Posted On: March 05, 2002          Updated On: March 05, 2002
© Terence T. Gorski, 2001

Terence T. Gorski, a leader in the field of addictions treatment, through interviews with hundreds of alcoholics and nonalcoholics and by observing their reactions when they drink, has developed a theory that describes four typical ways that people respond to the ingestion of alcohol. The first type of reaction, pattern one, indicates a low risk of alcoholism. Pattern two indicates high risk of alcoholism. Pattern three indicates the presence of alcoholism. And the fourth pattern indicates the use of alcohol to escape problems or painful life circumstances.

Pattern One
People who are in low risk of becoming alcoholic, the pattern one drinkers, have a limited tolerance for alcohol. When they drink there is a feeling of relaxation, a pure sedative effect. Each drink increases the sedation of the central nervous system, and there is a gradual and predictable progression toward intoxication. These people know how much they can drink to experience a certain reaction, and because they know, they can control it. Because they know ahead what is going to happen to them when they drink, they believe everyone does and usually cannot understand why some people cannot control their drinking or drinking behavior.

Alcohol exaggerates the mood these people are in when they drink. If they are happy, they become happier. If they are sad, they become sadder, or if they are angry, they become angrier. Hangovers will occur in proportion to the amount of alcohol consumed; the more they drink, the worse the hangover will be. Drinking several days in a row usually causes them to become so ill that they cannot continue daily drinking.

Tolerance for alcohol generally does not increase over a period of time. Practice does not make perfect. These people cannot consume the amounts of alcohol needed to become addicted, and therefore, are in low risk of developing alcoholism.

Pattern Two
Pattern two drinkers are capable of drinking large quantities of alcohol frequently enough to create addiction, but they do not show definite symptoms of alcoholism. They have the potential of developing alcoholism and may actually be early stage alcoholics.

Like people who are in low risk, they have a sedative reaction when they begin to drink; there is a feeling of relaxation. As they continue to drink, however, they reach a “click point” and enter a period of control-level or tolerance-level drinking. They do not experience the usual indications of intoxication. They can consume large amounts of alcohol and still function well and feel good.

While these people are in the period of control-level drinking, negative moods are counteracted. If they are angry before they start drinking, the anger disappears. If they are depressed, they feel happier. If they are under stress, they can use alcohol to reduce the stress. They learn to use alcohol to cope with stressful situations and do not learn to handle problems in other ways. There is not a physical need to drink, but as they use alcohol more and more frequently to feel good and to relieve stress, a strong psychological dependence may develop. Severe physical damage can occur while people are in the period of control-level drinking because they are unable to feel the damage being done by alcohol. State dependent learning occurs while in the period of control-level drinking.

Pattern two drinkers experience rapid onset intoxication. In pattern one there are progressive warning signs of intoxication. This is not the case in pattern two drinkers. They become intoxicated very rapidly and without warning. At times they may suddenly pass out, or they may become very agitated or violent. Because these episodes of loss of control happen infrequently, pattern two drinkers tend to ignore or minimize them. Because of high tolerance, they can mask and ignore physical damage and developing addiction, and they generally don’t notice early warning signs of alcoholism.

Pattern Three
Pattern three drinkers, people with alcoholism, react to the ingestion of alcohol much like pattern two drinkers except that there is a feeling of agitation that develops after the first drinks and results in an urgency to drink more. Alcoholics are powerless over this compulsion. They usually “gulp” the first few drinks to quickly reach the “click point” and relieve the feeling of agitation. When they reach control level they feel better, behave better, and do not appear intoxicated in spite of high blood alcohol levels. They take pride in the ability to “hold their liquor.” As the tolerance for alcohol increases, the body changes and adapts to higher levels of alcohol and dependence develops.

There is no longer just a tolerance for alcohol but a need. These people no longer drink because they want to but because they need to. People with alcoholism are not aware of the developing need for alcohol. They are usually in control, feel good while drinking, function better than when sober. But alcoholism is a progressive disease. It takes more and more alcohol to reach the click point and fewer and fewer drinks before becoming intoxicated. The period of control decreases and they get drunk more and more frequently. People with alcoholism are powerless to control the response of their bodies to alcohol and over the ability to control drinking behavior.

Pattern Four
At times people who may be any one of the first three patterns drink in a way that can be described as oblivion drinking. We will call this pattern four because oblivion drinking makes it difficult to determine whether these people are pattern one, two, or three. These people drink with the intent to get drunk. They use alcohol to escape physical or emotional pain. They have psychological, behavioral, and social problems because of drinking whether or not they are physically dependent on alcohol. Drinking affects their thinking, feeling, behavior, or social life, even if there are no physical symptoms. These people are dependent on alcohol to relieve pain. Pattern four drinkers may or may not be physically addicted to alcohol, but there is no doubt that they have developed a dangerous dependence. They need help to recover, and they must remove alcohol from their lives to resolve the problems it creates. Any type of dependence on alcohol requires treatment and abstinence for recovery.

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