Alcoholism

 

What is Alcoholism?

 

Alcoholism is a chronic and often progressive disease that includes problems controlling your drinking, being preoccupied with alcohol, continuing to use alcohol even when it causes problems, having to drink more to get the same effect (physical dependence), or having withdrawal symptoms when you rapidly decrease or stop drinking. If you have alcoholism, you can't consistently predict how much you'll drink, how long you'll drink, or what consequences will occur from your drinking.

 

It's possible to have a problem with alcohol, even when it has not progressed to the point of alcoholism. Problem drinking means you drink too much at times, causing repeated problems in your life, although you're not completely dependent on alcohol.

 

Binge drinking — a pattern of drinking where a male consumes five or more drinks in a row, or a female downs at least four drinks in a row — can lead to the same health risks and social problems associated with alcoholism. The more you drink, the greater the risks. Binge drinking, which often occurs with teenagers and young adults, may lead to faster development of alcoholism.

 

If you have alcoholism or you have a problem with alcohol, you may not be able to cut back or quit without help. Denying that you have a problem is usually part of alcoholism and other types of excessive drinking.

 

Symptoms

 

 

Alcoholism signs and symptoms include those below. You may:

• Be unable to limit the amount of alcohol you drink

• Feel a strong need or compulsion to drink

• Develop tolerance to alcohol so that you need more to feel its effects

• Drink alone or hide your drinking

• Experience physical withdrawal symptoms — such as nausea, sweating and shaking — when you don't drink

• Not remember conversations or commitments, sometimes referred to as a "black out"

• Make a ritual of having drinks at certain times and become annoyed when this ritual is disturbed or questioned

• Be irritable when your usual drinking time nears, especially if alcohol isn't available

• Keep alcohol in unlikely places at home, at work or in your car

• Gulp drinks, order doubles or become drunk intentionally to feel good, or drink to feel "normal"

• Have legal problems or problems with relationships, employment or finances due to drinking

• Lose interest in activities and hobbies that used to bring you pleasure

 

If you binge drink or have other problems with alcohol, you may have many of the signs and symptoms above, although you may not feel as much of a compulsion to drink compared with someone who has alcoholism. Also, you may not have physical withdrawal symptoms when you don't drink. But this pattern of drinking can still cause serious problems and lead to alcoholism. As with alcoholism, you may not be able to quit problem drinking without help.

 

What about my drinking?

 

If you've ever wondered whether your drinking crosses the line into problem drinking or alcoholism, ask yourself these questions:

• If you're a man, do you ever have five or more drinks in a day?

• If you're a woman, do you ever have four or more drinks in a day?

• Do you ever need a drink to get you started in the morning?

• Do you feel guilty about your drinking?

• Do you think you need to cut back on how much you drink?

• Are you annoyed when other people comment on or criticize your drinking habits?

 

If you answered yes to even one of these questions, you may have a problem with alcohol.

 

When to see a doctor

 

If you feel that you sometimes drink too much or your family is concerned about your drinking, talk with your doctor. See your doctor even if you don't think you have alcoholism, but you're concerned about your drinking or it's causing problems in your life. Other ways to get help include talking with a mental health provider or seeking help from a support group such as Alcoholics Anonymous.

 

Because denial is common, you may not feel like you have a problem with drinking or that you need help to stop. You might not recognize how much you drink or how many problems in your life are related to alcohol use. Listen to family members, friends or co-workers when they ask you to examine your drinking habits or to seek help.

 

Causes

 

Alcoholism is influenced by genetic, psychological, social and environmental factors that have an impact on how it affects your body and behavior.

 

The process of becoming addicted to alcohol occurs gradually, although some people have an abnormal response to alcohol from the time they start drinking. Over time, drinking too much may change the normal balance of chemicals and nerve tracks in your brain associated with the experience of pleasure, judgment and the ability to exercise control over your behavior. This may result in your craving alcohol to restore good feelings or remove negative ones.

 

Risk Factors

• Steady drinking over time. Drinking too much on a regular basis for an extended period or binge drinking on a regular basis can produce a physical dependence on alcohol.

• Age. People who begin drinking at an early age are at a higher risk of problem drinking or physical dependence on alcohol.

• Family history. The risk of alcoholism is higher for people who have a parent or other close relatives who have problems with alcohol.

• Depression and other mental health problems. It's common for people with a mental health disorder such as anxiety, depression or bipolar disorder to have problems with alcohol or other substances.

• Social and cultural factors. Having friends or a close partner who drinks regularly could increase your risk of alcoholism. The glamorous way that drinking is sometimes portrayed in the media also may send the message that it's OK to drink too much.

• Mixing medication and alcohol. Some medications interact with alcohol, increasing its toxic effects. Drinking while taking these medications can either increase or decrease their effectiveness, or even make them dangerous.

 

Treatment

 

Many people with alcoholism hesitate to get treatment because they don't recognize they have a problem. An intervention from loved ones can help some people recognize and accept that they need professional help. If you're concerned about a friend or family member who drinks too much, talk to a professional for advice on how to approach that person.

 

Various treatments may help. Depending on the circumstances, treatment may involve a brief intervention, individual or group counseling, an outpatient program, or a residential inpatient stay.

 

The first step is to determine if you have a problem with alcohol. If you haven't lost control over your use of alcohol, treatment may involve reducing your drinking. If you have become addicted, simply cutting back is ineffective. Working to stop the use of alcohol to improve quality of life is the main treatment goal.

 

Treatment for alcoholism may include:

• Detoxification and withdrawal. Treatment for alcoholism may begin with a program of detoxification, which generally takes two to seven days. You may need to take sedating medications to prevent shaking, confusion or hallucinations (delirium tremens), or other withdrawal symptoms. Detoxification is usually done at an inpatient treatment center or a hospital.

• Learning skills and establishing a treatment plan. This usually involves alcohol treatment specialists. It may include goal setting, behavior change techniques, use of self-help manuals, counseling and follow-up care at a treatment center.

• Psychological counseling. Counseling and therapy for groups and individuals help you better understand your problem with alcohol and support recovery from the psychological aspects of alcoholism. You may benefit from couples or family therapy — family support can be an important part of the recovery process.

• Continuing support. Aftercare programs and support groups help people recovering from problem drinking or alcoholism to stop drinking, manage relapses and cope with necessary lifestyle changes. This may include medical or psychological care or attending a support group such as Alcoholics Anonymous.

• Treatment for psychological problems. Alcoholism commonly occurs along with other mental health disorders. You may need talk therapy (psychotherapy or psychological counseling), medications, or other treatment for depression, anxiety or another mental health condition, if you have any of these conditions.

• Medical treatment for other conditions. Common medical problems related to alcoholism include high blood pressure, high blood sugar, liver disease and heart disease. Many alcohol-related health problems improve significantly once you stop drinking.

• Spiritual practice. People who are involved with some type of regular spiritual practice may find it easier to maintain recovery from alcoholism or other addictions. For many people, gaining greater insight into their spiritual side is a key element in recovery.

• Residential treatment programs. For a serious alcohol problem, you may need a stay at a residential treatment facility. Many residential treatment programs include individual and group therapy, participation in alcoholism support groups such as Alcoholics Anonymous, educational lectures, family involvement, activity therapy, and working with counselors, professional staff and doctors experienced in treating alcoholism.