Saturday, December 13, 2008

Alcohol Abuse and Alcoholism

(Alcohol Dependence)
Alcohol abuse refers to excessive or problematic alcohol consumption even when faced with alcohol-related job, legal, social, health, or family problems. Alcohol abuse can progress to alcoholism. Alcoholism is a disease characterized by chronic alcohol abuse that results in a physical dependence on alcohol (withdrawal symptoms occur if alcohol consumption is abruptly stopped) and an inability to stop or limit drinking (“loss of control”).
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 is something that 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
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, often including drinking and driving
• Continuing to drink despite alcohol-related difficulties
Alcohol abuse often progresses to alcohol dependence (alcoholism). Symptoms of alcohol dependence 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's effects
• 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:
o Nausea
o Sweating
o Shaking
o Anxiety
o Increased blood pressure
o Seizures (delirium tremens, “DTs”)
In addition to the brain, nervous system, heart, and liver, the stomach, gastrointestinal tract, and pancreas can also be damaged by alcoholism.
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
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 individual's 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 professionals who treat people with alcohol problems 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, so that you are carefully monitored for side effects. You may need medication while you are undergoing detoxification.
Treatments include:

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 (ReVia)
• disulfiram (Antabuse)
• acamprosate (Campral)
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.
Mentoring and Community Help
Alcoholics Anonymous (AA) helps many people to 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.
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
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
o Moderate is two or fewer drinks per day for men and one or fewer for women and older adults
o 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.”