|It is important to understand that the following questions and
answere answers are not meant to provide specific medical advice, but to provide
information to better understand the health consequences of alcohol abuse and dependence
(alcoholism). Please consult your physician or health care provider if you or a loved one
has an alcohol problem.
- What do we mean by alcoholism?
- Is alcoholism a disease?
- Is alcoholism inherited?
- Can alcoholism be cured?
- Are there any medications for
- Does alcoholism treatment work?
- Does a person have to be alcoholic to
experience problems from alcohol?
- Are certain groups of people more likely
to develop alcohol problems than others?
- How can you tell whether you or someone
close to you has an alcohol problem?
- If I have trouble with drinking, can't I simply reduce my
alcohol use without stopping altogether?
- How can a person get help for an alcohol problem?
- If an alcoholic is unwilling to seek help, is there any way to
get him or her into treatment?
- What is a safe level of drinking?
- Is it safe to drink during
- As people get older, does alcohol affect their bodies
- Does alcohol affect a woman's body differently from a man's
- I have heard that alcohol is good for your heart. Is this
- If I am taking over-the-counter or prescription medication, do
I have to stop drinking?
on Alcohol Abuse and Alcoholism
Alcoholism, also known
as "alcohol dependence," is a disease that includes alcohol craving and
continued drinking despite repeated alcohol-related problems, such as losing a job or
getting into trouble with the law. It includes four symptoms:
strong need, or compulsion, to drink.
control--The inability to limit one's drinking on any given occasion.
dependence--Withdrawal symptoms, such as nausea, sweating, shakiness, and anxiety,
when alcohol use is stopped after a period of heavy drinking.
need for increasing amounts of alcohol in order to feel its effects.
For clinical and
research purposes, formal diagnostic criteria for alcoholism also have been developed.
Such criteria are included in the Diagnostic and Statistical Manual of Mental
Disorders, Fourth Edition, published by the American Psychiatric Association, as well
as in the International Classification Diseases, published by the World Health
Alcoholism is a chronic, often progressive disease with symptoms that include a strong
need to drink despite negative consequences, such as serious job or health problems. Like
many other diseases, it has a generally predictable course, has recognized symptoms, and
is influenced by both genetic and environmental factors that are being increasingly
Alcoholism tends to
run in families, and genetic factors partially explain this pattern. Currently,
researchers are on the way to finding the genes that influence vulnerability to
alcoholism. A person's environment, such as the influence of friends, stress levels, and
the ease of obtaining alcohol, also may influence drinking and the development of
alcoholism. Still other factors, such as social support, may help to protect even
high-risk people from alcohol problems.
Risk, however, is not
destiny. A child of an alcoholic parent will not automatically develop alcoholism. A
person with no family history of alcoholism can become alcohol dependent.
Not yet. Alcoholism is
a treatable disease, and medication has also become available to help prevent relapse, but
a cure has not yet been found. This means that even if an alcoholic has been sober for a
long time and has regained health, he or she may relapse and must continue to avoid all
Yes. Two different
types of medications are commonly used to treat alcoholism. The first are tranquilizers
called benzodiazepines (e.g., Valium®, Librium®), which are used
only during the first few days of treatment to help patients safely withdraw from alcohol.
A second type of
medication is used to help people remain sober. A recently approved medicine for this
purpose is naltrexone (ReVia TM). When used together with counseling, this
medication lessens the craving for alcohol in many people and helps prevent a return to
heavy drinking. Another older medication is disulfiram (Antabuse®), which
discourages drinking by causing nausea, vomiting, and other unpleasant physical
reactions when alcohol is used.
is effective in many cases. Studies show that a minority of alcoholics remain sober 1 year
after treatment, while others have periods of sobriety alternating with relapses. Still
others are unable to stop drinking for any length of time. Treatment outcomes for
alcoholism compare favorably with outcomes for many other chronic medical conditions. The
longer one abstains from alcohol, the more likely one is to remain sober.
It is important to
remember that many people relapse once or several times before achieving long-term
sobriety. Relapses are common and do not mean that a person has failed or cannot
eventually recover from alcoholism. If a relapse occurs, it is important to try to stop
drinking again and to get whatever help is needed to abstain from alcohol. (See Question
12.) Ongoing support from family members and others can be important in recovery.
No. Even if you are
not alcoholic, abusing alcohol can have negative results, such failure to meet major work,
school, or family responsibilities because of drinking; alcohol-related legal trouble;
automobile crashes due to drinking; and a variety of alcohol-related medical
problems. Under some circumstances, problems can result from even moderate
drinking--for example, when driving, during pregnancy, or when taking certain
Yes. Nearly 14 million
people in the United States--1 in every 13 adults--abuse alcohol or are alcoholic.
However, more men than women are alcohol dependent or experience alcohol-related problems.
In addition, rates of alcohol problems are highest among young adults ages 18-29 and
lowest among adults 65 years and older. Among major U.S. ethnic groups, rates of
alcoholism and alcohol-related problems vary.
A good first step is
to answer the brief questionnaire below, developed by Dr. John Ewing. (To help remember
these questions, note that the first letter of a key word in each question 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 opener)?
answer suggests a possible alcohol problem. More than one "yes" answer means it
is highly likely that a problem exists. If you think that you or someone you know might
have an alcohol problem, it is important to see a doctor or other health provider right
away. He or she can determine whether a drinking problem exists and, if so, suggest the
best course of action.
That depends. If you
are diagnosed as an alcoholic, the answer is "no." Studies show that nearly all
alcoholics who try to merely cut down on drinking are unable to do
so indefinitely. Instead, cutting out alcohol (that is, abstaining) is nearly
always necessary for successful recovery. However, if you are not alcoholic but
have had alcohol-related problems, you may be able to limit the amount you drink. (See
Question 13 for recommended limits.) If you cannot always stay within your
limit, you will need to stop drinking altogether.
You can call the Center for Substance Abuse
Treatment at 1-800-662-HELP for information about treatment programs in your local
community and to speak to someone about an alcohol problem.
Many people also
benefit from support groups. For information on local support meetings run by Alcoholics Anonymous (AA), call your local
AA chapter (check your local phone directory under "Alcoholism") or call
212-870-3400. For meetings of Al-Anon (for
spouses and other significant adults in an alcoholic person's life) and Alateen (for children of alcoholics), call your
local Al-Anon chapter or call the following toll-free numbers: 1-800-344-2666 (United
States) or 1-800-443-4525 (Canada).
This can be a
challenging situation. An alcoholic cannot be forced to get help except under certain
circumstances, such as when a violent incident results in police being called or
following a medical emergency. This doesn't mean, however, that you have to wait for a
crisis to make an impact. Based on clinical experience, many alcoholism treatment
specialists recommend the following steps to help an alcoholic accept treatment:
"rescue missions." Family members often try to protect an alcoholic from
the results of his or her behavior by making excuses to others about his or her drinking
and by getting him or her out of alcohol-related jams. It is important to stop all such
rescue attempts immediately, so that the alcoholic will fully experience the harmful
effects of his or her drinking--and thereby become more motivated to stop.
intervention. Plan to talk with the drinker shortly after an alcohol-related
problem has occurred--for example, a serious family argument in which drinking played a
part or an alcohol-related accident. Also choose a time when he or she is sober, when both
of you are in a calm frame of mind, and when you can speak privately.
Tell the family member that you are concerned about his or her drinking and want to be
supportive in getting help. Back up your concern with examples of the ways in which his or
her drinking has caused problems for both of you, including the most recent incident.
consequences. Tell the family member that until he or she gets help, you will
carry out consequences--not to punish the drinker, but to protect yourself from the
harmful effects of the drinking. These may range from refusing to go with the person to
any alcohol-related social activities to moving out of the house. Do not make any threats
you are not prepared to carry out.
Be ready to
help. Gather information in advance about local treatment options. If the person
is willing to seek help, call immediately for an appointment with a treatment program
counselor. Offer to go with the family member on the first visit to a treatment program
and/or AA meeting.
Call on a
friend. If the family member still refuses to get help, ask a friend to talk with
him or her, using the steps described above. A friend who is a recovering alcoholic may be
particularly persuasive, but any caring, nonjudgmental friend may be able to make a
difference. The intervention of more than one person, more than one time, is often
necessary to persuade an alcoholic person to seek help.
Find strength in
numbers. With the help of a professional therapist, some families join with other
relatives and friends to confront an alcoholic as a group. While this approach may be
effective, it should only be attempted under the guidance of a therapist who is
experienced in this kind of group intervention.
Whether or not the alcoholic family member seeks help, you may benefit from the
encouragement and support of other people in your situation. Support groups offered in
most communities include Al-Anon, which holds regular meetings for spouses and other
significant adults in an alcoholic's life, and Alateen, for children of alcoholics. These
groups help family members understand that they are not responsible for an alcoholic's
drinking and that they need to take steps to take care of themselves, regardless of
whether the alcoholic family member chooses to get help.
For meeting locations,
call your local Al-Anon chapter (check your local phone book under "Alcoholism")
or call the following toll-free numbers: 1-800-344-2666 (United States) or 1-800-443-4525
Most adults can drink
moderate amounts of alcohol--up to two drinks per day for men and one drink per day for
women and older people--and avoid alcohol-related problems. (One drink equals one 12-ounce
bottle of beer or wine cooler, one 5-ounce glass of wine, or 1.5 ounces of 80-proof
certain people should not drink at all. They include women who are pregnant or trying to
become pregnant; people who plan to drive or engage in other activities requiring
alertness and skill; people taking certain medications, including certain over-the-counter
medicines; people with medical conditions that can be worsened by drinking; recovering
alcoholics; and people under the age of 21.
No. Drinking during
pregnancy can have a number of harmful effects on the newborn, ranging from mental
retardation, organ abnormalities, and hyperactivity to learning and behavioral problems.
Moreover, many of these disorders last into adulthood. While we don't yet know exactly how
much alcohol is required to cause these problems, we do know that they are
100-percent preventable if a woman does not drink at all during pregnancy. Therefore, for
women who are pregnant or are trying to become pregnant, the safest course is to
abstain from alcohol.
Yes. As a person ages,
certain mental and physical functions tend to decline, including vision, hearing, and
reaction time. Moreover, other physical changes associated with aging can make older
people feel "high" after drinking fairly small amounts of alcohol. These
combined factors make older people more likely to have alcohol-related falls, automobile
crashes, and other kinds of accidents.
In addition, older
people tend to take more medicines than younger persons, and mixing alcohol with many
over-the-counter and prescription drugs can be dangerous, even fatal. (See Question 18.)
Further, many medical conditions common to older people, including high blood pressure and
ulcers, can be worsened by drinking. Even if there is no medical reason to avoid alcohol,
older men and women should limit their intake to one drink per day.
Yes. Women become more
intoxicated than men after drinking the same amount of alcohol, even when differences in
body weight are taken into account. This is because women's bodies have proportionately
less water than men's bodies. Because alcohol mixes with body water, a given amount of
alcohol becomes more highly concentrated in a woman's body than in a man's. That is why
the recommended drinking limit for women is lower than for men. (See Question 13 for
addition, chronic alcohol abuse takes a heavier physical toll on women than on men.
Alcohol dependence and related medical problems, such as brain and liver damage, progress
more rapidly in women than in men.
Several studies have
reported that moderate drinkers--those who have one or two drinks per day--are less
likely to develop heart disease than people who do not drink any alcohol or who drink
larger amounts. Small amounts of alcohol may help protect against coronary heart disease
by raising levels of "good" HDL cholesterol and by reducing the risk of
blood clots in the coronary arteries.
If you are a
nondrinker, you should not start drinking only to benefit your heart. Protection against
coronary heart disease may be obtained through regular physical activity and a low-fat
diet. And if you are pregnant, planning to become pregnant, have been diagnosed as
alcoholic, or have any medical condition that could make alcohol use harmful, you should
Even for those who can
drink safely and choose to do so, moderation is the key. Heavy drinking can actually
increase the risk of heart failure, stroke, and high blood pressure, as well as cause many
other medical problems, such as liver cirrhosis.
Possibly. More than
100 medications interact with alcohol, leading to increased risk of illness, injury and,
in some cases, death. The effects of alcohol are increased by medicines that slow
down the central nervous system, such as sleeping pills, antihistamines,
antidepressants, antianxiety drugs, and some painkillers. In addition, medicines for
certain disorders, including diabetes and heart disease, can be dangerous if used
with alcohol. If you are taking any over-the-counter or prescription medications, ask
your doctor or pharmacist whether you can safely drink alcohol.
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.