Alcoholism is a chronic, often progressive disease in which a person craves alcohol and drinks despite repeated alcohol-related problems. Alcohol is the number one substance abuse problem in the United States; 1 in 6 people have a drinking problem. Alcoholism is called a family disease because it hurts the lives of family members and others who are close to the alcoholic. For the alcoholic to get well, family members often must take part in treatment.
Alcoholism can manifest itself in the forms of alcohol abuse or alcohol dependence:
Alcohol Abuse is defined as one or more of the following:
- Failure to fulfill obligations at work, school or home.
- Legal problems.
- Continued use of alcohol despite having problems caused by drinking.
- Recurrent alcohol use in dangerous situations.
Alcohol Dependence is more serious and is defined as three or more of the following:
- Increased tolerance for alcohol, requiring more and more to get the same effects.
- Inability to stop or cut back on drinking.
- Spending lots of time drinking or recovering from drinking.
- Drinking despite knowing it's causing problems.
- Withdrawal symptoms if an attempt to stop drinking is made.
- Giving up social or work activities to drink.
Causes of Alcoholism
There is no one single cause for alcoholism. Genetics, social factors, inability to cope with emotional or high stress situations, may all contribute to someone developing alcoholism.
The effects of drinking over time can be cumulative and can create an imbalance in brain chemicals, which associate alcohol intake with pleasure.
People at Risk for Alcoholism:
- Men who drink 15 or more alcoholic beverages a week (one drink equals one 12 oz beer, 5 oz of wine, or 1.5 oz of liquor).
- Women who drink 12 or more alcoholic beverages a week.
- Any person who has 5 or more drinks per occasion per week.
- Individuals whose parents exhibit alcohol abuse or dependence.
- Individuals who begin drinking at a young age.
- Individuals with depression, anxiety, and other mental disorders.
Symptoms of Alcohol Abuse
- Drinking alone
- Inability to decrease or stop alcohol intake
- Making excuses to drink
- Attempting to conceal drinking activity
- Becoming hostile when confronted by others about drinking
- Missing work, school, or other livelihood activities due to drinking
- Needing alcohol to function during the day
- Irritability when sober
- Needing alcohol to feel “normal”
- Shaking or tremors when sober
- Failing to care for oneself (i.e., lack of hygiene or a healthy diet)
Symptoms of Alcohol Dependence
- All or some of the above symptoms of alcohol abuse
- Black-outs (memory lapses during periods of heavy drinking)
- Withdrawal symptoms during periods of sobriety (see “Treatment” section below for more information on withdrawal)
- Increased intake because the individual can’t “feel” drunk as easily anymore
- Alcohol-related liver disease
Five Types of Alcoholics:
1) Young Adult Subtypes are the largest subtype of alcoholics. Alcoholics by age twenty-four, they rarely seek treatment for alcoholism. They do drink less frequently than other types of alcoholics, but engage in binge-drinking when they do drink.
2) Young Antisocial Subtype are twenty-six years old on average, often smoke cigarettes and pot but tend to become alcoholics by age eighteen. This subtype doesn't overlap with Young Adult alcoholics. Over half of them have an antisocial personality disorder.
3) Functional Subtype are generally middle-aged working adults who have stable relationships, higher education and higher income than other alcoholics. They drink every other day, five or more drinks on drinking days.
4) Immediate Familial Subtype who typically began drinking at seventeen and became alcoholic by age thirty. Over half of these have an immediate family member who is an alcoholic.
5) Chronic Severe Subtype is the rarest type. Mostly includes divorced men who frequently use illicit drugs.
Treatment for Alcoholism:
Withdrawal from alcohol requires medical treatment and care as alcohol withdrawal syndrome can be life-threatening. The 4 phases of alcohol withdrawal are as follows:
1) Tremulous Stage - tremor of hands and legs often accompanied by restlessness and agitation.
2) Seizures occur in 25% of people withdrawing from alcohol.
3) Hallucinations affect 25% of people withdrawing from alcohol. They can be visual, tactile, or auditory.
4) Delirium Tremens (DT's) affect about 5% of people withdrawing from alcohol and begins 48-72 hours after drinking ceases. People are awake but confused, agitated, sweating, often hallucinating, with high blood pressure and a rapid pulse. This is a medical emergency as death may occur in up to 35% of untreated patients.
After alcohol withdrawal, patients are encouraged to try in- or outpatient rehabilitation programs to learn new coping skills for a new life without alcohol, since the relapse rate for alcoholics and other addicts is high.
If You or a Family Member Has a Drinking Problem:
- Join a support group for people who are struggling with the same problems you are. Al-Anon, Alateen, and Adult Children of Alcoholics are all excellent support groups.
- See a therapist, talk to a friend, or someone you can confide in. Isolation makes the situation much harder for you and your family.
- Denying that there is a problem is damaging to you and to the rest of the family. As hard as it is to admit there is a problem, it can be liberating.
What Not To Do:
- Don't cover up the problem or make excuses for the addict
- Don't take over responsibilities for the addict as that will remove their dignity and sense of importance and enable their negative behavior.
- Don't be a martyr. Emotional appeals may further push the addict to abuse.
- Don't hide the bottles or shelter them from situations where alcohol is present.
- Don't try to punish, threaten, preach or bribe the addict.
- Don't ever, ever, EVER feel guilty or responsible for the behavior of the substance abuser. It's not your fault. It cannot be your fault. You cannot make someone else do something.
Related Resource Pages on Band Back Together:
Recovery from Alcoholism:
The 12-step programs, the Anonymous Programs, cover almost every addiction:
Alcoholics Anonymous The most widely used recovery and support group for alcoholics.
Al-Anon/Alateen 12-step recovery program for the families of alcoholics as alcoholism is a family disease.
Adult Children of Alcoholics- an anonymous 12-step program for adult children who grew up in an alcoholic home.
Additional Resources for Alcoholism:
National Institute on Alcohol Abuse- Research, publications, and resources about alcohol, alcoholism for families, health care providers and the general public.
Adult Children of Alcoholics, Janet G Woititz. This book provides wisdom and information for all adult children of dysfunctional families of alcoholics. It's easily one of the best and most powerful books out there about growing up in an alcoholic home.
National Council on Alcoholism and Drug Dependence, Inc Information and resources on alcoholism and drug dependencies, as well as support for parents, young people, and recovering addicts. Online tests available to help you determine if you or your loved one should seek help.
The Alcoholism Guide Resources and guidance for those who are searching for alternatives to Alcoholics Anonymous and the 12 step program.
Alcohol Drug Abuse Help & Resource Center Information on various treatment regimens, links to local resources, and non-12 step programs.
Substance Abuse and Mental Health Services Administration An exhaustive resource for publications and research on addictions and mental health disorders.
