Breaking the Ashes: The Culture of Illicit Liquor in Sri Lanka

8. Too Much Is Good for Nothing: Alcohol Dependence

8 Too Much Is Good for Nothing: Alcohol Dependence People everywhere strike a balance between pleasure and pathology when discussing alcohol consumption (Keane 2002). Martin Plant and Douglas Cameron write, “We drink alcohol because it is good for us, and study it because it is bad for us”(2000, 237). Small quantities of alcohol are good for the body and facilitate interactions, but excess drinking can cause physical, psychological,and social problems.An anthropological approach to alcohol use explores both “normal” and “deviant” drinking within cultural frameworks (Heath 1987, 19; Room 1984). Although the majority of drinking in Naeaegama takes place in a socially accepted fashion for pleasure and camaraderie , some alcohol-dependent men display harmful drinking habits. Naeaegama villagers tend to merge what happens when an individual drinks too much on one occasion (and gets intoxicated) with what happens when someone regularly drinks too much (and becomes addicted to liquor). Teasing apart these separate but related phenomena, I deal with issues of inebriation in other chapters by exploring the Sinhala concept of sihiya naetuwa (being without one’s right mind, memory, or consciousness) and considering some adverse effects of intoxication, including accidents, fights, domestic violence, and suicide. Here I examine excessive regular consumption of alcohol, particularly alcohol dependence. Beginning with a discussion of the physical effects of drinking,I explore the cross-cultural validity of the concept of alcoholism as a disease. To compare Euro-American and Naeaegama concepts of “problem drinking,” I examine how villagers identify and explain the physical, psychological, and social symptoms of addiction. I conclude with several case studies of heavy drinkers. The stories that drinkers, their families, and their neighbors tell to make sense of Too Much Is Good for Nothing 177 drinkers’ ailments reveal how people conceptualize the meanings, stigmas, and problems associated with drinking. Addiction Each human develops through an interaction of genetic potential and social and physical environment (Gould 1984). Without a conducive setting, potentials cannot be fulfilled. For example, a desert dweller with potential to be a great swimmer may never set foot in a pool, and a would-be pianist who never touches the instrument will never develop the ability to play. Alcohol addiction works similarly, resulting from“the interplay of a genetic predisposition with particular environmental circumstances which act to trigger a biopsychological response that we label ‘alcoholism’” (Marshall, Ames, and Bennett 2001, 159). Biomedical researchers suggest a “25–50 percent likelihood that the development of alcohol dependence may stem from genetic factors” (Acuda and Alexander 1998, 45), and Euro-American research indicates that alcoholism runs in families (Heath 1987). But without exposure to alcohol, the potential will never be realized. For example, in Sri Lanka’s rural social environment, women do not drink, so women who might have become alcohol-dependent if they had been exposed to alcohol never fulfill this potential. Even with exposure to alcohol, very few drinkers become addicts. In the United States, researchers estimate that only one in ten people have the propensity for alcohol dependence or habitual use (Royce and Scratchley 1996; Wilcox 1998). The World Health Organization suggests that globally, two billion people drink, but less than four percent of them have diagnosable alcohol disorders (2004a, 1). In the Naeaegama social environment, where men can, do, and in some contexts must drink, most moderate social drinkers have no problems. As mentioned in Appendix 2, 45.5 percent of Naeaegama ’s 277 adult men use alcohol at least occasionally. Among the 126 men over 18 who drink in Naeaegama, 34.9 percent drink occasionally, 27.8 percent drink at least once a month, and 37.3 percent (47 individuals) drink more than four times a week. At 37.3 percent, the percentage of drinkers in the heavy use category in Naeaegama exceeds both the national average (11.4 percent) and the district average (21.6 percent) (ADIC 2005, 7; see Appendix Tables 2.1 and 2.2).1 Among the heavy drinkers, a large portion is addicted to liquor. As with the manifestation of other human potentials, 1. In Appendix 2, I discuss several factors that may contribute to the differences between the numbers in the Naeaegama sample and the ADIC surveys. 178 Breaking the Ashes the causes of addiction lie in both biological predispositions and environmental contexts. Alcohol Metabolism The physical process of metabolizing ingestible alcohol (known technically as ethyl alcohol or ethanol) offers some clues to...