Alcoholism: Getting the Facts
For many people, the facts about alcoholism are not clear. What is
alcoholism, exactly? How does it differ from alcohol abuse? When should a
person seek help for a problem related to his or her drinking? The
National Institute on Alcohol Abuse & Alcoholism (NIAAA) has prepared
this booklet to help individuals & families answer these & other common
questions about alcohol problems. The information below will explain
alcoholism & alcohol abuse, symptoms of each, when & where to seek help,
treatment choices & additional helpful resources.
A Widespread Problem
====================
For most people, alcohol is a pleasant accompaniment to social
activities. Moderate alcohol use-up to two drinks per day for men & one
drink per day for women & older people (A standard drink is one 12-ounce
bottle of beer or wine cooler, one 5-ounce glass of wine, or 1.5 ounces
of 80-proof distilled spirits) - is not harmful for most adults.
Nonetheless, a substantial number of people have serious trouble with
their drinking. Currently, nearly 14 million Americans-1 in every 13
adults-abuse alcohol or are alcoholic. Several million more adults engage
in risky drinking patterns that could lead to alcohol problems. In
addition, approximately 53 percent of men & women in the United States
report that one or more of their close relatives have a drinking problem.
The consequences of alcohol misuse are serious-in many cases,
life-threatening. Heavy drinking can increase the risk for certain
cancers, especially those of the liver, esophagus, throat & larynx (voice
box). It can also cause liver cirrhosis, immune system problems, brain
damage & harm to the fetus during pregnancy. In addition, drinking
increases the risk of death from automobile crashes, recreational
accidents & on-the-job accidents & also increases the likelihood of
homicide & suicide. In purely economic terms, alcohol-use problems cost
society approximately $100 billion per year. In human terms, the costs
are incalculable.
What Is Alcoholism?
===================
Alcoholism, which is also known as "alcohol dependence syndrome," is a
disease that is characterized by the following elements:
* Craving: A strong need, or compulsion, to drink.
* Loss of control: The frequent inability to stop drinking once a
person has begun.
* Physical dependence: The occurrence of withdrawal symptoms, such as
nausea, sweating, shakiness & anxiety, when alcohol use is stopped
after a period of heavy drinking. These symptoms are usually relieved
by drinking alcohol or by taking another sedative drug.
* Tolerance: The need for increasing amounts of alcohol in order to get
"high."
Alcoholism has little to do with what kind of alcohol one drinks, how
long one has been drinking, or even exactly how much alcohol one
consumes. But it has a great deal to do with a person's uncontrollable
need for alcohol. This description of alcoholism helps us understand why
most alcoholics can't just "use a little willpower" to stop drinking. He
or she is frequently in the grip of a powerful craving for alcohol, a
need that can feel as strong as the need for food or water. While some
people are able to recover without help, the majority of alcoholic
individuals need outside assistance to recover from their disease. With
support & treatment, many individuals are able to stop drinking & rebuild
their lives. Many people wonder: Why can some individuals use alcohol
without problems, while others are utterly unable to control their
drinking? Recent research supported by NIAAA has demonstrated that for
many people, a vulnerability to alcoholism is inherited. Yet it is
important to recognize that aspects of a person's environment, such as
peer influences & the availability of alcohol, also are significant
influences. Both inherited & environmental influences are called "risk
factors." But risk is not destiny. Just because alcoholism tends to run
in families doesn't mean that a child of an alcoholic parent will
automatically develop alcoholism.
What Is Alcohol Abuse?
======================
Alcohol abuse differs from alcoholism in that it does not include an
extremely strong craving for alcohol, loss of control, or physical
dependence. In addition, alcohol abuse is less likely than alcoholism to
include tolerance (the need for increasing amounts of alcohol to get
"high" ). Alcohol abuse is defined as a pattern of drinking that is
accompanied by one or more of the following situations within a 12-month
period:
* Failure to fulfill major work, school, or home responsibilities;
* Drinking in situations that are physically dangerous, such as while
driving a car or operating machinery;
* Recurring alcohol-related legal problems, such as being arrested for
driving under the influence of alcohol or for physically hurting
someone while drunk;
* Continued drinking despite having ongoing relationship problems that
are caused or worsened by the effects of alcohol.
While alcohol abuse is basically different from alcoholism, it is
important to note that many effects of alcohol abuse are also experienced
by alcoholics.
What Are the Signs of a Problem?
================================
How can you tell whether you, or someone close to you, may have a
drinking problem? Answering the following four questions can help you
find out. (To help remember these questions, note that the first letter
of a key word in each of the four questions spells "CAGE.")
* Have you ever felt you should Cut down on your drinking?
* Have people Annoyed you by criticizing your drinking?
* Have you ever felt bad or Guilty about your drinking?
* Have you ever had a drink first thing in the morning to steady your
nerves or to get rid of a hangover (Eye opener)?
One "yes" response suggests a possible alcohol problem. If you responded
"yes" to more than one question, it is highly likely that a problem
exists. In either case, it is important that you see your doctor or other
health care provider right away to discuss your responses to these
questions. He or she can help you determine whether you have a drinking
problem & if so, recommend the best course of action for you.
Even if you answered "no" to all of the above questions, if you are
encountering drinking-related problems with your job, relationships,
health, or with the law, you should still seek professional help. The
effects of alcohol abuse can be extremely serious-even fatal-both to you
& to others.
The Decision To Get Help
========================
Acknowledging that help is needed for an alcohol problem may not be easy.
But keep in mind that the sooner a person gets help, the better are his
or her chances for a successful recovery.
Any reluctance you may feel about discussing your drinking with your
health care professional may stem from common misconceptions about
alcoholism & alcoholic people. In our society, the myth prevails that an
alcohol problem is somehow a sign of moral weakness. As a result, you may
feel that to seek help is to admit some type of shameful defect in
yourself. In fact, however, alcoholism is a disease that is no more a
sign of weakness than is asthma or diabetes. Moreover, taking steps to
identify a possible drinking problem has an enormous payoff-a chance for
a healthier, more rewarding life.
When you visit your health care provider, he or she will ask you a number
of questions about your alcohol use to determine whether you are
experiencing problems related to your drinking. Try to answer these
questions as fully & honestly as you can. You also will be given a
physical examination. If your health care professional concludes that you
may be dependent on alcohol, he or she may recommend that you see a
specialist in diagnosing & treating alcoholism. You should be involved in
making referral decisions & have all treatment choices explained to you.
Getting Well
============
Alcoholism Treatment
The nature of treatment depends on the severity of an individual's
alcoholism & the resources that are available in his or her community.
Treatment may include detoxification (the process of safely getting
alcohol out of one's system); taking doctor-prescribed medications, such
as disulfiram (Antabuse®) or naltrexone (ReViaT), to help prevent a
return to drinking once drinking has stopped & individual and/or group
counseling. There are promising types of counseling that teach recovering
alcoholics to identify situations & feelings that trigger the urge to
drink & to find new ways to cope that do not include alcohol use. Any of
these treatments may be provided in a hospital or residential treatment
setting or on an outpatient basis.
Because the involvement of family members is important to the recovery
process, many programs also offer brief marital counseling & family
therapy as part of the treatment process. Some programs also link up
individuals with vital community resources, such as legal assistance, job
training, child care & parenting classes.
Alcoholics Anonymous
====================
Virtually all alcoholism treatment programs also include meetings of
Alcoholics Anonymous (AA), which describes itself as a "worldwide
fellowship of men & women who help each other to stay sober." While AA is
generally recognized as an effective mutual help program for recovering
alcoholics, not everyone responds to AA's style & message & other
recovery approaches are available. Even those who are helped by AA
usually find that AA works best in combination with other elements of
treatment, including counseling & medical care.
Can Alcoholism Be Cured?
========================
While alcoholism is a treatable disease, a cure is not yet available.
That means that even if an alcoholic has been sober for a long while &
has regained health, he or she remains susceptible to relapse & must
continue to avoid all alcoholic beverages. "Cutting down" on drinking
doesn't work; cutting out alcohol is necessary for a successful recovery.
However, even individuals who are determined to stay sober may suffer one
or several "slips," or relapses, before achieving long-term sobriety.
Relapses are very common & do not mean that a person has failed or cannot
eventually recover from alcoholism. Keep in mind, too, that every day
that a recovering alcoholic has stayed sober prior to a relapse is
extremely valuable time, both to the individual & to his or her family.
If a relapse occurs, it is very important to try to stop drinking once
again & to get whatever additional support is needed to abstain from
drinking.
Help for Alcohol Abuse
======================
If your health care provider determines that you are not alcohol
dependent but are nonetheless involved in a pattern of alcohol abuse, he
or she can help you:
Examine the benefits of stopping an unhealthy drinking pattern.
* Set a drinking goal for yourself. Some people choose to abstain from
alcohol, while others prefer to limit the amount they drink.
* Examine the situations that trigger your unhealthy drinking patterns
& develop new ways of handling those situations so that you can
maintain your drinking goal.
Some individuals who have stopped drinking after experiencing
alcohol-related problems choose to attend AA meetings for information &
support, even though they have not been diagnosed as alcoholic
Contact:
The Legacy Group of Alcoholics Anonymous © 2005