Alcoholism (alcohol dependence) and alcohol abuse are two different forms of problem drinking.
There is no known cause of alcohol abuse or alcoholism. Research suggests that certain genes may increase the risk of alcoholism, but which genes and how they work are not known.
How much you drink can influence your chances of becoming dependent. Those at risk for developing alcoholism include:
One drink is defined as a 12-ounce bottle of beer, a 5-ounce glass of wine, or a 1 1/2-ounce shot of liquor.
You have an increased risk for alcohol abuse and dependence if you have a parent with alcoholism.
You may also be more likely to abuse alcohol or become dependent if you:
Alcohol abuse is rising. Around 1 out of 6 people in the United States have a drinking problem.
People who have alcoholism or alcohol abuse often:
Symptoms of alcohol dependence include:
The health care provider will perform a physical exam and ask questions about your medical and family history, including use of alcohol.
The following questions are used by the National Institute on Alcohol Abuse and Alcoholism to screen for alcohol abuse or dependence:
Tests that may be done include:
Completely stopping the use of alcohol is the ideal goal of treatment. This is called abstinence. A strong social network and family support are important in achieving this.
Completely stopping and avoiding alcohol is difficult for many people with alcoholism. There will be times when it is difficult. You should aim to avoid drinking for as long as possible.
Some people who abuse alcohol may be able to simply reduce the amount they drink. This is called drinking in moderation. If this method does not work, you should try to quit drinking completely.
DECIDING TO QUIT
Many people with alcohol problems do not recognize when their drinking gets out of hand.
The ideal approach to treatment is to help the person realize how much their alcohol use is harming their life and those around them.
Studies find that more people with alcohol problems opt for treatment when their family members or employers are honest with them about their concerns, and try to help them see that drinking is preventing them from reaching their goals.
Withdrawal from alcohol is best done in a controlled, supervised setting. Complications from withdrawal can be life threatening. For more information, see: Alcohol withdrawal
Your health care provider should order blood and urine tests to check for health problems that are common in people who abuse alcohol.
Alcohol recovery or support programs can help you stop drinking completely. These programs usually offer:
You may be treated in a special recovery center (inpatient), or you may attend a program while you live at home (outpatient).
Medications are sometimes prescribed to prevent you from drinking again.
You cannot take these medications if you are pregnant or have certain medical conditions. The medications are often used with long-term treatment with counseling or support groups.
Depression or other mood or anxiety disorders may be noticed after you stop drinking. These should be promptly treated.
It is important that the patient has a living situation that supports their need to avoid alcohol. Some programs offer housing options for people with alcoholism or alcohol abuse.
Support groups are available to help people who are dealing with alcoholism.
ALCOHOLICS ANONYMOUS (AA)
Alcoholics Anonymous (AA) is a self-help group of recovering alcoholics that offers emotional support and specific steps for people recovering from alcohol dependence. The program is commonly called a "12-step" approach. There are local chapters throughout the United States.
AA offers help 24 hours a day and teaches that it is possible to participate in social functions without drinking.
Family members of a person with an alcohol abuse problem often need counseling. Al-Anon is a support group for partners and others who are affected by someone else's alcoholism.
Alateen provides support for teenage children of people with alcoholism.
OTHER SUPPORT GROUPS
Several other support groups are available.
See also: Alcoholism - support group
How well a person with alcoholism or alcohol abuse does depends on whether or not they can stop drinking.
Alcoholism is a major social, economic, and public health problem. Problem drinking can affect every part of a person's life. If you have an alcohol problem, abstinence can help improve your mental and physical health and possibly, your relationships.
Treatment programs can help you quit. However, drinking again after treatment is common. It is important to have a good support system.
Alcoholism and alcohol abuse can increase your risk of many health problems, including:
Alcohol use also increases your risk for sexually transmitted infections (STIs) and violence.
Drinking alcohol while you are pregnant can lead to severe birth defects in the baby. See: Fetal alcohol syndrome
Seek immediate medical care or call your local emergency number (such as 911) if:
The National Institute on Alcohol Abuse and Alcoholism recommends:
One drink is defined as 12 ounces of beer, 5 ounces of wine, or 1½ ounces of liquor.
Alcohol dependence; Alcohol abuse; Problem drinking; Drinking problem
Kleber HD, Weiss RD, Anton RF Jr., George TP, Greenfield SF, Kosten TR, et al. Work Group on Substance Use Disorders; American Psychiatric Association; Steering Committee on Practice Guidelines. Treatment of patients with substance use disorders, second edition. Am J Psychiatry. 2007;164:5-123.
In the clinic. Alcohol use. Ann Intern Med. 2009 Mar 3;150(5):
O'Connor PG. Alcohol abuse and dependence. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 31.
Schuckit MA. Alcohol-use disorders. Lancet. 2009;373:492-501.
Reviewed by: David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.; David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine.
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