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 information below will explain
alcoholism and alcohol abuse, symptoms of each, when and where to seek help, treatment
choices, and additional helpful resources.
most people, alcohol is a pleasant accompaniment to social activities. Moderate alcohol
use--up to two drinks per day for men and one drink per day for women and 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 and women in the United
States report that one or more of their close relatives have a drinking problem.
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, and larynx (voice box). It can also cause liver cirrhosis, immune
system problems, brain damage, and harm to the fetus during pregnancy. In addition,
drinking increases the risk of death from automobile crashes, recreational accidents, and
on-the-job accidents and also increases the likelihood of homicide and suicide. In purely
economic terms, alcohol-use problems cost society approximately $100 billion per year. In
human terms, the costs are incalculable.
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, and
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."
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 and treatment, many individuals are able to stop drinking and
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 and the availability of alcohol, also are significant influences. Both
inherited and 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.
Is Alcohol Abuse?
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;
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 abuse is basically different from alcoholism, it is important to note that many
effects of alcohol abuse are also experienced by alcoholics.
Are the Signs of a Problem?
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
- 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
"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 and, if so, recommend the best course of action for
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 and to others.
Decision To Get Help
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.
reluctance you may feel about discussing your drinking with your health care professional
may stem from common misconceptions about alcoholism and 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.
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 and 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 specalist in diagnosing and
treating alcoholism. You should be involved in making referral decisions and have all
treatment choices explained to you.
The nature of treatment depends on the severity of an individual's alcoholism and 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 (ReViaTM), to help
prevent a return to drinking once drinking has stopped; and individual and/or group
counseling. There are promising types of counseling that teach recovering alcoholics to
identify situations and feelings that trigger the urge to drink and 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.
the involvement of family members is important to the recovery process, many programs also
offer brief marital counseling and 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, and parenting classes.
all alcoholism treatment programs also include meetings of Alcoholics Anonymous (AA),
which describes itself as a "worldwide fellowship of men and 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 and message, and
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 and
Alcoholism Be Cured?
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 and has regained health, he or she remains
susceptible to relapse and must continue to avoid all alcoholic beverages. "Cutting
down" on drinking doesn't work; cutting out alcohol is necessary for a successful
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 and 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 and to his or her
family. If a relapse occurs, it is very important to try to stop drinking once again and
to get whatever additional support is needed to abstain from drinking.
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, and develop new ways of handling those
situations so that you can maintain your drinking goal.
individuals who have stopped drinking after experiencing alcohol-related problems choose
to attend AA meetings for information and support, even though they have not been
diagnosed as alcoholic.
information on alcohol abuse and alcoholism, contact the following organizations:
1600 Corporate Landing Parkway
Virginia Beach, VA 23454-5617
Internet address: http://www.al-anon.alateen.org
referrals to local Al-Anon groups, which are support groups for spouses and other
significant adults in an alcoholic person's life. Also makes referrals to Alateen groups,
which offer support to children of alcoholics.
of Al-Anon or Alateen meetings worldwide can be obtained by calling the toll-free numbers
Monday through Friday, 8 a.m.-6 p.m. (e.s.t.):
U. S.: (800) 344-2666
Canada: (800) 443-4525
informational materials can be obtained by calling the toll-free numbers (operating 7 days
a week, 24 hours per day):
U. S.: (800) 356-9996
Canada: (800) 714-7498
Anonymous (AA) World Services
475 Riverside Drive, 11th Floor
New York, NY 10115
Internet address: http://www.alcoholics-anonymous.org
referrals to local AA groups and provides informational materials on the AA program. Many
cities and towns also have a local AA office listed in the telephone book.
National Council on
Alcoholism and Drug Dependence (NCADD)
12 West 21st Street
New York, NY 10010
Internet address: http://www.ncadd.org
Provides phone numbers
of local NCADD affiliates (who can provide information on local treatment resources) and
educational materials on alcoholism via the above toll-free number.
on Alcohol Abuse and Alcoholism
Scientific Communications Branch
6000 Executive Boulevard, Suite 409
Bethesda, MD 20892-7003
Internet address: http://www.niaaa.nih.gov
chemical dependency and its toxic impact on family members. Raise your
children to choose to be alcohol and other drugs
free. Learn how
to in Dr. Frischs, Psy.D. Recovery book series.