Alcoholism is the medical condition of people who often drink too much alcohol. Some people who suffer from alcoholism feel that they have to drink alcohol, even when it causes health and social problems. Alcoholism means addiction to alcohol. People who suffer from it are called alcoholics. As the condition goes on, those who suffer from it change their habits: obtaining alcohol and consuming it becomes more important. Very often, other interests disappear. Many alcoholics do not think they have a problem with drinking alcohol. With time, they better support bigger quantities, and their personality changes.
Medically, there are two different conditions:
- Drinking too much alcohol, and seeing the negative effects of this behaviour
- Being dependent on alcohol
According to the World Health Oranization, there are approximately 140 million people with alcoholism worldwide. In the United States and Western Europe, ten to twenty percent of men and five to ten percent of women at some point in their lives will meet criteria for alcoholism.
Alcoholism is called a "dual disease": There are both mental and physical components. The biological mechanisms that cause alcoholism are not well understood. Social environment, stress, mental health, family history, age, ethnic group, and gender all influence the risk for the condition. Consuming large amounts of alcohol produces changes in the brain's structure and chemistry. Some changes occur very early, even when small amountas of alcohol are consumed, in a short time. Examples are tolerance and physical dependence. Because of the changes, it is very difficult for an alcoholic to stop drinking, as this would result in alcohol withdrawal syndrome if the person stops. Alcohol damages almost every organ in the body, including the brain. Chronic alcohol abuse can cause both medical and psychiatric problems.
Alcoholism is a condition with a social stigma. As a result, people suffering from it, avoid being diagnosed or treated, as this may be shameful, or have social consequences. The evaluation responses to a group of standardized questioning is a common method for diagnosing alcoholism. These can be used to identify harmful drinking patterns, including alcoholism. In general, problem drinking is considered alcoholism when the person continues to drink despite experiencing social or health problems caused by drinking.
Generally, there are different stages to alcoholism.
- Drinking alcohol starts in a social setting, on occasion, together with friends. With time progressing, the potential alcoholic feels relieved when he drinks. This relief is usually attributed to the situation, or the people, not the alcohol. With the time people seek out occasions where "social drinking" occurs. People also develop tolerance. This means over time, they need a larger quantity of alcohol to get the same feeling of relief.
- In the next phase, the drinker has problems remembering things. The alcoholic may be completely normal, but they cannot remember certain events, or how certain events occurred. This is independent of a feeling of drunkenness. The patient also begins to see that he drinks more alcohol than other people. For this reason, drinking is often done in secret. The first glasses are consumed more quickly; this is done so as to not stand out, and to get the feeling quicker. There are feelings of guilt; the patient tries to avoid talking about alcohol for this reason.
- The alcoholic is no longer able to control his drinking. He may not drink for a long time, but once he gets a tiny bit of alcohol, he is unable to stop until he is either drunk, or too sick to continue; this is called craving. The patient thinks this is just a lack of resolve, but in truth he is dependent on alcohol. Excuses are found for the drinking habit. To the patient it is important to be able to explain, because except for alcohol, there are no other solutions to problems. Because of this behaviour there are problems with the rest of his family. There are whole families who get isolated, because they try to hide the drinking problem of a family member. This is called co-dependence.
Treatment options [change]
The overuse of alcohol has different causes, and there are different forms of treatment available. Some of these treatments are:
- Detoxification: Alcohol use is stopped abruptly. The alcohol is sometimes replaced with other drugs that have similar effects, to prevent withdrawal symptoms.
- Therapy: Various therapies are available.
- Moderation: Alcohol use is lowered and lowered.
- Drugs: Some drugs can help the transition to drinking less, or are very dangerous if they are consumed with alcohol.
Treatment of alcoholism takes several steps. Direct withdrawal leads to medical problems. For this reason, the process of withdrawal needs to be controlled carefully. Alcohol detoxification often involves the use of special drugs; benzodiazepines such as diazepam are used frequently. Sometimes, people with alcoholism also have other addictions. Benzodiazepines are addictive. If the person is addicted to both alcohol, and benzodiazepines, this step gets more complicated. After detoxification, other support such as group therapy or self-help groups are used to help the person remain sober. Thombs (1999) states according to behavioural sciences alcoholism is described as a “maladaptive behaviour”. He explains this must not be confused with “misbehaviour”. Behavioural scientists explain that addicts have a behaviour pattern that may lead to destructive consequences for themselves, their families and society. This does not label addicts as bad or irresponsible. Compared with men, women are more sensitive to alcohol's harmful physical, cerebral, and mental effects.
- Dr Gro Harlem Brundtland (19 February 2001). "WHO European Ministerial Conference on Young People and Alcohol". World Health Organisation. http://www.who.int/director-general/speeches/2001/english/20010219_youngpeoplealcohol.en.html.
- Ms Leanne Riley (31 January 2003). "WHO to meet beverage company representatives to discuss health-related alcohol issues". World Health Organisation. http://www.who.int/mediacentre/news/releases/2003/pr6/en/index.html.
- "alcoholism". Encyclopædia Britannica. 2010. http://www.britannica.com/EBchecked/topic/13448/alcoholism.
- "DEFINITIONS" (PDF). USA: AMA. http://www.ama-assn.org/ama1/pub/upload/mm/388/alcoholism_treatable.pdf.
- Glavas MM, Weinberg J (2006). "Stress, Alcohol Consumption, and the Hypothalamic-Pituitary-Adrenal Axis". In Yehuda S, Mostofsky DI. Nutrients, Stress, and Medical Disorders. Totowa, NJ: Humana Press. pp. 165–183. ISBN 978-1-58829-432-6.
- Agarwal-Kozlowski, K.; Agarwal, DP. (Apr 2000). "[Genetic predisposition for alcoholism]". Ther Umsch 57 (4): 179–84. PMID 10804873.
- Chen, CY.; Storr, CL.; Anthony, JC. (Mar 2009). "Early-onset drug use and risk for drug dependence problems". Addict Behav 34 (3): 319–22. doi:10.1016/j.addbeh.2008.10.021. PMC 2677076. PMID 19022584.
- Hoffman, PL.; Tabakoff, B. (Jul 1996). "Alcohol dependence: a commentary on mechanisms". Alcohol Alcohol 31 (4): 333–40. PMID 8879279.
- Caan, Woody; Belleroche, Jackie de, eds. (11 April 2002). Drink, Drugs and Dependence: From Science to Clinical Practice (1st ed.). Routledge. pp. 19–20. ISBN 978-0-415-27891-1. http://books.google.com/?id=nPvbDUw4w5QC.
- Kahan, M. (Apr 1996). "Identifying and managing problem drinkers". Can Fam Physician 42: 661–71. PMC 2146411. PMID 8653034.
- Diagnostic and statistical manual of mental disorders: DSM-IV. Washington, DC: American Psychiatric Association. 31 July 1994. ISBN 978-0-89042-025-6. http://books.google.com/?id=W-BGAAAAMAAJ.
- Blondell, RD. (Feb 2005). "Ambulatory detoxification of patients with alcohol dependence". Am Fam Physician 71 (3): 495–502. PMID 15712624.
- Johansson BA, Berglund M, Hanson M, Pöhlén C, Persson I (November 2003). "Dependence on legal psychotropic drugs among alcoholics" (PDF). Alcohol Alcohol. 38 (6): 613–8. doi:10.1093/alcalc/agg123. ISSN 0735-0414. PMID 14633651. http://alcalc.oxfordjournals.org/cgi/reprint/38/6/613.
- Morgan-Lopez, AA.; Fals-Stewart, W. (May 2006). "Analytic complexities associated with group therapy in substance abuse treatment research: problems, recommendations, and future directions". Exp Clin Psychopharmacol 14 (2): 265–73. doi:10.1037/1064-12126.96.36.1995. PMID 16756430.
- Soyka, M.; Helten, C.; Scharfenberg, CO. (2001). "[Psychotherapy of alcohol addiction—principles and new findings of therapy research]". Wien Med Wochenschr 151 (15–17): 380–8; discussion 389. PMID 11603209.
- Thombs, Dennis L. Thombs (1999). Introduction To Addictive Behaviors 2ed. London: The Guildford Press. pp. 8–9.