Alcoholism Health Article

Definition

Alcoholism is the layman's term for alcohol dependence and alcohol abuse. According to the Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association and commonly called the DSM-IV, the essential feature of substance abuse (in this instance, alcohol abuse) is maladaptive use of the substance with recurrent and significant adverse consequences related to its repeated use. Dependence is a physical addiction with psychological, social and genetic components. Despite damage to health, finances, reputations, and relationships, the alcohol dependent person will continue to drink unless an intervention occurs. Abuse, distinguished from dependence by retaining some control over the use of alcohol, nevertheless carries many of the same consequences over time, and certainly increases risk of dependence.

Today, alcohol abuse and alcohol dependence are often associated with abuse of, or dependence on, other substances including nicotine, marijuana, cocaine, heroin, amphetamines, sedatives, and anxiolytics (antianxiety drugs). Alcoholism is more common in males than in females, with an estimated male-to-female ratio as high as five-to-one. A United States study conducted between 1990 and 1991, using DSM standards, found that 14% of the adult population (ages 15–54) had, at some time, met the criteria for alcohol dependence; and 7% had been alcohol-dependent in the past year. An earlier, similar study showed that about 5% of Americans qualified for a diagnosis of alcohol abuse at some point during their life. According to a 2002 report by the National Council on Alcoholism and Drug Dependence, 14 million Americans abuse alcohol, and 100,000 die annually of alcohol related preventable causes. Though it is difficult to develop accurate statistics worldwide, it is known that the incidence of what we call alcoholism has been steadily rising around the globe for several years.

Description

The effects of alcoholism are quite far-reaching. Alcoholism affects every body system, causing a wide range of drinking related health problems, including lower testosterone, shrinking gonads, erectile dysfunction, interference with reproductive fertility, weak bones, memory disorders, difficulty with balance and walking, liver disease (including cirrhosis and hepatitis), high blood pressure, weakness of muscles (including the heart), disturbances of heart rhythm, anemia, clotting disorders, weak immunity to infections, inflammation and irritation of the entire gastrointestinal system, acute and chronic problems with the pancreas, low blood sugar, high blood fat content, and poor nutrition.

Its mental health implications include marital and other relationship difficulties, depression, unemployment, poor performance at school or work, spouse and child abuse, and general family dysfunction. Alcoholism causes or contributes to a variety of severe social problems: homelessness, murder, suicide, injury, and violent crime. Alcohol is a contributing factor in 50% of all deaths from motor vehicle accidents. In fact, 50% of the 100,000 deaths that occur each year due to the effects of alcohol are due to injuries of some sort. Alcohol costs the United States over $150 billion yearly in lost productivity and alcohol related medical expense.

Causes & symptoms

A physical dependence on alcohol develops insidiously, over time. The body is a magnificent adaptor; therefore, with persistent use, many adaptations occur physically and psychologically, resulting in both a higher tolerance to and increased need for alcohol—craving it—The physical adaptation to alcohol involves changing levels and altered balances of neurotransmitters, chemicals in the brain which not only affect physical abilities like muscle coordination, but also mood. The abuse of alcohol is associated with a desire to feel better and to avoid feeling poorly. Initially a stimulant, it eventually acts as a central nervous system (CNS) depressant and is used in a majority of societies or cultures in the world as an accepted part of dealing with life events, except where religious opposition bans, discourages or prohibits its use, as in most Muslim communities. It is included in celebrations and, ironically, its use is perceived as an appropriate response to sadness and loss, such as at wakes.

There is, at this point, no single known factor that causes some people to be alcohol-dependent and others not. Recent genetic studies have demonstrated that close biological relatives of an alcoholic are four times more likely to become alcoholics themselves. Furthermore, this risk holds true even for children who were adopted away from their biological families at birth and raised in non-alcoholic homes, without knowledge of their biological family's difficulties with alcohol. Male gender,

being the child of an alcoholic parent or parents, extended family history and being of Irish (Celtic), Scandinavian, German, Polish, Russian or Native American ancestry, beginning drinking as a teenager, and being depressed or highly anxious all increase the risk of experiencing problems with alcohol. Further research may determine if genetic factors are accountable, in part, for differences in alcohol metabolism and increase the risk of an individual becoming an alcoholic. Other cause related factors in alcoholism include high levels of stress and turmoil or pain, having drinking friends, drinking partners, and "enablers"—people who facilitate a drinkers habits and denial mechanisms. Heavy advertising that makes drinking appear to be "sexy" or the basis of a good time also contributes. Consider, for example, the number of televised sporting events that are sponsored heavily by alcohol related enterprises.

One of the classic symptoms of alcoholism is denial of a problem with alcohol. An addicted person, under the influence of the addictive substance, is physically and psychologically motivated to perpetuate the addiction. Therefore, intervention often starts when loved ones, recognizing the signs and symptoms, bring attention to the problem and call for help. Occasionally, an intervention requires a whole family unit and outside assistance. Signs and symptoms of alcohol dependence and abuse may include the following:

• not remembering conversations or commitments
• losing interest in activities that were once pleasurable
• ritualized drinking, before, with, and after dinner and being upset if the pattern is interrupted
• becoming irritable as "happy hour" approaches, especially if alcohol is not available
• drinking alone or secretly
• hiding alcohol in unusual places
• ordering doubles, drinking quickly, and drinking to become drunk, intentionally
• focusing attention on the source of one's next drink
• unstable relationships, financial, legal, and employment difficulties

Physical symptoms of alcoholism can be broken into two major categories: symptoms of acute alcohol use and symptoms of long-term alcohol use.