Definition

Alcoholism –

     Alcoholism or alcohol dependence is a chronic disease, characterized by the consumption of alcohol beverages at a level that interferes with physical and mental health.  It can also interfere with family, social, and legal responsibilities.  An alcoholic will continue to drink despite serious problems in any of the above areas.  Alcoholism is the most severe form of alcohol abuse.

     Like many other diseases, alcoholism is chronic, meaning that it lasts a person's lifetime; it usually follows a predictable course; and it has symptoms.  The risk for developing alcoholism is influenced both by a person's genetic background and his or her circumstances and lifestyle.

Alcohol Abuse –

     Alcohol abuse differs from alcoholism in that it does not include an extremely strong craving for alcohol, loss of control, over drinking, or physical dependence.  By definition, alcohol abuse is defined as a pattern of drinking that results in one or more of the following situations within a 12-month period:  

Although alcohol abuse is basically different from alcoholism, alcoholics also experience many effects of alcohol abuse.

     Alcohol abuse and alcoholism cut across gender, race, and nationality.  Nearly 14 million people in the United States (1 in 13 adults) abuse alcohol or are alcoholics.  In general, tmore men than women are alcohol dependent or have alcohol problems.  Alcohol problems are highest among young adults ages 18-29 and lowest among adults ages 65 and older.  We also know that people who start drinking at an early age (for example, at age 14 or younger) greatly increase the chance that they will develop alcohol problems at some point in their lives.

     Alcohol's effects do vary with age.  Slower reaction times, problems with hearing and seeing, and a lower tolerance to alcohol's effects put older people at higher risk for falls, car crashes, and other types of injuries that may result from drinking.  Older people also tend to take more medicines than younger people.  Mixing alcohol with over-the-counter or prescription medications can be dangerous, even fatal.  More than 150 medications interact harmfully with alcohol.

     Alcohol affects women differently than men.  Women become more impaired than men do after drinking the same amount of alcohol, even when differences in body weight are taken into account.  This is because women's bodies have less water than men's bodies.  Because alcohol mixes with body water, a given amount of alcohol becomes more highly concentrated in a woman's body than in a man's.  In other words, it would be like dropping the same amount of alcohol into a much smaller pail of water.  That is why the recommended drinking limit for women is lower than for men.

     In addition, chronic alcohol abuse takes a heavier physical toll on women than on men.  Alcohol dependence and related medical problems, such as brain, heart, and liver damage, progress more rapidly in women than in men.

Symptoms

Symptoms of Alcoholism –  

Symptoms of Alcohol Abuse -                                            

     One “yes” answer suggests a possible alcohol problem.  A “yes” to more than one question indicates that it is highly likely a problem exists.  In either case, it is important to consult a doctor or other health care provider right away to discuss these responses.  He or she can help you determine if they have a drinking problem and, if so, recommend the best course of action.  Even if you answered “no” to all of the above questions, if you encounter drinking-related problems with your job, relationships, health, or the law, you should seek professional help.  The effects of alcohol abuse can be extremely serious — even fatal — both to you and to others.

Side effects  -

Health hazards -

Treatment

     Alcoholism treatment programs use both counseling and medications to help a person stop drinking.  Most alcoholics need help to recover from their disease.  With support and treatment, many people are able to stop drinking and rebuild their lives.

Medication – 

     A range of medications is used to treat alcoholism.  Benzodiazepines (Valium®, Librium®) are sometimes used during the first days after a person stops drinking to help him or her safely withdraw from alcohol.  Because these medications are highly addictive, they’re not usually recommended and used beyond the first few days.

     Neuroscience research has discovered many drugs in the arsenal against alcoholism.  Naltrexone (ReVia™), Disulfiram (Antabuse®), and Acamprosate are just a few.  Through several medications help treat alcoholism; there is no "magic bullet."  In other words, no single medication is available that works in every case and/or in every person.  Developing new and more effective medications to treat alcoholism remains a high priority for researchers.

     Research supported by the National Institute of Alcohol Abuse and Alcoholism (NIAAA) has made considerable progress in evaluating commonly used therapies and developing new types of therapies to treat alcohol-related problems.  One large-scale study sponsored by NIAAA found that the three commonly used behavioral treatments for alcohol abuse and alcoholism (motivation enhancement therapy, cognitive-behavioral therapy, and 12-step facilitation therapy) significantly reduced drinking in the year following treatment.  This study also found that approximately one-third of the study participants who were followed up either were still abstinent or were drinking without serious problems 3 years after the study ended.  Other therapies that have been evaluated and found effective in reducing alcohol problems include brief intervention for alcohol abusers (individuals who are not dependent on alcohol) and behavioral marital therapy for married alcohol-dependent individuals.

Alcoholics Anonymous –

     Virtually all alcoholism treatment programs also include Alcoholics Anonymous (AA) meetings.  AA describes itself as a “worldwide fellowship of men and women who help each other to stay sober.”  Although AA is generally recognized as an effective mutual help program for recovering alcoholics, not everyone responds to AA’s style or message, and other recovery approaches are available.  Even people who are helped by AA usually find that AA works best in combination with other forms of treatment, including counseling and medical care.

Seeking Help for an unwilling alcoholic –

     A person can't be forced to get help except under certain circumstances, such as a violent incident that results in court-ordered treatment or a medical emergency.  But you don't have to wait for someone to "hit rock bottom" to act.  Many alcoholism treatment specialists suggest the following steps to help an alcoholic get treatment:

Stop all “cover ups” –

     Family members, friends, and loved ones often make excuses to others or try to protect the person from the results of their.  It’s important to stop covering for the person so that they experience the full consequences of drinking.

Time your intervention –

     The best time to talk to a person is shortly after an alcohol-related problem has occurred—-like a serious family argument or an accident.  Choose a time when they are sober, both of you are fairly calm, and you have a chance to talk in private.

Be specific –

     Tell the person you are concerned about their drinking.  Use examples of the ways in which the drinking has caused problems, including the most recent incident.

State the results –

     Explain to the person what you will do if they don’t go for help (not to punish the drinker, but to protect yourself from his or her problems).  What you say may range from refusing to go with the person to any social activity where alcohol will be served, to moving out of the house.  Do not make any threats you are not prepared to carry out.

Get help –

     Gather information in advance about treatment options in your community.  If the person is willing to get help, call immediately for an appointment with a treatment counselor.  Offer to go with the person on the first visit to a treatment program and/or an Alcoholics Anonymous meeting.

Call on a friend –

     If the person still refuses to get help, ask a friend to talk with them using the steps just described.  Another person who is a recovering alcoholic may be particularly persuasive, but any person who is caring and nonjudgmental may help.  The intervention of more than one person, more than one time, is often necessary to coax a person to seek help.

Find strength in numbers –

     With the help of a health care professional, some people join with other family members, friends, or loved ones to confront a person as a group.  This approach should only be tried under the guidance of a health care professional that is experienced in this kind of group intervention.

Get support –

     It is important to remember that you are not alone.  Support groups offered in most communities include; Al-Anon, which holds regular meetings for spouses and other significant adults in an alcoholic person’s life, Alateen, which is geared to children of alcoholics.  These groups help family members understand that they are not responsible for an alcoholic person’s drinking, and that they need to take steps to take of themselves, regardless of whether the alcoholic person’s family member chooses to get help.

     In conclusion, alcoholism treatment works for many people.  But just like any chronic disease, there are varying levels of success when it comes to treatment.  Some people stop drinking and remain sober.  Others have long periods of sobriety with bouts of relapse.  And still others (such as MDA) cannot stop drinking for any length of time.  With treatment, one thing is clear, however: the longer a person abstains from alcohol, the more likely he or she will be able to stay sober.

I would like to thank the The National Institute of Alcohol Abuse and Alcoholism for their invaluable assistance.