Substance Abuse Alcoholism Almost everyone witnesses the out-of-control antics of a problem drinker. But, do you know when problem drinking is the same as alcoholism, and at what point does problem drinking become alcoholism? In general, problem drinking qualifies as alcoholism when the person: drinks compulsively; keeps drinking in spite of adverse consequences; gets upset when alcohol is not readily available. Not everyone who gets drunk is an alcoholic. Many people drink to experiment; to act sociable; or to gain attention. Alcoholics, however, do not plan to get drunk; their drinking is an uncontrollable urge. How Common is Alcoholism? In any randomly selected group of Americans, 10 to 15 of every 100 people either are alcoholics or will become alcoholics. Ten million Americans are alcoholics, and another 10 million are problem drinkers who may be on their way to becoming alcoholics. Alcoholism is not a gender-related disease, between one-third and one-half of all alcoholics are women. Many alcoholics are teenagers; some are even preteens. What Causes Alcoholism? Doctors believe the tendency toward alcoholism is an inherited physical characteristic, possibly involving liver enzymes. Other theories indicate that message-carrying chemicals within the nervous system may make a person more vulnerable to the disease. Individual reactions to alcohol vary widely: Certain people dislike and avoid alcohol because even small amounts disagree with them. Others enjoy a certain amount of alcohol, but instinctively stop drinking as soon as they get dizzy or sleepy. Still others love the high they get from alcohol, but have no sense of when they should stop drinking. When they drink, they get drunk - even though they’ve had sufficient experience with alcohol to know better. The people in this third group are said to be predisposed to alcoholism. This predisposition is not a moral weakness, but an inborn part of their body chemistry. How Can You Tell Who Will Become An Alcoholic? Medically speaking, you can’t. To date, there is no diagnostic test that can single out people who have an inherited predisposition to alcoholism. Practically speaking, however, there are two important clues: Children of alcoholics have a two to four times greater risk of developing alcoholism than children of non-alcoholics. People who are drinking ever-increasing amounts of alcohol, and who become irritable when they don’t drink, are clearly at risk for alcoholism Alcoholics Suffer From Their Illness As their disease progresses, alcoholics need to drink more and more often, just to feel normal. Increasingly, they realize that once they start to drink, they can’t stop. Yet they desperately want to keep from getting drunk, both to avoid embarrassment and unpleasant withdrawal symptoms such as trembling, irritability, nausea, or insomnia. They may try different strategies to regain control over their drinking, maybe switching from liquor to wine, or perhaps going "on the wagon" for weeks at a time. No strategy works for long, however. Inwardly disgusted with themselves, alcoholics vacillate between anger and depression. Personal relationships deteriorate. Job performance suffers. In addition, physical problems develop. Alcoholics suffer from disturbing memory lapses called blackouts. Feeling edgy and anxious, some may experiment with and become addicted to tranquilizers. Alcoholics eat poorly, because their irritated liver and inflamed digestive system give them heartburn, nausea, and gas. Sex drive dwindles. Insomnia robs them of needed sleep. Loved Ones of Alcoholics Suffer Too   Women who drink heavily during pregnancy are giving alcohol to the unborn child. The baby may be born with fetal alcohol syndrome, an incurable condition that involves stunted growth, physical abnormalities, and mental retardation.   Active alcoholics often have marital problems. They can’t be committed marriage partners as their compulsion to drink makes them self-centered, irresponsible, and possibly abusive.   Likewise, active alcoholics also have difficulties fulfilling their parental responsibilities. Alcohol-abusing mothers and fathers have been known to neglect or abuse their children. For a child, growing up with an alcoholic parent is a painful experience that usually leaves lasting emotional scars. Alcoholism Can Kill People with advanced alcoholism drink almost constantly; have trouble keeping a job; relate poorly to others; and may have self-destructive impulses, including frequent thoughts of suicide. Some of the serious physical consequences of late-stage alcoholism are convulsions, hallucinations, mental confusion, partial paralysis, and/or cirrhosis of the liver. The longer alcoholism goes without treatment, the greater the damage to the body. Untreated alcoholism is potentially fatal. There is Help The good news is that alcoholism is treatable. With the right kind of help, most alcoholics can learn to lead a deeply satisfying life without alcohol. People used to think the only way an alcoholic could quit drinking was to go "cold turkey." However, sudden withdrawal from alcohol is difficult, painful and dangerous. Hazards include hallucinations, convulsions, and potentially life-threatening shifts in blood pressure, temperature, and heart rate. A safer way is medically supervised detoxification in a specialized hospital setting. "Detox," which starts with a physical exam, involves bed rest, nursing care, short-term tranquilizers, a balanced diet, and vitamin and mineral supplements. After a few days of "detox," when the acute withdrawal period is over, the alcoholic moves into the second stage of treatment. This stage, called rehabilitation, can be structured into a period of hospitalization, or it can take the form of frequent visits to an outpatient clinic. In either case, rehabilitation involves ongoing medical monitoring, nutritional therapy, a program of moderate physical exercise, though education about alcoholism, and an introduction to a 12-step self-help support group for alcoholics. The third stage of professional treatment for alcoholism is a return to full independence, monitored through a series of medical follow-up visits and guided by ongoing participation in a support group. Alcoholics who maintain close ties with a support group as Alcoholics Anonymous greatly increase their chances for a solid, lasting recovery. What to Do If You Think You Have a Drinking Problem Popular magazines occasionally publish questionnaires to help people determine whether they are alcoholics. Quizzes can be misleading, because people tend to answer them in ways that suggest they don’t have a drinking problem. If you have ever had the slightest suspicion that your own drinking might be turning into a problem, ask yourself only these three questions: Am I drinking more than I used to? Once I start drinking, am I sometimes unable to stop? Do I get irritated when I’m in a place where I can’t drink? Answering "yes" to even one of these questions suggests that your use of alcohol may be unhealthy or problematic. To delve deeper, make an appointment for an evaluation at an alcohol or drug treatment center. A licensed physician will be able to determine if you are dependent on alcohol. What To Do If Someone You Know Has A Drinking Problem When someone you know has a drinking problem, the crucial first step is getting that person to acknowledge that the problem exists. This may not be easy. Typically, alcoholics insist that they can control their alcohol intake and reject any suggestion that they should quit drinking. If they are employed, find out if his or her workplace provides a benefit called "employee assistance." Such a program can provide a smooth, confidential link between a person who drinks too much and an appropriate alcoholism treatment center. You might consider asking your family doctor for advice. Or you can check your phone book for nearby alcohol and drug treatment centers. Such a facility will probably offer "intervention counseling," which can help you and other family members or friends plan how to confront a person about his or her problem drinking. It’s True Most alcoholics are alcoholics for life, meaning they will always be in danger of relapsing if they take even a single drink. But recovering alcoholics learn how to cut this daunting problem down to manageable size. They make the decision not to drink – they make it "one day at a time." Although alcoholism is a common and serious problem, large numbers of alcoholics can and do recover. For anyone with a drinking problem, a properly certified, professional, medically supervised treatment program offers a chance for a lasting recovery. Hope Lies in Learning More The more you learn about alcoholism the better you will understand that it is an illness and it is treatable. This pamphlet gives you the facts you need to recognize the signs and symptoms of problem drinking. By reaching out for help you could be giving someone a healthier and more fulfilling life. Treatment can make the difference. This publication is generously supported by a grant from the William H. Donner Foundation and Eli Lilly and Company. Copyright 1997 Return