Alcohol, drugs and anti-life mentality
Gonzalo Herranz, department de Bioética, Universidad de Navarra
Alcohol, Drugs and Anti-life Mentality / Alcool, drogue et comportements en opposition de la vie
Thursday, November 21, 1991. 15:00h.
discussion paper in: VIª lecture International: Contra spem in spem. Drugs and Alcoholism against Life. Drogue et Alcoolisme contre la Vie.
Pontifical committee for the Pastoral Care of Health Care Workers.
Vatican City, Synod Hall. November 21-23, 1991
1. Alcoholism and drug addiction, as a quantitative expression of the anti-life mentality.
2. The anti-life mentality and the elements that comprise it.
3. Where to look for the remedy
The subject I have to deal with has a degree scroll (Alcohol, drugs and anti-life mentality) that has much in common with that of the lecture (Drugs and alcoholism against life). I am sure that the topic will be developed in depth and with extraordinary skill throughout the three days, in the communications and round tables of our meeting. I, perforce, must limit myself to deal with it only in outline.
Two points deserve, in my opinion, to be addressed in this preliminary reflection. The first is to make us position aware of the tremendous dimensions of the problem we are analyzing: alcoholism and drug addiction are not only an important manifestation of the anti-life mentality; they are an instrument of death of enormous quantitative importance. This is affirmed by the harsh language of mortality and economic cost figures. The second refers to the elements that make up the anti-life mentality and the relationship that this mentality has with the alcoholism-drug addiction phenomenon. The resulting image, not at all flattering, should move us to prompt and courageous action in favor of life, trusting in the power of hope against all hope, the "motto" of the Epistle to the Romans that inspires our work of these days.
Before I begin, I would like to focus my considerations on an ever-present idea that we must not lose sight of: that there are many human beings who, harmed by alcohol or drugs, are agonizing right now, living at this very moment the last minutes of their existence. They die, one or two every minute, in a parade that goes on day and night, victims of what is called, in epidemiological manuals, substance abuse. But, in reality, what kills them is not intoxication. They succumb to the effect of a strange and paradoxical syndrome, which, although as old as man himself, has never before harassed mankind as relentlessly as it does now. That syndrome is the anti-life mentality.
1. Alcoholism and drug addiction, as a quantitative expression of the anti-life mentality.
It is not easy for the healthy man to understand in depth the extent and intensity of the suffering that other men inflict on themselves with alcoholism and drug addiction. It seems to him absurd, meaningless. For the healthy person, his own life, with its crises and its hopes, is the greatest of fortunes, a treasure that God has freely given him, a marvelous gift that he must love, care for and protect. The healthy person knows that only by respecting his life will it be possible for him to fully realize his own adventure staff and write the days and events of his biography, that of the man who, precisely in himself, has been entrusted to him. For this reason, the healthy man finds it strange, incomprehensible, that another man, before the absurdly irresistible attraction of alcohol or drugs, consents to throw his own destiny out of the window, to destroy his life and, with it, the imago Dei that he carries in him. No one, not even a poet, will be able to describe, in its inner process and in its external causality, the vertigo of just one of these personal tragedies.
But if it is difficult for us to understand, unless we strain our capacity to understand in love to the maximum, what is really happening when a singular human being allows himself to be first attracted and then trapped in the labyrinth of drug addiction, this difficulty is increased by many orders of magnitude when we try to perceive the massive dimensions, qualitative and quantitative, of the global phenomenon of alcoholism and drug addiction. It is beyond man's comprehension that absurd sum total of human beings gone bad, each with his name and his terrible share of misfortune. To consider the problem, we must resort to cold, abstract, numerical terms. Only the methods of epidemiology allow us to measure the morbidity and mortality caused by these self-aggressive behaviors. But it happens then that the figures and statistical analyses we use hide the human, individual dimension of the problem from us, making it even more inaccessible behind the average truth of the mathematical treatment.
We know that alcohol and drugs are very important causes of premature death. If we put all their lethal effects into a single account, alcohol appears in the statistics of causes of death in advanced countries, immediately after cardiovascular diseases and cancer. But this sharp shortening of life expectancy is probably not the worst thing: alcohol and drug abuse induces in its victims a progressive biological deterioration, impoverishing the quality of physical and spiritual life. Alcohol and drugs are both an expression and an instrument of the anti-life mentality, for those who allow themselves to be dragged into their deadly trap not only devalue their own lives and anticipate their own death, but also make the lives of others very unhappy, creating around them circles of social discouragement and sadness about life.
Let's take a quick look at the situations in which alcohol and drugs express and instrumentalize this anti-life mentality.
It is worth noting at the outset something very important and significant: that women are particularly sensitive to the acute effect and cumulative damage of alcohol. The mortality rate of alcoholic women is significantly higher than that of non-alcoholic women or alcoholic men. Alcohol abuse thus consumes a specific damage to humanity in the very reality of femininity, both as a biological fact and as a particular and qualified value staff .
Moreover, at both the partner-cultural and biological levels, alcohol and drugs are particularly aggressive noxae for prenatal life. At the partner-cultural level, self-marginalization, which is so often part of addictive behavior, includes, among its essential features, a withdrawal of interest. This is limited to the immediate, to the self, to the present day. The addict ignores others and tomorrow. Many addicts think that, as things stand, there is no interest in bringing children into the world, that the ideal issue of children is zero. At the biological level, alcohol and drugs are particularly aggressive toxins for prenatal life. Other speakers will refer in this lecture to the fetal alcohol syndrome and the effects of drugs on the neonate. I am now interested in highlighting a few complementary data .
The abuse of alcohol and drugs induces, during pregnancy, risky situations for the child and the mother. The extreme sensitivity of the human embryo-fetal organism to alcohol is shown by the fact that it is enough for a pregnant woman to drink a glass of wine or a glass of liquor a day for the child to be born with a decrease in weight and a delay in birth development. In addition, alcohol or drug abuse often leads the mother to neglect prenatal hygiene advice, to neglect her own diet and to suffer from anemia. The addicted woman suffers frequent miscarriages or premature births; she is also often neglected in the care of her child. As the incidence of sexually transmitted diseases is higher among alcoholic and drug addicted women, children are often born damaged by these infections. In particular, HIV infection of drug-addicted mothers is one of the most worrisome aspects of AIDS epidemiology today. All these problems are particularly acute in the case of adolescent girls, where early sexual activity, pregnancy, and drug and alcohol use tend to be closely interrelated.
The anti-life character of alcohol and drug abuse is dramatically manifested in suicide. The relationships between personality disorders, substance abuse and the threat, attempt or completion of suicide are complex. The old assumption that alcoholism or drug abuse is a substitute for suicide, a chronic suicide, and that, therefore, alcoholics and drug addicts rarely commit suicide, is now widely believed to be erroneous. Some series of programs of study carried out in recent years and in different countries, with rigorous methodology, have served to demonstrate and, to some extent, to quantify the relationship between alcoholism or drug addiction and suicide. A significant proportion of suicides (between 15 % and more than 50 %) have a history of alcohol or drug abuse. The association between substance abuse and suicide is particularly marked in the case of youth suicide. In some areas, more than half of young suicides have a primary diagnosis of substance abuse (alcohol, cocaine and marijuana, often in combination) of several years' duration. Alcohol and drug dependence is nowadays included, together with psychiatric illness and marginal behavior, among the most reliable factors to delimit, especially among adolescents and young people, but also among adults, the group risk for suicidal behavior.
Alcohol and drugs destroy, through violence, many human lives. A well-known scenario is the road and the streets of the cities. According to very extensive and reliable statistics, although always biased (because the research breathalyzer test is only applied to a small fraction of those involved in traffic accidents), drunk drivers are responsible for one in five traffic accidents. But, more importantly, the accidents they cause are often more calamitous, accounting for a quarter of all serious injuries and half of all road fatalities. This puts the annual death toll on the alcohol tab at an estimated 20,000 to 25,000 in the United States and over 20,000 in the European Community.
Alcoholism and drug abuse are the determining cause of a large proportion of homicides. Although homicide is an enormously complex phenomenon, with considerable differences from one country to another, a sharp increase in alcohol- and drug-related crime has been observed worldwide in recent decades. In the Nordic countries, for example, the figures are devastatingly eloquent: in Finland, Iceland and Greenland, from the 1960s onwards, between half and two thirds of murderers and homicide victims were under the influence of alcohol at the time of the tragedy.
How many human lives are cut short each year by drugs and alcohol? It is not possible to obtain a figure that exceeds requirements demanding standards of reliability. The most careful estimates available come from the United States. There, the number of deaths caused by alcohol abuse in 1980 has been put at 69,000, and more than 6,000 deaths caused by drug dependence, accidental overdoses of psychoactive drugs, and drug-related homicides in the same year. Thus, 10 years ago, more than 75,000 deaths were caused annually in the United States by alcohol and drugs.
The economic cost of the alcohol-drug pandemic is difficult to assess. In the United States, the direct costs of treating addictive disease consume more than one-eighth of the enormous total spent on health care in that country. Adding direct costs (medical treatment) and indirect costs (lost productivity, property damage, etc.), the price that American society had to pay in 1983 for alcohol abuse amounted to $11.67 billion, and $46900 million for the abuse of other drugs. I confess my inability to comprehend this figure.
The transcribed data on deaths or economic costs referring to the United States could be extrapolated to obtain a shocking world total of money squandered, of lives wasted, unproductive, incapable of effort. And, above all, of premature deaths. I said, in passing, at the beginning, that not a minute goes by without someone dying as a result of this plague. The world should dress in mourning and groan with grief. But, paradoxically, this vital hemorrhage is condoned, endured with very little pain. The widespread social tolerance of alcohol and drugs, the indifference that stifles the noble efforts to deal with this expanding plague, is easy to explain. One reason is enough: among men, the anti-life mentality has taken deep root.
2. The anti-life mentality and the elements that comprise it.
As something negative, as aversion and rejection, the anti-life attitude is based on selective ignorance, on not wanting to know about life. In order to destroy one's own life with drugs or alcohol, or to watch with indifference as others crush it, it is necessary that everyone has an impoverished notion of what each human life is and what it is worth. There is, around life, a conspiracy of silence. The majority today are those who prefer not to think about such a lofty matter; those who, allowing themselves to be intimidated by the currents of opinion of the moment, have narrowed their consciences and gregariously accept the permissive customs and laws of so-called advanced societies; those who no longer feel any curiosity about the meaning and purpose of life. One comes to have a mentality against life by the simple transcript of not wanting to know about it, of refusing to think about it, about its mysterious character. Life, for many, has become an irrelevant routine, disconnected from any relationship with God. It is then possible to decline the responsibility staff of administering it, and to consider human beings as things, dispensable, replaceable. Many people today live indifferent to life. Their attitudes have been shaped by the influential culture of death.
In the Education of modern man, the teaching about life has disappeared. Incomprehensibly, what is and what is worth the life of a man is not, in this time free of prejudice, topic of Education general, academic matter. It is neither part of the content of the elementary biology or civic Education courses of the high school diplomaIt is neither subject of the curriculum of programs of study of the Schools of Philosophy, Biology, Law or Medicine. If we were to ask people what they think of their own lives, the answers of many of them would astound us by their one-dimensional, tautological, rudimentary character, poor in content and meaning, closed to transcendent dialogue with God, blind even to the dignity of their physical context, ignorant of the respect that each one owes to himself in his own body, in his entrails, his skin or his bones.
The anti-life mentality finds an excellent breeding ground in that specific bewilderment of today's man, characterized by an almost unlimited capacity for technical minutiae and the simultaneous obfuscation of intelligence for what is essential and basic. In a world in which economic calculations take up much of the time of people's inner dialogue and conversation, almost no one cares to consider what a man's life is and what it is worth in non-economic terms.
Human violence does not only cause the direct victims of war, street brawls, gratuitous aggression. It involves us all through an indirect phenomenon: we are saturated with information about violence, we are victims of habituation, of boredom. Almost every day, as we read the newspaper or watch the news, a massive procession of death parades before us: natural catastrophes, traffic accidents, victims of terrorism or civil war, urban violence, malnutrition, hunger: a procession of countless human corpses, anonymous, repeated, faceless.
In the mind of the man in the street, full of information, anesthetized or satisfied by the hasty interpretations of the commentator of the moment, the appreciation of life has been devalued, for the simple reason that it is not possible to have so much compassion. There is no longer time for mourning or reflection, because after one piece of news comes another that demands our attention. No dead person is so important any more, nor any crowd of dead so numerous that they can be 'topical' beyond the few hours of official mourning, the few minutes that the news lasts, which is more an exercise of rhetoric of images than a human message of compassion. Death has been trivialized: it is no longer mystery or destiny. It has become mere fleeting news. Death no longer financial aid to understand life. We have been subjected, thanks to the information we are served every day, to a process of mithridization: we are capable of ingesting, without experiencing any disorder, massive doses of deaths. The dead are simply too numerous to take care of them, to give them importance.
It happens, moreover, that the living are too numerous for any of them to be of importance. The neo-Malthusian ideology, which is today a solidly rooted element in the thinking and actions of advanced societies and of the populations culturally colonized by them, reduces our identity to being a multitude, issue, a mass, which threatens to exceed a critical size. For the credulous neo-Malthusian, human life, every human life, is a potential danger. Thus is born and expands the notion that there are human beings who are surplus to requirements. Consequently, some of them are marked with the stigma of being unhappy, unproductive, or simply unwanted, so that their elimination is socially accepted, through contraception, abortion or euthanasia, because their life is superfluous, annoying or lacking in quality. For the neo-Malthusian mentality, so obsessed by the quantitative, the value of any human life, the broken one divided by seven billion, appears as an insignificant magnitude, empirically imperceptible: each individual man is an infinitesimal fraction of humanity. The death of many, the terrible toll of years of life lost through premature death, of lives aborted before birth; the non-existence of those whose lives were deliberately not conceived, is ultimately transmuted into gain. The anti-life mentality glories in being a safety valve for excess population pressure.
Sensitivity to individual life has also been lost. Very few people today speak of the wonder, the miracle, that is each human being, of each and every one of the human beings that inhabit the earth. Individualism, seduced by things to be had and enjoyed, has become blind to see beyond the apparent. The animalis homo does not perceive the things of the soul. There are few who profess the belief that every human being, including the handicapped, perceives the world, interprets it, constructs it, thinks it in his own way staff, unique and unrepeatable. The wonder of wonders is not that the genome of each one of us, the DNA received from our parents, is singular, different from that of all other human beings. The great thing is that each one of us is capable of knowing the world, of loving it, of enjoying it in core topic absolutely our own way, staff; above all, that we have, in the eyes of God, an untransferable destiny staff to fulfill, a soul to save.
But the responsibility that everyone has for himself - before himself, but also before others and before God - has become, for large sectors of the population, intolerably heavy. The moral life is for many an annoying, unbearable burden. It is more gratifying to ignore oneself or to live the fragmented and anonymous existence of the automaton than to repent and change one's behavior. An essential means to facilitate and accelerate the process of turning oneself into a stranger, a stranger, is the resource to psychotropic hedonism. Alcohol has always been used to drown one's sorrows and memories. financial aid It happens now, however, and to an increasing extent, that many "normal" people, faced with the stresses of ordinary life, turn to alcohol or minor stimulants or tranquilizers to obtain the "gas" necessary to face their professional duties or to get rid of anxiety, insomnia or a declining vital tone. The sales figures for alcoholic beverages and psychotropic drugs point to the existence of a widespread state of alcohol and drug dependence, as well as a growing intolerance for the rough and tumble of life and for the minor symptoms of emotional stress. Humanity is moving towards the implementation of a scientistic-reductionist model for the ordinary life of people: everything is physical -Chemistry, man is molecular.
The Chemistry takes the place of virtue, the mechanism replaces life. Alcohol and psychotropic substances occupy an increasingly larger space in the affective, intellectual and moral life of many men. Whether by dulling emotions, or by providing pleasure, the molecules are taking possession of many lives. The phenomenon is alarming. The social extension of drug dependence, not only drug dependence, should not be understood only as an epidemiological status of great diffusion: it is already, in a certain way, a sign that a mutation of man's identity is taking place, that a new human subject is emerging: man is conceived as a complex molecular mechcano. The mechanistic mentality holds that life, including that of the living man, can be fully explained in terms of molecules, in terms of mechanisms, in terms of non-living elements. There is no longer room for freedom: everything is reduced to molecular language.
As the complex molecular language of neurotransmitters, of their agonisms and antagonisms, of their brain topography, is deciphered and the art of designing molecules that modify them pharmacologically is mastered, both opportunities and risks will be created. Opportunities for increasingly competent treatment of mental illnesses; risks of having more aggressive or refined forms of psychopharmacological hedonism. Man will have to choose, then as now, between life and death.
3. Where to look for the remedy
(This section is undeveloped, although the outline is sufficiently clear).
Rebuilding respect for life. The struggle led by a society that winks at death in abortion and euthanasia. The ability to transmit the courage to live, to invite to life, cannot be done by doctors, health operators, ambivalent, who at times rescue and at times help to shipwreck. Lack of strength, not only of moral authority.
Medicine. Teaching drug and alcohol. data in AJDC, 1991;145:609. Ethical obligation to teach what is important. Unarmed physicians contribute to the consolidation of the indifferent-to-life mentality, a form of the anti-life mentality.
Education on the value of life. True biology. Respect for the physical body: respect for the receptors, for the cells. A physical anthropology of respect. The effects of disregard: Knox.
Family. Parental alcoholism. I'm my keeper. I'm my brother's keeper.
Centrality of the family. Inheritance. withdrawal of the children. I am my keeper; I am my brother's keeper. (Pediatrics, 1991;87:396).
Defeat of physicians. Chang. Jama. 1988;260:2533
To whom shall we go? You alone have the words of life (Ioh. 6:68).
Because this requires a kind of binocular vision: that we know how to have in the focus of our gaze, simultaneously and clearly, each of its singular victims and the endless procession that they all form.