THERE ARE ALCOHOLICS AND THEN THERE ARE ALCOHOLICS

by Lida Prypchan

“All we know of happiness is the word itself.  Our oldest companion is new wine.  Caress with your eyes and clasp in your fingers the only good thing that never fails: the living amphora of the blood of the grapevine.”                 (Omar Khayyam, Rubaiyat)

Unquestionably there are alcoholics and then there are alcoholics; they are rich and perfumed, poor and slovenly, ill-humored and aggressive, sweet and affectionate, weeping or silent, brilliant or dull, shrewd or perverse, refined or tasteless.  Those were not the parameters, however, which Fouquet and Jellinek selected to define their classifications of the main types of alcoholism.  The classification I am presenting here is an adaptation of the one established by Jellinek in which he elaborated upon certain aspects of Fouquet’s classification.

A.    The drinker with a dependence on alcohol: This is the individual with a psychological dependence, who finds relief from some emotional tension or some physical discomfort, or who simply claims to have courage to face “soberly” the burdens of everyday life.  He ingests large quantities of alcohol but does not lose control and is able to abstain.  Withdrawal symptoms are rare, unless consumption is interrupted abruptly, such as being hospitalized for injury or sickness (frequently cirrhosis of the liver or polyneuritis).

B.    The alcoholic who drinks wine:  This individual is able to control the quantity of drink which he imbibes at a certain moment and seldom needs to drink to the point of severe intoxication, but he is unable to abstain for one single day.  If he does, he experiences strong cravings and almost immediately displays withdrawal symptoms, which within a few days lead to delirium tremens.  He thus displays both physical and psychological dependence.  Few of these types consider themselves alcoholics, but the truth is that they are in a constant state of slight intoxication.  It is for this reason that this is a public health problem in wine-consuming countries such as France and Italy.

C.    The compulsive drinker: This is the individual who, once he has taken the first swig, drinks until his stock of money or alcohol runs dry, or until loss of consciousness or an accident ends the session.  This loss of control is accompanied by increasing tolerance, psychological then physical dependence, violent cravings, and withdrawal symptoms in the event of deprivation.  It is frequently observed in Canada, the United States, Australia and Nordic countries.

D.    The symptomatic alcoholic: In this, individual alcoholism is secondary to some psychiatric disorder, such as neurosis (phobias, in particular), psychosis (depression or schizophrenia), or some organic lesion (such as the initial changes accompanying a brain tumor).  It is particularly common in males who in time develop a physical dependence and addiction.

E.    The occasional drinker: This is the person who alternates brief periods in which he drinks pathological quantities, with long periods during which he is able to drink reasonably or to abstain altogether.  The weekend drunk belongs to this group.  This is the predominant form of alcoholism in Venezuela: those timeworn machos that, if they don’t go out for a spin and end up smashing into a wall, spend from Friday to Sunday boasting about their conquests.

F.    The dipsomaniac:    This one only drinks during brief crises (for hours or days) without anything else mattering to him; he generally hides away and ingests anything he can find in his path, drinking even eau de cologne, perfume or ethylated spirits, reaching a severe state of alcoholic intoxication which produces a comatose condition from which he emerges repentant and rejecting alcohol.  He abstains for long periods but as the years pass he develops an alcoholic neurosis.  Dipsomania is more common among women.

G.    The chronic alcoholic: This is the final fate of excessive drinkers, whatever form their alcoholism takes.  The chronic alcoholic displays psychological and physical changes, the latter being due not only to the unfortunate effect of alcohol on the various organs and systems, but also to inadequate nutritional habits and hydroelectrolitic disturbances.  This individual suffers constant diarrhea and nausea which aggravate his malnutrition even more.  This condition is frequently complicated by polyneuritis or cirrhosis of the liver followed shortly after by liver failure.  At this stage he feels drunk even after drinking small quantities, because his tolerance has decreased.  His economic situation deteriorates because he is incapable of work; he is rejected by his family and society and ends up in hospital for some physical complication or psychiatric disturbance such as delirium tremens, alcoholic hallucinosis, epilepsy or paranoid psychosis.

So, as a toast to the future of alcoholism in Venezuela, shall we serve another drink?