Alcoholism
Alcoholism or alcohol dependence syndrome is a disease characterized by a pattern of alcohol consumption that includes cravings or preoccupation with alcohol, loss of control over consumption, physical dependence and increased tolerance. Physical addiction often leads to physical, mental health or social issues. Family or occupational problems are often an indicator that an individual has developed alcoholism. Using a substance for longer than initially planned, or having issues reducing frequency of use are also factors that are involved in the onset of alcoholism as a mental disorder.
Alcoholism is a chronic, progressive disease that can be fatal. Some symptoms include spending copious amounts of time consuming, acquiring or recovering from alcohol, even when the individual is aware of its negative effects.
Individuals who become dependent on alcohol often display denial, and tend to minimize the impact of drinking on their health and wellbeing. Their lack of understanding and acceptance about the severity of the problem detracts them from seeking help.
Many other dangers are associated with excessive alcohol consumption including increased risk for certain cancers, liver damage, brain damage and in some cases birth defects.
7 Criteria for diagnosis (Edwards and gross 1976)
1. Narrowing of the drinking repertoire (involving the establishment of daily drinking patterns and selective choices of alcoholic beverages)
2. Excessive alcohol-seeking behavior
3. Increased tolerance to alcohol’s effects
4. Repeated withdrawal symptoms
5. Drinking to relieve or avoid withdrawal symptoms
6. Subjective awareness of a compulsion to drink
7. Reinstatement of established drinking patterns following a period of abstinence
Abuse vs. Addiction
Alcohol abuse is different from alcoholism. Alcohol abuse is typically not associated with the cravings for alcohol or the physical dependence. Alcohol abusers are also less likely to experience a change in tolerance to alcohol over time.
Alcohol abuse is classified as a pattern of alcohol consumption that follows one or more of the following situations over the last 12 months
- Inability to fulfill work, school, or home responsibilities
- Alcohol consumption in situations that are physically hazardous such as driving or operating heavy machinery
- Being arrested for drinking in public or drinking and driving
- Hurting someone physically when you are drunk
- Continuation of drinking even after its apparent that it negatively affects one’s relationship(s)
Symptoms
- Drinking while alone
- Continuing to drink even after health, work, family or friends are negatively affected
- Displaying violent behavior when drinking
- Becoming hostile when asked about alcohol consumption
- Inability to control how much is consumed
- Missing work or school due to a hangover or excessive drinking
- Making excuses to drink
- Not taking part in activities that had been of interest
- Needing alcohol to “get through” the day
- Neglecting to eat enough or eat properly
- Neglecting hygiene
- Memory loss after a night of heavy drinking
- Increased tolerance to alcohol
- Alcohol withdrawal symptoms
- Alcoholic related disease (e.g., cirrhosis, liver issues etc.)
Risk Factors
Some risk factors for developing alcohol addiction include
- Anxiety disorder
- Depression disorder
- Various mood disorders
- Genetics; parents or grandparents who had alcoholism
- Low or lowered self-esteem/self-efficacy
- Feeling out of place or lonely
- Being abused during childhood
- Asocial behavior (in women)
- Impulsivity (in women)
Tolerance
An increased tolerance involves the need to consume more of the same substance to achieve the same level of satisfaction or “high”.
Binge Drinking (according to CDC 2010)
- For men, consumption of 5 or more drinks in one sitting
- For women, consumption of 4 or more drinks on one occasion
Heavy Drinking
- For men, more than 2 drinks per day on average (CDC-2010)
- More than 1 for women (CDC)
Health Risks according to the Center for Disease Control
Acute Health Risks:
- Unintentional injuries such as traffic injuries, falls, burns, drowning
- Violence and child maltreatment (35% of victims have reported that individuals were under the influence)
- Risky sexual behavior which includes; unprotected sex, sex with multiple partners, higher risk of sexual assault and intimate partner violence
- Erectile dysfunction
- Increased blood pressure (that can eventually lead to hypertension)
- Miscarriage and stillbirths among pregnant women
- Changes in menstrual cycle
- Alcohol poisoning
- Insomnia
- Coma, respiratory issues, death
Long-term Risks:
- Neurological issues including dementia, stroke, neuropathy, and brain cell damage
- Cardiovascular issues including heart attack, cardiomyopathy, atrial fibrillation and hypertension
- Depression, anxiety, mood disorders and suicide
- Cancer of the throat, liver, colon, breast, mouth etc.
- Various other liver diseases including cirrhosis, hepatitis C virus and other gastrointestinal problems
Alcohol facts
- There are approximately 79,000 deaths attributed to excessive alcohol use each year in the US (CDC-2010)
- Alcohol is 3rd leading “lifestyle” related cause of death in the US
- Excessive alcohol use accounts for approximately 30 years of life lost for each death
- In 2005 there were over 1.5 million hospitalizations and 4 million emergency room visits for alcohol-induced situations
Treatment
Modern treatment varies with each person but primarily focuses on the individual’s preoccupation with alcohol use, which is a target for both behavioral and physiologic interventions. Complete abstinence is the main goal of treatment with specific attention to psychological, social and cultural differences among individuals. Ways to help reach complete abstinence of alcohol include building a social network of family and friends for support, and following other support programs including Alcoholics Anonymous (for extended periods of time). Counseling therapy, medical care and sometimes the use of medication are necessary to keep an individual from returning to heavy drinking. Alcohol withdrawal symptoms are very serious and can be life threatening. For this reason, it is common for an individual to opt for a detox in a clinical setting with professional supervision. ALTERNATIVES…
Prescription Drugs
Acamprosate
- A drug that has been shown to lower relapse rates
Disulfiram (antabuse)
- Even small amounts of alcohol produce extremely unpleasant side effects (for a 2 week period after the drug is taken)
Naltrexone (vivitrol)
- Decreases individuals cravings for alcohol