What are alcohol abuse and alcoholism?

Risk Factors and Symptoms

Several factors can contribute to alcohol abuse and alcoholism, including genetics, brain chemistry, social pressure, emotional stress, chronic pain, depression or other mental health problems, and problem drinking behaviors learned from family or friends. Other factors that increase the chance of developing alcoholism include a family history of alcohol abuse (especially for men whose fathers or brothers are alcoholics), alcohol use at an early age (beginning when younger than fourteen years), illicit drug use, peer pressure to drink, easy access to alcoholic beverages, the presence of psychiatric disorders, and cigarette smoking.

It is common for a person to deny an alcohol problem, and alcohol abuse can occur without physical dependence. Symptoms of alcohol abuse include repeated work, school, or home problems due to drinking; risking physical safety to drink; recurring trouble with the law, often involving drunk driving or violent behavior; and continuing to drink despite alcohol-related difficulties. Symptoms of alcoholism include craving alcohol; an inability 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; drinking that continues even when it causes or worsens health problems; and wanting to stop or reduce drinking, but being unable.

It is also important to understand and recognize withdrawal symptoms. Drug withdrawal is an unpleasant physical reaction that occurs when a substance-dependent person suddenly stops using drugs or alcohol. Withdrawal symptoms may include nausea, sweating, shaking, anxiety, increased blood pressure, and hallucinations and seizures (known as delirium tremens). The brain, nervous system, heart, liver, stomach, gastrointestinal tract, and pancreas are all damaged by alcoholism.

Diagnosis

To help with diagnosis, doctors ask a series of questions to assess possible alcohol-related problems:

• 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?

• Blood tests may be done to look at the size of red blood cells and to check for alcohol-related liver disease and other health problems.

Treatment

Treatment for alcohol abuse or dependence is aimed at teaching patients how to manage the disease. Most professionals believe that this requires giving up alcohol completely and permanently. The first and most important step is recognizing a problem exists; successful treatment depends on the desire to change. A doctor can help an individual withdraw from alcohol safely. Recovery may require supervised care in a detoxification center. Certain medications can help to relieve some of the symptoms of withdrawal and to prevent relapse. A doctor may prescribe medication to reduce cravings for alcohol. Medications used to treat alcoholism and to prevent drinking include naltrexone (ReVia, Vivitrol), which helps to block the cravings for alcohol; disulfiram (Antabuse), which will make individuals sick if they drink alcohol; and acamprosate (Campral), which reduces cravings for alcohol. Additionally, a study showed that an anticonvulsant drug, topiramate (Topamax), may reduce alcohol dependence.

Therapy helps individuals to recognize alcohol’s dangers. Education raises awareness of underlying issues and lifestyles that promote drinking. In therapy, recovering alcoholics work to improve coping skills and learn other, more adaptive ways of dealing with stress or pain. Additionally, recovery groups, such as Alcoholics Anonymous (AA), help many people to stop drinking and stay sober. AA members meet regularly and provide support for each other throughout the recovery process. Family members may also benefit from attending meetings of Al-Anon, as living with an alcoholic can be a painful, stressful situation. The general statistics on treatment outcomes for alcoholism indicate that one year after attempting to stop drinking, one-third of patients achieved total abstinence, one-third resumed drinking but at a lower level, and one-third had relapsed completely.

Bibliography

Bellenir, Karen, and Amy Sutton. Alcoholism Sourcebook. Detroit: Omnigraphics, 2007. Print.

Berg, Beverly. Loving Someone in Recovery: The Answers You Need When Your Partner Is Recovering from Addiction. Oakland: New Harbinger, 2014. Print.

Blane, Howard T., and Kenneth E. Leonard, eds. Psychological Theories of Drinking and Alcoholism. New York: Guilford, 1999. Print.

Dudley, Robert. The Drunken Monkey: Why We Drink and Abuse Alcohol. Berkeley: U of California P, 2014. Print.

Ketcham, Katherine, William F. Asbury, Mel Schulstad, and Arthur P. Ciaramicoli. Beyond the Influence: Understanding and Defeating Alcoholism. New York: Bantam, 2000. Print.

Meyer, Stephen. Alcohol, Tobacco, and Illicit Drugs. Detroit: Gale, 2014. Print.

Natl. Inst. on Alcohol Abuse and Alcoholism. The Link Between Stress and Alcohol. Rockville: Natl. Inst. of Health, 2013. Print.

Phillips, Rod. Alcohol: A History. Chapel Hill: U of North Carolina P, 2014. Print.

Samuels, Howard C., and Jane O’Boyle. Alive Again: Recovering from Alcoholism and Drug Addiction. Hoboken: Wiley, 2013. Print.

Sullivan, Edith V., and Adolf Pfefferbaum, eds. Alcohol and the Nervous System. Philadelphia: Elsevier, 2014. Print. Handbook of Clinical Neurology.

Svanberg, Jenny, Adrienne Withall, Brian Draper, and Stephen Bowden, eds. Alcohol and the Adult Brain. New York: Psychology, 2015. Print. Current Issues in Neuropsychology.