Alcoholism is a chronic disease in which your body becomes dependent on alcohol. When you have alcoholism, you lose control over your drinking. You may not be able to control when you drink, how much you drink, or how long you drink on each occasion. If you have alcoholism, you continue to drink even though you know it's causing problems with your relationships, health, work or finances.
It's possible to have a problem with alcohol but not have all the symptoms of alcoholism. This is known as "alcohol abuse," which means you drink too much and it causes problems in your life although you aren't completely dependent on alcohol. If you have alcoholism or you abuse alcohol, you may not be able to cut back or quit without help. A number of approaches are available to help you recover from alcoholism, including medications, counseling and self-help groups.
Alcoholism symptoms include:
People who abuse alcohol may have many of the same signs and symptoms as people who have full-blown alcoholism. However, if you abuse alcohol but aren't completely addicted to it, you may not feel as much of a compulsion to drink. You may not have physical withdrawal symptoms when you don't drink. But alcohol abuse can still cause serious problems. As with alcoholism, you may not be able to quit drinking without help.
If you've ever wondered whether your drinking crosses the line into alcohol abuse or dependence, ask yourself these questions:
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 a frequent characteristic of alcohol abuse and alcoholism, you may not feel like you need treatment. 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.
Alcohol addiction — physical dependence on alcohol — occurs gradually. Over time, drinking too much changes the balance of chemicals in your brain associated with the pleasurable aspects of drinking alcohol. Excessive, long-term drinking can affect the balance of these chemicals, causing your body to crave alcohol to restore good feelings or to avoid negative feelings.
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 and muscle coordination and affects vital centers of your brain. A heavy drinking binge may even cause a life-threatening coma.
Excessive drinking can cause a number of problems. Some of these include:
Health problems caused by excessive drinking can include:
Alcohol use leads to serious consequences for many teens. Alcohol-related motor vehicle accidents are a major cause of teen deaths. Alcohol is also often a cause in other teenage deaths, including drowning, suicides and homicides. Teens who drink are more likely to become sexually active, have sex more frequently and engage in risky, unprotected sex than are teens who don't drink.
Preparing for your appointment
You're likely to start by seeing your primary care doctor or a general practitioner.
Because appointments can be brief, and because there's often a lot of ground to cover, 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:
Your time with your doctor is limited, so preparing a list of questions ahead of time will help you make the most of your time together. List your questions from most important to least important in case time runs out. For alcohol abuse or alcoholism, some basic questions to ask your doctor include:
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment at any time that you don't understand something.
What to expect from your doctor
Tests and diagnosis
A doctor who suspects you might have an alcohol problem will ask you a number of 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 rules 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 (DMS), published by the American Psychiatric Association.
The criteria required for a diagnosis of alcoholism include a pattern of alcohol abuse leading to significant 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 enter treatment reluctantly because they don't recognize that they have a problem. An intervention from loved ones is needed to help some people recognize and accept that they need to get help. If you're concerned about a friend or family member, talk to a professional for advice about how to approach that person about his or her drinking.
Various treatments are available to help people with alcohol problems. Depending on the circumstances, treatment may involve a brief intervention, an outpatient program or counseling, or a residential inpatient stay.
The first step in treatment is to determine whether you're alcohol dependent. If you haven't lost control over your use of alcohol, treatment may involve reducing your drinking. If you're dependent on alcohol, simply cutting back is ineffective. Giving up alcohol entirely must be part of your treatment goal.
Treatment for alcoholism can include:
Residential treatment programs
Lifestyle and home remedies
Coping with alcohol abuse or dependence usually requires that you change your habits and make different lifestyle choices.
There are a number of alternative medicine techniques that may be helpful when recovering from alcoholism. These 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 abuse 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 is important to prevent alcoholism in teens. For young people, the likelihood of addiction depends on the influence of parents, peers and other role models; susceptibility to advertising; 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 and spend quality time together, but respect your child's need for independence. 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: 2010-05-06
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