Alcohol addiction is characterized as the inability to regulate drinking. When under this addiction, it is observed that they have a high reliance on alcohol when dealing with physical and emotional aspects of life. This dependence on alcohol has become increasingly deadly and affects many aspects of people’s lives. According to the 2015 NSDUH, 15.1 million adults ages 18 and older (6.2 percent of this age group) had Alcohol Use Disorder (AUD). This includes 9.8 million men and 5.3 million women (Substance, 2014). An estimated 88,000 people (approximately 62,000 men and 26,000 women) die from alcohol-related causes annually, making alcohol the third leading preventable cause of death in the United States (Center, 2010). In 2014, alcohol-impaired driving fatalities accounted for 9,967 deaths which is 31 percent of overall driving fatalities (National, 2015). This harmful addiction has been studied to find what actions can be taken to prevent or reduce alcoholism. Through behaviorist and social learning theories, combined with the three types of prevention, alcoholism has shown to decrease.
Primary prevention aims to avoid the development of a disease in healthy individuals. In primary prevention, the goal is to take certain steps to avoid having issues such as alcoholism. The best type of prevention begins with parenting styles (Kristjansson, 2016). Behaviorists believe in the concept that babies form certain relationships with the caregiver based on the level of attention and warmth given. These relationships, also known as attachment types, are early predictors of substance abuse probability (Berge, 2016). These attachment types later evolve into child temperament types which are considered future predictive traits. Neglectful parenting styles are viewed as the best indicator for future alcohol abuse. This neglectful parenting style paves way to child temperaments that also influence future alcohol abuse. According to Chess, the two most dominant indicators of alcohol abuse are the impulsive and lower frustration levels, both which are temperament traits. Active children who rush into new experiences also would likely be more at risk to experiment with alcohol as adults than less active children because they might see alcohol as new and exciting, not potentially dangerous (Chess, 1986). Research has also found that different temperaments follow distinct causal pathways to different childhood behaviors and some of those behaviors increase the risk of adult addiction. For instance, one pathway involves children with low fearful inhibition. Having a low fearful inhibition allow the child to be more at risk for alcoholism than others because they would be more likely to experiment with new substances. Having a low fearful inhibition makes them more curious than those with high fearful inhibitions (Frick, 2004). Another pathway involves children with problems of emotion regulation. These children would likely be more at risk to abuse drugs/alcohol as adults than children with higher emotional regulation because drugs/alcohol would, momentarily, help them reduce their emotional upset (Frick, 2004). Although neglectful parenting styles led children to more likely abuse alcohol, prevention during early stages of alcohol consumption is far more important than the role of the parent-child relationship.
Secondary prevention focuses on prevention during early stages of detection. For example, preventing alcoholism from getting worse. During this time, the person already consumes alcohol but is not at the stage where they heavily rely on it (not yet an addict). Social Learning theory is a strong model in which secondary prevention utilizes. For example, operant conditioning focuses on the increase or decrease of a behavior through reinforcement and punishment. Punishment plays a vital role in the development of addiction. If there is significant punishment during the early stages of addiction, it could potentially lower the probability of becoming an addict. For example, getting a DUI or medical problem will lower the chances of the person relying on alcohol in the future (Kirby, 1999). Although punishment could potentially lead to a decrease in addiction patterns, reinforcements has proved to be a more successful approach. By increasing reward for healthy behavioral choices, and by taking away rewards for addictive behavior, the potential addict can stray from future addictive behaviors. However, what is considered rewarding to one person is not rewarding to another. Community Reinforcement and Family Training (CRAFT) is a therapy which focuses on his positive reinforcement but stresses the importance of family members or those close to the addict. CRAFT teaches concerned significant others (CSO’s) to reward the addicted person’s positive, healthy behaviors which oppose addition. The CSO’s also learn to remove rewards for unhealthy behaviors which supports addiction (Manuel, 2011). For instance, a wife may plan a pleasant evening for her husband when he comes home from work, without stopping at a bar. However, if he comes home drunk, her kind attention is withdrawn. In this case, she would excuse herself from his company for the rest of the evening. By rewarding healthy behavior, and withdrawing rewards for unhealthy behavior, the wife is applying the principles of operant conditioning. This approach will increase the husband’s healthy behaviors but only if quality time with his wife is rewarding (Manuel, 2011). Another husband might find time alone to be more rewarding. Once again, we must target the rewards to each person. Frameworks such as CRAFT allow positive reinforcement to influence an addict’s decision on alcohol consumption based on family presence.
Tertiary prevention focuses on reducing the negative effects of a condition well established. In many cases, punishments for early addiction occur much later, when the addiction is already firmly in place. At this point, many chemical and physiological changes have already occurred in the brain. This makes it more difficult to discontinue the addiction. Simultaneously, unhealthy cognitive and emotional patterns have become well-established. This too makes it more difficult to change addictive behavior. Therefore, in these later stages of addiction punishment alone is usually insufficient to create a lasting change (Orford, 2010). Classical conditioning, part of the Social Learning Theory, works best as a tertiary prevention since it takes into account environment cues and associations. Therapists use classical conditioning to diminish and/or eliminate many types of unwanted behaviors. This includes addictive behaviors. Aversion therapy is one application of classical conditioning. In aversion therapy, we intentionally form a paired association between an unwanted behavior and an unpleasant experience. For instance, administering a drug that causes someone to become horribly nauseous and vomit if he/she ingests even the slightest bit of alcohol. This intentionally forms a paired association between alcohol and vomiting (Wikler, 1971). Prior to the aversion therapy, a person would ordinarily associate alcohol with positive feelings. After aversion therapy, alcohol is associated with nausea and vomiting. For many aversion therapy patients, the thought of drinking elicits feelings of nausea. The effect of aversion therapy can wear off over several months. However, during the period it is effective a person can learn to develop a new manner of healthy living. They can practice coping skills that strengthen their ability to enjoy life without alcohol. To clarify, although drinking is a voluntary behavior, cravings and desire for alcohol are not. Treatment from a classical conditioning approach (aversion therapy) diminishes craving and desire for alcohol by diminishing its appeal.
Primary prevention can best be established through parenting styles. With better parenting styles, the child will be more likely to regulate their emotions and deal with stress in others ways other than addiction. Operant conditioning best illustrates how early intervention can lead to a decrease in future addictive behavior. Tertiary prevention and classical conditioning demonstrates how environmental cues play a vital role in addictive behavior. Prevention can occur within the three stages to either prevent a person from drinking alcohol or to prevent an addict’s behavior to worsen.