Alcohol is commonly used as a form of celebration, to relax, or when socializing with others. Our age, family history, how often we drink and how much we drink are important variables to keep in mind when considering our relationship with alcohol. Drinking in moderation is a reasonable way to use alcohol. However, when we drink in excess, as a way to cope with or avoid other problems and stressors, it can lead to physical and emotional problems.
According to the "Dietary Guidelines for Americans 2015-2020,” U.S. Department of Health and Human Services and U.S. Department of Agriculture, moderate drinking is up to 1 drink per day for women and up to 2 drinks per day for men.
In the U.S., one "standard" drink contains roughly 14 grams of pure alcohol, which is found in:
Because alcohol use varies greatly between people and over time, it can be helpful to think about signs that can signal the start of a problem, such as when drinking interferes with home life, school, or work. There may be a problem if you continue to drink even though it causes problems with family and friends. Or there may be a problem if you had to cut back activities because of drinking.
Alcohol abuse cuts across gender, race, and ethnicity. Nearly 14 million people in the U.S. are dependent on alcohol. More men than women are alcohol dependent or have alcohol problems. Issues surrounding alcohol are highest among young adults ages 18-29 and lowest among adults ages 65 and older. Defining and diagnosing Alcohol Use Disorder can be complicated when working with young adults; the lifestyle of college students often includes excessive use of alcohol, making it difficult to ascertain when it is a problem and when it isn't.
Short-term effects include memory loss, hangovers, and blackouts. Long-term problems associated with heavy drinking include stomach ailments, heart problems, cancer, brain damage, memory loss, and liver cirrhosis. Heavy drinkers also markedly increase their chances of dying from automobile accidents, homicide, and suicide.
Alcohol use and abuse is also linked to a higher incidence of unemployment, domestic violence and legal issues.
Alcohol Use Disorder is defined as a problematic pattern of drinking that results in two or more of the following situations within a 12-month period:
Alcoholism, or alcohol dependence, used to be considered the most severe form of alcohol abuse. The DSMV integrates alcohol abuse and alcohol dependence, into a single disorder called alcohol use disorder (AUD) with mild, moderate, and severe sub-classifications.
Mild: The presence of two to three symptoms
Moderate: The presence of four to five symptoms
Severe: The presence of six or more symptoms.
Answering the following four questions can help you find out if you or a loved one has a drinking problem:
One yes answer suggests a possible problem. A yes answer to more than one question indicates that a problem likely exists. Answering no to the above questions may still imply the need for help. It is important to consult a doctor or other health care provider immediately and be honest and forthcoming with them to determine if you have a drinking problem and, if so, collaborate on the best course of action.
Health Hazards that may indicate problematic drinking habits or alcohol abuse:
The risk for developing alcoholism is influenced by both genetic and environmental factors.
Alcohol use tends to run in families, and the rate of the condition is three to four times higher in close relatives. When there is a family history of alcohol or substance use behaviors, the risk increases with closer genetic relationship to the affected person.
Environmental factors include cultural attitudes about drinking, availability of alcohol, stress levels, substance abuse by peers, positive expectations of the use of alcohol and maladaptive ways of coping. Impulsivity as a personality variable is also linked to high alcohol use and abuse.
Risk for abusing alcohol also increases if an individual uses alcohol to avoid thinking about things or numbing themselves to their problems, to cope with anxiety, fears or mood issues, or enhance their creativity.
Many people with alcohol problems don't recognize when their drinking becomes problematic, and others are not ready to get help with their drinking. It is important for each individual person to consider the pros and cons related to their drinking and to decide whether they need to cut down (harm reduction) or quit altogether (abstinence).
Abstinence from alcohol is strongly recommended for those who have
Others may benefit from the harm reduction approach, aimed to help individuals reduce the impact of the consequences associated with drinking.
When drinking is associated with significant intoxication (problematic behavior or changes caused by recent ingestion of alcohol) and/or withdrawal symptoms (nausea, vomiting, agitation, insomnia, seizures, hand tremors), detoxification may be required to start the process of treatment.
Detoxification, entailing withdrawal from alcohol, is done in a controlled, supervised setting in which medications relieve symptoms. Detoxification usually takes four to seven days. Examination for other medical problems is necessary. For example, liver and blood-clotting problems are common. A balanced diet with vitamin supplements is important. Complications associated with the acute withdrawal from alcohol may occur, such as delirium tremens (DT's), which could be fatal. Depression or other underlying mood disorders should be evaluated and treated, as alcohol abuse often develops from efforts to self-treat an illness.
Following detoxification, alcohol recovery or rehabilitation programs support the affected person to maintain abstinence from alcohol. Counseling, psychological support, nursing, and medical care are usually available within these programs. Education about the disease of alcoholism and its effects is part of the therapy. Many of the professional staff involved in rehabilitation centers are recovering alcoholics who serve as role models. Programs can be either inpatient, with the patient residing in the facility during the treatment, or outpatient, with the patient attending the program while living at home.
It is also important to remember that oftentimes other psychiatric conditions, such as depression or bipolar disorder, may coexist with alcoholism. Therefore, coexisting or underlying disorders may also need to be treated. Individuals suffering from other underlying psychiatric conditions may use alcohol as a form of self-medication. If this is the case, dual diagnosis of any coexisting condition is essential as it can guide treatment.
Three oral medications—disulfiram (Antabuse), naltrexone (Depade, ReVia), and acamprosate (Campral)—are currently approved to treat alcohol dependence. In addition, an injectable, long-acting form of naltrexone (Vivitrol) is available. These medications have been shown to help people with dependence reduce their drinking, avoid relapse to heavy drinking, and achieve and maintain abstinence. Naltrexone acts in the brain to reduce craving for alcohol after someone has stopped drinking. Acamprosate is thought to work by reducing symptoms that follow lengthy abstinence, such as anxiety and insomnia. Disulfiram discourages drinking by making the person taking it feel sick after drinking alcohol.
Other types of drugs are available to help manage symptoms of withdrawal (such as shakiness, nausea, and sweating) if they occur after someone with alcohol dependence stops drinking. Early recognition of these symptoms and immediate treatment can prevent some of the symptoms or drastically limit severity.
Virtually all alcoholism treatment programs also include support meetings such as Alcoholics Anonymous (AA). AA describes itself as a "worldwide fellowship of men and women who help each other to stay sober." Although AA is generally recognized as an effective mutual help program for recovering alcoholics, not everyone responds to AA's style or message. Even people who are helped by AA usually find that AA works best in combination with other forms of treatment, including counseling and medical care.
Seeking Help for an Unwilling Alcoholic
An alcoholic can't be forced to get help except under certain circumstances, such as a violent incident that results in court-ordered treatment or medical emergency. Many alcoholism treatment specialists suggest the following steps to help an alcoholic:
Alcoholism treatment works for many people. But just like any chronic disease, there are varying levels of success when it comes to treatment. Some people stop drinking and remain sober. Others have long periods of sobriety with bouts of relapse. And still others cannot stop drinking for any length of time. With treatment, one thing is clear, the longer a person abstains from alcohol the more likely he or she will stay sober.
Last reviewed 04/19/2017