Alcoholism is a chronic and often progressive disease that includes problems controlling your drinking, being preoccupied with alcohol, continuing to use alcohol even when it causes problems, having to drink more to get the same effect (physical dependence), or having withdrawal symptoms when you rapidly decrease or stop drinking. If you have alcoholism, you can't consistently predict how much you'll drink, how long you'll drink, or what consequences will occur from your drinking.
It's possible to have a problem with alcohol, even when it has not progressed to the point of alcoholism. Problem drinking means you drink too much at times, causing repeated problems in your life, although you're not completely dependent on alcohol.
Binge drinking — a pattern of drinking where a male consumes five or more drinks in a row, or a female downs at least four drinks in a row — can lead to the same health risks and social problems associated with alcoholism. The more you drink, the greater the risks. Binge drinking, which often occurs with teenagers and young adults, may lead to faster development of alcoholism.
If you have alcoholism or you have a problem with alcohol, you may not be able to cut back or quit without help. Denying that you have a problem is usually part of alcoholism and other types of excessive drinking.
Alcoholism signs and symptoms include those below. You may:
If you binge drink or have other problems with alcohol, you may have many of the signs and symptoms above, although you may not feel as much of a compulsion to drink compared with someone who has alcoholism. Also, you may not have physical withdrawal symptoms when you don't drink. But this pattern of drinking can still cause serious problems and lead to alcoholism. As with alcoholism, you may not be able to quit problem drinking without help.
What is considered one drink?
What about my drinking?
If you answered yes to even one of these questions, you may have a problem with alcohol.
When to see a doctor
Because denial is common, you may not feel like you have a problem with drinking or that you need help to stop. You might not recognize how much you drink or how many problems in your life are related to alcohol use. Listen to family members, friends or co-workers when they ask you to examine your drinking habits or to seek help.
Alcoholism is influenced by genetic, psychological, social and environmental factors that have an impact on how it affects your body and behavior.
The process of becoming addicted to alcohol occurs gradually, although some people have an abnormal response to alcohol from the time they start drinking. Over time, drinking too much may change the normal balance of chemicals and nerve tracks in your brain associated with the experience of pleasure, judgment and the ability to exercise control over your behavior. This may result in your craving alcohol to restore good feelings or remove negative ones.
Risk factors for alcoholism include:
Alcohol depresses your central nervous system. In some people, the initial reaction may be stimulation. But as you continue to drink, you become sedated. Alcohol lowers your inhibitions and affects your thoughts, emotions and judgment.
Too much alcohol affects your speech, muscle coordination and vital centers of your brain. A heavy drinking binge may even cause a life-threatening coma or death.
If you have problems with alcohol, you're more likely to also have problems with other substances.
Excessive drinking can reduce your judgment skills and lower inhibitions, leading to poor choices and dangerous situations or behaviors, such as:
Health problems caused by excessive drinking can include:
Alcohol use leads to serious consequences for many teens and young adults. In this age group:
Preparing for your appointment
You're likely to start by seeing your primary care doctor or a general practitioner. Because your appointment can be brief, it's a good idea to be well prepared. Here's some information to help you get ready, and what to expect from your doctor:
Prepare a list of questions ahead of time, from most important to least important, to make the most of your time. For excessive drinking or alcoholism, basic questions to ask your doctor include:
Don't hesitate to ask questions during your appointment any time that you don't understand something.
What to expect from your doctor
Be ready to answer questions your doctor may ask, which include:
Tests and diagnosis
A doctor who suspects you have an alcohol problem will ask you several questions regarding drinking habits and may have you fill out a questionnaire. The doctor may ask for permission to speak with family members or friends. Family members may also contact the doctor on their own to discuss their concerns. However, confidentiality laws prevent your doctor from giving out any information about you without your consent.
There are no specific tests to diagnose alcoholism, but you may need other tests for health problems that may be linked to your alcohol use.
To be diagnosed with alcoholism, you must meet criteria spelled out in the Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association. These include a pattern of alcohol use leading to serious problems, as indicated by three or more of the following at any time during one 12-month period:
Treatments and drugs
Many people with alcoholism hesitate to get treatment because they don't recognize they have a problem. An intervention from loved ones can help some people recognize and accept that they need professional help. If you're concerned about a friend or family member who drinks too much, talk to a professional for advice on how to approach that person.
Various treatments may help. Depending on the circumstances, treatment may involve a brief intervention, individual or group counseling, an outpatient program, or a residential inpatient stay.
The first step is to determine if you have a problem with alcohol. If you haven't lost control over your use of alcohol, treatment may involve reducing your drinking. If you have become addicted, simply cutting back is ineffective. Working to stop the use of alcohol to improve quality of life is the main treatment goal.
Treatment for alcoholism may include:
Residential treatment programs
Lifestyle and home remedies
Coping with problem drinking or alcoholism requires that you change your habits and make different lifestyle choices.
Several alternative medicine techniques may be helpful in addition to your treatment plan when recovering from alcoholism. Examples include:
Coping and support
Many people who have alcoholism and their family members find that participating in support groups is an essential part of coping with the disease, preventing or dealing with relapses, and staying sober.
Recovery in AA is based on accepting the unique experience of each person. Through listening and sharing stories, people who have problem drinking or are dependent on alcohol learn they aren't alone. There are no fees for membership or requirements for following the 12 steps — only a willingness to try to remain sober.
Al-Anon and Alateen
Your doctor or counselor can refer you to an AA group or other local support group. These groups are also commonly listed in the phone book, in the local newspaper and on the Web.
Early intervention can prevent alcoholism in teens. For young people, the likelihood of addiction depends on the influence of parents, peers and other role models; how much they're influenced by advertising of alcohol; how early in life they begin to use alcohol; the psychological need for alcohol; and genetic factors that may increase their risk of addiction.
If you have a teenager, be alert to signs and symptoms that may indicate a problem with alcohol:
You can help prevent teenage alcohol use. Start by setting a good example with your own alcohol use. Talk openly with your child, spend quality time together, and become actively involved in your child's life. Let your child know what behavior you expect — and what the consequences will be if he or she doesn't follow the rules.
Last Updated: 2012-08-09
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