Alcoholism
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Alcoholism
Alcoholism is a chronic disease that makes the body dependent on alcohol. Alcoholism develops over time, to the point where the alcoholic becomes obsessed over alcohol, can no longer control alcoholic intake, and drinking causes serious problems with health, relationships, finances and work. Alcoholism is not a manifestation of weak character.
Left untreated, alcoholism can lead to serious physical and mental consequences. However, alcoholism is a treatable disease, a fact that is often overlooked.
Signs of Alcoholism
Alcoholics display a number of signs, but not all alcoholics will exhibit all of them or at the same time. Some of the signs of alcoholism are:
• Denial that there is a problem with alcohol
• Inability to limit the amount of alcohol consumed
• Drinking alone or keeping consumption of alcohol a secret
• Stashing alcohol in hiding places at home, work or other locations for ready access
• Experiencing “blackouts,” which is defined as not remembering conversations, commitments or activities that occurred while intoxicated
• Becoming irritable when it’s time to drink, especially if alcohol is not available
• Making a ritual of the drinking process: drinking at certain times of the day, with dinner, after dinner, during “cocktail hour,” or other times and being extremely annoyed if this ritual is at all disturbed or questioned by others
• Loss of interest in activities, hobbies and friends that used to be pleasurable
• Feeling compelled to drink, a compulsion that cannot be ignored
• Increasing tolerance to alcohol, to the point where greater quantities of alcohol are required to achieve the same “buzz” or high
• Gulping drinks, ordering multiple drinks or doubles of a drink, getting drunk intentionally to feel good, normal, or to overcome shyness
• Problems developing with relationships, job, finances or work as a result of alcoholism
• Experiencing symptoms of withdrawal, such as nausea, sweating, tremors or shaking, when alcohol is not consumed
It is important to remember that people who abuse alcohol can also display many of these symptoms. The difference is that alcohol abusers often don’t feel compelled to drink, or don’t feel the same level of compulsion as those who are dependent on alcohol. Alcohol abusers also do not generally experience withdrawal symptoms when they stop drinking.
Crossing the Line from Abuse to Alcoholism
Addiction experts say that crossing the line from abuse to alcoholism is dependent on a number of factors and is unique to each individual. There are self-quizzes on various alcohol addiction treatment sites that individuals can take to help determine if their alcohol intake is a problem or if it is becoming an addiction.
Questions to ask include:
• Do I need a drink first thing in the morning when I get up?
• Do I think I really need to cut back on my alcohol intake?
• Do I feel guilty about my drinking?
• Do I get annoyed or angry when someone else criticizes or questions me about my drinking?
• Do I drink in order to forget my troubles?
• Do I ever experience a loss of memory after drinking?
• Have I experienced financial problems as a result of my drinking?
• Do I feel remorseful after drinking?
• Have I neglected my family’s welfare as a result of my drinking?
• Do I have to drink to build up my self-confidence?
• Am I missing work because of my drinking?
• Have I been hanging out with others who are not a good influence while I am drinking?
• Am I less efficient since I’ve been drinking?
• Is my job performance or effectiveness been compromised by my drinking?
• Do I drink because I feel anxious when I’m with others?
• Do I have less ambition as a result of my drinking?
• Is my home life negatively affected by my drinking?
• Has my reputation suffered as a result of my drinking?
• Do I drink alone or in private most of the time?
• Have I ever been hospitalized or jailed because of my drinking?
• Have I ever sought treatment by a doctor for my drinking?
Answering in the affirmative to two or more questions means the person most likely has a problem with alcohol. Even one yes answer may indicate a problem with alcohol.
Causes of Alcoholism
There is no single cause that can be identified as the reason for alcoholism. Physical addiction, or dependence on alcohol, occurs gradually over time. Excessive drinking changes chemicals in the brain. These include gamma-aminobutyric acid (GABA), which limits impulsiveness, and glutamate, which excites the nervous system. In addition, alcohol increases the levels of dopamine in the brain, long associated with the pleasurable effects of drinking (the so-called “pleasure center”). Chronic, long-term excessive drinking can increase or deplete these chemicals, resulting in the drinker’s body to crave more alcohol in order to feel good again or to get rid of bad feelings.
Addiction experts point to other contributing factors of alcoholism:
• Heredity and genetics – Certain individuals may have genetic factors that make them vulnerable to addiction to alcohol as well as other types of addiction.
• Emotional state – Some persons may drink in order to control their emotions, to hide them, to feel good, or to compensate for perceived shortcomings or anxieties. Emotional pain, anxiety and stress may lead people to drink in order to block out those emotions. Researchers have found that certain stress hormones may be associated with alcoholism.
• Psychological factors – Persons with low self-esteem or self-confidence and those suffering from depression may be more prone to abuse of alcohol and alcoholism than others. Being in close proximity to others who drink regularly but do not abuse alcohol could prompt drinking in these individuals who may find it difficult to distance themselves from these “enablers.”
• Social and/or cultural factors – In a society that glamorizes drinking, or being around others who feel it’s okay or cool to drink often influences the development of a problem with alcohol abuse and alcoholism.
Alcoholism and Risk Factors
Are there individuals who are at more risk for developing a problem with alcohol or alcoholism? Again, addiction experts and researchers point to increasing evidence that there are certain risk factors that predispose individuals to vulnerability with alcohol. Such risk factors include:
• Steady drinking – more than 15 drinks per week for men and more than 12 drinks per week for women – increase the chances of developing dependence on alcohol.
• Age – Drinking at an early age – 16 or younger – creates a higher risk of alcohol dependence.
• Sex – Men are more likely than women to experience a problem with alcohol dependence.
• Genetics – Genetics may play a part in increased risk of alcohol dependency.
• Family history – Persons with a parent or parents who abuse alcohol may be at a higher risk for alcohol dependency and alcoholism.
• Emotional disorders – Individuals with mental disorders or emotional problems are at higher risk for alcoholism. These include persons suffering from depression or anxiety. Research has shown that adults with attention-deficit hyperactivity disorder (ADHD) could also be more likely to become dependent on alcohol.
Seeking Help for Alcoholism
Alcoholics most often deny that they have a problem with alcohol. As such, they won’t seek treatment on their own. In fact, it is usually a family member or close friend or co-worker that will try to encourage the alcoholic to seek help for their problem.
Screening tests must be performed in order for a person to be diagnosed as having alcoholism. These criteria are spelled out in the Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association (APA).
Criteria include a pattern of alcoholic abuse leading to significant distress or impairment, specifically indicated by the presence of three or more of the following during a 12-month period:
• Tolerance – needing to drink more and more often in order to achieve the same effect. As alcoholism progresses, this level may decrease as a result of damage to liver or central nervous system.
• Withdrawal symptoms – tremors, anxiety, insomnia and nausea when the individual attempts to stop drinking. To overcome the symptoms, individuals may increase their drinking levels.
• Quantity and duration – drinking more alcohol or over a longer period of time than the individual intended.
• Unsuccessful attempts to quit or cut down.
• Time – spending inordinate amounts of time in the pursuit of alcohol, using alcohol, and recovering from the effects of alcohol.
• Neglecting or giving up important social, occupational or recreational activities.
• Continued use of alcohol – despite the knowledge that it’s causing physical and psychological problems.
Complications from Alcoholism
Alcoholics may suffer from many physical and psychological conditions as a result of their disease. Over a period of time, excessive alcohol use can result in the following:
• Short-term memory loss.
• Fatigue.
• Eye muscle weakness and paralysis.
• Liver disorders – including hepatitis, an inflammation of the liver, and cirrhosis, the progressive and irreversible destruction and scarring of liver tissue.
• Birth defects – alcohol use by women who are pregnant may lead to fetal alcohol syndrome (FAS)in the child.
• Bone loss – alcohol may interfere with the production of new bone, leading to the thinning of bones and increased risk of fractures.
• Cancer – alcohol abuse increases the risk of certain cancers, including mouth, throat, esophagus, breast, colon, larynx, liver, and rectum.
• Cardiovascular problems – heart attack and stroke.
• Diabetes complications.
• Gastrointestinal problems – including inflammation to the lining of the stomach, and pancreatitis.
• Neurological impairment – alcohol abuse may affect the central nervous system, resulting in numbness in feet and hands, dementia and disordered thinking.
• Sexual problems – leading to erectile dysfunction in men and interruption in menstruation in women.
Alcoholism also causes other problems: increased accidents in motor vehicles caused by intoxicated drivers, accidental injuries from other causes, divorce, domestic abuse, violence, poor school or work performance, and a higher incidence of suicide and murder.
Treatment for Alcoholism
As previously stated, alcoholism is a treatable disease. The course of treatment may involve use of certain medications, counseling, both individual and group, and participation in self-help groups such as Alcoholics Anonymous (AA).
Various treatment programs are available to treat alcoholism. Depending on the type chosen, treatment may include an intervention, evaluation, counseling or residential treatment program. Counseling methods include behavioral therapy, such as motivation enhancement therapy (MET), cognitive behavioral therapy (CBT), and pharmacological treatments. MET seeks to motivate persons who are resistant to treatment, while CBT gives patients the skills to reduce or abstain from drinking. Contingency management interventions are another tool that center on rewarding positive behavior. Aversion therapy may also be appropriate in some circumstances. Through counseling, the alcoholic learns to identify triggers that cause him or her to drink, as well as coping mechanisms to deal with urges and cravings for alcohol. Alternative treatments may also be offered, including acupuncture.
Inpatient or residential alcoholism treatment programs should include the following:
• An alcohol detoxification center located on the property of the treatment facility.
• Medically-supervised alcohol detoxification on a 24-hour basis.
• Physician trained in addiction medicine (ASM-certified).
• Family treatment component to the addiction program.
• Intensive relapse prevention as part of the overall treatment plan.
• Dual-diagnosis treatment program, if necessary.
• State license and accreditation through appropriate addiction organizations.
Importance of Continuing Support
Alcoholism can be treated, but it cannot be cured. Once a person is an alcoholic, they will be an alcoholic for life. There is also no single treatment that works for everyone. Each case must be evaluated and an individualized treatment program designed for the patient depending on their particular needs.
More research is needed to identify effective treatments for different populations, particularly youth, the elderly and those with co-occurring psychiatric disorders.
After treatment for alcoholism or alcohol addiction, it is critically important that the individual receive continuing support. This can be accomplished through aftercare programs that are a part of the overall treatment plan, as well as participation in 12-step support groups such as Alcoholics Anonymous.
Family members are also strongly encouraged to participate in support groups for those whose lives are affected by another’s alcoholism. These groups include Al-Anon Alateen and Adult Children of Alcoholics.
--Suzannekane 20:07, 1 February 2010 (UTC)
