According to 75yr Harvard Study, alcoholism is the worst indicator for a long and happy life.
Good stable relationship is the best predictor.
I see alcohol excess as a manifestation or symptom of poor relationship or poor connection with one’s tribe and oneself.
Alcohol, smoking, drugs, gambling, excess food, and other excessive “comforting or distracting behaviours” are at the tip of the iceberg. Disconnection, shame, and loneliness are often at the bottom, and are unlikely to be seen by the patients and others including Health Professionals.
In General Practice, we often see folks with disconnection/shame, leading to fear and anxiety, leading to fight/flight/distraction, leading to more disconnection and shame. This is a viscous cycle.
If we don’t improve the stuff underneath the surface, the top won’t improve sustainably.
So as Family Doctors, not only do we have to think about biopsychosocial, we really have to think about socialpsychobio.