Alcoholism
A Widespread Problem
Currently, nearly 14 million
Americans—1 in every 13 adults-abuse alcohol or are alcoholic.
Several
million more adults engage in risky drinking patterns that could lead to
alcohol problems.
In addition, approximately 53 percent of men and women
in the United States
report that one or more of their close relatives have
a drinking problem.
What Is Alcoholism?
Alcoholism is a disease that is characterized by the following:
Craving: A strong need, or
compulsion, to drink.
Loss of control: The frequent
inability to stop drinking once a person has begun.
Physical dependence: The
occurrence of withdrawal symptoms, such as nausea, sweating, shakiness,
and anxiety, when alcohol use is stopped after a period of heavy drinking.
These symptoms are usually relieved by drinking alcohol or by taking another
sedative
drug. Alcoholism
Tolerance: The need for increasing
amounts of alcohol in order to get “high.”
Alcoholism has little to
do with what kind of alcohol one drinks, how long one has been drinking,
or even exactly how much alcohol one consumes. But it has a great deal
to do with a person's uncontrollable need for alcohol. This description
of alcoholism helps us understand why most alcoholics can't just “use a
little willpower” to stop drinking. He or she is frequently in the grip
of a powerful craving for alcohol, a need that can feel as strong as the
need for food or water. While some people are able to recover without help,
the majority of alcoholic individuals need outside assistance to recover
from their disease. With support and treatment, many individuals are able
to stop drinking and rebuild their lives. Many people wonder: why can some
individuals use alcohol without problems, while others are utterly unable
to control their drinking? Recent research has demonstrated that for many
people a vulnerability to alcoholism is inherited. Yet it is important
to recognize that aspects of a person's environment, such as peer pressure
and the availability of alcohol, also are significant influences. Both
inherited and environmental influences are called “risk factors.” But risk
is not destiny. Just because alcoholism tends to run in families doesn't
mean that a child of an alcoholic parent will automatically develop alcoholism.
What Is Alcohol Abuse?
Alcohol abuse differs from alcoholism in that it does not include an extremely strong craving for alcohol, loss of control, or physical dependence. In addition, alcohol abuse is less likely than alcoholism to include tolerance (the need for increasing amounts of alcohol to get “high”). Alcohol abuse is defined as a pattern of drinking that is accompanied by one or more of the following situations within a 12-month period:
failure to fulfill major
work, school, or home responsibilities;
drinking in situations that
are physically dangerous, such as while driving a car or operating machinery;
recurring alcohol-related
legal problems, such as being arrested for driving under the influence
of alcohol or for physically hurting someone while drunk;
continued drinking despite
having ongoing relationship problems that are caused or worsened by the
effects of alcohol.
While alcohol abuse is basically
different from alcoholism, it is important to note that many effects of
alcohol abuse are also experienced by alcoholics.
Alcoholism Treatment
The nature of treatment depends on the severity of an individual's alcoholism and the resources that are available in his or her community. Treatment may include detoxification (the process of safely getting alcohol out of one's system); taking doctor-prescribed medications, such as disulfiram (Antabuse®) or naltrexone (ReVia™) to help prevent a return to drinking once drinking has stopped; and individual and/or group counseling. There are promising types of counseling that teach recovering alcoholics to identify situations and feelings that trigger the urge to drink and to find new ways to cope that do not include alcohol use. Any of these treatments may be provided in a hospital or residential treatment setting or on an outpatient basis.
Because the involvement of family members is important to the recovery process, many programs also offer brief marital counseling and family therapy as part of the treatment process. Some programs also link up individuals with vital community resources, such as legal assistance, job training, child care, and parenting classes.
Alcoholics Anonymous
Virtually all alcoholism treatment programs also include meetings of Alcoholics Anonymous (AA), which describes itself as a “worldwide fellowship of men and women who help each other to stay sober.” While AA is generally recognized as an effective mutual help program for recovering alcoholics, not everyone responds to AA's style and message, and other recovery approaches are available. Even those who are helped by AA usually find that AA works best in combination with other elements of treatment, including counseling and medical care.
Can Alcoholism Be Cured?
While alcoholism is a treatable
disease, a cure is not yet available. That means that even if an alcoholic
has been sober for a long while 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 eventually recover from alcoholism. Keep in mind, too, that every day that a recovering alcoholic has stayed 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 is needed to abstain from drinking.