Casual drinking is a familiar ritual in our culture -- from campus keg parties to a "beer and a dog" at the ballgame to a nice bottle of wine on the dinner table. In countless advertisements, fun-loving youth frolic on the beach with beer cans in hand.
For millions of Americans, drinking is the root of a nightmarish disease. For alcoholics, behind the glamor of crystal snifters and decorative ice buckets looms an addiction that causes more than 140,000 deaths every year.
What is alcoholism?
Alcoholism, also called "alcohol dependence," is a chronic, progressive disease marked by a high tolerance for alcohol and physical dependence. Contrary to what many people believe, people with alcohol dependence aren't people with weak moral character or a lack of willpower. Instead, alcoholism is an illness affecting more than 15 million Americans.
How does alcoholism differ from alcohol abuse?
The two disorders have many symptoms in common, so the line between them is often tough to draw. However, most experts say physical dependence is not found in alcohol abusers, who are also less likely to have a high tolerance for drink found in alcoholics. Alcohol abusers may progress to becoming alcoholics, but not necessarily.
What causes alcoholism?
No one knows, but experts agree that the disease's development is influenced by many forces: hereditary, social, psychological and environmental.
Many researchers believe most of the harmful effects seen in those with alcohol use disorder are caused by a buildup of a toxic metabolic byproduct of alcohol called acetaldehyde. This substance may interact with brain chemicals to create a physiological need for the alcoholic to continue drinking, scientists believe. It may also cause cell damage in many organs.
Curiously, a strong tolerance for alcohol may predict the development of alcoholism later in life. For example, young men who can "drink others under the table" are more likely to become develop an addiction than their peers who cannot. One theory is that young men with an early high tolerance have a neurochemical deficiency that allows them to drink more alcohol before feeling its intoxicating effects. This way, the disease can sneak up before they realize what's happening.
Are some people more apt to develop alcoholism than others?
Yes. Studies show that children of those with alcohol use disorder are much more prone to alcoholism due to both nature and nurture, a combination of genetic factors and the impact of growing up in an alcoholic home. Alcoholics are two to three times as likely to be male as female. Some studies show that people who begin drinking very young have a much higher rate of alcoholism than others.
How do I know if I have an alcohol use disorder?
The following symptoms should tip you off that you -- or someone you know -- may need alcoholism treatment:
An uncontrollable craving. An actual need for alcohol may seem unfathomable to someone who doesn’t have an alcohol use disorder. Still, if you're addicted, you have a craving for alcohol similar to that of food and water.
People with alcohol use disorder can't just have a drink or two. You may have good intentions, but once you start, you have to keep drinking.
Needing a drink first thing in the morning is a sign of alcoholism.
Drinking for one. Drinking in secret (and hiding the evidence) is another indicator.
High tolerance. Someone with alcohol use disorder can drink an extraordinary number of drinks and still appear to function relatively normally.
Needing more and more. Someone with alcohol use disorder often needs increasing amounts to achieve the "high."
Drinking dominates everyday life. When drinking is doing significant harm to your work, school or home responsibilities regularly, and you still can't control it or cut back, you are likely suffering from alcoholism.
Withdrawal symptoms. If you regularly experience nausea, sweating, shakiness or anxiety when you stop after a period of heavy drinking, you are physically dependent on alcohol.
What are the consequences of alcoholism?
Studies show that problem drinking increases:
The incidence of domestic violence
Job loss
Likelihood of serious conflict with partners, children and friends
Risk of automobile crashes
Risk of drowning
On-the-job accidents
Suicide and homicide
Serious health problems for the drinker:
Alcoholic hepatitis. This disease involves liver inflammation, possibly leading to death if heavy drinking continues. Hepatitis of any kind causes the characteristic yellowish color in the eyes and skin, leading to liver dysfunction, fever and abdominal pain. If you're able to quit, the symptoms may vanish altogether.
Cirrhosis of the liver. Cirrhosis is an actual scarring of the liver developed by 10 to 20 percent of alcoholics. The disease is irreversible, and if you can't stop drinking, cirrhosis may eventually require a liver transplant. This condition can also lead to death. Telltale signs may include red lines on the face and in other areas caused by tiny, broken blood vessels.
Digestive issues. Heavy drinking may cause stomach ulcers and pancreatitis, an inflammation of the pancreas.
Increased risk of certain cancers. Heavy drinkers are more likely to have cancer of the liver, esophagus, throat and larynx (voice box).
Central nervous system disorders. Short-term memory loss and even dementia may occur in late-stage alcoholics.
Brain damage. A University of California, San Diego revealed binge drinking during the developmental stage of ages 15 to 16 may damage teenagers' ability to think, putting them at a disadvantage in school and finding a job. And a University of Oklahoma Health Sciences Center study found that just four years of heavy drinking (at least 10 drinks a day) can cause significant mental decline.
Fetal Alcohol Syndrome (FAS). Heavy drinking while pregnant can cause severe and irreversible congenital disabilities, including FAS, one of the leading causes of mental disabilities. Even light drinking during pregnancy may cause learning difficulties in your offspring. Federal health agencies recommend that women avoid alcohol entirely while pregnant and nursing.
How is alcoholism treated?
Most experts believe that total abstinence for life is the only way people with alcoholism can recover and avoid relapse, which is the goal of most successful treatment programs. Treatment usually begins with an initial period of detoxification, followed by counseling, a nutrition program and sometimes prescription medicines to help prevent relapse.
Treating alcoholism is a long and challenging process; few people can weather it independently. Your doctor and/or the National Council on Alcoholism and Drug Dependence (NCADD) can help you find treatment programs and support groups in your area.
Alcoholics Anonymous, the best-known program, offers a 12-step path to recovery that focuses on getting people to admit that their drinking is a problem and must stop. With the help of such programs, millions of people have gone on to lead healthy lives free of alcohol.
Are any medications useful in treating alcoholism?
Yes. While drug treatment alone is not likely to help someone with alcohol use disorder, drugs used alongside a behavioral program may improve chances for recovery. These drugs have been approved for the treatment of alcoholism in the U.S.:
Disulfiram (Antabuse) makes drinking unpleasant by causing nausea, vomiting and throbbing headaches when combined with alcohol.
Naltrexone (ReVia) helps some people keep cravings in check. Vivitrol, an injectable version of naltrexone, requires a monthly shot; it may be easier for people to use it consistently.
Acamprosate (Campral) may act on the brain pathways associated with alcohol use to help someone who has quit drinking avoid alcohol in the future.
Valium (Diazepam) and other sedatives may be prescribed to ease anxiety while struggling to stay sober.
What can I do if I think a loved one has an alcohol use disorder?
Discuss the concern with your doctor if you or your loved one have symptoms like those described above. Many people with alcoholism do not want help and often deny that they have a problem. In this case, family members can seek professional help from counselors to plan an "intervention," a group confrontation to urge the loved one to accept treatment for their problem.
If you think that a loved one has an alcohol use disorder, seek assistance as soon as possible. Do not attempt to talk to your friend or relative about the problem when they are drinking and try to avoid blaming them when you talk about it. Also, seek support for yourself through a group such as Al-Anon, which helps families and friends of alcoholics.
Source: HealthDay
