Alcoholism

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Also known as: Alcohol dependence

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 U.S. Centers for Disease Control and Prevention (CDC), alcohol abuse is a pattern of drinking that results in particular problematic 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.

An estimated 18 million Americans abuse alcohol or are alcohol dependent. In the United States, nearly 20% of patients treated in general medical practices report drinking at levels considered "risky" or "hazardous."

The NIAAA defines risky drinking of "standard drinks," with one standard drink equal to about 12 ounces of typical American beer, 5 ounces of wine, or 1.5 ounces of hard liquor. These figures are based on "typical" (mass market) forms of beer and wine; particularly for beer, many specialty beers may contain up to twice the amount of alcohol as a mass market beer does. For wine, the alcohol content is more constant, but wine coolers often contain less alcohol and some types of wine, such as zinfandels and port, may contain twice the average amount of alcohol. For men, 4 or more drinks a day or 14 or more a week within the last year 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.

Long-term health risks

According to the CDC, long-term, excessive alcohol use can lead to the development of several medical and social problems. These include:

  • Neurological conditions, including dementia, stroke and neuropathy, or diseased peripheral nerves
  • Cardiovascular problems, such as heart attack, weakened and enlarged heart, irregular heart beat, and high blood pressure
  • Psychiatric conditions, including depression, anxiety, and suicide
  • Cancer of the mouth, throat, esophagus, liver, colon, and breast; in general, the more you drink, the greater your risk.
  • Liver diseases, including alcoholic hepatitis (inflammation) and cirrhosis (scarring), which is among the 15 leading causes of death in the United States
  • Gastrointestinal disease, including pancreatitis and gastritis

Having hepatitis C virus (HCV) and using alcohol reduces liver function and can interfere with medications taken to treat the HCV. In addition, if you have another form of liver disease (including hepatitis C), alcohol can make the disease more likely to progress to cirrhosis and cause death.

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, stillbirth, 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 due to a mother's alcohol use may result in behavioral problems, speech and language delays, and learning disabilities, according to the March of Dimes.

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