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What do we mean by alcoholism?
Is alcoholism a disease?
Is alcoholism inherited?
Can alcoholism be cured?
Are there any medications for alcoholism?
Does alcoholism treatment work?
Does a person have to be alcoholic to experience problems from
alcohol?
Are certain groups of people more likely to develop alcohol problems
than others?
How can you tell whether you or someone close to you has an alcohol
problem?
If I have trouble with drinking, can't I simply reduce my alcohol
use without stopping altogether?
How can a person get help for an alcohol problem?
If an alcoholic is unwilling to seek help, is there any way
to get him or her into treatment?
What is a safe level of drinking?
Is it safe to drink during pregnancy?
As people get older, does alcohol
affect their bodies differently?
Does alcohol affect a woman's
body differently from a man's body?
I have heard that alcohol is
good for your heart. Is this true?
If I am taking over-the-counter
or prescription medication, do I have to stop
drinking?
Alcoholism, also known as "alcohol dependence,"
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. It includes four symptoms:
- Craving--Strong need,
or compulsion, to drink.
- Impaired control--Inability
to limit one's drinking on any given occasion.
- Physical dependence--Withdrawal
symptoms, such as nausea, sweating, shakiness,
and anxiety, when alcohol use is stopped after
a period of heavy drinking.
- Tolerance--Need for
increasing amounts of alcohol in order to
feel its effects.
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Yes. Alcoholism is a chronic, often progressive
disease with symptoms that include a strong
need to drink despite negative consequences, such
as serious job or health problems. Like many other
diseases, it has a generally predictable course,
has recognized symptoms, and is influenced by
both genetic and environmental factors that
are being increasingly well defined. (See also
NIAAA "Publications," Alcohol
Alert No. 30: Diagnostic Criteria for
Alcohol Abuse and Dependence.)
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Yes, alcoholism tends to run in families, and
genetic factors partially explain this pattern.
Currently, researchers are attempting to identify
the specific genes that increase the risk of someone
developing alcohol problems. However, genetics
are not the only risk factor. A person's environment,
such as his or her influence of friends, stress
levels, and the ease of obtaining alcohol may
also influence drinking and the development of
alcoholism. Still other factors, such as social
support, may help to protect even high-risk
people from alcohol problems. Risk, however, is
not destiny. A child of an alcoholic parent will
not automatically develop alcoholism, nor will
a person with no family history of alcoholism
be free from alcohol dependency. (For additional
information, please see NIAAA "Publications,"
Alcohol Alert No. 18:
The Genetics of Alcoholism.)
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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.
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Yes, but please consult a medical professional
for more information. Three different types of
medications are commonly used to treat alcoholism.
(Please see NIAAA "Press Releases,"
Media Advisory, Jan.
17, 1995: Naltrexone Approved for Alcoholism
Treatment and "Publication," Alcohol
Alert No. 33: Neuroscience Research
and Medications Development.)
- Tranquilizers called Benzodiazepines
(e.g., Valium®, Librium®)
are used only during the first few days of
treatment to help patients safely withdraw
from alcohol.
- Naltrexone (ReVia TM)
are used to help people remain sober. When
used together with counseling, this medication
lessens the craving for alcohol in many people
and helps prevent a return to heavy drinking.
- An older medication is Disulfiram
(Antabuse®), which discourages
drinking by causing nausea, vomiting, and
other unpleasant physical reactions when
alcohol is used.
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Alcoholism treatment is effective in many cases.
Studies show that a minority of alcoholics remain
sober one year after treatment, while others have
periods of sobriety alternating with relapses.
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. (For
additional information, see "Publications,"
Alcohol Alert No. 17: Treatment
Outcome Research.)
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No. Many negative consequences can result from
the use and/ or abuse of alcohol. These include
failure to meet major responsibilities related
to work, school, or family; alcohol-related legal
trouble; automobile crashes due to drinking; and
a variety of alcohol-related medical problems.
Under some circumstances, problems can even
result from moderate drinking--for example,
when driving, during pregnancy, or when taking
certain medicines. (For additional information,
please see NIAAA "Publications," Alcohol Alert No. 30:
Diagnostic Criteria for Alcohol Abuse and Dependence.)
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Yes. Nearly 14 million people in the United
States--1 in every 13 adults--abuse alcohol or
are alcoholic. However, more men than women
are alcohol dependent or experience alcohol-related
problems. In addition, rates of alcohol problems
are 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.
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A good first step is to answer the brief questionnaire
below, developed by Dr. John Ewing. (To help remember
these questions, note that the first letter of
a key word in each question spells "CAGE.")
- Have you ever felt you should Cut
down on your drinking?
- Have people Annoyed you by
criticizing your drinking?
- Have you ever felt bad or Guilty
about your drinking?
- Have 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.
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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 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. (Please see
"Pamphlets and Brochures," How to Cut Down on
Your Drinking.)
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- Call the 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.
- Join a support group such as Alcoholics
Anonymous (AA). For information on local
AA support meetings, call your local AA chapter
(check your local phone directory under "Alcoholism")
or call 212-870-3400. For Al-Anon meetings (for spouses and other
significant adults in an alcoholic person's
life) and Alateen
(for children of alcoholics), call your local
Al-Anon chapter or call the following toll-free
numbers: 1-800-344-2666 (United States) or
1-800-443-4525 (Canada). Please visit our
links website for additional resources.
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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:
- Stop all "rescue missions."
Family members often try to protect an alcoholic
from the results of his or her behavior 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.
- Time 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.
- Be 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.
- State 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.
- Be 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 counselor. Offer to go with the family
member on the first visit to a treatment program
and/or an AA 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 described
above. A friend who is a recovering alcoholic
may be particularly persuasive, but any caring,
nonjudgmental 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.
- Find 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.
- Get support. Whether or not the alcoholic
family member seeks help, you may benefit
from 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.
For meeting locations, call your local Al-Anon
chapter (check your local phone book under "Alcoholism")
or call the following toll-free numbers: 1-800-344-2666
(United States) or 1-800-443-4525 (Canada).
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There is no specific level applicable for all
people. However, 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.) (For additional
information, see NIAAA Alcohol
Alert No. 16: Moderate Drinking; Alcohol
Alert No. 13: Fetal Alcohol Syndrome; and
Alcohol Alert No. 27:
Alcohol-Medication Interactions.)
Certain people should not drink at all.
They include people who are:
- pregnant or trying to become pregnant;
- planning to drive or engage in activities
requiring alertness and skill;
- taking certain medications, including certain
over-the-counter medicines;
- suffering from medical conditions that can
be worsened by drinking;
- recovering alcoholics;
- under the age of 21.
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No. Drinking during pregnancy can have a number
of harmful effects on the newborn, ranging from
mental retardation, organ abnormalities, and hyperactivity
to learning and behavioral 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-percent 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 is
to abstain from alcohol. (See NIAAA "Publications"
Alcohol Alert No. 13:
Fetal Alcohol Syndrome)
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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. (Please see
NIAAA "Publications/Pamphlets and Brochures"
Age
Page: Aging and Alcohol Abuse and Alcohol
Alert No. 40: Alcohol and Aging
for additional information.)
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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. (See also NIAAA "Publications,"
Alcohol Alert No. 10:
Alcohol and Women.)
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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.
However, if you are a nondrinker, you should
not start drinking only to benefit your heart.
Protection against coronary heart disease may
be obtained through other means. For example,
regular physical activity and a low-fat diet help
decrease your risk. 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.
Even 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.
(Please see NIAAA "Publications," Alcohol Alert No. 16:
Moderate Drinking.)
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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,
anti-anxiety 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. (Please see NIAAA "Publications," Alcohol Alert No. 27:
Alcohol-Medication Interactions.)
Source: Hazelden, http://www.hazelden.org/
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