Alcohol Abuse and Alcoholism
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Alcohol Abuse and Alcoholism

(Alcohol Dependence; Alcohol Use Disorder)

En Español (Spanish Version)More InDepth Information on This Condition

Definition

Alcohol abuse is excessive or problematic alcohol consumption. It can progress to alcoholism.

Alcoholism is chronic alcohol abuse that results in a physical dependence on alcohol (withdrawal symptoms) and an inability to stop or limit drinking.

Causes

Several factors can contribute to alcohol abuse and alcoholism, 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 increases your chance of getting a disease or condition.

Risk factors include:

  • Sex: male
  • Family members who abuse alcohol (especially men whose fathers or brothers are alcoholic)
  • Starting to use alcohol at an early age (younger than 14)
  • Using illicit drugs or non-medical use of prescription drugs
  • Peer pressure
  • Easy access to alcoholic beverages
  • Psychiatric disorders, such as depression or anxiety
  • Smoking

Symptoms

It is common to deny an alcohol problem. 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, often including drinking and driving
  • Continuing to drink despite alcohol-related difficulties

Symptoms of alcoholism include:

  • Craving a drink
  • Unable to stop or limit drinking
  • Needing greater amounts of alcohol to feel the same effect
  • Giving up activities in order to drink or recover from alcohol
  • Drinking that continues even when it causes or worsens health problems
  • Wanting to stop or reduce drinking, but not being able
  • Withdrawal symptoms if alcohol is stopped include:
    • Nausea
    • Sweating
    • Shaking
    • Anxiety
    • Increased blood pressure
    • Seizures ( delirium tremens , “DTs”)

The brain, nervous system, heart, liver, stomach, gastrointestinal tract, and pancreas can all be damaged by alcoholism.

Some of the Organs Damaged in Alcohol Abuse

Alcohol damaged organs right size

© 2008 Nucleus Medical Art, Inc.

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?

Blood tests may be done to:

  • Look at the size of your red blood cells and to check for a substance called carbohydrate-deficient transferrin
  • Check for alcohol-related liver disease and other health problems

Treatment

Treatment for alcohol abuse or dependence is aimed at teaching patients how to manage the disease. Most professionals believe that this means giving up alcohol completely and permanently.

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 alcohol safely. This could require hospitalization in a detoxification center. They will carefully monitor you for side effects. You may need medication while you are undergoing detoxification.

Treatments include:

Medications

Drugs can help relieve some of the 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 (ReVia)—blocks the high that makes you crave alcohol
  • Disulfiram (Antabuse)—makes you very sick if you drink alcohol
  • Acamprosate (Campral)—reduces your craving for alcohol

A study showed that an anticonvulsant drug, topiramate (Topamax), may reduce alcohol dependence. *

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 learn other ways of dealing with stress or pain.

Mentoring and Community Help

Alcoholics Anonymous (AA) helps many people to stop drinking and stay sober. Members meet regularly and support each other. Your family members may also benefit from attending meetings of Al-Anon. Living with an alcoholic can be a painful, stressful situation.

Here are some general statistics on treatment outcomes of individuals one year after attempting to stop drinking:

  • 1/3 remained abstinent
  • 1/3 resumed drinking but at a lower level
  • 1/3 relapsed completely

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 nondrinking friends.
  • Do fun things that do not involve alcohol.
  • Avoid reaching for a drink when stressed or upset.
  • 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

Most professionals who treat alcohol abuse and dependence believe that complete abstinence is the only effective “prevention.”

RESOURCES:

Alcoholics Anonymous
http://www.alcoholics-anonymous.org

The National Council on Alcoholism and Drug Dependence
http://www.ncadd.org

CANADIAN RESOURCES:

Alcoholics Anonymous
http://www.aacanada.com/

Health Canada
http://www.hc-sc.gc.ca/index_e.html

References:

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Text Revision. Washington, DC: American Psychiatric Association; 2000.

Dambro M, Griffith JA. Griffith's 5-Minute Clinical Consult . Philadelphia, PA: Lippincott Williams and Wilkins; 2006.

Data/Statistical Tables. National Institute on Alcohol Abuse and Alcoholism website. Available at: http://www.niaaa.nih.gov/ . Accessed June 15, 2008.

Goroll AH, Mulley AG. Primary Care Medicine. 4th ed. Philadelphia, PA: Lippincott Williams and Wilkins; 2000.

JAMA patient page: Benefits and dangers of alcohol. JAMA . 1999;281(No.1).

JAMA patient page: Do you have a drinking problem? JAMA . 1999;281(No.14).

National epidemiologic survey on alcohol and related conditions. Alcohol Alert (No. 70). National Institute on Alcohol Abuse and Alcoholism website. Available at: http://pubs.niaaa.nih.gov/publications/AA70/AA70.htm . Accessed February 19, 2007.

*10/25/2007 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Johnson BA, Rosenthal N, Capece JA, et al. Topiramate for treating alcohol dependence: a randomized controlled trial. JAMA. 2007;298:1641-1651.



Last reviewed March 2008 by Rosalyn Carson-DeWitt, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.


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