Alcoholism 

Alcoholism: Signs and Symptoms

It is estimated that 5% to 10% of the adult population in the US is afflicted with alcoholism.  It is more prevalent among men than women, although alcohol abuse among women is on the increase.  It cuts across all class, ethnic and socio-economic lines.  Alcoholism often goes undiagnosed as most alcoholics deny the extent of their usage of alcohol.  

Alcoholics tends to rationalize their problems as the cause of the problem and not the result of drinking.  Work, interpersonal relationships and almost all areas of life are affected by their drinking.  Alcoholics typically do not seek treatment on their own.  Physical and emotional abuse is not uncommon in alcoholic families.

• Dependence on alcohol
• Excessive consumption of alcohol
• Low tolerance for anxiety.

• Impairment in concentration

• Impairment of attention span and memory

• Inappropriate aggressive or sexual behavior

• Mood lability

• Impaired judgment

• Impaired social functioning

• Slurred speech

• Inco-ordination

• Increased need for alcohol at the beginning of the day, or at times of stress.

• Insomnia; nightmares.

• Hangovers, and absences from school and work.

• Preoccupation with obtaining alcohol and hiding drinking from family and friends.

• Guilt or irritability when others suggest drinking is excessive.

• Blackouts; memory loss.

• Delirium tremens (tremors, hallucinations, confusion, sweating, rapid heartbeat).

• Liver disease (jaundice, internal bleeding, bloating).

• Neurological impairment (numbness and tingling in hands and feet, declining sexual interest and potency, confusion, coma).

• Congestive heart failure (shortness of breath, swelling of feet).  

Adapted from:
Diagnostic and Statistical Manual of Mental Disorders.  Vol. IV  American Psychiatric        Association.  1994

About Alcoholism

Almost everyone witnesses the out-of-control antics of a problem drinker. But, do you know when problem drinking is the same as alcoholism, and at what point does problem drinking become alcoholism?

In general, problem drinking qualifies as alcoholism when the person:

• drinks compulsively.
• keeps drinking in spite of adverse consequences;
• gets upset when alcohol is not readily available.

Not everyone who gets drunk is an alcoholic. Many people drink to experiment; to act sociable; or to gain attention. Alcoholics, however, do not plan to get drunk; their drinking is an uncontrollable urge.

The key elements of any addiction, whether chemical or behavioral are:

• Compulsivity- meaning loss of control over the behavior - i.e. continuing to engage in a particular behavior after repeated attempts to stop.
• Continuation despite adverse consequences, such as loss of job, money, marriage, or health - or arrests or public humiliation.
• Preoccupation or obsession with obtaining and using the substance or participating in the behavior to the detriment of other essential life activities or goals

Addictions are defined not by how much of the drug or behavior is used, but rather the effects on the person's life. An addiction can be suspected when the behavior has made the person's life unmanageable.

How Common is Alcoholism?

In any randomly selected group of Americans, 10 to 15 of every 100 people either are alcoholics or will become alcoholics. Ten million Americans are alcoholics, and another 10 million are problem drinkers who may be on their way to becoming alcoholics.

Alcoholism is not a gender-related disease, between one-third and one-half of all alcoholics are women. Many alcoholics are teenagers; some are even preteens.

What Causes Alcoholism?

Doctors believe the tendency toward alcoholism is an inherited physical characteristic, possibly involving liver enzymes. Other theories indicate that message-carrying chemicals within the nervous system may make a person more vulnerable to the disease. Individual reactions to alcohol vary widely:

• Certain people dislike and avoid alcohol because even small amounts disagree with them.
• Others enjoy a certain amount of alcohol, but instinctively stop drinking as soon as they get dizzy or sleepy.
• Still others love the high they get from alcohol, but have no sense of when they should stop drinking. When they drink, they get drunk - even though they’ve had sufficient experience with alcohol to know better.

How Can You Tell Who Will Become An Alcoholic?

Medically speaking, you can’t. To date, there is no diagnostic test that can single out people who have an inherited predisposition to alcoholism. Practically speaking, however, there are two important clues:

• Children of alcoholics have a two to four times greater risk of developing alcoholism than children of non-alcoholics.
• People who are drinking ever-increasing amounts of alcohol, and who become irritable when they don’t drink, are clearly at risk for alcoholism

Alcoholics Suffer From Their Illness

As their disease progresses, alcoholics need to drink more and more often, just to feel normal. Increasingly, they realize that once they start to drink, they can’t stop. Yet they desperately want to keep from getting drunk, both to avoid embarrassment and unpleasant withdrawal symptoms such as trembling, irritability, nausea, or insomnia. They may try different strategies to regain control over their drinking, maybe switching from liquor to wine, or perhaps going "on the wagon" for weeks at a time.

No strategy works for long, however. Inwardly disgusted with themselves, alcoholics vacillate between anger and depression.  Personal relationships deteriorate. Job performance suffers.

In addition, physical problems develop.  Alcoholics suffer from disturbing memory lapses called blackouts.  Feeling edgy and anxious, some may experiment with and become addicted to tranquilizers. Alcoholics eat poorly, because their irritated liver and inflamed digestive system give them heartburn, nausea, and gas.  Sex drive dwindles.  Insomnia robs them of needed sleep.

Loved Ones of Alcoholics Suffer Too

• Women who drink heavily during pregnancy are giving alcohol to the unborn child. The baby may be born with fetal alcohol syndrome, an incurable condition that involves stunted growth, physical abnormalities, and mental retardation.
• Active alcoholics often have marital problems. They can’t be committed marriage partners as their compulsion to drink makes them self-centered, irresponsible, and possibly abusive.
• Likewise, active alcoholics also have difficulties fulfilling their parental responsibilities. Alcohol-abusing mothers and fathers have been known to neglect or abuse their children. For a child, growing up with an alcoholic parent is a painful experience that usually leaves lasting emotional scars.

Alcoholism Can Kill

People with advanced alcoholism drink almost constantly; have trouble keeping a job; relate poorly to others; and may have self-destructive impulses, including frequent thoughts of suicide. Some of the serious physical consequences of late-stage alcoholism are convulsions, hallucinations, mental confusion, partial paralysis, and/or cirrhosis of the liver. The longer alcoholism goes without treatment, the greater the damage to the body. Untreated alcoholism is potentially fatal.

Treatment: There is Help

The good news is that alcoholism is treatable. With the right kind of help, most alcoholics can learn to lead a deeply satisfying life without alcohol.

People used to think the only way an alcoholic could quit drinking was to go "cold turkey." However, sudden withdrawal from alcohol is difficult, painful and dangerous. Hazards include hallucinations, convulsions, and potentially life-threatening shifts in blood pressure, temperature, and heart rate.

A safer way is medically supervised detoxification in a specialized hospital setting. "Detox," which starts with a physical exam, involves bed rest, nursing care, short-term tranquilizers, a balanced diet, and vitamin and mineral supplements.

After a few days of "detox," when the acute withdrawal period is over, the alcoholic moves into the second stage of treatment. This stage, called rehabilitation, can be structured into a period of hospitalization, or it can take the form of frequent visits to an outpatient clinic. In either case, rehabilitation involves ongoing medical monitoring, nutritional therapy, a program of moderate physical exercise, though education about alcoholism, and an introduction to a 12-step self-help support group for alcoholics.

The third stage of professional treatment for alcoholism is a return to full independence, monitored through a series of medical follow-up visits and guided by ongoing participation in a support group. Alcoholics who maintain close ties with a support group as Alcoholics Anonymous greatly increase their chances for a solid, lasting recovery.

What to Do If You Think You Have a Drinking Problem

Popular magazines occasionally publish questionnaires to help people determine whether they are alcoholics. Quizzes can be misleading, because people tend to answer them in ways that suggest they don’t have a drinking problem.

If you have ever had the slightest suspicion that your own drinking might be turning into a problem, ask yourself only these three questions:

• Am I drinking more than I used to?
• Once I start drinking, am I sometimes unable to stop?
• Do I get irritated when I’m in a place where I can’t drink?

To delve deeper, make an appointment for an evaluation at an alcohol or drug treatment center. A licensed physician will be able to determine if you are dependent on alcohol.

What To Do If Someone You Know Has A Drinking Problem

When someone you know has a drinking problem, the crucial first step is getting that person to acknowledge that the problem exists. This may not be easy. Typically, alcoholics insist that they can control their alcohol intake and reject any suggestion that they should quit drinking.

If they are employed, find out if his or her workplace provides a benefit called "employee assistance." Such a program can provide a smooth, confidential link between a person who drinks too much and an appropriate alcoholism treatment center.

You might consider asking your family doctor for advice. Or you can check your phone book for nearby alcohol and drug treatment centers. Such a facility will probably offer "intervention counseling," which can help you and other family members or friends plan how to confront a person about his or her problem drinking.

It’s True

Most alcoholics are alcoholics for life, meaning they will always be in danger of relapsing if they take even a single drink. But recovering alcoholics learn how to cut this daunting problem down to manageable size. They make the decision not to drink – they make it "one day at a time."

Although alcoholism is a common and serious problem, large numbers of alcoholics can and do recover. For anyone with a drinking problem, a properly certified, professional, medically supervised treatment program offers a chance for a lasting recovery.

Hope Lies in Learning More

The more you learn about alcoholism the better you will understand that it is an illness and it is treatable. The above information gives you the facts you need to recognize the signs and symptoms of problem drinking. By reaching out for help you could be giving someone a healthier and more fulfilling life. Treatment can make the difference.

References and Links

The above information has been provided by:
National Mental Health Association.. Information Fact Sheets  
        http://www.nmha.org/
Diagnostic and Statistical Manual of Mental Disorders.  Vol. IV  
        American Psychiatric Association.  1994

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