Nonetheless, a substantial number of people have serious trouble with their drinking. Currently, nearly 14 million Americans -- 1 in every 13 adults -- abuse alcohol or are alcoholic. Several million more adults engage in risky drinking patterns that could lead to alcohol problems. In addition, approximately 53 percent of men and women in the United States report that one or more of their close relatives have a drinking problem.
The consequences of alcohol misuse are serious -- in many cases, life-threatening. Heavy drinking can increase the risk for certain cancers, especially those of the liver, esophagus, throat, and larynx (voice box). It can also cause liver cirrhosis, immune system problems, brain damage, and harm to the fetus during pregnancy. In addition, drinking increases the risk of death from automobile crashes, recreational accidents, and on-the-job accidents and also increases the likelihood of homicide and suicide. In purely economic terms, alcohol-use problems cost society approximately $100 billion per year. In human terms, the costs are incalculable.
What Is Alcoholism?
Alcoholism, which is also known as "alcohol dependence syndrome," is a disease that is characterized by the following elements:
While some people are able to recover without help, the majority of alcoholic individuals need outside assistance to recover from their disease. With support and treatment, many individuals are able to stop drinking and rebuild their lives.
Many people wonder: Why can some individuals use alcohol without problems, while others are utterly unable to control their drinking? Recent research supported by NIAAA has demonstrated that for many people, a vulnerability to alcoholism is inherited. Yet it is important to recognize that aspects of a person's environment, such as peer influences and the availability of alcohol, also are significant influences. Both inherited and environmental influences are called "risk factors." But risk is not destiny. Just because alcoholism tends to run in families doesn't mean that a child of an alcoholic parent will automatically develop alcoholism.
What Is Alcohol Abuse?
Alcohol abuse differs from alcoholism in that it does not include an extremely strong craving for alcohol, loss of control, or physical dependence. In addition, alcohol abuse is less likely than alcoholism to include tolerance (the need for increasing amounts of alcohol to get "high"). Alcohol abuse is defined as a pattern of drinking that is accompanied by one or more of the following situations within a 12-month period:
Even if you answered "no" to all of the above questions, if you are encountering drinking-related problems with your job, relationships, health, or with the law, you should still seek professional help. The effects of alcohol abuse can be extremely serious--even fatal--both to you and to others.
The Decision To Get Help
Acknowledging that help is needed for an alcohol problem may not be easy. But keep in mind that the sooner a person gets help, the better are his or her chances for a successful recovery.
Any reluctance you may feel about discussing your drinking with your health care professional may stem from common misconceptions about alcoholism and alcoholic people. In our society, the myth prevails that an alcohol problem is somehow a sign of moral weakness. As a result, you may feel that to seek help is to admit some type of shameful defect in yourself. In fact, however, alcoholism is a disease that is no more a sign of weakness than is asthma or diabetes. Moreover, taking steps to identify a possible drinking problem has an enormous payoff--a chance for a healthier, more rewarding life.
When you visit your health care provider, he or she will ask you a number of questions about your alcohol use to determine whether you are experiencing problems related to your drinking. Try to answer these questions as fully and honestly as you can. You also will be given a physical examination. If your health care professional concludes that you may be dependent on alcohol, he or she may recommend that you see a specalist in diagnosing and treating alcoholism. You should be involved in making referral decisions and have all treatment choices explained to you.
Getting Well: Alcoholism Treatment
The nature of treatment depends on the severity of an individual's alcoholism and the resources that are available in his or her community. Treatment may include detoxification (the process of safely getting alcohol out of one's system); taking doctor-prescribed medications, such as disulfiram (Antabuse®) or naltrexone (ReViaTM), to help prevent a return to drinking once drinking has stopped; and individual and/or group counseling. There are promising types of counseling that teach recovering alcoholics to identify situations and feelings that trigger the urge to drink and to find new ways to cope that do not include alcohol use. Any of these treatments may be provided in a hospital or residential treatment setting or on an outpatient basis.
Because the involvement of family members is important to the recovery process, many programs also offer brief marital counseling and family therapy as part of the treatment process. Some programs also link up individuals with vital community resources, such as legal assistance, job training, child care, and parenting classes.
Virtually all alcoholism treatment programs also include meetings of Alcoholics Anonymous (AA), which describes itself as a "worldwide fellowship of men and women who help each other to stay sober." While AA is generally recognized as an effective mutual help program for recovering alcoholics, not everyone responds to AA's style and message, and other recovery approaches are available. Even those who are helped by AA usually find that AA works best in combination with other elements of treatment, including counseling and medical care.
Can Alcoholism Be Cured?
While alcoholism is a treatable disease, a cure is not yet available. That means that even if an alcoholic has been sober for a long while and has regained health, he or she remains susceptible to relapse and must continue to avoid all alcoholic beverages. "Cutting down" on drinking doesn't work; cutting out alcohol is necessary for a successful recovery.
However, even individuals who are determined to stay sober may suffer one or several "slips," or relapses, before achieving long-term sobriety. Relapses are very common and do not mean that a person has failed or cannot eventually recover from alcoholism. Keep in mind, too, that every day that a recovering alcoholic has stayed sober prior to a relapse is extremely valuable time, both to the individual and to his or her family. If a relapse occurs, it is very important to try to stop drinking once again and to get whatever additional support is needed to abstain from drinking.
Help for Alcohol Abuse
If your health care provider determines that you are not alcohol dependent but are nonetheless involved in a pattern of alcohol abuse, he or she can help you:
Genetic research: Scientists are now studying 3,000 individuals from several hundred families with a history of alcoholism in order to pinpoint the location of genes that influence vulnerability to alcoholism. This new knowledge will help identify individuals at high risk for alcoholism and also will pave the way for the development of new treatments for alcohol-related problems. Other research is investigating the ways in which genetic and environmental factors combine to cause alcoholism.
Treatment approaches: NIAAA also sponsored a study called Project MATCH, which tested whether treatment outcome could be improved by matching patients to three types of treatment based on particular individual characteristics. This study found that all three types of treatment reduced drinking markedly in the year following treatment.
New medications: Studies supported by NIAAA have led to the Food and Drug Administration's approval of the medication naltrexone (ReViaTM) for the treatment of alcoholism. When used in combination with counseling, this prescription drug lessens the craving for alcohol in many people and helps prevent a return to heavy drinking. Naltrexone is the first medication approved in 45 years to help alcoholics stay sober after they detoxify from alcohol.
In addition to these efforts, NIAAA is sponsoring promising research in other vital areas, such as fetal alcohol syndrome, alcohol's effects on the brain and other organs, aspects of drinkers' environments that may contribute to alcohol abuse and alcoholism, strategies to reduce alcohol-related problems, and new treatment techniques. Together, these investigations will help to prevent alcohol problems; identify alcohol abuse and alcoholism at earlier stages; and make available new, more effective treatment approaches for individuals and families.
For more information on alcohol abuse and alcoholism, contact the following organizations:
Al-Anon Family Group Headquarters
1600 Corporate Landing Parkway
Virginia Beach, VA 23454-5617
Internet address: http://www.al-anon.alateen.org
Makes referrals to local Al-Anon groups, which are support groups for spouses and other significant adults in an alcoholic person's life. Also makes referrals to Alateen groups, which offer support to children of alcoholics.
Locations of Al-Anon or Alateen meetings worldwide can be obtained by calling the toll-free numbers Monday through Friday, 8 a.m.-6 p.m. (e.s.t.):
U. S.: (800) 344-2666
Canada: (800) 443-4525
Free informational materials can be obtained by calling the toll-free numbers (operating 7 days a week, 24 hours per day):
U. S.: (800) 356-9996
Canada: (800) 714-7498
Alcoholics Anonymous (AA) World Services
475 Riverside Drive, 11th Floor
New York, NY 10115
Internet address: http://www.alcoholics-anonymous.org
Makes referrals to local AA groups and provides informational materials on the AA program. Many cities and towns also have a local AA office listed in the telephone book.
National Council on Alcoholism and Drug Dependence (NCADD)
12 West 21st Street
New York, NY 10010
Internet address: http://www.ncadd.org
Provides phone numbers of local NCADD affiliates (who can provide information on local treatment resources) and educational materials on alcoholism via the above toll-free number.
National Institute on Alcohol Abuse and Alcoholism
Scientific Communications Branch
6000 Executive Boulevard, Suite 409
Bethesda, MD 20892-7003
Internet address: http://www.niaaa.nih.gov
Makes available free informational materials on all aspects of alcoholism, including the effects of drinking during pregnancy, alcohol use and the elderly, and help for cutting down on drinking.