Alcohol Abuse and Alcoholism

Alcohol abuse is a disease that involves desire for alcohol and continuing to drink even when faced with alcohol-related job, legal, health or family problems. Alcohol abuse can progress to alcoholism. Alcoholism is a condition in which the individual is physically dependent on the effects of alcohol to avoid symptoms of withdrawal.

Causes

Several factors contribute to alcohol abuse, including:
  • Genes
  • Brain chemicals that may be different than normal
  • Social pressure
  • Emotional stress
  • Pain
  • Depression and other mental health problems
  • Problem drinking behaviors learned from family or friends

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.
  • Sex: male
  • Alcohol use
  • Family members who abuse alcohol (especially men whose fathers or brothers are alcoholic)
  • Using illicit drugs
  • Peer pressure
  • Easy access to alcoholic beverages
  • Psychiatric disorders, such as depression or anxiety
  • Smoking

Symptoms

Denial that an alcohol problem exists is common. Alcohol abuse can occur without physical dependence.

Alcohol abuse symptoms include:
  • Repeated work, school or home problems due to drinking
  • Risking physical safety
  • Recurring trouble with the law
  • Continuing to drink despite alcohol-related difficulties
Alcohol abuse often progresses to alcohol dependence. Symptoms of alcohol dependence include:
  • Craving a drink
  • Unable to stop or limit drinking
  • Needing greater amounts of alcohol to feel the same effect
  • Withdrawal symptoms if alcohol is stopped, including:
  • Nausea
  • Sweating
  • Shaking
  • Anxiety
  • Increased blood pressure
  • Seizures
     
  • Giving up activities in order to drink or recover from alcohol's effects
  • Drinking that continues even when it causes or worsens health problems
  • Wanting to stop or reduce drinking and not being able to

Diagnosis

Doctors ask a series of questions to assess possible alcohol-related problems, including:

• Have you tried to reduce your drinking?

• Have you felt bad about drinking?

• Have you been annoyed by another person's criticism of your drinking?

• Do you drink in the morning to steady your nerves or cure a hangover?

• Do you have problems with a job, your family or the law?

• Do you drive under the influence of alcohol?

Tests may include:
  • Blood tests to look at the size of your red blood cells and to check for a substance called carbohydrate-deficient transferrin
  • Blood tests to check for alcohol-related liver disease and other health problems

Treatment

The first step in treatment is getting the patient to accept that he or she has a problem. A group intervention brings together important people in an individuals' life. They confront him or her about how alcohol is affecting all of his or her relationships and functioning.

Treatment for alcohol abuse or dependence is aimed at teaching patients how to manage the disease. Most often that means not drinking. If you abuse alcohol but are not dependent, you may be able to reduce your drinking. If you cannot stay within your alcohol limits, you will need to stop drinking completely.

The first and most important step is recognizing a problem exists. Successful treatment depends on your desire to change. Your doctor can help you withdraw from it safely. This could require hospitalization in a detoxification center, so that you are carefully monitored for side effects. You may need medication while you are undergoing detox.

Treatments include:

Medications

Drugs can help alleviate symptoms of withdrawal and help prevent relapse. The doctor may prescribe medication to reduce cravings for alcohol.

Medications used to treat alcoholism and to try to prevent drinking include:
  • Naltrexone
  • Disulfiram (Antabuse)
  • Acamprosate (Campral)
  • Selective serotonin reuptake inhibitors (SSRIs), including:
  • Fluoxetine (Prozac)
  • Sertraline (Zoloft)
  • Paroxetine (Paxil)
  • Citalopram (Celexa)
  • Fluvoxamine (Luvox)
     
  • Buspirone (BuSpar) – an antianxiety drug

    Education and Counseling

    Therapy helps you recognize alcohol's dangers. It raises awareness of underlying issues and lifestyles that promote drinking. In therapy, you work to improve coping skills and develop other ways of dealing with stress or pain. You learn new methods of handling situations where alcohol is served.

    Self-help Organizations

    Alcoholics Anonymous (AA) helps many people stop drinking and stay sober. Members meet regularly and talk about their troubles with alcohol. They support each other. If you feel like drinking, you can call your AA sponsor for help. Your family members may also benefit from attending meetings of Al-Anon, because living with an alcoholic can be a painful, stressful situation.

     

Prevention

Realizing that alcohol causes problems helps some people avoid it. Suggestions to decrease the risk of alcohol abuse and dependence include:
  • Socialize without alcohol.
  • Avoid going to bars.
  • Do not keep alcohol in your home.
  • Avoid situations and people that encourage drinking.
  • Make new non-drinking friends.
  • Do fun things that do not involve alcohol.
  • Avoid reaching for a drink when stressed or upset.
  • Drink slowly
     
  • Limit your alcohol intake to a moderate level.
  • Moderate is two or fewer drinks per day for men and one or fewer for women and older adults.
  • A 12-ounce bottle of beer, a five-ounce glass of wine or 1.5 ounces of liquor is considered one drink.