Alcoholism
Chapter 16. Mental Health Conditions

Alcoholism is used here to describe alcohol abuse and/or dependence. Alcohol abuse is the repeated use of alcohol that results in daily living problems. Examples include:
Failing to fulfill work, school, or home duties
Getting arrested for drunk driving, disorderly conduct, etc.
Having relationship problems such as arguments or physical fights

Alcohol dependence is alcohol addiction. It means not being able to stop using alcohol without some degree of distress. The distress can be from:
Cravings for alcohol
The need for more and more alcohol to get the desired effect
Withdrawal symptoms when blood alcohol levels decline

Causes
A tendency to become alcoholic is increased if family members are alcoholic. Men and women are about 4 times more likely to become alcoholic if one of their parents was, and 10 times more likely if both parents were. Environmental factors also play a role. For example, the more a person drinks, the greater the risk. Also, being able to consume a lot of alcohol (having a high tolerance) is a risk factor, not a safeguard, for alcoholism.

Alcohol abuse and/or dependence can develop in several ways:
Drinking in excess on an almost daily basis
Drinking a lot at certain times, such as every weekend
Drinking a lot in binges, with or without long periods of not drinking
Drinking infrequently, but with loss of control over drinking and/or behavior problems while drinking

Alcoholism is a disease which affects the alcoholic's physical health, emotional well-being and behavior.

Physical Effects of Alcohol
Can impair mental/physical reflexes. The chart below describes the typical effects as blood alcohol content (BAC) increases.

* For most states, blood alcohol content (BAC) of 0.10 is the indicator for driving while intoxicated.

Can increase the risk of diseases such as cancer of the brain, tongue, mouth, esophagus, larynx, liver, and bladder; cirrhosis of the liver and hepatitis; gastritis and brain damage when used heavily. It can also cause heart and blood pressure problems.
Can lead to malnutrition
Is known to cause birth defects

Emotional and Behavioral Effects of Alcohol
May cause someone to do things they might not do otherwise, such as driving at dangerous speeds or other daredevil acts.
May result in anger, violent behavior, or depression which can intensify as more alcohol is consumed. Can result in suicide.
May result in memory loss, the inability to concentrate, and problems in other intellectual functions
Can make family life chaotic. The divorce rate is 7 times higher among alcoholics. Also, children of alcoholics often have emotional problems lasting into adulthood.
Often results in decreased work attendance and performance as well as problems in dealing with employees and coworkers

Treatment
Treating alcoholism as an illness is important. Recovery requires lifelong changes. Types of treatment are:
Self-help groups such as:
Alcoholics Anonymous (AA)
Rational Recovery (RR)
Women for Sobriety (WFS)
Men for Sobriety (MFS)
(See "Places to Get Information & Help" under Alcohol/Drug Abuse.)
Alcohol treatment programs. Many types exist:
Outpatient treatment is held in hospitals, clinics, or other alcohol rehabilitation centers.
It focuses on education and is often set up in a group format. Substance abuse counselors,
psychologists, social workers, etc., staff this type of treatment, which generally lasts from
6-10 weeks.
Day treatment programs in which the person checks into a facility all day, but goes home
at night. Individual and group therapy as well as education are provided. This type of treatment
is suitable for persons with more severe problems that can be helped by outpatient programs.
It is less costly than inpatient treatment.
Inpatient treatment usually takes 14 to 28 days in a hospital or other residential treatment facility.
The alcoholic may need to go through detoxification. The focus of treatment is to rehabilitate the
person to not use alcohol. This is done through education and individual and group therapy.
"Aftercare" eases the person back into the "real world" through individual counseling, group
therapy, and support group meetings such as AA, after inpatient or outpatient treatment is finished.
This can last one year. The person continues with individual and group therapy and support group
meetings such as AA.
Psychotherapy, which can be individual, family, and/or group therapy
Medications. One called Naltrexone, blocks the craving for alcohol and the pleasure of getting high. Another one, called Antabuse, causes physical reactions such as vomiting when drinking alcohol. Antabuse is rarely used.

Questions to Ask

{Note: "Counselor" in this section may also refer to self-help support groups such as Alcoholics Anonymous (AA).}

Have you had memory lapses or blackouts due to drinking?	OR
Do you continue to drink even though you have health problems caused by alcohol?	OR
Do you get withdrawal symptoms such as headaches, chills, shakes, and a strong craving for alcohol, and, as a result, drink more to get rid of these symptoms?	OR
Do you take part in high-risk behaviors such as: unsafe sex in a nonmonogamous relationship or driving a boat or car or working with hazardous machinery when under the influence of alcohol?	OR
Has drinking caused trouble at home, at work, and/or with relationships with others?	OR
Do you have to drink alcohol for any of the following reasons? To get through the day or unwind at the end of the day To cope with stressful life events To escape from ongoing problems	OR
Do you answer yes to 2 or more of the following questions? Have you ever tried to cut down on your drinking? Have you ever been annoyed by anybody criticizing your drinking? Have you ever felt guilty about your drinking? Have you ever had an eye-opener (drink) in the morning?	OR

Self-Care Tips

Tips to Reduce the Risks Associated With Drinking:
Know your limit and stick to it or don't drink any alcohol.

Know Your Limit1 Body Weight lbs. # of Drinks2 During a 2-Hour Period
100 120 140 160 180 200 220 240	1A2B3C4C5C6C7C8C9C10C 1A2B3B4C5C6C7C8C9C10C 1A2B3B4B5C6C7C8C9C10C 1A2A3B4B5C6C7C8C9C10C 1A2A3B4B5C6C7C8C9C10C 1A2A3B4B5B6C7C8C9C10C 1A2A3B4B5B6C7C8C9C10C 1A2A3B4B5B6B7C8C9C10C
A - Be CarefulB - Driving May BeC - Do Not Drive DrivingImpairedBAC .10 and up BAC* to .05BAC to .05-.093 1 This chart provides averages only. Individuals may vary, and factors such as food in the stomach, medication, and fatigue can affect your tolerance. 2 One drink is 1 1/4 oz. of 80-proof liquor, 12 oz. of beer, or 4 oz. of wine. 3 The BAC percentages for impairment and intoxication vary from state to state. * BAC = blood alcohol content Developed by Techniques for Alcohol Management. Used with permission. If you're in doubt about your ability to drive, play it safe. Don't drive!

Drink slowly. You are apt to drink less.
Pour less alcohol and more mixer in each drink.
Alternate an alcoholic beverage with a non-alcoholic one.
Eat when you drink. Food helps to slow alcohol absorption.
Talk to persons who will listen to your feelings and concerns without putting you down. You will be less likely to turn to alcohol to "drown your sorrows."
Find ways to calm yourself other than with alcohol. Examples include hobbies, relaxation exercises, physical activities, music, movies, etc.
Realize that you are a role model for your children. They learn what they see. When you drink, do so responsibly.
Don't mix drinking with driving, drugs, or operating machines. Doing so can be fatal.
Don't rely on coffee or fresh air to make you sober. Even though you see these things done on TV, they won't make a person sober.
Don't have any alcohol if you are pregnant.
Contact your Employee Assistance Program (EAP) at work for information and other suggestions.

HEALTH AT HOME - Your Complete Guide to Symptoms, Solutions, and Self-Care © 1999 by Don R. Powell. American Institute for Preventive Medicine. 

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Date updated 04/20/99