Alcoholism

What is Alcoholism?

For most adults, consuming moderate servings of alcohol is not harmful. However, there are currently more than 17.6 million adults in the United States who are clinically diagnosed as alcoholics or have a moderate to severe alcohol problem.

Early signs of alcoholism  or alcohol dependence may include an established pattern of heavy drinking,  frequent intoxication, and drinking in dangerous situations, such as when driving. Other early signs of alcoholism may also include drastic changes in demeanor while drinking such as violence or anger consistently, and blackouts.

There are serious dangers associated with alcoholism including risks of developing certain cancers, as well as damage to bodily organs, particularly the brain and liver. Other serious dangers include increased risk of suicide, homicide, risk of death from car crashes, and may cause birth defects.

Symptoms of Alcoholism

• Craving – a strong urge or need to drink
• Loss of control – not being able to stop drinking once started
• Physical dependence – withdrawal symptoms, such as anxiety, shakiness, nausea, or sweating after drinking has stopped
• Tolerance – the need to drink larger amounts of alcohol in order to reach the same feeling of being “high”

For someone who is alcohol dependent or alcoholic, the symptoms include all that are associated with alcohol abuse. The primary difference is that alcoholics will continue to drink regardless of the problems drinking has caused in their daily lives. When alcohol abuse reaches the stage of alcohol dependence or alcoholism, the person also experiences additional symptomatology to include:

• Neglect of other activities
• Excessive use of alcohol
• Impaired control of alcohol consumption
• Increased amounts of time spent in alcohol-related activities

What Causes Alcoholism?

There is no definitive cause of alcoholism; however, there are some factors that may contribute to it. Alcoholism or alcohol dependence can remain undetected for years. Much of that is due to the availability of the substance and the social patterns in which it is used.

Research shows that there may be a genetic component of alcoholism as alcohol dependence has been shown to cluster in some families; however, it has been difficult to show whether the clustering is due to genetics or learned behavior. What is clear is that a person’s lifestyle choices are a primary causal factor in the development of alcoholism.

Diagnosis of Alcoholism

According to the DSM IV-R, alcoholism is a maladaptive pattern of alcohol use that leads to clinically significant distress or impairment, manifested by three of the following seven criteria in the same 12 month time frame:

1. Tolerance, as defined by either marked diminished effect with continued use of the same amount of alcohol consumed or a need for significantly increased amounts of alcohol to achieve the desired effect or intoxication.
2. Withdrawal, as defined by either characteristic withdrawal (nausea, vomiting, shakiness, sweating) or the need to drink alcohol to avoid or relieve withdrawal symptoms.
3. Alcohol is often taken over a long period of time in larger amounts than was intended.
4. Persistent desire to drink or unsuccessful efforts to decrease or control alcohol use.
5. Increased amount of time spent in activities necessary to obtain, use or recover from alcohol and its effects.
6.  Important occupational, social, or recreational activities are reduced or eliminated because of alcohol use.
7.  Continued alcohol use despite knowledge of having recurrent or persistent psychological or physical problems that are caused or exacerbated by the alcohol.

Treatments of Alcoholism

Because alcohol dependence or alcoholism is a chronic disease, there is no cure. Even if an alcoholic has abstained from use for long periods of time, they can still suffer a relapse. Most alcohol treatment programs use counseling and medication to assist the person in discontinuing drinking and drinking related activities.

More times than not, the first step after diagnosis in the treatment process is detoxification. The detoxification process can take between three to seven days, after which the physical or chemical dependence to alcohol has been abated; however, the psychological dependency is left to be addressed.

There are a plethora of alcohol treatment facilities in the United States that offer a range of treatment services from short-term residential, in-patient hospitalization to long-term, outpatient therapy and counseling. The goal of treatment is to help the alcoholic resist the urge to drink and learn how to remain sober.

For many, a pharmacological component is necessary in addition to abstinence and counseling. There are three oral medications that are frequently prescribed to address alcoholism and alcohol dependence. Antabuse or Disulfiram , Depada, ReVia or Naltrexone , and Campral or Acamprosate are currently approved medications for the treatment of alcohol dependence. In addition, there is a long acting, injectable, form of Naltrexone that is available. These medications have been clinically shown to help alcoholics reduce their drinking, avoid relapse to heavy drinking, and achieve and/or maintain abstinence. There are other kinds of medications available to help manage withdrawal symptomatology if they arise after someone with alcohol dependence has abstained from drinking.

Although medications aid in treatment, there is no single medication available that works with every person or in every case.

How to Prevent and Manage Alcoholism

Overcoming an addiction to alcohol can be a long arduous process. Just as with many other chronic diseases, there are varying levels of success in the management of the disease. Preventing alcoholism comes down to making a decision not to engage in drinking; regardless of social settings, and particularly if there is a familial pre-disposition to alcoholism.
Most authorities indicate that the first step to managing alcoholism is acknowledging that there is a problem.

Secondly, there has to be a commitment to stopping the behavior and the person being committed to changing all aspects of their lifestyle that trigger drinking behaviors. Abstaining from alcohol consumption is paramount, and many are able to manage the condition with regular support group attendance, and having a committed sponsor.

References:

1.DSM-IV. American Psychiatric Association. (1994). Diagnostic and Statistical Manual of Mental Disorders (4th ed.). Washington, DC.

http://www.nlm.nih.gov/medlineplus/alcoholism.html