This article belongs to Addictions theme.

Although the term has been common in the Standard American English (SAE) lexicon for many decades, the uses to which it has been put have been highly varied. Suffering the fate of other, originally specific terms such as "paranoid" and "schizophrenic", addiction has been casually generalized to overly cute, and often euphemistic, applications such as "chocoholic", "shopaholic" and "sexaholic".

Addiction, either as psychological, physiological, or as some combination of the two manifests in numerous ways. Most of them are anything but funny or cute. And, there is still scientific controversy when it comes to human addiction studies. Numerous animal studies support the physiological model for addiction. And, large case numbers for episodes of withdrawal, some with fatal or crippling outcomes suggest, in non-human animal and in human animal studies, that the addicted individual has apparently attained a new level of "normalcy". Hence, the behaviour which some label as an attempt to "get high" is not that at all; it is an attempt to avoid departing from the new normalcy.

As alluded to above, the concept "addiction" may be applied so universally as to become almost meaningless. For this article, the focus will be on alcohol addiction, usually known as "alcoholism".

My first encounters with alcoholism occurred in the late 1950's during my mid-teens. I became involved with a neighbour's family as the father, the sole income earner, progressed through a series of harrowing events. I noticed the reconstructed face of his wife, who had gone through a car wind shield. I noticed the withdrawn, almost apologetic behaviour of his two sons, who bracketed me in age. Yet, the common wisdom of the day was such that I did not generalize this situation; I did not sense this scene playing out throughout America. A few years later, seeing what, now, was obviously alcoholic behaviour among fellow Airmen in the U.S. Air Force also did not register.

But, in the 1970's and 1980's, having established myself as one of the first college instructors teaching college classes on Death & Dying, I was very quickly drawn into the larger community as many families saw the broad media coverage of my work, attended my classes, or were present at my workshops. Asked to come and spend time with families awaiting the death of a member, often at home, or asked to help a family work through a difficult passing, I was admittedly startled at the high percentage of cases in which alcohol related problems were involved somewhere in the case.

In such familial scenarios, it is easy to see the end stage patient at the center of a solar system. After all, it is his/her show. Close friends also may be in the orbit, sometimes closer than relatives. More distant friends and acquaintances orbit in fashions particular to their relationship, some as recurring comets, some as one time meteors.

Alcoholism is as an incurable but manageable (through A.A.) disease and commonly disparages any attempts to bring other resources to bear.
Common parlance has frequently linked "abusive" with "alcoholic", as in abusive alcoholic. While that is too frequently the case, it is often not accurate, unless one seeks to expand the concept abusive to include such things as neglect and the infliction of worry on those closely associated. These factors are frequently, if not always there. Yet, discussion of neglect may disclose some surprises. A frequent recourse for alcoholics, by choice or by some form of coercion, is Alcoholics Anonymous (A.A.). A.A., a confederation of local groups which has been very persuasively characterized as a thinly disguised religious cult, not only does not address the almost ubiquitous psychological issues underlying alcohol dependency (despite its "12 Steps"), it professes alcoholism as an incurable but manageable (through A.A.) disease and commonly disparages any attempts to bring other resources to bear.

Thus, in "switching one addiction for another", the A.A. participant may temporarily mitigate some of the familial worry, but at the cost of simply spending familial "quality time" another way (A.A. meetings). A.A.'s common answer to this is to try to recruit the family into satellite groups such as Al-Anon and even Al-Ateen, striving to convince family members that they, too, are sick; in this case, with the disease of "co-dependence".

Rarely does a family not have at least one member who wonders, "how did he/she get this condition" (the condition from which death is imminently expected). Where there is a history of alcohol dependency, it is always at least in the background. Even despite circumstances which warrant medical advice to the contrary, family members and even the patient may see some connection, even if nothing beyond some form of magical retribution. In these cases, it is necessary to get those involved to voice their beliefs, and to move beyond the recriminations. It is also necessary to uncover and address, as understandable, any feelings of relief that the painful part of this family history is soon to close. Working with the family, as a group, through all these possible permutations, even after the demise of the patient, brings resolution and productive reintegration.

This drama, however, is played out largely beyond the orbit of more distant family and friends. And, the results here can be disconcerting. People approaching the situation from a physical and/or emotional distance are usually not privy to the resolution and reintegration which has been developing in the immediate family. They often tread lightly, being careful to guard against any inadvertent reference to the addiction history, and to what they feel must be levels of unresolved anger and feelings of "poetic justice" within the family.

The family should not be expected to greet every visitor or mourner with, "Hi. Sorry you missed it, but we've had a great time fully discussing the addiction issues and we're all cool with that." So those who are just passing through this familial solar system for this particular event may be left to wonder. Perhaps, in time, their subsequent circumstances will allow them to understand and appreciate the changed family dynamics; perhaps not.

All this is a way of saying that, when addiction is mentioned as affecting some very large number of people, it's usually accurate, though the circumstances and the levels vary.