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A glass of New Glarus Brewery's Spotted Cow beer. More than 400 new craft breweries opened in the U.S. in 2012 alone.

The bottom of the bottle: Alcoholism still tough to treat in an era of craft liquor

by Sara Kupper
Nov 21, 2013


Sara Kupper/MEDILL

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Evanston’s first craft brewery, Temperance Beer Company, started churning out batches of booze earlier this year; its first craft whiskey distillery, FEW Spirits, just won a $250,000 loan from the town for an expansion project.

With 409 craft breweries opening in the U.S. in 2012 alone and five times as many U.S. micro-distilleries in 2012 as in 2005, it’s clear that the small-batch liquor industry is booming. For some people, however, one sip of alcohol is a sip too many.

Alcoholism threatens many people in the United States. And it doesn’t just affect the 80,374 Americans who died due to excessive alcohol use between 2001 and 2005, but also those 18 million people who struggle with some form of alcohol abuse every day – a disease with a relapse rate of more than 70 percent, according to the National Institute on Alcohol Abuse and Alcoholism and the National Institutes of Health.

Five years ago, Kate B. was one such person. Kate, a 26-year-old recovering alcoholic from Colorado Springs, began abusing alcohol during her sophomore year of college at the University of Kansas. At first, drinking helped alleviate her insecurities about a new relationship, but soon Kate spiraled out of control. “I found myself becoming a closet drinker. I alienated myself from my friends. I quit going to classes. I was combining Gatorade and vodka to write papers. I took finals drunk. And nobody knew,” she said.

Things came to a head when a drunken Kate called Utah’s Cirque Lodge after hearing that actress Lindsay Lohan had recently checked into rehab there. “I need help. I have a problem, and I don’t know what to do,” she told Cirque Lodge’s admissions assistant.

The assistant notified her father, who traveled to Kansas and stood by Kate as she went through alcohol detox. She began attending 12-step meetings in Lawrence, and now she says she hasn’t had a drink since March 2, 2008.

There are many definitions for alcoholism. It’s “a pathological pursuit of reward and/or relief by substance use and other behaviors,” according to the American Society of Addiction Medicine. The Centers for Disease Control defines it as “a strong craving for alcohol” and “continued use despite repeated physical, psychological or interpersonal problems.” The Mayo Clinic’s definition highlights what happens when an alcoholic stops drinking; namely, he or she experiences withdrawal.

The fact that no two definitions of alcoholism are the same sheds light on why the disease is so difficult to diagnose and treat. “It’s multi-dimensional,” said Laura Parise, an addiction psychiatrist at Evanston Hospital’s Chapman treatment center. “There’s a high percent of heritability, but there are other factors -- social factors, psychological factors -- that contribute as well.”

“I think that part of it is a genetic disposition, and a part of it is behavioral. Somewhere I crossed that line between social drinking and alcoholic drinking, but I’m not sure where that line was crossed,” Kate said. She noted that she had trouble discussing her illness with her parents because, unlike many alcoholics, she did not have a family history of alcoholism.

Treatments for alcoholism include anti-craving medications such as Campral and Naltrexone, but the medications are most effective when coupled with psychiatric intervention, Parise said. “The rule, not the exception, is that people who have alcohol problems typically have depression, anxiety, or other psychiatric illness.”

Another well-known form of treatment is joining a 12-step program, first pioneered by Alcoholics Anonymous in the 1930s. The program “is based on the idea that with the help of a power within ourselves, we can find the power to stay away from a drink one day at a time,” said Rick Walker, staff coordinator at AA’s national office in New York City.

AA, a support organization with nearly 1.3 million members as of January 2013, chooses not to adopt a formal definition of alcoholism. “Most of us have the understanding that it is a mental obsession that compels us to drink, combined with an abnormal reaction to alcohol, so that when we start to drink, we continue to drink. We often call it an allergy,” Walker said.

Kate B. uses the lessons of the 12-step program every day. “The 12 steps are a set of tools that help me, on a daily basis, to deal with triggers and to keep my disease in remission,” she said.

She advocates the 12 steps at her new job as an admissions assistant at the University of Colorado Hospital’s Center for Addiction Recovery and Rehabilitation in Aurora, Colo.

To her patients, she offers advice born of her sobriety saga:

“People with alcoholism are not their disease, like people with cancer are not their disease and people with diabetes are not their disease,” she said. “They have a disease, but they have the tools to treat those diseases.”

(See related article on alcohol and mental illness: Pat's story)