Alcohol Abuse and Alcoholism (Alcohol Dependence)

by Debra Wood, RN

Definition

Alcohol abuse is a disease that involves desire for alcohol and continuing to drink even when faced with alcohol-related job, legal, social, health, or family problems. Alcohol abuse can progress to alcoholism. Alcoholism is a condition in which the individual is physically dependent on the effects of alcohol to avoid symptoms of withdrawal.

Causes

Several factors contribute to alcohol abuse, including:

• Genes
  
• Brain chemicals that may be different than normal
  
• Social pressure
  
• Emotional stress
  
• Pain
  
• Depression and other mental health problems
  
• Problem drinking behaviors learned from family or friends

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.

• Sex: male
  
• Alcohol use
  
• Family members who abuse alcohol (especially men whose fathers or brothers are alcoholic)
  
• Using illicit drugs
  
• Peer pressure
  
• Easy access to alcoholic beverages
  
• Psychiatric disorders, such as depression or anxiety
  
• Smoking

Symptoms

Denial that an alcohol problem exists is common. Alcohol abuse can occur without physical dependence.

Alcohol abuse symptoms include:

• Repeated work, school or home problems due to drinking
  
• Risking physical safety
  
• Recurring trouble with the law, often including drinking and driving
  
• Continuing to drink despite alcohol-related difficulties

Alcohol abuse often progresses to alcohol dependence. Symptoms of alcohol dependence include:

• Craving a drink
  
• Unable to stop or limit drinking
  
• Needing greater amounts of alcohol to feel the same effect
  
• Withdrawal symptoms if alcohol is stopped, including:
  
  
  
  • Nausea
    
  • Sweating
    
  • Shaking
    
  • Anxiety
    
  • Increased blood pressure
    
  • Seizures
  
  
• Giving up activities in order to drink or recover from alcohol's effects
  
• Drinking that continues even when it causes or worsens health problems
  
• Wanting to stop or reduce drinking and not being able to

Organs That Can Be Damaged by Alcoholism

Copyright © 2005 Nucleus Communications, Inc. All rights reserved. www.nucleusinc.com

Diagnosis

Doctors ask a series of questions to assess possible alcohol-related problems, including:

• Have you tried to reduce your drinking?
  
• Have you felt bad about drinking?
  
• Have you been annoyed by another person's criticism of your drinking?
  
• Do you drink in the morning to steady your nerves or cure a hangover?
  
• Do you have problems with a job, your family or the law?
  
• Do you drive under the influence of alcohol?

Tests may include:

• Blood tests to look at the size of your red blood cells and to check for a substance called carbohydrate-deficient transferrin
  
• Blood tests to check for alcohol-related liver disease and other health problems

Treatment

The first step in treatment is getting the patient to accept that he or she has a problem. A group intervention brings together important people in an individuals' life. They confront him or her about how alcohol is affecting all of his or her relationships and functioning.

Treatment for alcohol abuse or dependence is aimed at teaching patients how to manage the disease. Most professionals who treat people with alcohol problems believe that this means giving up alcohol completely and permanently.

The first and most important step is recognizing a problem exists. Successful treatment depends on your desire to change. Your doctor can help you withdraw from alcohol safely. This could require hospitalization in a detoxification center, so that you are carefully monitored for side effects. You may need medication while you are undergoing detox.

Treatments include:

Medications

Drugs can help alleviate symptoms of withdrawal and help prevent relapse. The doctor may prescribe medication to reduce cravings for alcohol.

Medications used to treat alcoholism and to try to prevent drinking include:

• Naltrexone
  
• Disulfiram (Antabuse)
  
• Acamprosate (Campral)
  
• Selective serotonin reuptake inhibitors (SSRIs), including:
  
  
  
  • Fluoxetine (Prozac)
    
  • Sertraline (Zoloft)
    
  • Paroxetine (Paxil)
    
  • Citalopram (Celexa)
    
  • Fluvoxamine (Luvox)
    

    Please Note: On March 22, 2004, the Food and Drug Administration (FDA) issued a Public Health Advisory that cautions physicians, patients, families and caregivers of patients with depression to closely monitor both adults and children receiving certain antidepressant medications. The FDA is concerned about the possibility of worsening depression and/or the emergence of suicidal thoughts, especially among children and adolescents at the beginning of treatment, or when there is an increase or decrease in the dose. The medications of concern ­- mostly SSRIs (Selective Serotonin Re-uptake Inhibitors) - are: Prozac (fluoxetine), Zoloft (sertraline), Paxil (paroxetine), Luvox (fluvoxamine), Celexa (citalopram); Lexapro (escitalopram), Wellbutrin (bupropion), Effexor (venlafaxine), Serzone (nefazodone), and Remeron (mirtazapine). Of these, only Prozac (fluoxetine) is approved for use in children and adolescents for the treatment of major depressive disorder. Prozac (fluoxetine), Zoloft (sertraline), and Luvox (fluvoxamine) are approved for use in children and adolescents for the treatment of obsessive compulsive disorder. For more information, please visit http://www.fda.gov/cder/drug/antidepressants.

    
    

  
  
• Buspirone (BuSpar) – an antianxiety drug

Education and Counseling

Therapy helps you recognize alcohol's dangers. It raises awareness of underlying issues and lifestyles that promote drinking. In therapy, you work to improve coping skills and develop other ways of dealing with stress or pain. You learn new methods of handling situations where alcohol is served.

Mentoring and Community Help

Alcoholics Anonymous (AA) helps many people stop drinking and stay sober. Members meet regularly and talk about their troubles with alcohol. They support each other. If you feel like drinking, you can call your AA sponsor for help. Your family members may also benefit from attending meetings of Al-Anon, because living with an alcoholic can be a painful, stressful situation.

Prevention

Realizing that alcohol causes problems helps some people avoid it. Suggestions to decrease the risk of alcohol abuse and dependence include:

• Socialize without alcohol.
  
• Avoid going to bars.
  
• Do not keep alcohol in your home.
  
• Avoid situations and people that encourage drinking.
  
• Make new non-drinking friends.
  
• Do fun things that do not involve alcohol.
  
• Avoid reaching for a drink when stressed or upset.
  
• Drink slowly.
  
• Limit your alcohol intake to a moderate level.
  
  
  
  • Moderate is two or fewer drinks per day for men and one or fewer for women and older adults.
    
  • A 12-ounce bottle of beer, a five-ounce glass of wine or 1.5 ounces of liquor is considered one drink.

RESOURCES:

Alcoholics Anonymous
http://www.alcoholics-anonymous.org/

National Council on Alcoholism and Drug Dependence
http://www.ncadd.org

Sources:

Benefits and dangers of alcohol. Journal of the American Medical Association. January 6, 1999.

Do you have a drinking problem? Journal of the American Medical Association. April 14, 1999.

Griffith's 5-Minute Clinical Consult, 1999 ed. Lippincott Williams and Wilkins;1999.

National Institute on Alcohol Abuse and Alcoholism.

Primary Care Medicine, 4th ed. Lippincott Williams and Wilkins;2000.

---

Last reviewed January 2004 by Rosalyn Carson-DeWitt, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

Copyright © 2005 HealthGate Data Corp. All rights reserved.

More Health & Healing Prayers for Healing: A multifaith collection

• Better Get-Well Gift Ideas
  
• Sign up for daily health tips & tools
  
• More on Health & Healing

Sponsor
Ads_kid=0;Ads_bid=0;Ads_xl=120;Ads_yl=600;Ads_xp='';Ads_yp='';Ads_opt=0;Ads_wrd='';Ads_prf=''; function Ads_PopUp() {} dcmaxversion = 7 dcminversion = 3 Do On Error Resume Next plugin = (IsObject(CreateObject("ShockwaveFlash.ShockwaveFlash." & dcmaxversion & ""))) If plugin = true Then Exit Do dcmaxversion = dcmaxversion - 1 Loop While dcmaxversion >= dcminversion
Newsletters Sign up to receive FREE newsletters and special offers:
Daily

Inspiration

Health & Happiness
 
 




-- Edited by chrissy at 07:03, 2005-11-10