Drug Dependence Review
The article: Jacobson IG., Ryan MA., Hooper TI., Smith TC., Amoroso PJ, Boyko EJ, Gackstetter G, Wells TS, Bell NS, 2008, Alcohol use and alcohol-related problems before and after military combat deployment, JAMA, 13;300(6):663-78
The high rates of alcoholism in America and Australia especially from the soldiers who come home from previous conflicts are quite evidence and devastating. Nonetheless, there are very limited literature material and evidences to show that this subject has been conclusively investigated. The current studies have explored the role of having laws that deal with alcohol, the societal norms on parenting, early use of alcohol as in adolescents and parental alcoholism impact on the children. However, it is important to note that the stress and the traumatizing experienced on the war field only vaguely address the reason why the ex-soldiers have widely been diagnosed with alcoholism.
What Are The Conclusions?
The conclusion of the article addressed the risk in the new-onset of heavy drinking, binge drinking and the alcohol-related crises among the soldiers who return from war. The study found that when people were deployed to go and fight in the conflicts that dominated the east, for instance in Iraq or Afghanistan, their return was highly related to heavy drinking and other alcohol related problems (Jacobson et al., 2008, p. 667). This was very common among the young officers returning from the deployment. The outcomes of the study are among the first to provide quantified changes in the consumption of alcohol among the returning troops. The use of intervention should concentrate on the mat risk groups as the authors suggest particularly the younger soldiers, reserve personnel and those previously diagnosed with mental disorders (Jacobson et al., 2008, p. 667). The study also suggested that a further prospective analysis by use of millennium data was important in the timing and longevity and possible co-morbidity of alcohol consumption and other related problems. There is also the need to better define the impact of military deployment on these very significant outcomes in health of human beings (Bray et al., 2010, p. 392).
Evidence
The results of the study indicated that there were two groups of participants in the research; those who were deployed and experienced combat activity and those deployed but did not get combat exposure. The follow up study of these groups of people indicated that those former solders with combat exposure reported higher post traumatic stress disorders rates higher than those without exposure. Other groups of people were excluded because they did not have baseline of follow up data in this study. These groups included the young non-Hispanic and African American, smokers and marines.
By assessing the data among the active duty personnel, the three main variables, that is, the new onset heavy drinking, binge drinking and alcohol related problems, it was found that they were highest in the deployed personnel with exposure to combat compared to the non-deployed. Proportionally, the reports of heavy drinking in women were higher than that of men especially for the new onset and baseline drinking (Bray et al., 2010, p. 392). However, more men report cases of binge drinking and alcohol associated problems (Stahre et al., 2009, p. 211).
The reserve or guard personnel also showed higher new onset dinking for the three variables and the rates were higher for the personnel deployed and were exposed to combat (Wilk et al., 2010, p. 117), those who were younger by time of exposure, those who served in the marine, those who were smokers by time of exposure, and those who suffers depression then (Bray et al., 2010, p. 392).
Do You Agree with Evidence
I totally agree with the evidence provided by the study because it is in line with a number of related studies in the past which indicate that the military personnel who have been exposed to combat have some kind of drinking problem. The commonest problem is the binge drinking among the active duty combat staff and the problem has a strong relationship with the occurrence of the alcohol health and social problems among these individual (Bray et al., 2010, p. 397). Sometimes the effects of alcoholism affect their job performance like driving. These statistics are drawn from the centre for disease control and prevention and supported by the University of Minnesota.
Binge drinking which is basically the consumption of more than four units of alcohol in women on one drinking session units (and five units for a man) is the commonest problem (Bray et al., 2010, p. 396). Studies show that about 43% of the active duty military staff over the previous year had engaged in binge drinking and the ages of these personnel was averagely 17 to 25 years. More than half of the combat and active personnel report binge drinking in comparison to non-binge drinkers. The binge drinkers also record highest rates of alcohol associated problems like driving under the influence and poor performance at work (Gunzerath et al., 2010, p. 18; Stahre et al., 2009, p. 211).
Because of the possible impact of the drinking problem among the military staff, this could be a serious risk to the military men and people around them. Heavy drinking has become common among these military personnel and its strong association with adverse health and social impact is scary. This needs to attract effective intervention like enforcing minimum drinking age and amount in military personnel (Gunzerath et al., 2010, p. 18).
Conclusions Justified
The conclusions are justified because the patterns of drinking have been shown to have strong correlation with the health and social impact on consumers. Besides, the cause of the drinking has been proven by a number of other studies to be a strong influence for drinking (Gunzerath et al., 2010, p. 19). Studies of drinking problem among the military personnel may not be generalizeable to all war veterans but there is strong evidence that military service particularly combat was associated with alcohol abuse consequently leading to higher prevalence of alcohol-related health problems or social problems as well (Coughlin et al., 2011, p. 7).
The causes of increased drinking in the military personnel is quite intriguing since the reports of heavy drinking are reported highest among younger staff (17-25 years) and also among the marines. For instance, the marine and army have a drinking rate of 32 and 31 percent a rate that is way far higher than that of civilian population (Coughlin et al., 2011, p. 8). Many of them claim drinking was a way of adapting to new life and social status and fitting with peers (Wood et al., p. 21). That means alcohol was a social ingredient essential for socialization (McKenzie et al., 2006, p. 1689). There are drinking rituals or routines that promote this type of drinking as many of the drinkers drink with colleagues even during the week days and deployment liberties (Van Der Vorst et al, 2005, p. 1464). Availability of alcohol to the young military officers also encourages drinking habits that are inappropriate (Coughlin et al., 2011, p. 9). Even underage recruits can easily gain access to the alcohol in the barracks bars and businesses near their bases and to make matters worse the alcohol at these stations is cheaper (Stahre et al., 2009, p. 216).
Doctors Fail To Diagnose the Problem
In most cases, doctors fail to correctly diagnose drinking problems among their patients. This is because many are reluctant to conduct screening tests for alcoholism and do not take time to recognize the symptoms of alcohol problem (Buddy 2008, para. 2). Some doctors may lack adequate experience in alcohol problems and consequently often attribute the symptoms to other possible causes like depression, some have negative attitude for alcoholism or they could be generally reluctant to bring up the issue for discussion (Coughlin et al., 2011, p. 7). Additionally many people with alcohol problems are in denial or have another co-morbid disorder like depress, it could be problematic to make the correct diagnosis.
Diagnosis of alcohol problem is assessed depending on the impact alcohol has on the individuals life and the drinking habits and this is why doctors ask questions that mainly focus on the use of alcohol of the individual, the symptoms, the daily performance at work or at home or in social places and finally the psychological and psychiatric abnormalities (Buddy 2008, para. 2).
The doctor may administer a questionnaire and also perform physical test and laboratory test to confirm other related health problems and could then determine whether or not the individual in question has an alcohol problem (Buddy 2008, para. 2). Drinkers’ honesty and willingness to take part in the process of diagnosis also affects the doctor’s ability to correctly diagnosis. Considering that denial is a major symptom, and then this makes accurate diagnosis even more difficult.
Doctors Who Do Diagnose Alcohol Problems in Patients Respond Inadequately
There has been a problem in managing alcoholism even when its correctly diagnosed because the doctors sometimes lack proper training for such cases because of the residency, or the courses taken in medical school, their personal scepticism of abuse treatment and efficacy, uncomfortable feeling to discuss alcohol abuse, the patient noncompliance or uncooperative behaviour and the time constraints.
A very small percentage of doctors regarded themselves adequately prepared to diagnose and manage alcohol problems in patients. This is the same for other cases like illicit substance abuse and prescription drug abuse. Contrastingly a larger percentage of doctors are often ready and consider themselves well prepared to diagnose and treat diabetes, depression, and hypertension. Some physicians consider treatment for alcohol abuse to be very ineffective therefore is very reluctant to take the initiative of administering the intervention in the first place.
Problematic Drinking Is Partly Genetically Mediated
The National Institute on Alcohol Abuse and Alcoholism (NIAAA) reports that an individual’s risk of developing problematic alcohol drinking was 60% determined by his or her genetic makeup and the 40% was due to the environmental factors (McLeod, et al., 2001, p. 261). If these statistics are true, then it means that there is serious trouble of combating the issue because one cannot change the genetics of a person (McLeod, et al., 2001, p. 261).
There are some important studies that are important in the study of the genetics so that there is valid evidence of genetic influence. The family studies have been significant and they are used to investigate the issue of drug abuse among family members. The researcher of this topic have used the family history and structure information collected from proband and varied criteria for the study. A number of studies now show that there is a strong connection in familial influence on alcoholism even thought different criteria have been used for the diagnoses and ascertainment. The recent works of Mirin have shown that male members of extended families were almost twice likely to show symptoms of alcoholism than the female relatives (McLeod, et al., 2001, p. 266).
Adoption studies on the other hand showed that there is significant correlation between drug abuse in the adopted person and alcoholism in the biological parent with a big odds ratio of 4.3. However there was no increased risk if the adopting parent had a drinking problem. This is unique evidence of genetic basis for the alcoholism heritability. If the biological father was an alcoholic, then the risk was higher.
The twin studies also investigated the genetic evidence of alcoholism in families. McLeod, et al., 2001, p. 267 studied twin concordance for alcohol abuse for 50 participants who were monozygotic and 64 dizygotic participants- a proband in alcoholism was identified in the rehabilitation. The results of the studies indicated that alcoholism was 31% attributable to genetic components of the individuals. The corresponding statistic for the problem of alcohol dependence was 60%.
The Social and Psychological Factors of Alcoholism
There has been considerable focus on the relationship between stress and the consumption of alcohol. Studies indicate that people who suffered post traumatic stress disorders were also likely to be alcohol abusers (Kissin et al., 2008, p. 24). The connection is also evident among the combat military personnel who experience traumatic experienced in the war (Wilk et al., 2010, p. 117). Studies haves shown that these personnel engage I heavy drinking compared to those who did not experience the trauma. Studies of alcohol abuse in women on the other hand have shown that victims of sexual assault shown increasingly heavy consumption of alcohol compared to the normal population. The reason is that they use alcohol to help them cope with the post trauma stress (Kissin et al., 2008, p. 24).
On the social context, parent behaviour and peer influence are the top causes on alcohol problems (Wood et al., p. 21). The issues reviewed ranged from parental behave like the use of alcohol and the greater context on the societal and cultural influence. Broader model and specific studies like social developmental models indicate its proper to address the broad and specific context where individuals and families are embedded (Wood et al., p. 21). This would include laws, social values and culture. In places where the culture allows drinking or societies that deem drinking as classy, problems of alcoholism are high since alcohol is highly addictive (Prescott et al., p. 32).
Alcohol is mainly used for socialization and parents can begin early by alcohol specific socialization strategies where they can prevent the problem of drinking among their adolescents (Van Der Vorst et al, 2005, p. 1464). Strategies to apply would include stringent rules on alcohol consumptions, explicit expression of disapproval of drinking and discussions about alcohol at home.
Treatment Effectiveness and Compliance with Treatment for Patients with Alcohol-Related Problems
Compliance with the treatment for alcohol related problems has been observed to be very poor among patients or individuals diagnosed with the problem. Nonetheless, people getting into the treatment program come in reluctantly because denials as already indicated is a major problem. Therefore it is very important for the family members and other loved ones to take part in the intervention process. Family based intervention models have been among the few effective methods of managing alcoholism. Based on the situation, the intervention can be a shirt session and counselling program or inpatient stay. The first step should be to determine whether the patient is alcohol dependent or not.
Reference List
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