living with an alcoholic were gathered. Al-Anon members also follow the 12 steps of AA as they strive to come to terms with their emotions. This night's topic was resentment. Just like the AA meeting, people took a turn introducing themselves by first name and then addressing their own situation. They spoke on the condition of anonymity.

"Without letting it (resentment) go, I was only choking myself," said one woman, who added that she could now think back on good memories with her father and smile.

Another told of reconnecting with a cousin only to get the cold shoulder and thinking, "Those alcoholics don't come through again." She said she repeated the Serenity Prayer over and over as she tried to cope with repeated snubs.

The Serenity Prayer, which is said at every meeting, reads: 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.

Another woman told how she stopped expecting her mother to live up to her promises and accepted her for what she was, saying, "How can I expect something from her when she doesn't have it in her to give?" She thanked the group for "loving me until I could love myself."

Yet another woman told how Al-Anon allowed her to accept and forgive and move forward with her life, calling it an "amazing program." She said she shared the program with her daughter to "help break those chains, so (the pattern) doesn't go on and on, generation to generation."

The facilitator of the group said children of alcoholics often go on to marry alcoholics. Why did she think that was the case?

"It's all we know," she said with a shrug.

Visit aa.org or al-anon.org.

— To reach Summerlin Area View reporter Jan Hogan, email her at jhogan@viewnews.com or call 702-387-2949.