Alcoholism is a chronic disorder characterized by excessive and compulsive use of the drug alcohol. It also includes craving alcohol, loss of control over drinking, physical dependence on alcohol and tolerance.
Alcoholism is different than alcohol abuse, which is alcohol use that leads to legal or relationship problems, drinking in dangerous situations and failing to meet home, work or school responsibilities.
Alcoholism can result in a variety of negative health consequences such as liver disease, cardiovascular problems and an increased risk of cancer.
Signs and symptoms of alcoholism include blackouts (loss of memory after drinking), loss of interest in once pleasurable activities and legal problems, among others.
Treatment techniques for alcoholism vary according to the individual. Patients may be treated in an outpatient program or a residential inpatient program. Treatment may include detoxification (process by which patients withdraw from alcohol), medication to reduce or eliminate cravings and counseling and/or self-help groups to help avoid relapse (using alcohol after a period of abstinence).
Patients often require psychological and medication treatment for disorders that contribute to alcoholism, such as depression.
Alcoholism tends to develop gradually over time as heavy drinking increases or reduces brain chemicals, which causes a person to crave alcohol to elevate their mood or to avoid negative feelings.
Some other factors that may lead to excessive drinking and alcoholism include:
- Genetics. People with an inherited imbalance of brain chemicals may be more likely to develop alcoholism.
- Emotions and psychological factors. People who experience high levels of stress, anxiety and/or poor self-esteem may be more apt to drink to cope with the turmoil. People with mental health disorders, such as depression, bipolar disorder and schizophrenia, are also more likely to develop alcoholism. In addition, associating with heavy drinkers may increase the likelihood of drinking or the amount of alcohol consumed.
- Social and cultural factors. Alcohol is often portrayed in glamorous ways on television and in advertisements. This may contribute to social acceptance of heavy drinking.
- Over time, heavy drinking habits can result in a dependence on alcohol. In general, men who consume more than 14 drinks a week and women who consume more than seven drinks a week have a greater risk of developing alcoholism. Other risk factors include:
- Age. People who begin drinking early in life (age 14 or younger) are more likely to develop alcoholism.
- Gender. Men are more likely to develop alcoholism than women.
- Family history. People with a parent who abused alcohol are more likely to develop alcoholism.
- Recent research reveals that teenage girls who mature earlier than their peers and have older boyfriends are more likely to become problem drinkers. Additionally, research indicates that there is a relationship between frequent consumption of alcohol and unhealthy eating habits.
Signs and symptoms of alcoholism
There are many signs and symptoms associated with alcoholism. These may include:
- Compulsion. Feeling a strong need to drink.
- Blackouts. Periods of time after drinking that cannot be remembered.
- Tolerance. Requiring increasingly larger amounts of alcohol to experience the same effect.
- Physical withdrawal symptoms. These may include nausea as well as shaking, sweating, confusion and hallucinations (delirium tremens) while not drinking. Delirium tremens (also known as “the DTs”) is the most serious symptom of acute alcohol withdrawal.
- Legal, relationship, financial problems.
- Anhedonia. Loss of interest in once pleasurable activities.
- Unusual drinking habits. These may include drinking alone or in secret, gulping drinks or making a ritual of having drinks before, during and after dinner.
- Irritability. Feeling irritable when drinking patterns are disrupted.
- Research also suggests that people with alcoholism may have difficulty interpreting the emotions of others.
- Many people who abuse alcohol experience many of the same symptoms as those who have alcoholism. However, a main difference is that people who abuse alcohol do not experience compulsion to drink or physical withdrawal symptoms when they do not drink.
- Although it tends to take years for adults to develop alcoholism, young teenagers can become addicted to alcohol more quickly. Some signs and symptoms of problems with alcohol in teenagers include:
- Loss of interest in activities or hobbies
- Bloodshot eyes, slurred speech, scent of alcohol on breath or memory loss
- Difficulties in relationships or changes in friendships
- Declining school attendance, performance or other problems at school
- Mood swings and defensive behavior
- Many people with alcoholism also experience denial (the refusal to recognize truth or reality). This results in failure to recognize a problem with alcohol, even though signs and symptoms are present. Many people with alcoholism seek help only at the insistence of friends, family members, coworkers or others.
- People are encouraged to consult a physician about alcohol use if they:
- Feel that drinking is a problem
- Feel guilty about drinking
- Cannot control drinking
- Drink shortly after waking up
- Need increasing amounts of alcohol before feeling its effects
Treatment options for alcoholism
Because people with alcoholism often experience denial (the refusal to recognize truth or reality), they often begin treatment only at the insistence of friends, family members, coworkers or others. Sometimes, patients seek treatment after an intervention (an orchestrated attempt by family and friends to encourage a person to seek help for addiction).
Treatment techniques vary according to the severity of the alcohol problem and other factors. Treatment for people who abuse alcohol may involve cutting back on drinking. For those who are dependent upon alcohol, treatment must involve refraining from drinking (abstinence). Patients may be treated in an outpatient program or a residential inpatient program.
Components of alcoholism treatment programs may include:
- Detoxification. Patients withdraw from alcohol, a process which usually lasts four to seven days. Medications to minimize symptoms experienced with withdrawal (such as seizures) are usually administered.
- Medical assessment and treatment. Patients are treated for medical conditions that may be present with alcoholism, such as high blood pressure, increased blood sugar and liver and heart disease.
- Psychological treatment. Patients with mental health disorders that contribute to alcoholism, such as depression, may receive treatment for the underlying disorder. Others receive support through group and individual counseling.
- Medications. Some patients are treated with special drugs, designed to remove the compulsion to drink, block the intoxicating effects of alcohol or help to prevent relapses in people who have stopped drinking alcohol.
Because relapse (using alcohol after a period of abstinence) is common, people with alcoholism often receive ongoing treatment. This may involve individual or group counseling or participation in a self-help group. One of the most popular self-help groups is Alcoholics Anonymous (worldwide fellowship of people with alcoholism whose primary goal is to advocate recovery and sobriety through a 12-step process). Members meet on a regular basis and share personal stories of their recovery in an attempt to provide support and foster sobriety.
Because family support is important to recovery, many programs offer marital counseling or couples therapy, family therapy or other services as part of treatment. Programs may also help patients find other types of services needed for recovery, such as legal assistance, job training, childcare and parenting classes.
Other therapies for patients with alcoholism may include:
- Acupuncture. The insertion of thin needles under the skin. This may reduce cravings for alcohol. Acupuncture is performed by an acupuncturist.
- Motivational enhancement therapy. Therapy aimed at helping the patient acknowledge the alcohol problem and change behavior through stages.
- Cognitive behavior therapy. Psychotherapy that relies on the recognition of distorted thinking and replacing such thinking with more realistic ideas.
- Couples therapy. Therapy attended by both the patient with alcoholism and their significant other. Involving a partner may increase the chance of successful treatment.
- Aversion therapy. Involves taking a medication that causes an adverse response, such as nausea and vomiting, when alcohol is ingested.