Animation and alcohol addiction

To understand why animation is needed and how it works as part of addiction’s treatment, we need to know more about the impact of alcohol dependency.

History of alcohol addiction

Alcohol addiction has a long and complex history dating back to ancient times. The consumption of alcohol has been part of human culture for thousands of years, with early civilisations such as the Egyptians and Greeks using it for medicinal and religious purposes.

The past three hundred years have seen a complex relationship develop between alcohol abuse, consumerism and capitalism, politics, crime and health – see Britain’s early 18th-century gin craze and American prohibition in the 1920s.

Cost has always been a factor in the use and abuse of alcohol, and the debate around its affordability rages on today, as alcohol becomes increasingly available and socially acceptable.

Causes of alcohol addiction

Alcohol dependency is the nature/nurture question writ large, typified by the (false) binary question: is it a disease or a choice? This continuing debate frames and informs political policy around crime and healthcare.

The various reasons for addiction, such as childhood trauma or genetic influences, that ‘cause’ alcohol dependency and determine the effectiveness of treatment are highly subjective.

Dependency seems to incorporate a constellation of physical, psychological and even spiritual (existential) components. The treatment of alcohol dependency is therefore most effective when it addresses all three components and is tailored specifically to each individual.

Alcohol’s impact

Alcohol is often consumed as a way of managing our feelings: specifically, a way of self-soothing and pushing aside uncomfortable feelings such as disappointment, anxiety and depression. It appears to us a harmless, much-deserved reward.

Physical effect

Alcohol is a depressant drug that slows down the central nervous system, which can result in the immediate physical sensation of relaxation and decreased inhibition. (Our brains usually rely on GABA (gamma-aminobutyric acid), an inhibitory neurotransmitter, to decrease nervous system activity and reduce anxiety. GABA activity basically has a calming effect. Alcohol consumption promotes GABA receptor activity, creating the feeling of relaxation. But this effect is artificial and we can build up a tolerance, meaning we need more alcohol to achieve the same feeling.

Psychological effect

When we look forward to a drink, we are already on an arousal curve not dissimilar to the arousal curve of sex and gambling. Psychological anticipation, the reward mindset, is a major part of the soothing mechanism. That’s when the dopamine kicks in – research has shown that our brains release dopamine (the feel-good neurotransmitter) in anticipation of a reward. And we see that glass of wine at the end of a long day as very much a reward… When dopamine is released, we feel happy, content. Then we come to associate the feeling of contentment that arises when we anticipate a glass of wine with the glass of wine itself.

The road to addiction

Broadly speaking, alcohol can initially be consumed, for example as young adults, with no real side effects. Drinks are shared in social situations, we become relaxed, enjoy ourselves, and suffer a hangover the next day.

But for some of us, as we age we come to rely upon alcohol’s ability to soothe. The psychological ‘it would be nice to have a drink now’ becomes a physical necessity, as our GABA system, the natural calming process, becomes reliant on alcohol to function. And as we continue to drink, rather than grow accustomed to it, alcohol withdrawals worsen, amplifying the initial ‘life’ anxiety and stress that might have led to us drinking in the first place.

Our brain alters to accommodate the increase in alcohol, coming to rely on it, so we drink more to get the same hit as before…

Later in life, alcohol starts to become a crutch first to eliminate the hangover, then to make ourselves feel better. The amounts of alcohol ‘required’ to relax can hit toxic levels, sometimes leading to blackouts, and drinking has to start earlier in the day and at an increased cadence to keep the ‘shakes’ at bay. If we try to stop drinking there is this huge deficit in the brain, leading to all the worst hangover and withdrawal symptoms.

By this point there will be all sorts of personal and professional problems mounting up, leading to our drinking even more to escape them. Quitting alcohol seems impossible, so we end up suffering a combination of dire economic straits, dementia (as our frontal lobe packs in) and/or premature death.

Treatment

The twelve-step programme (the basis of Alcoholics Anonymous, which originated in 1935) still underpins around 80 per cent of interventions (with all addictions). Because an addict believes it is impossible that alcohol will not always play a part in their life, AA treatment emphasises the importance of tackling the addiction one day at a time. Success rates are hard to measure because of the necessary anonymity of patients.

The pernicious disease of alcohol addiction encompasses the physical, psychological and spiritual (and, subjectively, personal), and treatment must tackle all areas.

Physical

The physical addiction has to be stopped – but instant cessation can be fatal. The DTs (delirium tremens or alcohol withdrawal syndrome) can involve chest pains, fatigue, headaches, heavy sweating, increased heart rate, nausea, seizures, stomach pain and shakiness, as well as anxiety, delusions, depression, disorientation, fear, irritability, nightmares and rapid mood changes. A period in ICU or private rehab is recommended and sometimes necessary. The addict’s body has to regain its equilibrium and their brain’s GABA system return to functioning without alcohol.

Psychological

Addiction to alcohol can be counteracted by an outward connection to other people. Alcoholics Anonymous engages a process of (what is akin) group therapy with likeminded people and fellow addicts. This addresses the stigma surrounding alcohol dependency, provides addicts with the space and time to explore what has happened to them – eg, childhood trauma – and gives them the opportunity to rebuild their lives. They have to develop personal coping mechanisms so they don’t fall back on old drinking habits as a response to anxiety, stress, etc, and they need to have the opportunity to identify and understand the ‘triggers’ that could lead to relapse. These triggers can be simplified as the HALT method: Hungry, Angry, Lonely, Tired. The addict checks in with themself at various points throughout the day, or when they feel ‘triggered’, to identify whether they are hungry, angry, lonely or tired and then utilise a healthy coping mechanism, rather than turn to alcohol.

Spiritual

Treatment should include a spiritual dimension – controversial but necessary. By the time an addict is through the door of Alcoholics Anonymous, or any other addiction treatment, they are convinced that they are definitively unable to halt their addiction. They do not believe that, by their own volition, they can stop drinking. Therefore, having faith in a power outside themselves becomes necessary to help them break the addiction. In Alcoholics Anonymous, the notion of God – or a god – has become more secular and is now more a case of ‘as you choose to understand him’. God could represent Great Out Doors, Group Of Drunks, Gift Of Desperation, Grow Or Die… This spiritual dimension quest is also helpful to maintain ongoing sobriety; the addict believes in a power greater than themselves that has their interests at heart.

(Despite periodic claims that ‘grey area’ drinking is an alternative, in my opinion this fails as a treatment option. Complete abstention is most successful. Statistically and anecdotally we’ve nearly a hundred years of evidence to show that the desire to keep drinking immediately manifests itself once the first drink is consumed.)

Staying sober

The good news is, lasting sobriety can be achieved. The frontiers of medical science are rolling back and the development of neuroscience is increasing our understanding of the impact of alcohol misuse. Once we cease consumption of alcohol, the brain’s natural GABA system recovers, providing us once again with a natural system of relaxation – which can, however, take weeks. There is also a better cultural attitude since the formation of Alcoholics Anonymous – the stigma attached to addiction is decreasing, so people can ‘come out’ about their struggles. We are seeing celebrity endorsement of sober lifestyles, such as by Robert Downey Jr, Stephen King, Sir Anthony Hopkins and Daniel Radcliffe, an increasing number of zero alcohol drinks, and more pathways to treatment, such as social media groups including ‘Sober Instagram’. There is also the wonderful work of charities such as Alcohol Change UK and National Association for Children of Alcoholics (NACOA).

But significant headwinds remain. Governments are still flip flopping around policy on the cost of alcohol and ‘safe’ unit consumption. Despite evidence in Scotland of the effectiveness of minimum unit pricing (MUP), there’s no sign of that being introduced by the UK Government in England and Wales. Chancellor of the Exchequer Jeremy Hunt cut NACOA’s entire funding in March 2023. Covid and the cost-of-living crisis are seeing a double digit rise in alcohol consumption, with no sign of this reducing any time soon. The alcohol lobby is also very powerful, targeting the next generation of drinkers via ‘alcopops’ and opposing governments’ adoption of MUP. Sports sponsorship by alcohol brands is still very much in evidence (for example, Casillero del Diablo and Manchester Utd, Guinness and Six Nations rugby, Budweiser and Premier League football) and even celebrities are in on the act – most surprisingly Gwyneth Paltrow’s health and wellness Goop brand website includes recipes for cocktails, even claiming the health benefits of gin and vodka – “they tend to be lower in sugar than other spirits”.

Power of animation

In this context of an increasing mental health crisis and apparent government and societal approbation of alcohol consumption, all methods of treatment can only be welcomed. Animation has a unique part to play as an adjunct to traditional treatment of alcohol addiction; its immediacy and accessibility can help addicts understand their condition in a non-threatening way. Animation can be accessed anywhere at any time, freely via social media, giving addicts agency over their dependency. It can be used affordably as part of national campaigns such as Alcohol Change UK’s Alcohol Awareness Week. Crucially, while Alcoholics Anonymous still does so much work to help addicts recover, it retains its hold on the ‘anonymous’ ethos, thus reinforcing a perceived stigma; an easily accessible animation, however, highlights the disease’s prevalence and reduces the shame. Animation provides the opportunity to understand and take control.

References

Psychiatrist and neuropsychopharmacologist David Nutt, former chair of Advisory Council on the Misuse of Drugs, said in a 2010 ACMD national study: “Overall, alcohol was the most harmful drug (overall harm score 72), with heroin (55) and crack cocaine (54) in second and third places.” This was based on a comprehensive assessment of the harms of various drugs to both the user and society as a whole. (David Nutt, ‘Drink?: The New Science of Alcohol and Your Health’)

“If addiction is part of humanity, then, it is not a problem to solve. We will not end addiction, but we must find ways of working with it: ways that are sometimes gentle, and sometimes vigorous, but never warlike, because it is futile to wage a war on our own nature.” (Carl Erik Fisher, ‘The Urge’)

“Addiction can only be beaten by the alignment of desire with personally derived, future oriented goals. The medicalisation and the disease model have outlived their usefulness”. (Marc Lewis, ‘The Biology of Desire: Why Addiction is Not a Disease’)