DR. NEAL HOUSTON

Adult Integrative/Behavioral Health Specialist

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Thursday, May 9, 2013

WHAT IS ALCOHOL ABUSE & DEPENDENCE?

Addictions and Abuses




People who abuse or become dependent on alcohol often begin to drink heavily to relieve personal, business, and/or social stress. They generally find the relief they are looking for, at least in the short term and at the cost of occasional hangovers. They gradually begin to drink whenever they feel tense. The more they drink, the less tension they can tolerate without alcohol.

You should consider yourself an alcoholic, or in danger of becoming one, if you have reached a point where you need to drink not only to relieve tension but also to make yourself feel "normal." The illness and resulting disability are severe and require immediate treatment if drinking has begun to affect your health and interfere with your personal or work life, or both.

Some people can drink more, and more often, then others before reaching this stage. The difference depends in part of your tolerance of alcohol. The shift from social drinking to alcoholism can happen almost imperceptibly (gradually) over many years, or it can occur with drastic speed. Drinking habits also vary widely. Some alcoholics are never completely sober. Some drink only wine, or gin, or beer, while others will drink anything alcoholic.

What are the symptoms?
  • Family and close friends of people who are becoming alcoholics may not notice the early symptoms. At first the person just seems to have a tendency to drink too much, and this appears to be confined to social occasions. Later, however, drinkers may admit that they have blackouts, which can mean they wake up in the morning with no memory of what happened the night before or have no recollection of what occurred during previous drinking episodes. If this happens to you or to someone in your family, recognize a blackout as a sign of addiction.
  • In later stages an alcoholic may become secretive about drinking. Glasses of fruit juice may be secretly spiked with alcohol. Bottles may be hidden around the house. Alcoholics often feel guilty about their addiction and may become irritable and aggressive. Another symptom is repeated assertions that they are giving up drinking altogether, alternating with denials that they have a problem. Denial is the major defense employed by alcoholic's. They may become depressed, jealous, resentful, or even paranoid, which means the person has unreasonable fears that others are hostile or plotting against him or her. Eventually there is likely to be a loss of memory and concentration, along with an inability to meet the demands of a job. Physically, chronic alcohol abuse may cause a flushed and veiny face, bruises on the body, arms, and legs, a husky voice, trembling hands, and chronic gastritis.
What are the risk?
  • Alcoholism is more common in men than in women, although much of the difference in the past has resulted from a lack of diagnosis and reporting of women alcoholics. In the United States an estimated 9% of adult males and about 4% of adult females are alcoholics. People with alcoholic parents seem to be particularly susceptible, probably the cause of environmental rather than genetic factors. Some people have symptoms of alcoholism in adolescence or even earlier, but most active alcoholics are between 35 and 55.
  • Alcoholism can affect every system of the body. Although the exact figures are not known, it is thought that at least one in five long-term heavy drinkers eventually develops cirrhosis of liver. Heavy drinking makes the liver susceptible inflammation and may cause serious diseases of the stomach, heart, and brain. Because alcoholics seldom eat adequately, they are likely to develop vitamin deficiencies, particularly of vitamin B.
  • A pregnant woman who is an alcoholic or a heavy drinker subjects her fetus to the risk of being physically and mentally retarded if she continues to drink alcohol throughout her pregnancy. The association between maternal intake of alcohol and a variety of developmental abnormalities in the newborn has been firmly established and it is called fetal alcohol syndrome. According to some estimates, a woman with alcoholism has at least 4 chances in 10 of having a baby with fetal alcohol syndrome. But even sporadic or binge drinking at critical stages of pregnancy may also affect your child. Women who drink may have a higher risk of spontaneous abortion, premature births and stillbirths, as well as low birth-weight babies.
  • Another danger associated with alcoholism and heavy drinking is traffic accidents. An estimated 50% of automobile accident fatalities in the United States are alcohol-related. People with alcoholism also are difficult to live with because they are often irritable and sometimes violent. As a result, the alcoholic risks breaking up his or her family. The same problems of irritability and impaired judgment that affects the alcoholic's home life can also result in loss of a job. 
What are the treatment options?
  • Treatment is a planned, organized intervention to help the person in trouble achieve good physical and mental health as well as to function without resorting to alcohol or other drug use. Comprehensive treatment administered by a physician or other mental health professionals, usually consists of a complete physical, mental, and psycho-social examination of your emotional health, family situation, and occupational stresses. The treatment team monitors and assists in the detoxification (withdrawal phase) of the alcohol or alcohol dependence. Next is dealing with the medical and psychological consequences of past alcohol use, as well as any related disorders, such as depression. Counseling of the patient and family about the nature of addiction and the need to find positive alternatives to using alcohol is a high priority.
  • You may be treated as an outpatient, treatment center or in a hospital setting, or a combination of all. Treatment depends on the severity of the addiction, the condition of your general health, and the nature of your social support system as well as whether you can get any practical help you need from people who care about you. The length of treatment also varies from person to person. Usually the sooner the addiction is diagnosed and intervention takes place, the earlier treatment can be completed, and the greater the chances for recovery.
  • Both during treatment and in the recovery stage of the addiction, including any periods of relapse, self-help groups such as alcoholics anonymous, which is listed in the phone book, can be essential for the patient's progress and well-being. The entire family may self-help.
What are the long term prospects?
  • The general outlook for a person with alcoholism is highly variable. If you are an alcoholic and you are determined to give up alcohol, you can do so, with appropriate help. Admitting that you need help is always the first crucial step.
What should be done?

If you detect signs of an early stage of alcoholism in yourself, cut down on the amount and frequency of your drinking for your family's sake as well as your own. If you find that it is impossible to do, seek help immediately. Get in touch with a physician, doctor, or a recognized addiction treatment program. If someone close to you shows symptoms of alcoholism but denies that he or she is drinking too much ( as often occurs), consult a physician about the problem. You cannot force someone to seek help, but persuasion by a physician, social worker, or other mental health or addiction professional is sometimes effective. You should possibly attend an A.A. meetings to learn how you can help yourself and your family member. Psychotherapy can help people deal with the underlying cause of drinking, but the person must be sober and want to quit before psychotherapy can help.


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