For a potentially addictive drug, alcohol, to state the obvious, alters the person’s state of consciousness in dramatic ways. Its contribution to loss of life is no less enormous. Research into the causes of alcoholism is grossly intricate and complex, because several reasons — physiological, genetic and social, among others — contribute to any individual’s compulsion to it.
Although substantial progress has been made in understanding the causes of alcoholism and treating it, the consciousness-altering substance affects millions each day. It alters their functioning, or physiology, including changes in their perspective of the world and also relationship with family and friends. As Shakespeare wrote, “I would not put a thief in my mouth to steal my brains.”
People drink alcohol for a variety of reasons. One example — perhaps, the most prevalent — is a desire to relax. Because alcohol, which is actually a depressant, helps them to rid themselves of tension and anxiety. In doing so, they move from a state of active consciousness to one in which their tension is relieved. After several drinks, they may behave in irrational, erratic ways. This ‘alcoholic’ state is not only dangerous for the drinker, but also for people around them.
Alcohol-related problems are medical, social and/or psychological. A person who presents with an alcohol-related problem is labelled a ‘problem drinker.’ They are also said to be involved in alcohol abuse. So, there it is. Alcoholism is, in essence, a clear physiological addiction to alcohol, not just alcohol-related problem. All alcoholics are often called problem drinkers. However, not all problem drinkers are alcoholics. Or, as Oscar Wilde put it, “Alcohol, taken in sufficient quantities, may produce all the effects of drunkenness.”
Social acceptance of drugs also has its base in alcohol — for long a socially-accepted drug. People now accept marijuana, cocaine and heroin use the same way. Each time one ‘tags’ a drug, which has no relevance to any ethical therapy, or even when it does, they change their ability to function normally.
While some drugs increase alertness and athletic performance, others are relaxing and relieve high levels of arousal and tension. They change our behaviour by altering our physiology and our normal state of consciousness. While all drugs are considered consciousness-changing, because they modify a person’s thoughts and moods, some also heighten physical and psychological habituation.
Any addictive drug produces a physiological reaction, more so when the drug is no longer administered, or taken. This is called dependence. Is there a way out of the addictive impasse? There is just no shortcut, or quick-fix, because the most fundamental requirement of any treatment plan should aim at the individual’s drinking or addiction status; it must also be tailored to meet individual needs, not one-size-fits-all approach.
It should, of course, not deal with the problem in isolation too, but with whatever physical, psychological or social problems that accompany it. All specific goals should be realistically and clinically defined — with the individual actively taking adequate responsibility for realising them, because one of the primary goals of any line of treatment would be the safe, effective and holistic control of addiction.

(The writer is a physician, independent researcher and author)
Rajgopal Nidamboor