There is no single known cause of alcoholism, but the researchers wrote that about two-thirds of alcohol dependence could be attributed to genetic factors and one-third to environmental causes like stress or emotional problems. Men and women are equally affected, and age does not appear to affect prognosis.
In the treatment of alcohol abuse, which afflicts about 14 million Americans — one in every 13 adults. Alcohol abusers are defined as men who have five or more drinks per day and women who have four or more drinks each day.
Alcoholism is not a homogenous disease, so there is no magic bullet out there to treat it. There is a biological component and a psychological component and a cultural component and a social component, and they vary from individual to individual.
Five early symptoms that indicate a drinker already is an alcohol abuser or is at risk:
1. Repeatedly drinking more than self-set limits.
2. Having a persistent desire to quit or cut down.
3. Drinking and driving.
4. Spending too much time drinking.
5. Having hangovers or a sleep disorder.
Knowing the Signs
Several characteristics that can help people recognize themselves as high-functioning alcoholics:
They have trouble controlling their intake even after deciding that they will drink no more alcohol than a given amount.
They find themselves thinking obsessively about drinking . When and where and with whom they will drink next.
When they drink, they behave in ways that are uncharacteristic of their sober self.
They experience blackouts, unable to remember what took place during a drinking bout.
It’s not the number of drinks that defines an alcoholic, It’s what happens to you when you’re drinking.
They also tend to hide their excessive consumption by drinking alone or sneaking alcohol before or after a social event, and disguising or excusing the odor of alcohol on their breath.
High-functioning alcoholics are highly skilled at leading double lives. High-functioning alcoholics are able to maintain respectable, even high-profile lives, usually with a home, family, job and friends. That balancing act continues until something dreadful happens that reveals the truth — to themselves or to others — and forces the person to enter a treatment program or lose everything that means anything.
Estimates that as many as half of all alcoholics are high-functioning types. The abuse can go on for decades until and unless some alcohol-related crisis occurs, like being arrested for drunken driving, exposed for having made unwanted sexual advances or being asked for a divorce when their spouses can no longer tolerate the abusive drinking.
Alcoholism is divided into 2 categories: dependence and abuse. People who are dependent on alcohol spend a great deal of time drinking alcohol, and getting it.
Physical dependence involves:
A need for increasing amounts of alcohol to get drunk or achieve the desired effect (tolerance)
Memory lapses (blackouts) after drinking episodes
Withdrawal symptoms when alcohol use is stopped
The most severe drinking behavior includes long drinking binges that lead to mental or physical problems. Some people are able to gain control over their dependence in earlier phases before they totally lose control. But no one knows which heavy drinkers will be able to regain control and which will not.
There is no known common cause of alcoholism. However, several factors may play a role in its development. A person who has an alcoholic parent is more likely to become an alcoholic than a person without alcoholism in the immediate family.
Research suggests that certain genes may increase the risk of alcoholism, but which genes or how they work is not known.
Psychological factors may include:
A need for anxiety relief
Conflict in relationships
Social factors include:
Ease of getting alcohol
Social acceptance of alcohol use
The incidence of alcohol intake and related problems is rising. Data indicate that about 15% of people in the United States are problem drinkers, and about 5% to 10% of male drinkers and 3% to 5% of female drinkers could be diagnosed as alcohol dependent.
Alcohol affects the central nervous system as a depressant. This leads to a decrease in:
Even a few drinks can change behavior, slow motor skills, and decrease the ability to think clearly. Alcohol can impair concentration and judgment. Drinking a lot of alcohol can cause drunkenness (intoxication).
Some of the symptoms of alcoholism include:
Episodes of violence with drinking
Hostility when confronted about drinking
Lack of control over drinking — being unable to stop or reduce alcohol intake
Making excuses to drink
Nausea and vomiting
Need for daily or regular alcohol use to function
Neglecting to eat
Not caring for physical appearance
Numbness and tingling
Secretive behavior to hide alcohol use
Shaking in the morning
Develops because the brain adapts to the alcohol and cannot function well without the drug. Symptoms of withdrawal may include:
Confusion or seeing and hearing things that aren’t there
Increased blood pressure
Loss of appetite, nausea, or vomiting
Rapid heart rate
Restlessness or nervousness
Men who have 15 or more drinks a week
Women who have 12 or more drinks a week
Anyone who has 5 or more drinks per occasion at least once a week
(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.)
All doctors should ask their patients about their drinking. The health care provider can get a history from the family if the affected person is unwilling or unable to answer questions. A physical examination is done to identify physical problems related to alcohol use.
The following questions are used by the National Institute on Alcohol Abuse and Alcoholism to screen for alcohol abuse or dependence:
Do you ever drive when you have been drinking?
Do you have to drink more than before to get drunk or feel the desired effect?
Have you felt that you should cut down on your drinking?
Have you ever had any blackouts after drinking?
Have you ever missed work or lost a job because of drinking?
Is someone in your family worried about your drinking?
Alcohol consumption during pregnancy can cause severe birth defects. The most serious is fetal alcohol syndrome, which may lead to mental retardation and behavior problems. A milder form of the condition that can still cause lifelong problems is called fetal alcohol affects.
People who are dependent on or who abuse alcohol continue to drink it despite physical or mental problems. They may have problems with binge drinking (drinking 6 or more drinks at one sitting). Those with dependence have more severe problems and a greater need to drink.
Alcoholism is a major social, economic, and public health problem. Alcohol is involved in more than half of all accidental deaths and almost half of all traffic deaths. A high percentage of suicides involve the use of alcohol along with other substances.
People who abuse or are dependent on alcohol are more likely to be unemployed, involved in domestic violence, and have problems with the law (such as drinking and driving).