Alcoholism

What is alcoholism?

Alcohol use problems range from occasional problem drinking to alcohol abuse to alcoholism. Alcoholism, also known as alcohol dependence, is a primary, chronic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations. It is often progressive and fatal. As outlined by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), those affected experience:

• Physical dependence - withdrawal symptoms, such as nausea, sweating, shakiness, and anxiety after stopping drinking
• Tolerance - the need to drink greater amounts of alcohol to get "high"
• Craving - a strong need, or urge, to drink
• Loss of control - not being able to stop drinking once drinking has begun

According to the NIAAA, nearly 20% of patients treated in general medical practices report drinking at levels considered "risky" or "hazardous." They may be at risk for developing alcohol-related problems as a result.

The NIAAA defines risky drinking of "standard drinks," with one standard drink equal to about 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of hard liquor. For men, 4 or more drinks a day or 14 or more a week is considered risky, while for women it is 3 or more a day or 7 or more a week. While consuming alcohol is, by definition, necessary to develop alcoholism, the use of alcohol by itself does not predict the development of alcoholism. The quantity, frequency, and regularity of alcohol consumption required to develop alcoholism varies greatly from person to person. People's response to alcohol may be affected by their size, age, general state of health, and by the medications they are taking. In some, fewer drinks can still cause health problems. Since there is no known "safe" alcohol level for pregnant women, the Surgeon General advises women who are, or are planning to be, pregnant to abstain from drinking.

The major health risks of alcoholism include liver disease, heart disease, certain forms of cancer, pancreatitis, and nervous system disorders. These conditions often develop gradually and may become evident only after long-term heavy drinking. The liver is particularly vulnerable to diseases related to heavy drinking, most commonly, alcoholic hepatitis (inflammation) and cirrhosis (scarring of the liver). Women tend to be more sensitive to the effects of alcohol and may develop alcohol-related health problems sooner and after consuming less alcohol than men do. Alcohol use in pregnant women can lead to miscarriage, premature birth, low birth weight, and other problems in the baby, such as abnormal facial features, malformation of organs (such as the brain and heart), growth deficits, and hearing and vision problems. Brain damage may result in life-long learning disabilities and poor reasoning and judgment skills. According to the March of Dimes, up to 40,000 babies a year are born with some degree of damage related to alcohol.

Alcohol abuse, which is less serious than alcoholism, is defined as a pattern of drinking that results in particular situations, such as failure to fulfill major work, school, or home duties or having recurring alcohol-related legal problems, such as arrests for driving under the influence of alcohol. People who abuse alcohol do not have an extremely strong craving for alcohol, loss of control over drinking, or physical dependence; however, people who abuse alcohol also can develop the negative health consequences, such as liver disease, mentioned above.

In the United States, 17.6 million people abuse alcohol or are alcohol dependent. According to the NIAAA, more men than women are alcohol dependent or have alcohol problems, and alcohol problems are highest among young adults between the ages of 18 and 29 years and lowest among adults 65 and older.