Note from Eta Levenson: This is the second of three articles written by guest writer Lew Abrams, a well-known social worker in the field of chemical dependency who works with Jewish youth with chemical dependency issues. Last month’s column focused on understanding the basics of chemical dependency. In this month’s article, Abrams shares with us some of the common myths and misconceptions about chemical abuse/dependency. In next month’s column, he will discuss how all this impacts the family, and will give us helpful ideas of how to help our loved ones going through this illness. As always, we welcome your comments and questions about this article.

• The disease model of chemical dependency is an “excuse.” The belief exists that if we refer to chemical dependency as a disease, we let the alcoholic, addict or chemically dependent “off the hook.” After all, how can one be blamed for a disease they have? The reality is that every trained professional and treatment program, whether it be residential treatment, outpatient, intensive outpatient, partial hospitalization, half-way house and 12 Step Program, agrees that in order for the disease to be effectively arrested, the person with the problem must ultimately hold themselves “responsible and accountable” for their behavior, whether it be a substance or a process addiction. This means that intrinsic to the process of stopping and staying stopped from the addiction embracing that one owns the consequences of and takes responsibility for what has happened as a direct result of the addiction.

• Chemical dependency is the result of weakness, poor ethics and a lack of intelligence. Theses myths are in sync with ideas like the “disease is an excuse.” “If you were just stronger, smarter, a better person.” For an alcoholic, stopping drinking by the credo “Just say no” doesn’t work. If it did, there would be far fewer people with the disease of alcoholism. Studies have shown that alcoholics actually have a higher intellectual functioning, as long as they’re not drinking.

• Amount, type and frequency alone are enough to determine whether a person’s use of a substance constitutes abuse.

Frequency: There are people who drink frequently and do not have problems with alcohol.

Type: Problems can come from drinking beer just as they may occur with “hard liquor.” Calling certain types of alcohol beverages “hard liquor” (vodka, rum, bourbon, whiskey and Scotch to name a few) may be misleading, insinuating that they are more dangerous than beer or wine. However, beer, wine and “hard liquor” all have the active ingredient ethyl alcohol, which creates mood changes and may be habit forming. The ratio of ethyl alcohol to the other liquids in the drink determine the potency (% of alcohol in the drink). Remember, “It’s not the hops and barley that gets one drunk, it’s the ethyl alcohol!”

Amount: Tolerance and other variables play a role in “how much is too much.” Some teens just starting out experimenting with alcohol and have a low tolerance. It takes very little drink for them to have an altered consciousness and behavioral change. Because tolerance changes as use continues, especially if drinking increases, it is difficult to point to an amount of alcohol as a key determinant in whether or not a person has a problem with alcohol.

What is the definition of an alcoholic, of an addict? The most important area of assessment consistently becomes “what happens to the person when they drink alcohol, use legal, over-the-counter, prescribed, or street substances.” Simply stated, an alcoholic or addict is someone whose use of a substance and/or process is creating problems. Problems may be translated or linked to “loss.” Use of the substance or process continues despite consequences.

As an aside, I still haven’t figured out why liquor stores are an “essential” service in our society. With all the confusion, frustration and fear going on about COVID-19, I can only imagine the use and consumption of alcohol is going up—in part thanks to our state and local governments’ belief that people can’t survive without it.

Lew Abrams has over 40 years of experience in the fields of substance abuse and mental health treatment. Lew can be reached at 201-725-3627 or [email protected]

About Eta Levenson: Since the passing of her son Eric by suicide in 2016, Eta Levenson and her family founded the Eric Eliezer Levenson Foundation for Hope to fight the stigmatization of mental illness, raise awareness about mental health challenges and help prevent suicide. She can be reached at [email protected].