Alcoholism emerges from a drinking culture. Alcoholism is a serious health problem today, directly affecting a million of people in Pakistan. Alcohol is quickly absorbed in blood stream. Blood Alcohol Level (BAL) is a percentage of alcohol in the blood which determines the effect on behavior. The simple molecular structure of alcohol allows it to gain easy access to brain. The drinker feels happy, talkative, energetic, and euphoric. Performance on highly complex problems is improved with a little intake of alcohol. Alcoholic have a liver enzyme malfunction which speeds up production of a toxin acetaldehyde. Same amount of alcohol produce much higher level of this toxin in less time, hence, the word ‘intoxicated’. On the other hand, the break down of acetaldehyde in the alcoholics is performed about half a rate of normal drinkers. It is because of this error in metabolism that the acetaldehyde accumulates in blood. And don’t forget, acetaldehyde is toxic.

For most drinkers alcohol is harmless beverage. Yet for the minority who are alcoholics the criteria of the true drug addictionis fulfilled even after consuming small amount of alcohol. There is universal pattern of development of alcoholism; journey starting from drinking to alcoholism can be assessed by a feeling chart. The degree of mood swings can be controlled by the alcohol intake. There is no way of predicting when a social drinker will cross the line to fall into alcoholism. One person may enjoy drinking for a long time and the other may become alcoholic after a very short span. The drinker thinks that things are going fine, but an invisible line has been crossed into alcoholism, in which the formal drinker has been harmful dependent into alcohol.

The index of the process of disease is the degree of emotional cost. Emotional cost signal the beginning of the end of the good time for the drinker as well as the people around. The alcoholic still fails to understand the increasing clear sign of bio-psycho-social and spiritual destruction by alcohol. Even people around can see only the tip of ice-berg. Intellectual defenses rise to justify the emotional cost. Over a period of months and years the alcoholic self image continues to wane. Ego strength ebbs. At some point, this emotional stress becomes a chronic condition. Mood swings and changes in the personality are evident. And the drinking itself continues in spite of all efforts of well meaning people around to curb it. The alcoholic starts externalizing his problem by putting blame on others. Excessive drinking brings on lethal kind of depression and suicidal thoughts starting flashing through his mind. If the course of the disease in not interrupted, the end is certain to be suicide, either slowly with alcohol, or in a more direct violent way. Lethal depression is characteristic of the last stage of disease of alcoholism. A Chinese Phrase says, ’First a man take a drinks and then a drink takes a drink, and finally the drink takes the man.”

Alcoholism develops specific delusional system to justify their drinking defense mechanisms like rationalizationprojectionblackoutrepressions and euphoric recalls. When a near and dear spends a great deal of time with an alcoholic who is trapped in his delusional system, it is easy to get caught up in it. If he does not get help for him self, he moves on to codependency and become a shadow of alcoholic. The utmost role of family members is to halt this process of deterioration and move towards recovery by the intervention.