What is alcohol abuse?

Alcohol abuse is a disease. It is characterized by a maladaptive pattern of drinking alcohol that results in negative work, medical, legal, educational, and/or social effects on a person's life. The individual who abuses this substance tends to continue to use it despite such consequences. Effects of alcohol abuse and alcoholism on families can include increased domestic violence. The effects that parental alcoholism can have on children can be significantly detrimental in other ways as well. For example, the sons and daughters of alcoholics seem to be at higher risk for experiencing more negative feelings, stress, and alienation as well as aggression. There are a multitude of negative psychological effects of alcohol dependence, including depression and antisocial behaviors. Statistics about alcohol abuse in the Unites States include its afflicting about 10% of women and 20% of men. Other alcohol abuse facts and statistics include the following: Most people who ever have an episode of drinking too much tend to do so for the first time by the time they are in their mid teens.

Symptoms tend to alternate between periods of alcohol abuse and abstinence (relapse and remission) over time.

Most people who develop dependence on alcohol do so between 18 and 25 years of age.

The majority of individuals who abuse alcohol never go on to develop alcohol dependence.

Alcohol-use statistics by country indicate that among European countries, Mediterranean countries have the highest rate of abstinence and that wine-producing countries tend to have the highest rates of alcohol consumption.

In many European countries, beer tends to be the alcoholic drink of choice by teenagers, followed by distilled spirits over wine.

What is alcoholism?

Alcoholism, also called alcohol dependence or alcohol addiction, is a destructive pattern of alcohol use that includes tolerance to or withdrawal from the substance, using more alcohol or

using it for longer than planned, and trouble reducing its use. Other potential symptoms include spending an inordinate amount of time getting, using, or recovering from the use of alcohol, compromised functioning, and/or continuing to use alcohol despite an awareness of the detrimental effects it is having on one's life. Alcoholism is appropriately considered a disease rather than a weakness of character or chosen pattern of bad behavior. It is the third most common mental illness, affecting more than 14 million people in the United States. Other facts and statistics about alcohol dependence include its pattern of afflicting about 4% of women and 10% of men. It costs more than $165 billion per year in lower productivity, early death, and costs for treatment.

What differentiates alcohol abuse from alcoholism?

While both alcohol abuse and alcoholism involve engaging in maladaptive behaviors in the use of alcohol, abuse of this substance does not include the person having withdrawal symptoms or needing more and more amounts to achieve intoxication unless the person has developed alcoholism.

What are risk factors for alcoholism?

Risk factors for developing a drinking problem include depression, anxiety, or another mood problem in the individual, as well as having parents with alcoholism. Low self-esteem and feeling out of place are other risk factors for developing alcohol dependence. In women, antisocial behaviors and impulsivity are associated with the development of alcohol dependence. Both men and women are more likely to develop alcoholism if they have a childhood history of being physically or sexually abused. Children and teens who have their first drink of alcohol between 11 and 14 years of age are more at risk for developing a drinking problem than those who do so when either younger or older.

What are alcohol abuse and alcoholism symptoms and signs in teenagers, women, men, and the elderly?
Signs that indicate a person is intoxicated include the smell of alcohol on their breath or skin, glazed or bloodshot eyes, the person being unusually passive or argumentative, and/or a deterioration in the person's appearance or hygiene. Other physical symptoms of the state of being drunk include flushed skin. Cognitively, the person may experience decreased ability to pay attention and a propensity toward memory loss. Alcohol, especially when consumed in excess, can affect teens, women, men, and the elderly quite differently. Women and the elderly tend to have higher blood concentrations of alcohol compared to men and younger individuals who drink the same amount. Alcoholic women are more at risk for developing cirrhosis of the liver and heart and nerve damage at a faster rate than alcohol-dependent men. Interestingly, men and women seem to have similar learning and memory problems as the result of excessive alcohol intake, but again, women tend to develop those problems twice as fast as men. Elderly people who drink excessively are at risk for having more serious illnesses, doctor visits, and symptoms of depression, with less life satisfaction and smaller social support networks compared to senior citizens who have never consumed alcohol. While binge drinking is often thought to be a symptom of young people, an often unknown, uncommon fact is that a significant percentage of middle-aged and elderly individuals also engage in binge drinking. This behavior increases the risk for driving drunk, no matter what the age. Teenagers who consume alcohol excessively have been found to be at risk for abnormal organ development as the possible result of the hormonal abnormalities caused by alcohol. This is particularly a risk to their developing reproductive system. Just a few of the other many dangerous effects of alcohol abuse and alcoholism in teenagers include the following:

In contrast to adults, teens tend to abuse alcohol simultaneously with other substances, usually marijuana. Male teens who drink heavily tend to complete fewer years of education compared to male teens who do not drink. The younger a person is when they begin drinking, the more likely they are to develop a problem with alcohol. Each year, almost 2,000 people under 21 years of age die in car crashes in which underage drinking is involved. Alcohol is involved in nearly half of all violent deaths involving teens. More than three times the number of eighth-grade girls who drink heavily said they have attempted suicide compared to girls in that grade who do not drink. Teens who drink are more likely to engage in sexual activity, have unprotected sex, have sex with a stranger, or be the victim or perpetrator of a sexual assault. Excess alcohol use can cause or mask other emotional problems, like anxiety or depression. Drinking in excess can lead to the use of other drugs, like marijuana, cocaine, or heroin.

What are the stages of alcoholism?

Five stages of alcohol and drug use have been identified. The first stage is described as having access to alcohol rather than use of alcohol. In that stage, minimizing the risk factors that make a person more vulnerable to using alcohol are an issue. The second stage of alcohol use ranges from experimentation or occasional use to regular weekly use of alcohol. This or any of the higher stages of alcoholism may involve binge drinking. The third stage is characterized by individuals further increasing the frequency of alcohol use and/or using the substance on a regular basis. This stage may also include either buying or stealing to get alcohol. In the fourth stage of alcohol use, users have established regular alcohol consumption, have become preoccupied with getting intoxicated ("high") and have developed problems in their social, educational, vocational, or family life as a result of using the substance. The final and most serious fifth stage of alcohol use is defined by the person only feeling normal when they are using alcohol. During this stage, risk-taking behaviors like stealing, engaging in physical fights, or driving while intoxicated increase, and they become most vulnerable to having suicidal thoughts.

What is the treatment for alcoholism?

There are numerous individual treatments for alcoholism. Relapse prevention uses methods for recognizing and amending problem behaviors. Individualized drug counseling specifically emphasizes short-term behavioral goals in an attempt to help the individual reduce or stop the use of alcohol altogether. Cognitive-therapy techniques, like helping the individual with alcohol dependence recognize what tends to precede and follow their episodes of alcohol use, are often used to address alcohol abuse. Some treatment programs include drug testing. Twelve-step recovery programs like Alcoholics Anonymous are individualized drug-counseling methods. Motivational enhancement therapy encourages the person suffering from alcoholism to increase their desire to participate in therapy. Stimulus control refers to a treatment method that teaches the alcohol-dependent person to stay away from situations that are associated with alcohol use and to replace those situations with activities that are contrary to using alcohol. Urge control is an approach to changing patterns that lead to drug or alcohol use. Friends and family members of alcoholic individuals have often developed a codependent relationship with the substance abuser. Specifically, they often feel compelled to either help their loved one secure alcohol or to repair situations caused by the alcoholic's alcohol use. Social control involves family members and other significant others of the alcoholic in treatment. For people in the first stage of alcohol use (having access, but not having yet used alcohol), preventive measures are used. Therefore, limiting access to alcohol or other drugs, addressing any risk factors of the alcohol consumer or family, as well as optimal parental supervision for youth and expression regarding expectations are often recommended. The approach to those who have experimented with

alcohol should not be minimized by mental-health professionals, since infrequent use can progress to the more serious stages of alcohol use if not addressed. Therefore, professionals recommend that the alcohol-consuming individual be thoroughly educated about the effects and risks of alcohol, that fair but firm limits be set on the use of alcohol, and that the user be referred for brief counseling, a self-help group, and/or family support group. People who have progressed to the more advanced stages of alcoholism are typically treated intensively, using a combination of the medical, individual, and familial interventions already described. While group therapy can help teens stay sober, groups that include a number of teens who also engage in disordered behaviors can actually tend to increase alcohol use in this age group. Family interventions for alcoholism that tend to be effective for teens include multidimensional family therapy (MDFT), group therapy, and multifamily educational intervention (MFE). MDFT has been found to be quite effective. Longer-term residential treatment, often called rehab, of three to five months that addresses peer relationships, educational problems, and family issues is often used in treating alcoholism in teens.

How can someone find more information or get help or support to treat alcohol abuse and alcoholism?
Al-Anon-Alateen: 888-4AL-ANON Alcoholics Anonymous World Services: 212-870-3400 American Council on Alcoholism treatment referral line: 800-527-5344 Codependents Anonymous: http://www.coda.org Mothers Against Drunk Driving: 800-GET-MADD National Council on Alcoholism and Drug Dependence: 800-NCA-CALL National Institute on Alcohol Abuse and Alcoholism: 301-443-3860 National Clearinghouse for Alcoholism and Drug Information: 800-729-6686 National Resource Center: 866-870-4979

What are the long-term physical and psychological effects of alcohol abuse and alcoholism?
The long-term effects of alcohol abuse and alcoholism can be devastating and even life threatening. Chronic excessive alcohol consumption can negatively affect virtually every organ system. Specific examples of alcohol-abuse effects on the body include everything from general effects like poor coordination, thiamine deficiency, and other forms of poor nutrition, cardiovascular effects like hypertension and irregular heartbeat, reproductive effects like impotence and irregular menses, as well as gastrointestinal problems like cirrhosis of the liver and pancreatitis. Alcohol-abuse effects on the brain include, but are by no means limited to, strokes, confusion, and amnesia. Approximately 10%-15% of people with alcoholism tend to commit suicide. Intoxication is associated with suicide attempts using more lethal methods, and positive blood-alcohol levels are often found in people who complete suicide. Men who have lost their spouses within the year are at highest risk of suicide.