What is Alcoholism?
Alcoholism is not a character flaw or a sign of weakness; it is a chronic disease with a biological and genetic basis. The average person suffering from alcoholism is not a homeless person wandering the streets. In fact, 95% of people with alcohol dependency are employed and have families. Many people who drink alcohol occasionally consume excessive amounts of alcohol. However, the amount of alcohol consumed, the frequency of consumption, the type of alcohol, and the time of day that one chooses to drink are not the most important factors to consider. Rather, it is one’s overwhelming craving for alcohol and the consumption of alcohol in the face of alcohol-related dangers that are important. Alcoholism is a chronic disease, possibly fatal, that is characterized by an overwhelming need to drink alcohol.
Alcohol is the most used drug and is the most common substance abuse problem in the United States. Alcoholism is a serious disease that has far-reaching consequences including damage to one’s physical health, a negative impact on emotional stability, and harmful effects on one’s family and work. Alcoholism is dangerous and can be deadly. Alcohol use is implicated in approximately 100,000 deaths every year. Death associated with alcohol use is the third leading cause of preventable death in the US.
People afflicted with alcohol dependency have little or no control over their drinking. Their thoughts are consumed with drinking, and this begins to affect all areas of one’s life: family, friends and work. Most people with alcohol dependency deny that they have a problem with alcohol and continue to drink in spite of a history of alcohol-related problems (for example, getting arrested, losing a job or alienating friends or family because of alcohol).
What Causes Alcoholism?
No one truly knows what causes alcoholism. It is believed to result from biological, genetic, psychosocial and cultural factors. While alcoholism may develop in someone who has undergone a traumatic or stressful experience, it generally appears without any identifiable precipitating event. Some believe that genetic factors are involved; however, more research is needed.
If a person consumes alcohol over an extended period of time, something called "tolerance" occurs. This means that the person needs to consume a greater quantity of alcohol to produce the same effect or "high." Tolerance does not cause alcoholism. However, even though people often experience a "high" with alcohol use, alcohol acts as a depressant on the central nervous system. With long-term use, the brain’s chemistry is altered by the presence of alcohol. The effects of altered brain chemistry on alcoholism are not fully understood.
Who Develops Alcoholism?
Alcoholism affects millions of Americans directly and indirectly. Approximately 11 million Americans are afflicted with alcoholism. It is estimated that 43% of American adults have a family member dealing with alcohol dependency. While both men and women are at risk, more people with alcohol dependency are men.
Alcoholism runs in families. Those persons with a family history of alcoholism are at greater risk for developing alcoholism. In fact, the risk for developing alcoholism in a man whose father suffers from alcoholism is 25%.
Those who begin drinking in adolescence are four times more likely to develop alcoholism than those who wait until their early twenties. Alcohol use among the young is pervasive; in fact, one source estimates that 64% of high school seniors have been drunk. Approximately 1.9 million adolescents and young adults between the ages of 12 to 20 drink heavily while 4.4 million are considered binge drinkers (meaning that they consume at least five drinks on one occasion). While the incidence of alcohol abuse is highest in people between the ages of 18 and 29 years, it can affect people of any age, including the elderly.
People with certain types of emotional disorders (for example, depression or anxiety) are at risk. In fact, approximately one-third of all cases of alcoholism are associated with major clinical depression. It is not entirely clear if depression leads to alcoholism or if alcoholism causes depression.
Signs and Symptoms
The most common symptoms associated with alcoholism are:
An overwhelming need or desire to drink – a craving for alcohol
Inability to limit consumption –no control over the amount or frequency of alcohol consumption
Physical dependence on the effects of alcohol –the brain’s chemistry is altered in the presence of long-term alcohol ingestion. Withdrawal symptoms occur when drinking alcohol is stopped.
Tolerance –the need to consume increasing amounts of alcohol to feel the same effects (or "high").
The Diagnosis of Alcoholism
Alcoholism is difficult to diagnose. Often people with alcohol dependency deny their alcohol addiction or attempt to conceal it from their physicians. It is incredibly important that family, friends and/or the medical community be able to recognize the signs of alcoholism so that treatment can be initiated. Treatment is critical to control the disease and prevent fatal complications.
A physician who suspects alcoholism may ask the person to complete a questionnaire and answer certain questions relating to alcohol use and attitudes. The physician may complete a medical history, conduct a physical examination and perform laboratory analysis to ensure that there are no physical illnesses caused by alcohol abuse. People must remember that alcoholism truly is a disease and not simply a sign of a weak or flawed person.
How Serious is Alcoholism?
Complications of Alcoholism
There are numerous complications of alcoholism that are serious and in some cases deadly. Approximately 100,000 deaths every year are in some part related to alcohol use. Alcoholism decreases one’s life expectancy by 10-15 years. It can affect every facet of life from one’s physical health to one’s emotional health and one’s interpersonal relationships. In the U.S., the costs associated with alcoholism are staggering; the costs in 1995 for alcoholism and alcohol-related problems were estimated to be $166.5 billion dollars.
Alcohol affects nearly every part of one’s body: the brain and central nervous system (CNS), the gastrointestinal system, the immune system, the heart and blood vessels, sexual functioning and fetal development. Chronic alcohol abuse is associated with the development of cancer, liver disease (such as hepatitis and cirrhosis), impaired immune system, clinical depression, osteoporosis, and malnutrition, just to name a few. Women who drink alcohol even in moderate amounts while pregnant are at increased risk for causing damage to their fetus and for miscarriage.
Furthermore, alcohol ingestion during pregnancy is associated with a condition known as fetal alcohol syndrome (FAS). FAS, which is associated with growth problems and mental retardation in children, is the leading environmental cause of mental retardation.
Alcoholism affects one’s emotions and behaviors. It often removes inhibitions (causing people to do things that they would not normally do when sober), affects mood, causes memory loss, and may result in violent behavior that could result in suicide or homicide. It is associated with clinical depression and anxiety.
People with alcohol dependency have a higher rate of accidents and injury. Alcohol use contributes to more than 50% of all automobile fatalities. Alcoholism is also related to suicide, murder, and domestic violence.
There is no cure for alcoholism; however, it can be treated. Treatment is associated with total abstinence from alcohol. The longer one avoids alcohol, the greater the chance one has to attain long-term sobriety. People with alcohol dependency are always at risk for relapsing. Sometimes people relapse one or even several times. However, relapses do not rule out eventual success in achieving total abstinence.
What are the Complementary and Alternative Treatments for Alcoholism?
What are the Conventional Treatments for Alcoholism?
The treatment for alcoholism includes two phases: treatment of alcohol withdrawal and rehabilitation. When a person with alcohol dependency stops drinking alcohol, he will go through withdrawal. Symptoms of withdrawal can include nausea, vomiting, sweating, trembling, rapid heart rate, changes in blood pressure, agitation, anxiety and hallucinations. Symptoms tend to appear within one to two days after the last drink. A small percentage of patients may experience something called "delirium tremens" which is characterized by confusion and hallucinations that can be seen, heard and/or felt. Delirium tremens is potentially fatal and requires immediate treatment. A few patients develop seizures within the first one or two days after the last drink (sometimes referred to as "rum fits") These seizures are generally not life-threatening and are easily treated.
Before a person makes the decision to quit drinking, he or she should see a physician to ensure that there are no serious medical conditions that could be worsened by the symptoms of alcohol withdrawal. People going through alcohol withdrawal can often be treated in an out-patient setting. A physician may recommend an anti-anxiety medication, such as a benzodiazepine, for three to five days. Benzodiazepines help to minimize the symptoms as the depressant effects of alcohol wear off. Examples of benzodiazepines include diazepam (Valium), chlordiazepoxide (Librium), lorazepam (Ativan), and oxazepam (Serax). People may also receive vitamin supplements, particularly if they are malnourished.
After the symptoms of withdrawal have eased, the process of rehabilitation begins. Rehabilitation can take place as an out-patient, or as an in-patient in a hospital or center dedicated to substance abuse. Rehabilitation primarily involves counseling and/or involvement in group therapy. There are many types of support groups. There are those that focus on the person with the alcohol dependency, such as Alcoholics Anonymous (AA), and those that focus on the family members or friends, such as Al-Anon and Alateen.
There are several forms of medication that may be used in addition to the counseling. Disulfiram (Antabuse) causes a violent reaction in people who drink alcohol while taking the medication. People experience flushing, nausea, vomiting, and headaches. Naltrexone (ReVia) prevents the "high" associated with alcohol ingestion and may reduce the craving for alcohol.
The goals of treatment include:
Ease person through period of alcohol withdrawal
Provide maximum level of comfort to patient during period of alcohol withdrawal
Help the person attain and maintain sobriety
Help the person to manage their life without alcohol
Avoid complications associated with alcoholism
Provide thorough education regarding alcoholism and its management
How Can Alcoholism Be Managed?
There are a number of things that one can do to manage alcoholism:
If you are concerned that you or a friend of yours has an alcohol dependency problem, answer the following questions:
Have you ever felt that you should cut down on drinking?
Have people annoyed you by criticizing your drinking?
Have you felt bad or guilty about your drinking?
Have you ever had a drink in the morning to steady your nerves or treat a hang-over?
If you answer "yes" to one question, you may have a problem with alcohol. If you answered "yes" to more than one question, it is highly likely that you have a problem.
Admitting to a drinking problem is the first step toward recovery
Know that the earlier you quit drinking, the greater the chance that you will avoid complications down the road
Change your environment (for example avoid situations where alcohol is likely to be served, and avoid friends who do not support your choice of abstinence) while you are trying to achieve and maintain sobriety
Join a support group, such as Alcoholics Anonymous (AA)
Find ways to live your life and fill your time without alcohol – find new hobbies, meet new people, exercise, relax
Don’t despair if you relapse. Relapse is not a sign of weakness or failure. Abstinence is an achievable goal.