The High-Functioning Alcoholic

Understanding this Hidden Class of Alcoholics from a Professional and Personal View

Awareness of Risk Factors Can Help Decrease Risks of Developing Alcoholism

Is it possible to prevent alcoholism?

When individuals have a family history of diabetes or cancer, they often take precautions in order to prevent developing these conditions or at least feel comfortable admitting that they need to stay aware. In contrast, it seems that those with a family history of alcoholism do not always display the same caution. Could this be a reflection of the symptoms of alcoholism that include denial and an "obsession" with alcohol? Or is it a reflection of the stigma that alcoholism has in our society leading individuals to stay silent?

I have been asked if it is possible to avoid becoming alcoholic and while I do not feel that alcoholics have a "choice" in the matter, I do believe that there are certain ways to lower the risks.
The following risk factors greatly increase the chances of developing alcoholism or for having a predisposition:

1. Drinking before the age of 15: The Surgeon General's 2007 Call to Action for underage drinking 2007 found that 40% teens who starts drinking before age 15 meet diagnostic criteria for alcoholism at some time in their life with or without family history.
2. Family history: The Surgeon General's 2007 report also concluded that genetics account for 50% of the risk of developing alcoholism.
3. Underlying mental health issues: Individuals with underlying anxiety, depression, etc. have a higher chance of using alcohol to self-medicate than those without these pre-existing conditions. Therefore, it is necessary to treat both the alcoholism as well as the underlying mental illness in order to decrease the chances of relapse and to ensure a healthy sense of recovery. It is important to note that there are many depressed and anxious people who do not drink.
4. Trauma history: There is a strong correlation between those with a trauma history and/or post-traumatic stress disorder and alcohol or drug issues. An example of this is war veterans who return from service. Again, it is important that they seek appropriate trauma treatment in order to avoid self-medicating with alcohol. A person may start out drinking for one reason, but based on their predisposition or intense levels of alcohol consumption may end up developing alcoholism.
5. Impulsive personality: Those with addictions tend to have a need for immediate gratification and/or relief. They also may have a thrill-seeking personality.

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Given that the above are risk factors increasing the chances of developing alcoholism, there are certain strategies that may help reduce the risks. Taking into consideration the staggering findings about the genetics of alcoholism, it is clear that those with a family history should take caution. I have met some individuals of all ages who were mindful of their family history and made choices to abstain or limit their alcohol intake. One may wonder if those who are able to make this rational choice do not have the true alcoholic "mind". There are others with a family history who realized that they "liked alcohol too much" and quickly backed away. Even delaying the age in which one begins drinking to after age 15 can greatly reduce the chances of developing an alcohol problem. Important words of wisdom from parents to their children should include this information, given that most teens and college-age students will experiment with alcohol at some point. In terms of the other risk factors, it is important for those with mental health issues including trauma to seek appropriate professional help by receiving therapy and if necessary to be put on medication or utilize holistic and eastern medicine traditions such as acupuncture. Appropriate treatment may help these individuals to avoid self-medicating with alcohol or illegal drugs. Alcohol is a band-aid to treat something such as anxiety, in fact, it exacerbates this condition because the rebound effect of a depressant such as alcohol is a stimulation of the nervous system. Therefore, drinking can lead a person to feel jittery and agitated the following day which may then lead them to a dangerous cycle of drinking. Psychotropic medication and/or holistic alternatives will actually balance out brain chemistry and not just act as temporary "fix".

It is important for individuals to examine their relationship to alcohol no matter what their predisposition may be. If you or a loved one begins drinking beyond low risk limits (women no more than 7 standard drinks per week and no more than 3 drinks per sitting, men no more than 15 drinks per week and no more than 4 drinks per sitting) and are struggling to cut back then it is advised to seek help. The NIAAA "Rethinking Drinking" online assessment of drinking habits as well as a brief program to help individuals to set goals and cut back on their drinking:
http://rethinkingdrinking.niaaa.nih.gov/ By addressing this issue early, it can increase the chance of preventing a more serious problem.

If you need therapy for yourself, your loved one or to help in coping with a loved one's alcoholism there are many treatment options. Please visit the "Resource" page of my Website www.highfunctioningalcoholic.com or email me at sarah@highfunctioningalcoholic.com for help in finding a treatment referral.

 

Sarah Allen Benton, M.S., L.M.H.C., LPC, is a Licensed Mental Health Counselor and author of Understanding the High-Functioning Alcoholic: Professional Views and Personal Insights.

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