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FAQ on alcoholism in general

The following questions and answers are mostly from 

The answers are concise and more information is available at Information.

bulletWhat is alcoholism?
bulletWhy is alcoholism now considered a disease?
bulletIs alcoholism inherited?
bulletIs alcoholism an environmental disease?
bulletCan I have 100% (or zero) risk for alcoholism?
bulletIf alcoholism is a disease, can it be cured?
bulletWhat medications are there for alcoholism?
bulletCan the alcoholic control it?
bulletDoes alcoholism treatment work?
bulletWhat if there is a relapse?
bulletDoes someone have to be alcoholic to have problems from alcohol?
bulletHow common is alcoholism in the U.S.?
bulletAre certain groups of people more likely to develop alcohol problems than others?
bulletHow can you tell whether you (or someone close to you) has an alcohol problem?
bulletIf I have trouble with drinking, can I simply reduce my alcohol use without stopping altogether?
bulletIf an alcoholic is unwilling to seek help, is there any way to get him or her into treatment?
bulletWhat is a safe level of drinking?
bulletWho should not drink at all?
bulletIs it safe to drink during pregnancy?
bulletAs people get older, does alcohol affect their bodies differently?
bulletDoes alcohol affect a woman's body differently from a man's body?
bulletI have heard that alcohol is good for your heart. Is this true?
bulletIf I am taking over-the-counter or prescription medication, do I have to stop drinking?
bulletAlcohol Abuse and Alcoholism At A Glance

What is alcoholism?

Alcoholism is also known as "alcohol dependence." It is a disease that includes alcohol craving and continued drinking despite repeated alcohol-related problems, such as losing a job or getting into trouble with the law. Alcoholism includes four symptoms:

bulletCraving--A strong need, or compulsion, to drink.
bulletImpaired control--The inability to limit one's drinking on any given occasion.
bulletPhysical dependence--Withdrawal symptoms, such as nausea, sweating, shakiness, and anxiety, when alcohol use is stopped after a period of heavy drinking.
bulletTolerance--The need for increasing amounts of alcohol in order to feel its effects.

Why is alcoholism now considered a disease?

Alcoholism is now accepted as a disease. It is a chronic and often progressive disease. Like many diseases, it has symptoms that include a strong need to drink despite negative consequences, such as serious job or health problems. Like many diseases, it has a generally predictable course and is influenced by both genetic (inherited) and environmental factors.

Is alcoholism inherited?

Yes. Alcoholism tends to run in families and genetic factors partially explain this pattern. The genes that influence the vulnerability to alcoholism are under investigation

See also genetics

Is alcoholism an environmental disease?

Yes. A person's environment, such as the influence of friends, stress levels, and the ease of obtaining alcohol, may influence their drinking and the development of alcoholism. Still other factors, such as social support, may help to protect even high-risk people from alcohol problems.

See also causes of alcoholism

Can I have 100% (or zero) risk for alcoholism?

Risk is not destiny. A child of an alcoholic parent will not automatically develop alcoholism. A person with no family history of alcoholism can become alcohol dependent.

See also causes of alcoholism

If alcoholism is a disease, can it be cured?

Not yet. Alcoholism is a treatable disease, and medication has also become available to help prevent relapse, but a cure has not yet been found. This means that even if an alcoholic has been sober for a long time and has regained health, he or she may relapse and must continue to avoid all alcoholic beverages.

Can the alcoholic control it?

"Loss of Control" is Real. In alcoholics, ongoing use alters brain chemistry, causing addiction for which willpower is no match. Willpower can't lift depression or stop cravings caused by chemical disruption. Anxiety, irritability, mental confusion, and irrational thinking are often caused by physical disruption of the brain and central nervous system. "Talk "cannot reverse these conditions... biochemical repair must occur. 

Alcoholism results in loss of control. Once a drink is taken after sobriety, the alcoholic cannot control nor predict whether the drinking will be "normal" or "abnormal." The alcohol controls the alcoholic -- not vice versa.

What medications are there for alcoholism?

Two different types of medications are commonly used to treat alcoholism. The first are tranquilizers called benzodiazepines (e.g., Valium and Librium), which are used only during the first few days of treatment to help patients safely withdraw from alcohol.

A second type of medication is used to help people remain sober. A recently approved medicine for this purpose is naltrexone (ReVia TM). When used together with counselling, this medication lessens the craving for alcohol in many people and helps prevent a return to heavy drinking. Another, older medication is disulfiram (Antabuse), which discourages drinking by causing nausea, vomiting, and other unpleasant physical reactions when alcohol is used.

Does alcoholism treatment work?

Treatment is effective in many, but by no means all, cases of alcoholism. Studies show that a minority of alcoholics remain sober 1 year after treatment, while others have periods of sobriety alternating with relapses. Still others are unable to stop drinking for any length of time. Treatment outcomes for alcoholism compare favourably with outcomes for many other chronic medical conditions. The longer a person abstains from alcohol, the more likely that person is to remain sober.

What if there is a relapse?

It is important to remember that many people relapse once or several times before achieving long-term sobriety. Relapses are common and do not mean that a person has failed or cannot eventually recover from alcoholism. If a relapse occurs, it is important to try to stop drinking again and to get whatever help is needed to abstain from alcohol. Ongoing support from family members and others can be important in recovery

Does someone have to be alcoholic to have problems from alcohol?

No. Even if you are not alcoholic, abusing alcohol can have negative results, such as the failure to meet major work, school, or family responsibilities because of drinking, alcohol-related legal trouble, automobile crashes due to drinking, and a variety of alcohol-related medical problems. Under some circumstances, even moderate drinking can cause problems--for example, when driving, during pregnancy, or when taking certain medicines.

How common is alcoholism in the U.S.?

It is estimated that 14 million people in the United States -- 1 in every 13 adults -- abuse alcohol or are alcoholic.

Are certain groups of people more likely to develop alcohol problems than others?

More men than women are alcohol dependent or experience alcohol- related problems. Rates of alcohol problems are also highest among young adults ages 18-29 and lowest among adults 65 years and older. Among major U.S. ethnic groups, rates of alcoholism and alcohol- related problems vary.

How can you tell whether you (or someone close to you) has an alcohol problem?

A good first step is to answer the brief questionnaire below. (To help remember these questions, note that the first letter of a key word in each question spells "CAGE"):

bulletHave you ever felt you should Cut down on your drinking?
bulletHave people Annoyed you by criticizing your drinking?
bulletHave you ever felt bad or Guilty about your drinking?
bulletHave you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover (Eye opener)?

One "yes" answer suggests a possible alcohol problem. More than one "yes" answer means it is highly likely that a problem exists. If you think that you or someone you know might have an alcohol problem, it is important to see a doctor or other health provider right away. He or she can determine whether a drinking problem exists and, if so, suggest the best course of action.

If I have trouble with drinking, can I simply reduce my alcohol use without stopping altogether?

That depends. If you are diagnosed as an alcoholic, the answer is "no." Studies show that nearly all alcoholics who try to merely cut down on drinking are unable to do so indefinitely. Instead, cutting out alcohol (that is, abstaining) is nearly always necessary for successful recovery.

However, if studies show that you are not alcoholic but have had alcohol-related problems, you may be able to limit the amount you drink. If you cannot always stay within your limit, you will need to stop drinking altogether.

If an alcoholic is unwilling to seek help, is there any way to get him or her into treatment?

This can be a challenging situation. An alcoholic cannot be forced to get help except under certain circumstances, such as when a violent incident results in police being called or following a medical emergency. This doesn't mean, however, that you have to wait for a crisis to make an impact. Based on clinical experience, many alcoholism treatment specialists recommend the following steps to help an alcoholic accept treatment:

bulletStop all rescue missions. Family members often try to protect an alcoholic from the results of his or her behaviour by making excuses to others about his or her drinking and by getting him or her out of alcohol-related jams. It is important to stop all such rescue attempts immediately, so that the alcoholic will fully experience the harmful effects of his or her drinking--and thereby become more motivated to stop.

bulletTime your intervention. Plan to talk with the drinker shortly after an alcohol-related problem has occurred--for example, a serious family argument in which drinking played a part or an alcohol- related accident. Also choose a time when he or she is sober, when both of you are in a calm frame of mind, and when you can speak privately.

bulletBe specific. Tell the family member that you are concerned about his or her drinking and want to be supportive in getting help. Back up your concern with examples of the ways in which his or her drinking has caused problems for both of you, including the most recent incident.

bulletState the consequences. Tell the family member that until he or she gets help, you will carry out consequences--not to punish the drinker, but to protect yourself from the harmful effects of the drinking. These may range from refusing to go with the person to any alcohol-related social activities to moving out of the house. Do not make any threats you are not prepared to carry out.

bulletBe ready to help. Gather information in advance about local treatment options. If the person is willing to seek help, call immediately for an appointment with a treatment program counsellor. Offer to go with the family member on the first visit to a treatment program and/or AA meeting.

bulletCall on a friend. If the family member still refuses to get help, ask a friend to talk with him or her, using the steps described above. A friend who is a recovering alcoholic may be particularly persuasive, but any caring, non-judgemental friend may be able to make a difference. The intervention of more than one person, more than one time, is often necessary to persuade an alcoholic person to seek help.

bulletFind strength in numbers. With the help of a professional therapist, some families join with other relatives and friends to confront an alcoholic as a group. While this approach may be effective, it should only be attempted under the guidance of a therapist who is experienced in this kind of group intervention.

bulletGet support. Whether or not the alcoholic family member seeks help, you may benefit from the encouragement and support of other people in your situation. Support groups offered in most communities include Al-Anon, which holds regular meetings for spouses and other significant adults in an alcoholic's life, and Alateen, for children of alcoholics. These groups help family members understand that they are not responsible for an alcoholic's drinking and that they need to take steps to take care of themselves, regardless of whether the alcoholic family member chooses to get help.

What is a safe level of drinking?

Most adults can drink moderate amounts of alcohol -- up to two drinks per day for men and one drink per day for women and older people -- and avoid alcohol-related problems. (One drink equals one 12-ounce bottle of beer or wine cooler, one 5-ounce glass of wine, or 1.5 ounces of 80-proof distilled spirits.)

Who should not drink at all?

Certain people should not drink at all. They include women who are pregnant or trying to become pregnant; people who plan to drive or engage in other activities requiring alertness and skill; people taking certain medications, including certain over-the-counter medicines; people with medical conditions that can be worsened by drinking; recovering alcoholics; and people under the age of 21.

Is it safe to drink during pregnancy?

No. Drinking during pregnancy can have a number of harmful effects on the newborn, ranging from mental retardation, organ abnormalities, to hyperactivity and learning and behavioural problems. Moreover, many of these disorders last into adulthood.

While we don't yet know exactly how much alcohol is required to cause these problems, we do know that they are 100% preventable if a woman does not drink at all during pregnancy. Therefore, for women who are pregnant or are trying to become pregnant, the safest course at present is to abstain from alcohol.

As people get older, does alcohol affect their bodies differently?

Yes. As a person ages, certain mental and physical functions tend to decline, including vision, hearing, and reaction time. Moreover, other physical changes associated with aging can make older people feel "high" after drinking fairly small amounts of alcohol. These combined factors make older people more likely to have alcohol- related falls, automobile crashes, and other kinds of accidents.

In addition, older people tend to take more medicines than younger persons, and mixing alcohol with many over-the-counter and prescription drugs can be dangerous, even fatal. Further, many medical conditions common to older people, including high blood pressure and ulcers, can be worsened by drinking. Even if there is no medical reason to avoid alcohol, older men and women should limit their intake to one drink per day.

Does alcohol affect a woman's body differently from a man's body?

Yes. Women become more intoxicated than men after drinking the same amount of alcohol, even when differences in body weight are taken into account. This is because women's bodies have proportionately less water than men's bodies. Because alcohol mixes with body water, a given amount of alcohol becomes more highly concentrated in a woman's body than in a man's. That is why the recommended drinking limit for women is lower than for men.

In addition, chronic alcohol abuse takes a heavier physical toll on women than on men. Alcohol dependence and related medical problems, such as brain and liver damage, progress more rapidly in women than in men.

I have heard that alcohol is good for your heart. Is this true?

Several studies have reported that moderate drinkers -- those who have one or two drinks per day -- are less likely to develop heart disease than people who do not drink any alcohol or who drink larger amounts. Small amounts of alcohol may help protect against coronary heart disease by raising levels of "good" HDL cholesterol and by reducing the risk of blood clots in the coronary arteries.

If you are a non-drinker, you should not start drinking only to benefit your heart. Protection against coronary heart disease may be obtained through regular physical activity and a low-fat diet. And if you are pregnant, planning to become pregnant, have been diagnosed as alcoholic, or have any medical condition that could make alcohol use harmful, you should not drink.

For those who can drink safely and choose to do so, moderation is the key. Heavy drinking can actually increase the risk of heart failure, stroke, and high blood pressure, as well as cause many other medical problems, such as liver cirrhosis.

If I am taking over-the-counter or prescription medication, do I have to stop drinking?

Possibly. More than 100 medications interact with alcohol, leading to increased risk of illness, injury and, in some cases, death. The effects of alcohol are increased by medicines that slow down the central nervous system, such as sleeping pills, antihistamines, antidepressants, antianxiety drugs, and some painkillers. In addition, medicines for certain disorders, including diabetes and heart disease, can be dangerous if used with alcohol. If you are taking any over-the-counter or prescription medications, ask your doctor or pharmacist whether you can safely drink alcohol.

In the U.S. you can call the Center for Substance Abuse Treatment at 1-800-662-HELP for information about alcohol treatment programs in your local community and to speak to someone about an alcohol problem, or visit the Alcoholics Anonymous web site.

This article incorporates information provided by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), one of 18 institutes that comprise the National Institutes of Health (NIH), the principal biomedical research agency of the U.S. Government.

Alcohol Abuse and Alcoholism At A Glance

bulletAlcoholism is a very common disease.
bulletAlcohol abuse affects 1 in 13 U.S. adults.
bulletAlcoholism involves physical dependence.
bulletAlcoholism is a treatable, but not a curable disease.



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