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FAQ’s
on Alcohol Abuse and Alcoholism
Q #1: What is
alcoholism?
Alcoholism, also known as
alcohol dependence, is a disease that includes the following four
symptoms:
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Craving—A
strong need, or urge, to drink.
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Loss
of control—Not being able to stop drinking once drinking
has begun.
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Physical
dependence—Withdrawal symptoms, such as nausea, sweating,
shakiness, and anxiety after stopping drinking.
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Tolerance—The
need to drink greater amounts of alcohol to get “high.”
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For clinical and research
purposes, formal diagnostic criteria for alcoholism also have been
developed. Such criteria are included in the Diagnostic and
Statistical Manual for Mental Disorders, Fourth Edition, published
by the American Psychiatric Association, as well as in the International
Classification Diseases, published by the World Health Organization.
Q #2: Is alcoholism a
disease?
Yes, alcoholism is a
disease. The craving that an alcoholic feels for alcohol can be as
strong as the need for food or water. An alcoholic will continue to
drink despite serious family, health, or legal problems.
Like many other diseases,
alcoholism is chronic, meaning that it lasts the person’s lifetime; it
usually follows a predictable course; and it has symptoms. The risk for
developing alcoholism is influenced both by a person’s genes and by
his or her lifestyle.
Q #3: Is alcoholism
inherited?
Research shows that the
risk for developing alcoholism does indeed run in families. The genes a
person inherits partially explain this pattern, but lifestyle is a
factor. Currently, researchers are working to discover the actual genes
that put people at risk for alcoholism. Your friends, the amount of
stress in your life, and how readily available alcohol is also are
factors that may increase your risk for alcoholism.
But remember: Risk is not
destiny. Just because alcoholism tends to run in families doesn’t mean
that a child of an alcoholic parent will automatically become an
alcoholic too. Some people develop alcoholism even though no one in
their family has a drinking problem. By the same token, not all children
of alcoholic families get into trouble with alcohol. Knowing you are at
risk is important, though, because then you can take steps to protect
yourself from developing problems with alcohol.
Q #4: Can alcoholism
be cured?
No, alcoholism cannot be
cured at this time. Even if an alcoholic hasn’t been drinking for a
long time, he or she can still suffer a relapse. To guard against a
relapse, an alcoholic must continue to avoid all alcoholic beverages.
Q #5: Can alcoholism
be treated?
Yes, alcoholism can be
treated. Alcoholism treatment programs use both counseling and
medications to help a person stop drinking. Most alcoholics need help to
recover from their disease. With support and treatment, many people are
able to stop drinking and rebuild their lives.
Q #6:
Which medications treat alcoholism?
A range of medications
are used to treat alcoholism. Benzodiazepines (Valium®, Librium®) are
sometimes used during the first days after a person stops drinking to
help him or her safely withdraw from alcohol. These medications are not
used beyond the first few days, however, because they may be highly
addictive. Other medications help people remain sober. One medication
used for these purpose is Naltrexone (ReVia™). When combined with
counseling Naltrexone can reduce the craving for alcohol and help
prevent a person from returning, or relapsing, to heavy drinking.
Another medication, Disulfiram (Antabuse®), discourages drinking by
making the person feel sick if he of she drinks alcohol.
Though several
medications help treat alcoholism, there is no “magic bullet.” In
other words, no single medication is available that works in every case
and/or in every person. Developing new and more effective medications to
treat alcoholism remains a high priority for researchers.
Q #7:
Does alcoholism treatment work?
Alcoholism treatment
works for many people. But just like any chronic disease, there are
varying levels of success when it comes to treatment. Some people stop
drinking and remain sober. Others have long periods of sobriety with
bouts of relapse. And still others cannot stop drinking for any length
of time. With treatment, one thing is clear, however: the longer a
person abstains from alcohol, the more likely he of she will be able to
stay sober
Q #8 Do
you have to be an alcoholic to experience problems
No. Alcoholism is only
one type of an alcohol problem. Alcohol abuse can be just as harmful. A
person can abuse alcohol without actually being an alcoholic- that is,
he or she may drink too much and too often but still not be dependent on
alcohol. Some of the problems linked to alcohol abuse include not being
able to meet work, school, or family responsibilities; drunk-driving
arrests and car crashes; and drinking-related medical conditions. Under
some circumstances, even social or moderate drinking is dangerous-for
example, when driving, during pregnancy, or when taking certain
medications.
Q #9: Are
specific groups of people more likely to have problems?
Alcohol abuse and
alcoholism cut across gender, race, and nationality. Nearly 14 million
people in the United States-1 in every 13 adults- abuse alcohol or are
alcoholic. In general, more men than women are alcohol dependent or have
alcohol problems. And alcohol problems are highest among young adults
ages 18-29 and lowest among adults ages 65 and older. We also know that
people that start drinking at an early age- for example, at age 14 or
younger-greatly increase the chance that they will develop alcohol
problems at some point in their lives.
Q #10:
How can you tell if someone has a problem?
Answering the following
four questions can help you find out if you or a loved one has a
drinking problem:
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Have
you ever felt you should cut down on your drinking?
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Have
people annoyed you by criticizing your drinking?
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Have
you ever felt bad or guilty about your drinking?
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Have
you ever had a drink first thing in the morning to steady your
nerves or to get rid of a hangover?
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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 another healthcare provider right away. They can help
you determine if a drinking problem exists and plan the best course of
action.
Q #11:
Can a problem drinker simply cut down?
It depends. If that
person has been diagnosed as an alcoholic, the answer is “no.”
Alcoholics who try to cut down on drinking rarely succeed. Cutting out
alcohol- that is, abstaining- is usually the best course for recovery.
People who are not alcohol dependent but who have experienced
alcohol-related problems may be able to limit that amount they drink. If
they can’t stay within those limits, they need to stop drinking
altogether.
Q #12: If
an alcoholic is unwilling to get help, what can you do about it?
This can be a challenge.
An alcoholic can’t be forced to get help except under certain
circumstances, such as a violent incident that results in court-ordered
treatment or medical emergency. But you don’t have to wait for someone
to “hit rock bottom” to
act. Many alcoholism treatment specialists suggest the following steps
to help an alcoholic get treatment:
Stop all “cover
ups.” Family members often
make excuses to others or try to protect the alcoholic from the results
of his or her drinking. It is important to stop covering for the
alcoholic so that he or she experiences the full consequences of
drinking.
Time your
intervention. The best time to
talk to the drinker is shortly after an alcohol-related problem has
occurred- like a serious family argument or an accident. Choose a time
when he of she is sober, both of you are fairly calm, and you have a
chance to talk in private.
Be specific.
Tell the family member that you are worried about his or her drinking.
Use examples of the ways in which the drinking has caused problems,
including the most recent incident.
State the results.
Explain to the drinker what you will do if he or she doesn’t go for
help-not to punish the drinker, but to protect yourself from his or her
problems. What you say may range from refusing to go with the person to
any social activity where alcohol will be served, to moving out of the
house. Do not make any threats you are not prepared to carry out.
Get help.
Gather information in advance about treatment options in your community.
If the person is willing to get help, call immediately for an
appointment with a treatment counselor. Offer to go with the family
member on the first visit to a treatment program and /or an Alcoholics
Anonymous meeting.
Call on a friend.
If the family member still refuses to get help, ask a friend to talk
with him or her using the steps just described. A friend who is a
recovering alcoholic may be particularly persuasive, but any person who
is caring and nonjudgmental may help. The intervention of more than one
person, more than one time, is often necessary to coax and alcoholic to
seek help.
Find strength in
numbers. With the help of a
healthcare professional, some families join with other relatives and
friends to confront an alcoholic as a group. This approach should only
be tried under the guidance of a healthcare professional that is
experienced in this kind of group intervention.
Get support.
It is important to remember that you are not alone. 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, which is geared to 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.
You can call the National
Drug and Alcohol Treatment Referral Routing Service (Center for
Substance Abuse Treatment) at 1-800-662-HELP for information about
treatment programs in your local community and to speak to someone about
an alcohol problem.
Q #13:
What is a safe level of drinking?
For most adults, moderate
alcohol use-up to two drinks per day for men and one drink per day for
women and older people- causes few if any 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.)
Certain people should not
drink at all, however:
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Women
who are pregnant or trying to become pregnant
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People
who plan to drive or engage in other activities that require
alertness and skill (such as using high-speed machinery)
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People
taking certain over-the-counter or prescription medications
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People
with medical conditions that can be made worse by drinking
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Recovering
alcoholics
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People
younger that are 21.
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Q #14: Is
it safe to drink during pregnancy?
No, drinking during
pregnancy is dangerous. Alcohol can have a number of harmful effects on
the baby. The baby can be born mentally retarded or with learning and
behavioral problems that last a lifetime. We don’t know exactly how
much alcohol is required to cause these problems. We do know, however,
that these alcohol-related birth defects are 100% preventable, simply by
not drinking alcohol during pregnancy. The safest course for women who
are pregnant or trying to become pregnant is not to drink alcohol at
all.
Q #15:
Does alcohol affect older people differently?
Alcohol’s effects do
vary with age. Slower reaction times, problems with hearing and seeing,
and lower tolerance to alcohol’s effects put older people at higher
risk for falls, car crashes, and other types of injuries that may result
from drinking.
Older people also tend to
take more medicines that younger people. Mixing alcohol with
over-the-counter or prescription medications can be very dangerous, even
fatal. More than 150 medications interact harmfully with alcohol. In
addition, alcohol can make many of the medical conditions common in
older people, including high blood pressure and ulcers, more serious.
Physical changes associated with aging can make older people feel
“high” even after drinking only small amounts of alcohol. So even if
there is no medical reason to avoid alcohol, older men and women should
limit themselves to one drink per day.
Q #16:
Does alcohol affect women differently?
Yes, alcohol affects
women differently than men. Women become more impaired than men do after
drinking the same amount of alcohol, even when differences in body
weight are taken into account. This is because women’s bodies have
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. In other words, it would be like dropping the
same amount of alcohol into a much smaller pail of water. 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, heart,
and liver damage, progress more rapidly in women than in men.
Q #17: Is
alcohol good for your heart?
Studies have shown that
moderate drinkers-men who have two or less drinks per day and women who
have one or less drinks per day- are less likely to die from one form of
heart disease that are people who do not drink and alcohol or who drink
more. It’s believed that these smaller amounts of alcohol help protect
against heart disease by changing the blood’s chemistry, thus reducing
the risk of blood clots in the heart’s arteries.
If you are a nondrinker,
however, you should not start drinking solely to benefit your heart. You
can guard against heart disease by exercising and eating foods that are
low in fat. And if you are pregnant, planning to become pregnant, have
been diagnosed as alcoholic, or have another medical condition that
could make alcohol use harmful, you should not drink.
If you can safely drink
alcohol and you choose to drink, do so in moderation. Heavy drinking can
actually increase the risk of heart failure, stroke, and high blood
pressure, as well s cause many other medical problems, such as liver
cirrhosis.
Q #18:
When taking medications, must you stop drinking?
Possibly. More than 150
medications interact harmfully with alcohol. These interactions may
result in increased risk of illness, injury, and even death. Alcohol’s
effects are heightened by medicines that depress the central nervous
system, such as sleeping pills, antihistamines, antidepressants,
anti-anxiety drugs, and some painkillers.
In addition, medicines for certain disorders, including diabetes,
high blood pressure, and heart disease, can have harmful interactions
with alcohol. If you are taking over-the-counter of prescription
medications, ask your doctor or pharmacist if you can safely drink
alcohol.
Q #19:
How can a person get help for an alcohol problem?
There are many national
and local resources that can help. The National Drug and Alcohol
Treatment Referral Routing Service provides a toll-free telephone
number, 1-800-662-HELP, offering various resource information. Through
this service you can speak directly to a representative concerning
substance abuse treatment, request printed material on alcohol or other
drugs, or obtain local substance abuse treatment referral information in
your state.
Many people also find
support groups a helpful aid to recovery. The following list includes a
variety of resources:
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