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Alcohol Use Disorders

When Does Drinking Become A Problem?

For many people, drinking alcohol is nothing more than a pleasant way to relax. However, people with alcohol use disorders drink to excess, endangering both themselves and others. Although severe alcohol problems get the most public attention, even mild to moderate problems cause substantial damage to individuals, their families, and the community. Moderate use, however, lies at one end of a continuum that moves through alcohol abuse to alcohol dependence.

Alcohol abuse. A drinking pattern that results in significant and recurrent adverse consequences. Alcohol abusers may fail to fulfill major school, work or family obligations. They may have drinking-related legal problems, such as repeated arrests for driving while intoxicated. They may also have relationship problems related to their drinking.

Alcohol dependence. A drinking pattern in which a person has lost reliable control of their alcohol use. It doesn't matter what kind of alcohol someone drinks or even how much alcohol is consumed: alcohol-dependent people are often unable to stop drinking once they begin. Alcohol dependence is characterized by tolerance (the need to drink more to achieve the same "high") and withdrawal symptoms if drinking is suddenly stopped. Withdrawal symptoms may include nausea, sweating, insomnia, anxiety, restlessness, irritability, tremors, hallucinations, and seizures.

What Is Alcoholism? What Are The Symptoms?

Alcoholism, also known as alcohol dependence, is a disease. The craving that an alcoholic feels for alcohol can be as strong as the need for food or water. An alcoholic will continue to drink despite serious family, health, or legal problems. Like many other diseases, alcoholism is chronic, meaning that it lasts a person's lifetime; it usually follows a predictable course; and it has symptoms. The risk for developing alcoholism is influenced both by a person's genes and environmental influences. Alcoholism is characterized by 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."

When Should I Seek Help? What If I’m Not An Alcoholic?

Alcoholism is only one type of 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. Individuals often hide their drinking or deny they have a problem.

How Can You Tell If You Or Someone You Know Is In Trouble?

Signs of a possible problem include:
Having friends or relatives express concern
Being annoyed when people criticize your drinking
Feeling guilty about your drinking or drinking behavior
Thinking that you should cut down, but finding yourself unable to do so
Needing a morning drink to steady your nerves or relieve a hangover

What Are The Effects Of Alcohol Use Disorders?

Short-term effects include:
Memory loss
Long-term problems associated with heavy drinking include:
Stomach ailments
Heart problems
Brain damage
Serious memory loss
Liver cirrhosis

How Do Alcohol Use Disorders Affect People?

Alcohol-related disorders severely impair functioning and health. In addition to the adverse short- term and long-term effects, people suffering with alcohol use disorders are at-risk for other problems. Over 100,000 Americans die from alcohol-related causes each year. Heavy drinkers also markedly increase their chances of dying from automobile accidents, homicide, and suicide. Although men are much more likely than women to develop alcoholism, women's health suffers more, even at lower levels of consumption.

Drinking problems also have a very negative impact on mental health. Alcohol abuse and alcoholism can worsen existing conditions such as depression or induce new problems such as serious memory loss, depression, or anxiety.

Alcohol problems don't just hurt the drinker. According to National Institute on Alcohol Abuse and Alcoholism (NIAAA), more than half of Americans have at least one close relative with a drinking problem. Spouses and children of heavy drinkers are more likely to face family violence; children are more likely to suffer physical and sexual abuse and neglect and to develop psychological problems. Women who drink during pregnancy run a serious risk of damaging their fetuses. Relatives and friends can be killed or injured in alcohol-related accidents and assaults.

Can Alcoholism Be Cured?

Although alcoholism can be treated, a cure is not yet available. In other words, even if an alcoholic has been sober for a long time and has regained health, he or she remains susceptible to relapse and must continue to avoid all alcoholic beverages. "Cutting down" on drinking doesn't work; cutting out alcohol is necessary for a successful recovery.

However, even individuals who are determined to stay sober may suffer one or several "slips," or relapses, before achieving long-term sobriety. Relapses are very common and do not mean that a person has failed or cannot recover from alcoholism. Keep in mind, too, that each day a recovering alcoholic stays sober prior to a relapse is extremely valuable time, both to the individual and to his or her family. If a relapse occurs, it is very important to try to stop drinking once again and to get whatever additional support you need to abstain from drinking.

What If Someone Doesn’t Want To Get Help?

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 a 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. If the person is willing to get help, call immediately for an appointment with a treatment counselor. Offer to go with the family member on the first visit to a treatment program and/or an Alcoholics Anonymous meeting.
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 is a recovering alcoholic 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.

What Treatment Helps? What Can I Do Now?

There are several approaches available for treating alcohol problems. No one approach is best for all individuals.

1. Make an appointment with one of our clinicians for a comprehensive professional assessment and to put together a treatment plan for the alcohol use.

2. Make an appointment with your physician to address any physical problems which may be associated with alcohol use.

Source: National Institute on Alcohol Abuse and Alcoholism

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