Alcoholism or alcohol dependence is defined by the American Medical Association (AMA) as “a primary, chronic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations.” While 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.
What are the symptoms of alcoholism?
The signs of alcoholism and alcohol abuse are very similar, and are often just a question of degree or intensity. Typically, the last person to be aware that he/she has a serious drinking problem is the alcoholic himself/herself – they are in denial.
Some signs and symptoms of alcoholism as well as alcohol abuse include:
Drinking in secret.
Not being able to limit how much alcohol is consumed.
Blacking out – not being able to remember chunks of time.
Having rituals and being irritated/annoyed when these rituals are disturbed or commented on.
Losing interest in hobbies and activities the person used to enjoy.
Feeling an urge to drink.
Feeling irritable when drinking times approach. This feeling is more intense if the alcohol is not available, or there appears to be a chance it may not be available.
Having stashes of alcohol in unlikely places.
Gulping drinks down in order to get drunk and then feel good.
Having relationship problems (triggered by drinking).
Having problems with the law (caused by drinking).
Having work problems (caused by drinking, or drinking as root cause).
Having money problems (caused by drinking).
Requiring a larger quantity of alcohol to feel its effect.
Nausea, sweating, or even shaking when not drinking.
Additional risk factors include having a psychiatric condition such as schizophrenia, depression, or anxiety disorders. Poverty, social isolation, and shyness may also be risk factors. In addition, how one’s body processes alcohol can affect the risk of developing a dependence on alcohol.
Research has shown that people who need comparatively more alcohol to achieve an effect are more likely to become alcohol dependent. All drugs affect a “reward mechanism” in the brain. If a person feels good each time they use a drug, it tends to make them want to use the drug again. This common feature could explain why people abuse drugs, including alcohol. This is called tolerance, and it may be the final factor that contributes to the development of drug or alcohol dependence.
What Are the Treatments for Alcoholism?
Conventional Medicine for Alcoholism
Treatment for alcoholism can begin only when the alcoholic accepts that the problem exists and agrees to stop drinking. He or she must understand that alcoholism is curable and must be motivated to change. Treatment has three stages:
Detoxification (detox): This may be needed immediately after discontinuing alcohol use and can be a medical emergency, as detox can result in withdrawal seizures, hallucinations, delirium tremens (DT), and in some cases may result in death.
Rehabilitation: This involves counseling and medications to give the recovering alcoholic the skills needed for maintaining sobriety. This step in treatment can be done inpatient or outpatient. Both are equally effective.
Maintenance of sobriety: This step’s success requires an alcoholic to be self-driven. The key to maintenance is support, which often includes regular Alcoholics Anonymous (AA) meetings and getting a sponsor.
Because detoxification does not stop the craving for alcohol, recovery is often difficult to maintain. For a person in an early stage of alcoholism, discontinuing alcohol use may result in some withdrawal symptoms, including anxiety and poor sleep. Withdrawal from long-term dependence may bring the uncontrollable shaking, spasms, panic, and hallucinations of DTs. If not treated professionally, people with DTs have a mortality rate of more than 10%, so detoxification from late-stage alcoholism should be attempted under the care of an experienced doctor and may require a brief inpatient stay at a hospital or treatment center.
Treatment may involve one or more medications. Benzodiazepines are anti-anxiety drugs used to treat withdrawal symptoms such as anxiety and poor sleep and to prevent seizures and delirium. These are the most frequently used medications during the detox phase, at which time they are usually tapered and then discontinued. They must be used with care, since they may be addictive.
Aim of Treatment
The goal of treatment for alcoholism is abstinence. Among alcoholics with otherwise good health, social support, and motivation, the likelihood of recovery is good. Approximately 50% to 60% remain abstinent at the end of a year’s treatment and a majority of those stay dry permanently.
Those with poor social support, poor motivation, or psychiatric disorders tend to relapse within a few years of treatment. For these people, success is measured by longer periods of abstinence, reduced use of alcohol, better health, and improved social functioning.