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Drugs."The denial, from the teachers to parents to abusers themselves is a big shock! Drugs what can we as a community do about it?" Susan Gitau Nurse/Counselor

In order to recognize alcohol dependence, it is necessary to understand that, as with other illnesses, there is an early stage at which the illness is reversible. This is usually before physical addiction has occurred. Two important symptoms will be evident here:

1. INAPPROPRIATE DRINKING,
   i.e. drinking at socially unacceptable times or in socially unacceptable situations. For example, the person may take a drink before going for an important job interview to "steady his nerves".
2. RELIEF DRINKING,
   i.e. drinking for the depressant, anaesthetic effect of alcohol which calms nerves, relieves tension, changes mood, etc. It may be said that alcohol is used in relief drinking purely as a psychological medication.

SYMPTOMS OF DEVELOPING ALCOHOL DEPENDENCE
Some of the more obvious symptoms are:

1. SECRET DRINKING.
   The alcoholic will go out of his way to hide the fact that he is drinking. He will hide liquor in all sorts of unlikely places where he does not expect it to be found and will often slip away to his "hideout" to take a quick drink.
2. GUILT FEELINGS.
   The alcoholic becomes full of remorse and shame about his drinking which results in him experiencing devastating guilt. This is compounded by the fact that he will make promises to the effect that he will "never drink again" and mean it at the time but will start drinking again to avoid withdrawal symptoms or feelings of anxiety.
3. GULPING.
   The alcoholic will begin to drink his drinks much faster than the normal social drinker and may consume a large amount of alcohol in a very short space of time. Very often, he no longer bothers to use mixers with his drinks ­ he simply drinks his alcohol neat. This is due to the fact that he desires the intoxicating effect of alcohol and, because his tolerance has increased, he will need to drink more to achieve this state.
4. SHAKING/TREMORS.
   This can be a fine tremor of the hands increasing in severity until there may be a gross tremor of the entire body. "The shakes" are common in people who drink excessively and are also apparent at the onset of the withdrawal syndrome. Other withdrawal related symptoms are heavy sweating, gastritis, nausea and, in some cases, delirium tremens and alcoholic seizures.
5. REGMAKERS.
   These are necessary usually in the early morning because the body has been detoxifying and getting rid of alcohol during the night. As the alcohol content in the body drops, the body begins to show signs of withdrawal. Withdrawal requires medical treatment, or that the alcohol content be topped up to the level to which the body has become accustomed. This leads to another symptom of alcohol dependence: physical compulsive drinking.
6. PHYSICALLY COMPULSIVE DRINKING.
   (or loss of control) Because the body has adapted to the excessive amounts of alcohol being taken, it needs to maintain this level to feel comfortable. As soon as the level drops, the alcoholic feels the need to drink more alcohol and now needs it ­ not to get happy, but to be able to function normally and also to prevent withdrawal.
   

   ONCE THE BODY HAS BEEN DETOXIFIED, ANY FURTHER COMPULSION TO USE ALCOHOL IS PSYCHOLOGICAL.

7. CHANGING DRINKING COMPANIONS.
   The alcoholic no longer cares with whom he associates ­ he will drink with anyone regardless of his or her difference in social status. All that was previously important to him as regards the way he chose his friends becomes irrelevant and he will mix with anyone provided they are drinking or offer the chance of drinking. In the early stages, the person who is developing alcohol dependence often changes to a new group of friends who drink more heavily than his usual social group, so that his increased drinking will appear normal.
8. BLACKOUTS/MEMORY LOSS
   In a blackout, the person, although under the influence of alcohol, continues to act in a normal fashion but has little or no subsequent recollection of his actions. Alcohol eventually causes a sort of short circuit of the memory function.
   

   The blackout must not be confused with "passing out" which is complete anesthesia of body function, apart from breathing, and can occur in any person who has ingested a sufficient quantity of alcohol.

9. GEOGRAPHICAL ESCAPE.
   The alcoholic moves around from town to town in order to "run away" from his guilt and to avoid facing the reality of what is happening in his life. It stems from his hopeful desire to make a new start where things will be different. He sees his drinking as resulting from external circumstances, some of which he can change by starting afresh in a new town.
10. SEXUAL DIFFICULTIES.
    Very often, the alcoholic becomes unable to achieve sexual satisfaction and may become totally impotent. This may not occur in every case. Even Shakespeare recognizes the "alcohol promotes the desire but takes away the ability."
11. LOSS OF APPETITE.
    Eating becomes irrelevant as alcohol satisfies the person’s hunger. Deriving his energy from alcohol, the alcoholic eats very little and without discretion to dietary needs with the result that his protein and vitamin intake are dangerously insufficient.
12. SUICIDAL THOUGHTS AND ATTEMPTS.
    The alcoholic often becomes intensely depressed which is a direct result of his drinking, as alcohol is a central nervous system depressant. Coupled with his guild feelings, despair and self-loathing, he may be driven to contemplate or even attempt to take his won life.
13. HALLUCINATIONS.
    The alcoholic may begin to see strange things and hear weird voices and imagine that all sorts of unpleasant things are happening to him. A hallucination is a sensory perception, which occurs in the absence of an appropriate external stimulus. It is important to remember that hallucinations are not conjured up at will ­ they occur spontaneously. They may occur as a result of extreme intoxication or during the withdrawal period.
14. DELIRIUM TREMENS/SEIZURES.
    Deprived of his needed dosage of alcohol, the alcoholic with DT’s trembles furiously, perspires in streams, becomes anxious, confused, disorientated and suffers delusions and hallucinations which are usually visual and tactile, e.g. that he is being stalked and attacked by all manner of terrifying and disgusting creatures ­ snakes in the corner, cockroaches and spiders under his clothes. He may also hear voices. This condition usually lasts from three to six days after which the typical alcoholic vows that he will never take another drink in his life. DT’s are symptoms of advanced withdrawal and the alcoholic must receive medical treatment immediately.
15. DRINKING ALONE.
    Initially, the alcoholic may spend a great deal of time in various bars drinking in company. Then he will reach a stage where he will make sure that he has a bottle to take home after the bars close. Eventually, he will not even make the effort to go out and will ensure that he has an adequate supply of liquor readily available at home where he can drink to his heart’s content ­ on his own.

Not all alcoholics will show all the above signs. Depending on how advanced his dependence is, he may only show a few. What is important is his loss of control over his drinking and the consequent deterioration in lifestyle.

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