Alcoholism

Alcohol is sometimes associated with times of celebration - champagne on New Year's, for example, or punch at a holiday party. But alcohol can also be a cause for despair, both for those who have a drinking problem and for their families. (Read about "Violence and Abuse")

How can someone tell if they have a drinking problem? There aren't any hard and fast rules. But the National Institute on Alcohol Abuse and Alcoholism (NIAAA) says there are some questions people can ask themselves; if you answer "yes" to any of these questions, you may have a drinking problem:

• Do you drink alone when you feel sad or angry?
• Does your drinking ever make you late for work?
• Does your drinking worry your family?
• Do you ever drink after telling yourself that you won't?
• Do you ever forget what you did while you were drinking?
• Do you get headaches or hangovers after drinking?

You may also want to keep a drinking "diary," noting how many drinks you have a day, the times when you're most likely to drink, and other factors surrounding your drinking such as your mood and whether you were alone or with others. While keeping such a record, remember that a drink is defined as a 12-ounce bottle of beer, a 4-ounce glass of wine or a 1 ½ ounce shot of liquor. If you're pouring more than that into the glass, but only counting it as a single drink, you're not getting an accurate reflection of your habits.

Who's at risk

There are many things that can put a person at a higher risk of becoming an alcoholic. According to the American Psychological Association (APA), psychological traits such as impulsiveness, low self-esteem and a need for approval can prompt inappropriate drinking. Some people may drink as a way to cope with emotional pain or to "self-medicate" psychological disorders. Heavy drinking can also feed on itself, leading to physiological changes that make continued drinking the only way to avoid discomfort or anxiety. (Read about "Anxiety")

In addition, there may be a genetic tendency towards alcoholism, although APA says a family history (Read about "Family Health History") of alcoholism doesn't mean that children of alcoholics will automatically grow up to become alcoholics. Environmental factors such as peer pressure and the easy availability of alcohol can also play key roles, especially for young people who are at an increasing risk of binge drinking. (Read about "Teenage Health Risks") And finally, people with serious mental disorders and illnesses such as depression or schizophrenia may turn to alcohol to "self-medicate." (Read about "Depressive Illnesses" "Schizophrenia")

Making a change

In addition to social and psychological damage caused by alcohol, there are also physical health risks. Although alcohol isn't the only cause of liver disease (Read about "Cirrhosis"), it is one of the major ones. According to the American Liver Foundation, even moderate amounts of alcohol can have toxic effects when taken with over-the-counter drugs that contain acetaminophen. (Read about "Medicine Safety") Long-term alcohol abuse is also linked to some serious heart problems. (Read about "Cardiomyopathy" "Hypertension: High Blood Pressure" "Congestive Heart Failure" "Arrhythmia") Alcoholism can also lead to nerve damage. (Read about "Peripheral Neuropathy")

If you are concerned, for yourself or for a loved one, a doctor can help you determine if there is a problem with alcohol, how serious it is, and what can be done about it. If there is an underlying emotional or mental problem behind the use of alcohol, a doctor is also best able to determine how to deal with this problem.

If there are no underlying causes that need to be addressed first, and you have simply decided that it's time to either stop drinking or to cut back on the amount of alcohol you consume, NIAAA says there are several things that may be helpful:

• Watch out for people, places or times that seem to trigger an urge to drink
• Avoid bars and/or people who drink while they socialize
• Get support, either from friends and family or by seeking out a support group in your area
• Stay active; find activities that don't involve alcohol and spend more time on such activities
• Learn how to say "no" and plan ahead for what you'll do or say when offered a drink
• Don't keep alcohol at home

For someone with a serious drinking problem, APA says willpower alone isn't enough; outside help is essential. (Read about "Addiction") An alcoholic may need medically supervised detoxification, otherwise potentially life-threatening withdrawal symptoms such as seizures (Read about "Seizures") may occur. Depending on the extent of the problem, outside treatment and therapy may involve office visits, hospital stays or residential treatment programs. Alcoholics also need ongoing help resolving psychological issues that may be associated with problem drinking.

A residential treatment program for alcoholism may help. At such centers, the emphasis is on abstinence, combined with individual and group therapy. Such centers may be better able to help an alcoholic deal with detoxification and withdrawal symptoms. Medical and psychological support at such centers is also available.

There are also medications that can be used. One drug - disulfiram - will produce a severe physical reaction if you drink. The reaction includes nausea, vomiting and headaches. Other drugs block the pleasurable effects of alcohol on the brain, which can be a deterrent. Some of these medications are taken orally, others are injected. Medications need to be used in conjunction with counseling and therapy.

Giving up alcohol - even cutting back - is not an easy change to make. In many cases, alcoholism may be a coping mechanism for other illnesses. (Read about "Depressive Illnesses") But given the potential risks of overindulging, it can be one of the most important changes you ever make.

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