Alcohol Abuse and Alcoholism

Q: What is alcoholism?

Alcoholism, also known as alcohol dependence, includes the following four symptoms:

Craving--A strong need, or urge, to drink. -
Loss of control--Not being able to stop drinking once drinking has begun. -
Physical dependence--
Withdrawal symptoms, such as nausea, sweating, shakiness, and anxiety after stopping drinking. Tolerance--The need to drink greater amounts of alcohol to get "high."

Q: Can alcoholism be treated?

Yes, alcoholism can be treated successfully, depending on the type of program and how it fits to the individual's needs. With support and treatment, many people are able to stop drinking and rebuild their lives.

Q: Do you have to be an alcoholic to experience problems?

No. Alcoholism (addiction) is only one type of an alcohol problem. Alcohol abuse can be just as harmful. A person can abuse alcohol without actually being an alcoholic--that is, he or she may drink too much and too often but still not be dependent on alcohol. Some of the problems linked to alcohol abuse include not being able to meet work, school, or family responsibilities; drunk-driving arrests and car crashes; and drinking-related medical conditions. Under some circumstances, even social or moderate drinking is dangerous--for example, when driving, during pregnancy, or when taking certain medications.

Q: Are specific groups of people more likely to have problems?

Alcohol abuse and alcoholism cut across gender, race, and nationality. Over 14 million people in the United States--1 in every 13 adults--abuse alcohol or are alcoholic. In general, though, more men than women are alcohol dependent or have alcohol problems. And alcohol problems are highest among young adults ages 18-29 and lowest among adults ages 65 and older. We also know that people who start drinking at an early age--for example, at age 14 or younger--greatly increase the chance that they will develop alcohol problems at some point in their lives.

Q #10: How can you tell if someone has a problem?

Answering the following four questions can help you find out if you or a loved one has a drinking problem:

Have you ever felt you should cut down on your drinking?
Have people annoyed you by criticizing your drinking?
Have you ever felt bad or guilty about your drinking?
Have you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover?

One "yes" answer suggests a possible alcohol problem. More than one "yes" answer means it is highly likely that a problem exists. If you think that you or someone you know might have an alcohol problem, it is important to see a doctor or other health care provider right away. They can help you determine if a drinking problem exists and plan the best course of action.

Q: Can a problem drinker simply cut down?

It depends. Alcoholics who try to cut down on drinking have difficulty doing so successfully on their own. Cutting out alcohol--that is, abstaining--is usually the best course for recovery. People who are not alcohol dependent but who have experienced alcohol-related problems may be able to limit the amount they drink. If they can't stay within those limits, they need to stop drinking altogether

Q: If an alcoholic is unwilling to get help, what can you do about it?

This can be a challenge. 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. But you don't have to wait for someone to "hit rock bottom" to act. Many alcoholism treatment specialists suggest the following steps to help an alcoholic get treatment:

Stop all "cover ups." Family members often make excuses to others or try to protect the alcoholic from the results of his or her drinking. It is important to stop covering for the alcoholic so that he or she experiences the full consequences of drinking.

Time your intervention. The best time to talk to the drinker is shortly after an alcohol-related problem has occurred--like a serious family argument or an accident. Choose a time when he or she is sober, both of you are fairly calm, and you have a chance to talk in private.

Be specific. Tell the family member that you are worried about his or her drinking. Use examples of the ways in which the drinking has caused problems, including the most recent incident.

State the results. Explain to the drinker what you will do if he or she doesn't go for help--not to punish the drinker, but to protect yourself from his or her problems. What you say may range from refusing to go with the person to any social activity where alcohol will be served, to moving out of the house. Do not make any threats you are not prepared to carry out.

Get help. Gather information in advance about treatment options and have a plan of action prepared. If the person is willing to get help, call immediately for an appointment with a treatment counselor.

Call on a friend. If the family member still refuses to get help, ask a friend to talk with him or her using the steps just described. A friend who used to be addicted to or abuse alcohol may be particularly persuasive, but any person who is caring and nonjudgmental may help. The intervention of more than one person, more than one time, is often necessary to coax an alcoholic to seek help.

Find strength in numbers. With the help of a health care professional, some families join with other relatives and friends to confront an alcoholic as a group. This approach should only be tried under the guidance of a health care professional who is experienced in this kind of group intervention.

Get support. Continue to work with family counselors at the selected treatment facility and learn more about the rehabilitation process, which will help assist in the long-term recovery of your friend or family member.

Q: What is a safe level of drinking?

For most adults, moderate alcohol use--up to two drinks per day for men and one drink per day for women and older people--causes few if any problems. (One drink equals one 12-ounce bottle of beer or wine cooler, one 5-ounce glass of wine, or 1.5 ounces of 80-proof distilled spirits.)

Certain people should not drink at all, however:

Women who are pregnant or trying to become pregnant
People who plan to drive or engage in other activities that require alertness and skill (such as using high-speed machinery)
People taking certain over-the-counter or prescription medications
People with medical conditions that can be made worse by drinking
Recovering alcoholics
People younger than age 21.

Q: Is it safe to drink during pregnancy?

No, drinking during pregnancy is dangerous. Alcohol can have a number of harmful effects on the baby. The baby can be born mentally retarded or with learning and behavioral problems that last a lifetime. We don't know exactly how much alcohol is required to cause these problems. We do know, however, that these alcohol-related birth defects are 100-percent preventable, simply by not drinking alcohol during pregnancy. The safest course for women who are pregnant or trying to become pregnant is not to drink alcohol at all.

Q: Does alcohol affect older people differently?

Alcohol's effects do vary with age. Slower reaction times, problems with hearing and seeing, and a lower tolerance to alcohol's effects put older people at higher risk for falls, car crashes, and other types of injuries that may result from drinking.

Older people also tend to take more medicines than younger people. Mixing alcohol with over-the-counter or prescription medications can be very dangerous, even fatal. More than 150 medications interact harmfully with alcohol. In addition, alcohol can make many of the medical conditions common in older people, including high blood pressure and ulcers, more serious. Physical changes associated with aging can make older people feel "high" even after drinking only small amounts of alcohol. So even if there is no medical reason to avoid alcohol, older men and women should limit themselves to one drink per day.

Q: Does alcohol affect women differently?

Yes, alcohol affects women differently than men. Women become more impaired than men do after drinking the same amount of alcohol, even when differences in body weight are taken into account. This is because women's bodies have less water than men's bodies. Because alcohol mixes with body water, a given amount of alcohol becomes more highly concentrated in a woman's body than in a man's. In other words, it would be like dropping the same amount of alcohol into a much smaller pail of water. That is why the recommended drinking limit for women is lower than for men.

In addition, chronic alcohol abuse takes a heavier physical toll on women than on men typically. Alcohol dependence and related medical problems, such as brain, heart, and liver damage, progress more rapidly in women than in men.

Read more information about alcohol and other drug addiction treatment and rehabilitation.

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