American adults who are alcoholics or dependent on alcohol climbed from 13.8 million in 1992 to 17.6 million in 2002, growing from 7.41 percent of the population to 8.46 percent, according to a 2004 report by the federal National Institute on Alcohol Abuse. Whether you are a nurse or the family member or friend of a person with an alcohol problem, finding a treatment plan guided by a family theory that best fits the patient's situation requires careful thought.
History
In the Victorian era, sick people whose families could not nurse them were sent to public hospitals often staffed by nurses who were alcoholics, like the hard-drinking workhouse nurse, Mrs. Thingummy, in Charles Dickens's 1838 novel, "Oliver Twist." When Florence Nightingale created a modern nursing profession in Victorian England, she had to recruit students who were not alcoholics. Victorian medical professionals also struggled to transition from viewing their alcoholic patients as sinners to the modern view of alcoholism as an addiction. One Victorian era medical theory, described in a series of novels by French writer Emile Zola, suggested that alcoholism was entirely hereditary.
Current Family Theories
Currently, there are at least eight different theories of alcoholism, according to "The Grand Unification Theory of Alcohol Abuse," a 1990 paper by clinical psychologist Reid K. Hester and Nancy Sheeby, M.A. The theories that focus on alcoholics and their families are: the disease model, the general systems model and the biological model.
Disease Theory
The disease concept of alcoholism has been popularized by the self-help organization, Alcoholics Anonymous since its founding in the early 1930s, as described in a 2002 paper by Dr. Ernest Kurtz, "Alcoholics Anonymous and the Disease Concept of Alcoholism." AA members hypothesized that alcoholism was rooted in a physical allergy to alcohol, made worse by emotional and spiritual problems. AA suggests that alcoholics be sent to its self-help groups and given sponsors to mentor them through the recovery process. Groups for family members, Al-Anon and Alateen, were created because AA believed that alcoholism affects everyone in an alcoholic's family.
General Systems Theory
General systems theory as applied to alcoholism states that a family in which one person is an alcoholic is actually an "alcoholic family," a structure in which there are invisible rules, boundaries and roles that each family member plays, that help maintain the alcoholic's drinking problem. Helping an alcoholic involves consulting a family therapist and discovering the family dynamics that enable an alcoholic to keep drinking, according to family therapist Craig Chalquist, in a 2001 essay, "Twelve Characteristics of a Family System."
Biological Theory
Advocates for the biological theory of alcoholism focus on research showing that alcoholism is at least partly genetic, as discussed in a 2003 National Institute on Alcohol Abuse and Alcoholism analysis, "The Genetics of Alcoholism." Fifty to 60 percent of the risk for developing alcoholism appears to be genetic, so if several relatives of an alcoholic are also alcoholics, other biological relatives are likely to become alcoholics. Treatment would involve not only helping the alcoholic patient to stop drinking, but also discouraging other relatives from taking up drinking.
References
- Nursing Care Plan: NCP Alcohol Related Disorders
- National Institute on Alcohol Abuse and Alcoholism: The Genetics of Alcoholism
- Controversies in Addictions Field: The Grand Unification Theory of Alcohol Abuse
- Physician's News Digest: Managing Alcoholism as a Disease
- Alcoholics Anonymous and the Disease Concept of Alcoholism
- Serendip: Twelve Characteristics of a Family System
