Alcoholism, also known as alcohol use disorder (AUD) and alcohol dependence syndrome, is defined as a broad term for any drinking of alcohol that results in problems. Alcoholism was previously divided into two types: alcohol abuse and alcohol dependence. In a medical context alcoholism is said to exist when two or more of the following is present: a person drinks large amounts over a long time period, has difficulty cutting down, acquiring and drinking alcohol takes up a great deal of time, alcohol is strongly desired, usage results in not fulfilling responsibilities, usage results in social problems, usage results in health problems, usage results in risky situations, withdrawal occurs when stopping, and alcohol tolerance has occurred with use.
"From one perspective, Nancy was given an incredible gift in her last days, she had the opportunity to say goodbye to family members, friends, and loved ones like Kat."
Health issues or forms of disabilities are something every person on the planet will experience at some point during their lifetimes. While society at large tends to minimize or entirely ignore this fact, even the healthiest person will experience health issues. Forms of disabilities may be the result of health issues, or they may be something a person is born with.
My girlfriend's name is Kathleen; people call her Kat for short. She is a Peace Officer for the State of Colorado and has lived in Pueblo, Colorado for the vast majority of her life. Kat's best friend through the years, Nancy, lived in the same small city for her entire life. Their friendship is interesting for several reasons.
The Early Years
On the very first day of kindergarten, Nancy's mother sat her down next to Kat and said, 'Sit here honey, she seems like a nice girl.' How could either of them know this one simple act by Nancy's mother would lead to a lifetime of friendship, one that seemed more like a family relationship as time passed? The two kindergartners found themselves together all the way through public education, having fun both at school and afterward.
High school found Nancy and Kat beginning to do something many teenagers at the time did, experiment with alcohol. Soon, both Nancy and Kat were drinking before class began; they were young, wild and free. Neither of them considered with any real sense of understanding what they were doing to themselves at the time. What mattered was living an enjoyable life as perceived through their own perspectives as adolescents.
Depression and Friendship
Young adulthood found Nancy and Kat reaching for many of the same things other young adults do. For Kat, this meant marriage to a man who would later become an abusive alcoholic, resulting in trauma. For Nancy, marriage was also something to pursue; fortunately, she married a man who remained with her until the very end, no matter what. Both of them pursued employment and did quite well. Both Nancy and Kat also continued to consume alcoholic beverages.
As the years continued to pass, both Nancy and Kat found themselves having children. Kat has two sons, while Nancy had a daughter and a son. Motherhood suited both of them well and they enjoyed raising their children. Both Nancy and Kat also continued to drink alcohol as a means of dealing with life, instead of drinking for fun and giggles as they did when they were in high school.
At some point, which is hard to define, Nancy began to experience some tough times. For Kat, the same was true. Kat's husband at the time became so drunk and violent that she divorced him and chose to continue raising her sons on her own rather than have her sons witness the actions of their father. For both of these women, depression became a part of life.
Depression does not come in a, 'one size fits all,' way. The experience of depression for Nancy was quite different than it was for Kat. Nancy found herself living in her home as her husband walked out the door each day, alone. She had lost her job and that job was keeping her away from some of the effects of depression. When Nancy lost her job, it became increasingly easy to reach for an alcoholic drink.
For Kat, time was needed to recover from the actions of her ex-husband. Kat's depression was also as unique as she is as an individual. Finding yourself facing a drunk and violent man who refused to leave you alone, even after a divorce, found Kat feeling far more than, 'just the blues.' Kat found herself working three jobs and drinking when she was not working.
For both of these women, alcoholism became a very serious issue. Nancy dealt with her alcoholism by consuming more alcohol. Kat looked around, understood her responsibilities as a parent and left the alcoholic drinks behind her in favor of her sons. Yet which came first, the depression? Or the alcoholism? As I know from personal experience, when people believe there is no way out and that doctors are unable to do anything for them, management of their own symptoms through drugs and/or alcohol is all too common. My own mother essentially drank herself to death; she experienced depression as well. It is far too easy for people who experience depression to fall into the trap of drug and alcohol abuse.
Alcoholism and Physical Damages
The last time Nancy visited our home, both Kat and I noted that she looked very jaundiced. Jaundice is a sign/symptom of kidney and liver damage. Nancy had become very irritable, although she was friendly and kind that particular evening. Her choice of alcohol was in the form of mixed drinks with vodka.
While Kat had stopped drinking to the degree of alcoholic status, Nancy found vodka to be her one relief from the depression she clearly experienced. The two life-long friends certainly had discussions concerning drinking, but life still continued. What Nancy did not seem to be aware of was the fact that her drinking was killing her.
Nancy experienced a day, not too long ago at all, when she was hospitalized. The health care team diagnosed Nancy with liver cirrhosis and kidney failure. The hospital spent a few days attempting to get her body to perform at least to the point where she would survive; they failed.
Provision of Care
The question for Nancy then became one of where her final care would occur. The hospital was simply too expensive, although hospice care was not exactly cheap. Kat began to understand that her friend since the first day of kindergarten was going to die. While Kat had overcome her own depression and alcoholism, Nancy was unable to make the same leap.
Hospice care arrived at Nancy and her husband's home to take care of her in her final days. The fact of the matter is it was just too late to do much for Nancy other than ensure she was not in any pain. The hospice nurse was a true professional, but that does not change the facts of the matter. Nancy died from her abuse of alcohol due to depression and a lifetime of damages done by the consumption of alcohol.
A Life Gone Too Soon
From one perspective, Nancy was given an incredible gift in her last days, she had the opportunity to say goodbye to family members, friends, and loved ones like Kat. Many people are not given this opportunity and Nancy was as strong as she was able to be through the dying process. Nancy was in her very early fifties.
When Nancy died, Kat was inconsolable for a period of time. Kat asked me more than once how she is supposed to live without her best friend in the world. With no real understanding of what it means to have a friend for an entire lifetime, I could do nothing but be there and console Kat as best I could.
For some, denial of things such as depression and alcoholism are easier than fighting to regain their lives. People can purchase alcoholic beverages all across America, the only requirement being that the person is over the age of twenty-one. Nancy died far too soon.
At the funeral, people celebrated Nancy's accomplishments in life and not the health issues or disabilities she experienced. People cried, people shared their memories of Nancy and they consoled one-another. No one mentioned alcoholism or depression.
Substance Abuse Awareness, including alcoholism, is represented by the red awareness ribbon. The month of April is NCADD Alcohol Awareness Month. Each April since 1987, the National Council on Alcoholism and Drug Dependence, Inc. (NCADD) sponsors NCADD Alcohol Awareness Month to increase public awareness and understanding, reduce stigma and encourage local communities to focus on alcoholism and alcohol-related issues.
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