Alcoholism, alcoholics, and alcohol

What are alcohol abuse and alcohol dependence?

Alcohol abuse means having unhealthy or dangerous drinking habits, such as drinking every day or drinking too much at a time. Alcohol abuse can harm your relationships, cause you to miss work, and make it hard to do the things you need to do. It can lead to legal problems, such as being arrested for disorderly conduct or driving while intoxicated. If alcohol abuse continues, it can lead to alcohol dependence.

Alcohol dependence is also called alcoholism. Alcoholics cannot quit drinking or control how much they drink, even when they try to. They are physically and emotionally addicted to alcohol. They often feel like they must drink just to get by. They might drink secretly or hide the amount they drink. Alcohol controls their lives. Over time, alcoholics need to drink more before they can feel the effects of alcohol. They get grouchy or shaky or have other withdrawal symptoms when they are not able to drink or when they try to quit.

Over time, drinking too much alcohol can cause or make worse health problems such as heart disease, high blood pressure, stroke, liver disease, gallstones, pancreatitis, and certain types of cancer. If you have trouble with alcohol, cutting back or quitting can help you live a happier, healthier life.

How much drinking is too much?

Drinking can become a habit. You might have friends or family members who drink often, so drinking a lot might seem normal. Or you might not realize how much or how often you drink. You might not be aware of the problems that alcohol causes in your life. But the more you drink, the greater is your risk for becoming addicted to alcohol. You also have an increased chance of having health problems or other problems as a result.

You are drinking too much if you are:¹

• A woman who has more than 3 drinks at one time or more than 7 standard drinks a week.
• A man who has more than 4 drinks at one time or more than 14 standard drinks a week.

A standard drink is :

• 1 can or bottle of beer [12 fl oz].
• 1 glass of wine [5 fl oz].
• 1 mixed drink containing 1.5 fl oz of hard liquor.

While some studies show that moderate drinking may have some health benefits, most doctors do not recommend that you start drinking for your heart or other health reasons. The risks of drinking alcohol usually outweigh any benefits.

Many people who have alcohol problems are successful in other areas of their lives, and they might even be able to hide their problem for years. These people often deny that they have a problem. The good news is that when people admit to themselves and others that they have a problem and make a commitment to change, most are able to cut their drinking back to a safe level or to quit altogether.

If you think you might have a drinking problem, take a short quiz to evaluate your symptoms:

Interactive Tool: Do You Have a Drinking Problem?

What causes alcohol abuse and dependence?

It is not clear why some people have problems with alcohol and others do not, although experts know that alcoholism can be passed down in families (genetic link). Experts believe that alcohol problems are also caused by cultural values (such as being part of a group of people who drink a lot) and mental health issues (such as drinking as a way of coping with stress or problems). Addiction to alcohol is not a sign of weakness and does not mean you lack willpower. Alcoholism is a long-term disease, just like asthma or diabetes.

What are the signs of alcohol abuse and dependence?

You might have problems with alcohol abuse if:

• You have had trouble at work, school, or home because of drinking or being hung over.
• You have been in situations where you could have been hurt or could have hurt someone else because of your drinking, such as driving while intoxicated.
• You have had legal problems caused by drinking.
• You kept drinking even though you knew it was causing problems with your family or friends.

You might be dependent on alcohol if you have had three or more of the following problems in the last year:

• You need to drink much more than you once did to get the same effect. Or when you drink the usual amount, the effect is less than before.
• When you don't drink, you notice withdrawal symptoms (such as shakiness, sweating, or trouble sleeping), or you drink just to prevent withdrawal symptoms.
• You drink more often than you want to, or you drink larger amounts than you want to.
• You have tried unsuccessfully to quit drinking or to cut back the amount you drink.
• You spend a lot of time drinking and recovering from drinking.
• You have given up other activities that are important to you so that you can drink.
• You continue to drink even though you know your drinking might be causing problems.

How are alcohol problems diagnosed and treated?

Your doctor may diagnose alcohol abuse and dependence by asking questions about your symptoms and past health. He or she will give you a physical exam and sometimes a mental health assessment. Keep in mind that you will need to honestly answer questions about your drinking for your doctor to be able to help you. Further testing may be done to look for other health problems related to alcohol.

Admitting that you have a drinking problem can be hard, but it is the first step to recovery. Although starting to drink again is common, alcohol problems can be overcome.

People typically do not seek treatment for alcohol abuse until they are ready. They must accept that they are addicted and no longer have control of their lives. Sometimes family members point out the problem. Other times, people recognize that they have a problem after they have been arrested or lost a job or had other setbacks as a result of their drinking.

You can take steps today to stop drinking. Your first step might be to see your doctor, contact a support group, or set a date in the near future to stop.

Treatment depends on the extent of the problem. Some people are able to simply cut back to a moderate level of drinking with help from a counselor. Alcoholics need more help. People who are physically addicted to alcohol may need medical treatment when they stop drinking. They may need to stay in a hospital or treatment center where they get medicines to prevent seizures and other symptoms of withdrawal.

Once withdrawal symptoms have passed, the second step of treatment is to work on staying sober. Quitting alcohol is often described by alcoholics as one of the most difficult but worthwhile challenges in life.

Most people need continuing support to help stay sober. This can come from counseling or a support group, such as Alcoholics Anonymous (AA). Staying sober is a lifelong process.

Alcohol use problems can harm the relationships in your family. Often family therapy and education are a part of the recovery process.

Frequently Asked Questions

Learning about alcohol abuse and dependence:	What is the difference between abuse and dependence? What is the cause? What are the symptoms?
Being diagnosed:	Do I have a drinking problem? How are abuse and dependence diagnosed? Who should I see for treatment?
Getting treatment:	What kind of treatment is available? Are medicines used? Is other treatment available? How can I stop drinking?
Ongoing concerns:	What happens if I relapse?