Alcoholism and Silverberg family: Difference between pages

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{{Notability|fiction|date=May 2007}}

'''Alcoholism''' (Hopperism)(rel. [[drug abuse]]) is a behavioural and or chemical [[addiction]] to either or both the ''consumption of'' or the ''[[inebriation|inebriating]] effects of'' [[alcohol]].

{{in-universe}}

Whereas "addiction" is defined as ''"compulsive drug use despite negative consequences"''and drinking 2 litres of cider everyday (see max hopper) ([[American Journal of Psychiatry|AJP]] 2005), alcoholism is the continued abuse of alcohol regardless of the detrimental consequences to the [[health]] of mind or body.

The Silverberg family is a family of renoun military strategists from [[Konami]]'s [[Suikoden]] series of games. Among the characters listed are also those who have close ties to the Silverberg family.

In the ''Suikoden III'' manga, Caesar Silverberg attributes the countless successful strategists who have emerged from the Silverberg family as a result not only of the family passing down their teachings to a subsequent generation, but also because of each tactician's own personality traits. Throughout the course of history in Suikoden, the Silverberg family have been known to be heralds of change because of their involvement in nearly all the conflicts which have occurred.

Members of the Silverberg family frequently occupy the Tenki Star, the Star of Wisdom, amongst the [[108 Stars of Destiny (Suikoden)|108 Stars of Destiny]], which is the star assigned to the primary tactician of the hero or the Chikai Star, the Chief Star of Earth, which is assigned to the secondary tactician of the story.

Alcoholism is a multifactorial condition which has been controversially associated with both [[genetic causality|genetic]] and [[environmental causality|environmental factors]], in addition to behavioural aspects such as [[habit]], [[compulsion]], and self-destructive behaviour.

==Julian Silverberg==

==Discussion==

A legendary strategist who helped Karnach Rugner, ancestor of [[Barbarossa Rugner]], become independent from [[Harmonia]] without any bloodshed, creating the Scarlet Moon Empire more than 200 years ago.

The use of alcohol in this condition leads to impact upon physical, occupational, marital, educational, and other areas of function, despite which the individual continues to drink. The condition can be lifelong and can be sometimes treated through ongoing therapy accompanied by attendance at self-help meetings. Although medications have been developed to assist in the treatment of alcoholism, the research has not yet demonstrated long term efficacy for any specific methods of treatment. Alcoholics do not typically experience craving, unlike individuals afflicted with opioid dependence. Of importance is that frequency and quantity of alcohol use are not related to alcoholism; that is, individuals can drink a great deal without necessarily being alcoholic, and alcoholics may drink minimally and/or infrequently. As described in Psychiatric Annals by Pagano et al (June 2005), "alcoholism is a chronic, often progressive disease that can be fatal without intervention and treatment. Rationing or other attempts to control use fail as pathological attachment to the drug develops. Use continues despite serious adverse health, personal, work-related, and financial consequences. [[Comorbidity]], genetic, and psychosocial factors contribute to the risk of developing this disease." The lifetime prevalence of this condition was estimated in the mid-1990s at approximately 15% (DSM-IV-TR).

==Elenor Silverberg==

It is critical in a discussion of alcoholism to understand the terminology used in the field. There are many terms, such as use, misuse, heavy use, addiction, abuse, dependence, all of which have different and sometimes non-standard meanings. Use refers to simple use of a substance. An individual who drinks a beer once a day uses alcohol. Misuse and Heavy Use do not have standard definitions in the field. Addiction has two meanings: the first is that of an individual who develops tolerance to the use of a substance (needs more of the substance to achieve the same effect received from a lesser dose at an earlier point in time) or withdrawal effects upon discontinuing use. The second definition of addiction is the one given at the start of the first paragraph. The first definition refers to physiologic dependence, something which for certain drugs can be created in anyone taking the drug. The second refers to the "disease" state of interest to readers of this section, and which cannot be created in an individual simply through use of the drug. Psychiatrists and some others refer to the second definition of addiction as dependence. This is where frequent confusion arises since physiologic dependence does not imply the existence of the disease state which psychiatrists call dependence. For example, a test subject might be given alcohol in increasing amounts each day to the extent that the individual would have severe withdrawal if the alcohol were suddenly stopped; in this case, physiologic dependence has formed, but no disease is present. Similarly, an alcoholic in recovery is not drinking at all yet still has the condition just as a diabetic who keeps his blood glucose at precisely 100 (normal) all the time is still diabetic. Neither individual would be likely to suffer significant symptoms secondary to their ongoing illness, yet both are still afflicted.

Elenor Silverberg is the earliest known Silverberg since Julian himself. She was originally tactician for the Scarlet Moon Empire, but she was banished due to the actions of her subordinate, Graham Cray.

[[Image:King alcohol.jpg|frame|right|"King Alcohol and his Prime Minister" circa 1820]]

After this she headed south into the Island Nations where she settled on Hermitage Isle with her new apprentice, Agnes. She was recruited by the Island Nation Forces after hearing of Graham Cray's involvement and she eventually lead the army to victory against the Kooluk Forces. After the final battle she confront Graham Cray at the top of Fort El-Eal to question his actions which lead to his flight from the Scarlet Moon Empire and her exile. Fort El-Eal was destroyed in a massive explosion shortly after and it is believed that it was here that Elenor lost her life.

==Diagnosis==

There have been many efforts at diagnostic approaches to alcoholism.

Elenor appears in [[Suikoden IV]].

In a 1992 [[JAMA]] article, the [[Joint Committee of the National Council on Alcoholism and Drug Dependence]] and the [[American Society of Addiction Medicine]] published this definition for alcoholism: "Alcoholism is a primary chronic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations. The disease is often progressive and fatal. It is characterized by impaired control over drinking, preoccupation with

the drug alcohol, use of alcohol despite adverse consequences, and distortions in thinking, mostly denial. Each of these symptoms may be continuous or periodic."

==Leon Silverberg==

The [[DSM IV]] diagnosis of alcohol dependence represents another approach to the definition of alcoholism, one more closely based on specifics than the 1992 JAMA article. In part this is to assist in the development of research protocols in which findings can be compared with one another, but the DSM definition is the one in general use from a diagnostic standpoint. That definition is: Maladaptive alcohol use with clinically significant impairment as manifested by at least three of the following within any one-year period: Tolerance; Withdrawal; Taken in greater amounts or over longer time course than intended; Desire or unsuccessful attempts to cut down or control use; Great deal of time spent obtaining, using, or recovering from use; Social, occupational, or recreational activities given up or reduced; Continued use despite knowledge of physical or psychological sequelae.

The current head of the Silverberg family, the uncle of Odessa and Mathiu Silverberg, whom he took care of after the death of their parents, and grandfather of Albert and Caesar Silverberg. He appears in [[Suikoden I]] and [[Suikoden II]].

Leon is well-known throughout the world as a genius strategist and was involved in many wars, including the Succession War, the Toran Liberation Wars, and Dunan Unification Wars. He lives by his strategic maxim of "ending war as fast as possible with the fewest casualties", using whatever means necessary, regardless of the morality of it, and regardless of who will win the war. His philosophy is shared by his grandson, Albert.

Note that many [[sedative]] agents are cross-tolerant with alcohol (meaning that these agents can be taken instead of alcohol to relieve withdrawal symptoms or to maintain the level of sedation provided by alcohol). A more general diagnosis than alcohol dependence is that of sedative dependence. Whether an individual uses alcohol or another sedative, if they meet the criteria above, the process is likely the same.

As a strategist, he is responsible for the Kalekka Incident which legitimized Scarlet Moon Empire's act of war against Jowston. During the Gate Rune Wars, Leon acted as tactical advisor for the Toran Liberation Army and aids them in ending the war. During Suikoden II, he is requested to become the strategist of the Highlands by [[Jowy Atreides]] (Jowy Blight). He aids the Highland until its defeat at the end of the Dunan Unification War.

==Biological mechanism==

The biological mechanism of alcoholism is unknown, although the biologic mechanism of alcohol metabolism and alcohol-induced behavioral change is well-described in the literature. Alcohol itself is not a factor in the development of this condition, however, or one would be able to turn a non-alcoholic into an alcoholic through the provision of alcohol (the literature has demonstrated that this is impossible).

==AsMathiu a "disease"Silverberg==

Mathiu Silverberg is the brother of Odessa and nephew of Leon, and is a well known strategist. He is also the mentor of strategists Shu and Apple. Mathiu's tactical philosophy contrasts with his uncle's, where upon Mathiu believes that the method is more important that achieving the end goal as quickly as possible. He appears in [[Suikoden I]].

The American Society of Addiction Medicine and the American Medical Association both maintain extensive policy regarding alcoholism. The [[American Psychiatric Association]] recognizes the existence of "alcoholism" as the equivalent of alcohol dependence. With the publication of the DSM-III in 1980, two separate syndromes of ''alcohol dependence'' and ''alcohol abuse'' replaced the earlier category of alcoholism. The World Health Organization dropped the diagnostic category "alcoholism" in 1979, replacing it with the diagnostic categories "alcohol dependence" and "harmful use" (ICD-9,

ICD-10)[http://alcoholism.about.com/cs/alerts/l/blnaa30.htm]. The [[American Hospital Association]], the [http://www.apha.org American Public Health Association], the [[National Association of Social Workers]], and the [[American College of Physicians]] classify "alcoholism" as a [[disease]].

He became a member of the Scarlet Moon military during his youth and participated in the Succession War as a strategist for Kasim Hazil, then served as a vice-strategist for Barbarossa Rugner under his uncle Leon. When Leon devised the plan to slaughter the town of Kalekka, Mathiu reluctantly carried out his duty, but retired from his position soon after, having realized that war inevitably causes innocents to suffer.

[[Image:Stop_drinking.jpg|thumb|250px|Polish propaganda poster saying: "Stop drinking! Come with us and build a happy tomorrow."]] The causes for alcohol abuse and dependence cannot be easily explained. However, the belief that the roots are from moral or ethical weakness on the part of the sufferer has been largely altered. A 1995 [[Gallup Poll]] found that 90% of Americans currently believe that "alcoholism" is a [[disease]].{{fact}}

Over a decade later, Mathiu became the head strategist for the Toran Liberation Army during the Gate Rune Wars following the death of Odessa. Near the end of the war, he was fatally wounded during the attack on the floating fortress by a spy. He dies shortly thereafter, just after the fall of Barbarossa.

In contrast, in a 1988 U.S. Supreme Court decision on whether alcoholism is a condition for which the U.S. Veterans Administration should provide benefits, Justice Byron R. White agrees with the U.S. District Court that there exists "a substantial body of medical literature that even contests the proposition that alcoholism is a disease, much less that it is a disease for which the victim bears no responsibility." [4][5]

==Odessa Silverberg==

Whether or not alcoholism is a disease remains a controversial subject. It should be noted that not all participants in the debate are without self-interest. For example, if alcoholism is not considered a disease, third party payments to physicians and hospitals for its treatment would cease.

Odessa Silverberg is the sister of Mathiu and niece to Leon. She appears in [[Suikoden I]].

As an aristocrat, Odessa had lived most of her life in relative comfort and was unaware of the suffering of the common people. When she came to see the corruption within the Scarlet Moon Empire, she became one of the original founders of the Toran Liberation Army, an anti-imperial movement started by her late fiancé, Achilles.

==Effects==

{{seealso2|Effects of alcohol on the body|Alcohol consumption and health}}

As the leader of the Toran Liberation Army, Odessa also acted as the group's chief strategist, using her knowledge of military strategy as taught by Mathiu. She welcomes a young [[Tir McDohl]] into the army and begins to see him as a potential successor as he gained her respect. When the Imperial Army attacked the rebels' base, taking advantage of the absence of a considerable number of their forces, Odessa is assassinated while attempting to save a child.

Today, alcohol abuse and alcohol dependence are major [[public health]] problems in [[North America]], costing the region's inhabitants, by some estimates, as much as [[US dollar|US$]]170 [[billion]] annually. Alcohol abuse and alcohol dependence are life-threatening problems that sometimes end in death, particularly through [[liver]], [[pancreas|pancreatic]], or [[kidney]] disease, internal bleeding, [[brain]] deterioration, [[alcohol poisoning]], and [[suicide]]. Heavy alcohol consumption by a pregnant mother can also lead to [[fetal alcohol syndrome]], an incurable and damaging condition.

The surviving members of the Liberation Army seek out Mathiu to take up Odessa's place as chief tactician and nominate Tir as their new leader. Thanks to Odessa's foresight and advanced planning, the Toran Liberation Army is ultimately victorious in the war.

Additionally, alcohol abuse and alcohol dependence are major contributing factors for [[head injury|head injuries]], [[motor vehicle accident]]s (MVA), violence and assaults, [[neurology|neurological]], and other [[medicine|medical]] problems ([[cirrhosis]], etc.).

==??? Silverberg==

Of the one half of the North American population who consume alcohol, it has been estimated by some that 10% are alcohol abusers and alcohol dependents, and 6% consume more than half of all alcohol.

Mathiu and Odessa had a younger brother, but his name is unknown as is his current whereabouts. It is certain that he is still alive.

==Shu==

[[Stereotype]]s of alcohol abusers and alcohol dependents are often found in [[fiction]] and [[popular culture]]: for example the "[[town drunk]]," or the [[stereotype]] of [[Russians]] and the [[Irish ethnicity|Irish]] as alcoholics. In modern times, the recovery movement has led to more realistic portraits of abusers and dependents and their problems, such as in [[Charles R. Jackson]]'s ''[[The Lost Weekend]]'', or the films ''[[Days of Wine and Roses (movie)|Days of Wine and Roses]]'', and ''[[My Name is Bill W]]'' or the extreme "[[Leaving Las Vegas]]". [[Charles Bukowski]] describes honestly his alcohol addiction in the movie ''[[Barfly]]'' and in his other writings.

Shu is the chief tactician of the Allied Forces during the Dunan Unification War. As a child, he studied military strategy under Mathiu Silverberg and alongside Apple, whom he views as a surrogate sister. He appears in [[Suikoden II]].

Alcohol dependence can be harder to break and significantly more damaging than dependence on most other addictive substances. The physical symptoms when withdrawing from alcohol can be quite severe and dangerous, with death reported in extreme cases.

Under Mathiu, he learned everything about military strategy. Mathiu saw great potential in this young pupil. However, Shu used his knowledge for personal gain and was cast out from Mathiu's school. Since then, Shu has become a trader in Radat. With his uncanny grasp of the movements in the world, he quickly became rich through trade.

The alcoholic personality can exhibit a radical change when they drink, from passive when sober to aggressive when drunk, though the reverse can also be true.

During the Dunan Unification War, the Allied Forces asked Shu to join them. He initially refused, but with persistent begging by Apple and Riou, he agreed and quickly whipped the Allied Forces into shape by scoring an initial victory against the Highland Army, resulting in the execution of Solon Jhee. He quickly devised cunning strategies to rally support from other city-states and established an alliance with the Toran Republic.

An alcoholic does not have to be someone who is drunk every night, and a functional alcoholic can have largely normal work and family relationships. However, alcohol represents a major or the major focus of their lives.

===Long-term===

The long-term effects of high quantity alcohol use can include:

* [[pancreatitis]], or inflammation of the [[pancreas]] (but the [[acute pancreatitis|acute]] and [[chronic pancreatitis|chronic]] form)

* [[heart disease]], including [[dilated cardiomyopathy]]

* [[polyneuropathy]], or damage to the [[nerves]] leading to poor sensation or pain

* [[cirrhosis]] of the [[liver]], a chronic disease characterized by destruction of liver cells and loss of liver function, and its numerous complications, including bleeding from [[esophageal varices]]

* [[clinical depression|depression]], [[insomnia]], [[anxiety]], and [[suicide]]

* [[hypertension]] (high blood pressure)

* increased incidence of many types of [[cancer]], including [[breast cancer]], [[head and neck cancer]], [[esophageal cancer]] and [[colorectal cancer]]

* [[nutritional deficiency]] of [[folic acid]], [[thiamine]] (vitamin B1) and several others

* [[Wernicke-Korsakoff syndrome]], a neuropsychiatric disorder caused by thiamine deficiency that results from poor nutrition in alcoholics

*[[personality]] changes toward others, especially those who are close

* significant damage to occupational, social, and interpersonal areas, including [[sexual dysfunction]]

*[[gait ataxia]] due to damage to the [[superior vermis]]

However, Leon Silverberg suddenly sides with the Highland Army and causes disruption to Shu's plans. After the Dunan Army's retreat against Luca Blight, Leon helped Shu defeat Luca Blight by informing him of a planned night raid and Shu did not let that chance go by. Throughout the war, Shu's attitude towards military strategy had transformed. Originally, his philosophy was identical to Leon Silverberg's philosophy, where soldiers were pawns and strategists were never supposed to risk themselves.

==Screening==

Several tools may be used to detect the habitual abuse of alcohol. The CAGE questionnaire, developed by Dr. John Ewing and named for its four questions, is one such example that may be used to screen patients quickly in a doctor's office.

However, with the influence of Apple and Nanami, he started to see that it is sometimes necessary to put himself on the line in order to truly win. In the end, he leads the Allied Forces to victory after he defeats Leon Silverberg. After the war, he became the Chancellor for the new Allied Nation while awaiting the return of the hero to his rightful post. He later retires, but then is brought out of retirement by the Higheast Rebellion, in which he secretly planned a plot to cause internal discord within Harmonia, which caused them to withdraw from the Highland territory.

Two "yes" responses indicate that the respondent should be investigated further.

==Apple==

The questionnaire asks the following questions:

Like Shu, Apple is not a member of the Silverberg family, but was actually a student of Mathiu Silverberg. She appears in [[Suikoden I]], [[Suikoden II]] and [[Suikoden III]].

# Have you ever felt you needed to '''C'''ut down on your drinking?

# Have people '''A'''nnoyed you by criticising your drinking?

# Have you ever felt '''G'''uilty about drinking?

# Have you ever felt you needed a drink first thing in the morning ('''E'''ye-opener) to steady your nerves or to get rid of a hangover?

Apple deeply respects her mentor and aids him during the Toran Liberation Wars (Suikoden I). She becomes tactician to Viktor's mercenaries early in the Dunan Unification War (Suikoden II). After the fall of Muse, she successfully recruits Shu for the Allied Forces and helps him as a secondary strategist.

Another screening questionnaire is the Alcohol Use Disorders Identification Test (AUDIT), developed by the World Health Organization.

During Suikoden III, Apple works as a historian gathering information to compile a biography on Mathiu. She travels with a student of her own, Caesar Silverberg, and assists the young tactician as he acts as strategist for the Flame Champion during the Second Fire Bringer War. According to Apple, Caesar's tactical mindset is likely the closest to that of her master's.

The Alcohol Dependence Data Questionnaire [http://eib.emcdda.eu.int/index.cfm?fuseaction=public.Content&nNodeID=3556&sLanguageISO=EN] is a more sensitive diagnostic test than the CAGE test. The Alcohol Dependence Data Questionnaire serves to distinguish a diagnosis of alcohol dependence from one of alcohol abuse.

==BloodGeorge testsSilverberg==

George is the son of Leon Silverberg and the father of Albert and Caesar Silverberg. Nothing else is known about him.

Although there is no [[blood test]] specific for alcohol abuse or alcohol dependence (alcoholism), prolonged heavy alcohol consumption may lead to several abnormalities, including:

*[[Macrocytosis]] (enlarged [[Mean corpuscular volume|MCV]])¹

*Elevated [[Gamma glutamyl transpeptidase|GGT]]²

*Moderate elevation of [[Aspartate transaminase|AST]] and [[Alanine transaminase|ALT]] and an AST:ALT ratio of 2:1.

*High [[carbohydrate-deficient transferrin]]²

In the manga, Caesar describes his father as a "true tactician", a strategist who was capable of knowing when to choose between winning more battles or watching out for the soldiers under his command, which is what Caesar himself strives to become.

==Caesar Silverberg==

Caesar Silverberg is the son of George and the younger brother of Albert Silverberg. He travels with his mentor, Apple. Caesar appears in [[Suikoden III]].

Caesar is the youngest and most inexperienced of the strategists, though still possessing the talent his family is known for. Initially appearing to be a lazy and disinterested teenager, he possesses a keen and watchful mind and while he never demonstrates the elaborate plans of his predecessors his cunning misdirections and ability to see the situation stripped of emotional attachment serve the Flame Champion well.

==Treatments==

Treatments for alcohol dependence include [[detoxification]] programs run by medical institutions. These may involve stays for a number of weeks

in specialized [[hospital]] wards where drugs may be used to avoid [[withdrawal]] symptoms, which in severe cases may lead to [[death]].

His motivation to pursue the life of a tactician comes from his sibling rivalry with Albert, hoping to best his older brother. Caesar believes in Mathiu's ideology, where reducing the amount of casualties on both sides involved holds priority to the goal in mind so that neither opposing forces loses their strongest human resources such that they will be able to rebuild and manage a peaceful resolution because each side remains able to empathize with the other.

After detoxification, various forms of [[group therapy]] or [[psychotherapy]] can be used to deal with underlying psychological issues leading to alcohol dependence. Aversion therapies may be supported by drugs like [[Disulfiram]], which causes a strong and prompt [[hangover]] whenever alcohol is consumed. [[Naltrexone]] may improve compliance with abstinence planning. The standard pharmocopoeia of [[antidepressants]], anxiolytics, and other [[psychotropic]] drugs treat underlying [[mood disorder]]s, [[neurosis|neuroses]], and [[psychosis|psychoses]] associated with alcoholic symptoms.

Caesar is initially dismissed by the Grasslanders, despite how his tactics saved the Chisha clan from Harmonia forces, and becomes discouraged, though Apple assures him that as a strategist, he must find generals to guide in battle. He eventually earns his place as their strategist when he reveals that he is familiar with the tactical advisor of the Harmonian forces: Albert Silverberg. Karaya clan chief Lucia convinces the other chiefs to accept Caesar as their tactician since she knows of Caesar's grandfather, Leon Silverberg, and the value of having Silverberg tactician on their side.

Another treatment program is based on nutritional therapy. Many alcohol dependents have [[insulin]] resistance syndrome, a metabolic disorder where the body's difficulty in processing [[sugar]]s causes an unsteady supply to the blood stream. While the disorder can be treated by a [[hypoglycemic]] diet, this can affect behaviour and emotions, side-effects often seen among alcohol dependents in treatment. The metabolic aspects of such dependence are often overlooked, resulting in poor treatment outcomes. See: [http://www.hypoglycemia.asn.au]

He proves himself to be a skillful tactician (though assisted by Apple and Salome Haras of the Zexen Confederacy) and intends to test his skills against Albert by pledging his support to the new Flame Champion. While the Grasslanders and the Zexen Confederacy defeat the Harmonians and the Destroyer forces, Caesar realizes that Albert remains the superior tactician and decides to return to his studies in hopes of surpassing his brother some day.

In the mid-1930s, the mutual-help group-counselling approach to treatment began and has become very popular. [[Alcoholics Anonymous]] is possibly the best-known example of this movement. Other groups include [[LifeRing Secular Recovery]] and [[SMART Recovery]].

==Albert Silverberg==

Some programs attempt to help problem drinkers before they become dependents. These programs focus on harm-reduction and reducing alcohol intake as opposed to cold-turkey approaches. One such program is called [[Moderation Management]].

Albert Silverberg is the son of George and the older brother of Caesar Silverberg. He appears in [[Suikoden III]].

Albert excelled in his studies and is an excellent strategist, eventually gaining the role of Harmonia's chief tactical advisor during Harmonia's invasion of the Grasslands. His ideals are largely similar to that of his grandfather, Leon, where bringing about the end goal as quickly as possible to spare lives takes priority over the methods used, no matter how amoral the methods may be or how much suffering must be caused as a result. He and Caesar, as a result of their differing ideologies, is a sore point between the brothers along with their contrasting personalities, especially since Albert is much more serious in comparision to his younger brother.

==Social impact==

[[Image:Daddydontdrink.jpeg|thumb|right|220px|A Soviet poster reading "Daddy, don't drink", referring to the massive alcohol abuse problem in Russia]]The social problems arising from alcohol abuse can include loss of employment, financial problems, marital conflict and divorce, convictions for crimes such as drunk driving or public disorder, loss of accommodation, and loss of respect from others who may see the problem as self-inflicted and easily avoided. Alcohol dependence affects not only the addicted but can profoundly impact the family members around them. Children of alcohol dependents can be affected even after they are grown; the behaviors commonly exhibited by such children are collectively known as [[Adult Children of Alcoholics Syndrome]]. [[Al-Anon/Alateen]], a group modelled after Alcoholics Anonymous, offers aid to friends and family members of alcohol dependents.

He initially works alongside [[Sasarai]], a bishop of Harmonia and the commander of the Harmonian invaders searching for the [[27 True Runes|True Fire Rune]], but reveals that he is actually working for Luc, the Masked Bishop. Albert's motives are unclear, but it appears that he believes supporting Luc will allow him to gain power within the Harmonian bureaucracy. It is revealed that he chose to follow Luc in hopes of lessening the amount of casualties in Luc's war through strategic means.

Many people incorrectly assume that once an alcohol dependent stops drinking, all is well. However, many people, especially members of Alcoholics Anonymous who have stopped drinking still refer to themselves as "alcoholics" or "recovering alcoholics."

He eventually disappears at the end of the Second Fire Bringer War, intending leave the continent and start again under an assumed name. Caesar finds him before he leaves and informs his older brother that he will surpass him some day.

==Social versus physical dependence==

Symptoms of a person's dependence on alcohol may include, but are not limited to, a feeling of necessity in regard to consumption of alcohol, or an inability to resist alcohol if offered. Though these symptoms often arise from a physical dependence on the substance, it is not uncommon for individuals, especially teenagers and adolescents between the ages of fifteen and twenty, to rely on alcohol as a means of social interaction. If a person cannot refuse alcohol in the presence of others, insists on drinking alcohol excessively for fear of alienation and neglect, or feels they cannot socially interact with others unless under the influence then this person is considered socially dependent on the substance.

These traits can be noticed in individuals with no history of alcohol consumption who relocate (such as students attending a new university) whereby an individual begins to consume alcohol in order to associate and relate to others. Social dependence, though not physically threatening in early stages, can lead to physical dependence if the person cannot control their urges and moreso their reasons for drinking.

It should be noted that use of the term 'urges' are not merely to express a sense of want for the taste of alcohol, but could also be an urge that is stimulated by an individuals satisfaction in what is often referred to as "the buzz." It is a sense of euphoria brought on in people bearing a low tolerance to alcohol in about 2-3 standard drinks in a short period of time. Individuals bearing a higher tolerance to alcohol usually still crave "the buzz". Over time, the amount of alcohol needed to achieve the same affect increases as tolerance increases.

A persons "social dependence" is defined by the Prevention Research Institute from Kentucky (www.askpri.com) as a condition that a person experiences and re-experiences in a social setting. It reflects the habitual experiences one has as they enjoy "partying" with the same people.

==Politics and public health==

Because alcohol abuse affects society as a whole, governments and parliaments have formed alcohol policies in order to reduce the harm of alcoholism. The World Health Organization, the European Union and other regional bodies are working on alcohol action plans and programs.

Organisations working with alcohol abusers include:

* [[Alcoholics Anonymous]] (AA)

* [[IOGT International]] (IOGT)

* [[LifeRing Secular Recovery]] (LifeRing)

* [[Men For Sobriety]] (MFS)

* [[Moderation Management]] (MM)

* [[Rational Recovery]] (RR)

* [[Secular Organizations for Sobriety]] (SOS)

* [[SMART Recovery | Self-Management and Recovery Training]] (SMART)

* [[Women For Sobriety]] (WFS)

==Alcohol withdrawal==

There are several distinct but not mutually exclusive clinical [[alcohol withdrawal syndrome]]s caused by alcohol withdrawal:

* Tremulousness - "the shakes"

* Activation syndrome - characterized by tremulousness, agitation, rapid heart beat and [[high blood pressure]].

* [[Seizures]] - acute [[grand mal seizure]]s can occur in alcohol withdrawal in patients who have no history of seizure or any structural brain disease.

* [[Hallucinations]] - usually visual or tactile in alcoholics

* ''[[Delirium tremens]]'' - can be severe and often fatal.

Unlike withdrawal from [[opioid|opioids]] such as [[heroin]], which can be unpleasant but never fatal, alcohol withdrawal can kill (by uncontrolled convulsions or delirium tremens) if it is not properly managed. The pharmacological management of alcohol withdrawal is based on the fact that alcohol, [[barbiturates]], and [[benzodiazepine|benzodiazepines]] have remarkably similar effects on the brain and can be substituted for each other. Since benzodiazepines are the safest of the three classes of drugs, alcohol consumption is terminated and a long-acting benzodiazepine is substituted to block the alcohol withdrawal syndrome. The benzodiazepine dosage is then tapered slowly over a period of days or weeks.

==See also==

* [[Alcoholics Anonymous]]

* [[Drunkenness]]

* ''[[Delirium tremens]]''

* [[Wernicke-Korsakoff syndrome]]

* [[Beer]]

* [[Public house]]

* [[Beer belly]]

* [[Blind drunk]]

* [[List of famous deaths through alcohol]]

* [[List of fictional alcoholics]]

* [[Alcohol-related traffic crashes]]

* [[Alcohol tolerance]]

* [[Liver function tests]]

* [[Full blood count]]

*''[[Leaving Las Vegas]]'' (1995)

*''[[When a Man Loves a Woman]]'' (1994)

==External links==

* [http://www.suikosource.com '''Suikosource''']

* [http://counsellingresource.com/quizzes/alcohol-mast/index.html Online Screening Test for Alcohol Abuse]

[[Category:Suikoden characters]]

* [http://atoz.iqhealth.com/HealthAnswers/encyclopedia/HTMLfiles/2790.html Alcohol dependence at iqhealth.com]

* [http://www.mental-health-matters.com/disorders/dis_details.php?disID=4 Mental Health Matters: Alcohol Addiction]

* [http://www.psychforums.com/forums/viewforum.php?f=152 Psych Forums: Alcohol Addiction Forum]

* [http://www.alkoholpolitik.ch: Independent private site in German with some English texts]

* [http://health.dailynewscentral.com/content/view/0001478/31//alcohol_tolerance_genetic.html Alcohol Tolerance May Be Genetic] health.dailynewscentral.com

* [http://www.lifewisewa.com/pdfs/012695.pdf CAGE Questionnaire (PDF)]

* [http://www.alcoholics-anonymous.org/ Alcoholics Anonymous]

* [http://www.drugrehab101.com/directory.html Alcohol treatment centers]

* [http://www.unhooked.com/ LifeRing Secular Recovery]

* [http://www.nicd.us/ NICD: Alcoholism/addiction resources, treatment locator, family assistance and help]

==References==

# Tonnesen H, Hejberg L, Frobenius S, Andersen JR. Erythrocyte mean cell volume--correlation to drinking pattern in heavy alcoholics. Acta Med Scand. 1986;219(5):515-8. ([http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3739755&dopt=Abstract Medline abstract])

# Schwan R, Albuisson E, Malet L, Loiseaux MN, Reynaud M, Schellenberg F, Brousse G, Llorca PM. The use of biological laboratory markers in the diagnosis of alcohol misuse: an evidence-based approach. Drug Alcohol Depend. 2004 Jun 11;74(3):273-9. ([http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15194205 Medline abstract])

# Ewing, John A. “Detecting Alcoholism: The CAGE Questionaire” JAMA 252: 1905-1907, 1984

# U.S Supreme Court, Traynor v Turnage, 485 U.S 353 (1988) at 535-550

# 253 U.S Appellate District Court at 132-133

[[Category:Alcohol_abuse]]

[[Category:Drinking culture]]

[[Category:Social stigma]]

[[ca:Alcoholisme]]

[[cs:Alkoholismus]]

[[da:Alkoholisme]]

[[de:Alkoholkrankheit]]

[[es:Alcoholismo]]

[[eo:Alkoholismo]]

[[fr:Alcoolisme]]

[[ko:술 중독]]

[[is:Alkóhólismi]]

[[it:Alcolismo]]

[[he:אלכוהוליזם]]

[[jv:Alkoholisme]]

[[nl:Alcoholisme]]

[[ja:アルコール依存症]]

[[pl:Alkoholizm]]

[[pt:Alcoolismo]]

[[ru:Алкоголизм]]

[[sk:Alkoholizmus]]

[[sl:Alkoholizem]]

[[fi:Alkoholismi]]

[[sv:Alkoholism]]

[[vi:Chứng nghiện rượu]]

[[tr:Alkolizm]]

[[zh:酗酒]]