Alcoholism and Alcohol Abuse
Also
known as: Alcohol dependence
What
is it?
Alcoholism is a disorder that is characterized by
an excessive dependence upon and craving for
alcoholic beverages. This dependence affects every
aspect of the alcoholic’s life - socially,
personally, and professionally – and can lead to
physical and psychological harm to the alcoholic
and often to those around him or her. Many people
consider alcoholism and alcohol abuse to be the
same. However, a person who abuses alcohol does
not crave alcohol or become dependent on it. The
alcohol abuser has a pattern of excessive drinking
that results in poor judgment and recurring
social, legal, or professional consequences of the
abuse. Prolonged alcohol abuse often leads to
alcoholism.
Who
gets it?
Anyone
who drinks alcohol can fall into the trap of
alcoholism. However, people who have a family
history of alcohol abuse disorders are more likely
to also have this disorder. Men are more likely to
become alcoholics than women. Adolescents are at
higher risk for alcohol abuse because of the
tendency to binge drink.
What
causes it?
Many
factors can contribute to alcoholism and alcohol
abuse. These can include depression, a disruptive
home life, peer pressure, and job problems. Those
with a family history of alcoholism may have a
genetically inherited lower sensitivity to
alcohol, which means they can drink more without
feeling the effects. It is difficult to separate
the effects of environment and heredity as a cause
of alcoholism.
What
are the symptoms?
Alcoholics have an uncontrollable craving for
alcohol. While they may recognize that their use
of alcohol is self-destructive and hurts others,
they are unable to resist the compulsion to drink
and are unable to control the amount of alcohol
they drink at one time. With time, alcoholics need
to drink more and more to feel good because they
develop a tolerance for alcohol. An alcoholic who
suddenly stops drinking will develop withdrawal
symptoms, similar to a drug addict. These might
include weakness, tremors, sweating, and nausea.
More serious withdrawal symptoms include seizures,
hallucinations, and delirium tremens (DTs). The
DTs is a severe onset of anxiousness, confusion,
and delirium, accompanied by high fever, that can
be fatal if untreated. Untreated alcoholism can
damage just about every organ in the body.
Complications of alcoholism can include liver
damage (cirrhosis), brain damage, heart failure,
persistent tremor, depression, malnutrition,
stomach ulcers, high blood pressure, decreased sex
drive, bleeding in the esophagus, and certain
cancers, particularly of the throat, liver,
pancreas, and esophagus. Many alcoholics have a
thiamine deficiency, which can cause Korsakoff’s
and Wernicke’s syndromes.
With
Korsakoff’s, the patient cannot remember recent
events. Wernicke’s is characterized by a loss of
coordination and abnormal eye movements. Abusing
alcohol can also result in nausea, vomiting,
diarrhea, memory loss, slurred speech, and
difficulty with coordination. Pregnant women who
drink are more likely to have children with birth
defects (fetal alcohol syndrome), and drunken
drivers are more likely to cause accidents that
may result in death. Alcoholics are also more
likely to commit suicide, or physically harm
another person. People who abuse alcohol, but are
not alcoholics, drink to the point where their
good judgment is impaired. These people usually
have a pattern of letting drinking interfere with
personal or professional responsibilities, binge
drinking, or drinking and driving. These patterns
are also true of alcoholics.
How is
it diagnosed?
Doctors
define moderate alcohol use as up to two drinks
per day for men and one drink per day for women
and the elderly. To diagnose alcoholism or alcohol
abuse, your doctor will ask you about your
drinking habits. How often do you drink? How many
drinks do you have per day or week? How do you
feel if you don’t drink? Do you drink in the
morning to relieve a hangover? The doctor will
want to know why and when you are more likely to
drink, if you have felt guilty about your
drinking, if you ever experience withdrawal
symptoms as a result of not drinking alcohol, if
you find yourself choosing to drink over other
activities, and if your drinking has had an effect
on your job performance and personal
relationships, or has resulted in legal problems.
The doctor will take your medical history and
perform a physical examination. He or she may
order blood tests.
What
is the treatment?
Someone
who is an alcoholic or abuses alcohol regularly
must stop drinking all together. There is no cure
for alcoholism that allows the patient to drink
socially without relapses into old habits.
Successful treatment requires behavioral therapy
and a strong support system. Because of this,
treatment programs must have family participation,
if possible. During treatment, your doctor will
monitor your progress. Treatment begins with
detoxification, which is a medically supervised
program to rid the body of the toxic effects of
the alcohol. Detoxification results in mild to
severe withdrawals symptoms. Patients suffering
severe withdrawal symptoms may be treated in a
hospital setting with sedative medications to help
relieve symptoms and intravenous (IV) fluids to
replace those lost through nausea and vomiting.
These fluids often include essential nutrients,
such as thiamine, that are typically low in
alcoholics. Detoxification is followed by
rehabilitation, which helps restore the patient’s
physical and mental health. Most alcoholics
benefit from a program, such as Alcoholics
Anonymous, that provides peer support and
step-by-step guidance for abstaining from alcohol.
Some patients take a prescription drug, such as
disulfiram, which causes extremely unpleasant side
effects if combined with alcohol, or naltrexone,
which helps curb alcohol craving. People who are
not alcoholics, but abuse alcohol, are also
treated with behavioral therapy to help them
examine the reasons they drink, face the
consequences of their drinking, and find ways to
avoid those situations.
Self-care tips
People
who are diagnosed alcoholics or alcohol abusers
face a life-long recovery process. While it is not
uncommon to experience a relapse, it is important
to seek the support you need to continue to be
alcohol-free. Because teenagers are in the highest
risk group for alcohol abuse, it is extremely
important for parents to educate their children
about the dangers of alcohol consumption and
provide a model of healthy behavior in terms of
alcohol use.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
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