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Alcoholism, also known as alcohol dependence, is a disease that causes a person to be so physiologically dependent on alcohol that this dependence interferes with work, relationships or school.

Alcohol abuse does not include an extremely strong craving for alcohol, loss of control over drinking or physical dependence, but it can be just as devastating to your life.

Whether you have alcoholism or abuse alcohol, your problem can affect your quality of life and your career and can damage your relationships. Alcoholism and alcohol abuse can be factors in violent crimes, teen pregnancies and date rape.

As many as 13 million people in the United States may have a problem with alcohol.

Short-term physical effects of alcohol use include:

• Distorted vision, hearing and coordination.
• Altered perceptions and emotions.
• Impaired judgment.
• Bad breath.
• Hangovers.

Long-term physical effects of heavy alcohol use include:

• Loss of appetite.
• Vitamin deficiencies.
• Skin problems.
• Sexual impotence.
• Memory loss.
• Digestive-system disorders such as ulcers, inflammation of the pancreas, gastritis (inflammation of the stomach) and cirrhosis (liver damage).
• Central and peripheral nervous systems damage, including blackouts, hallucinations, tremors, alcohol withdrawal syndrome and death.
• Damage to unborn children (from even moderate drinking), including birth defects, mental retardation, learning problems and fetal alcohol syndrome.
• Psychological and interpersonal problems, including impaired thinking and judgment, changes in mood and behavior, child abuse, impaired social relationships, and marital, scholastic, job-related, legal, and financial problems.

Prognosis

Although a cure is not yet available, alcoholism can be treated. Even after a lengthy period of sobriety, however, there is always the chance of relapse. Cutting down on drinking usually doesn't work and you must completely cut out alcohol to recover.

Occasional relapses are common during the first stages of recovery. This does not mean you have failed. This is why you must have a support system in place -- your family, a support group or friends.

Frequently Asked Questions about Drinking Problems

I'm not an alcoholic. Can I be helped with a drinking problem?

You don't have to be an alcoholic to need help, or to get help. If your health care provider determines that you are not alcohol dependent, but you are involved in a pattern of alcohol abuse, he or she can help you:

• Examine your problem.
• Set goals and limits.
• Examine trigger situations.
• Develop new ways of handling problem situations.

If you have any alcohol-related problem, even if you are not alcoholic, Alcoholics Anonymous also can help with information and support.

How much can I drink?

According to the National Institute of Health, most adults can drink moderate amounts of alcohol-up to two drinks per day for men and one drink per day for women and older people-and avoid alcohol-related problems. However, certain people should not drink at all. That includes:

• Recovering alcoholics.
• People under the age of 21
• Women who are pregnant or trying to become pregnant.
• People who plan to drive or engage in other activities requiring alertness and skill.
• People taking certain medications, including some over-the-counter medicines.
• People with medical conditions that can be worsened by drinking.

Can alcoholism be cured?

Unfortunately, not yet. Although the symptoms of this disease can be treated, and medication is available that can help prevent relapses, a cure has not yet been discovered. This means that even an alcoholic who has been sober for years and has regained health is still vulnerable to relapse, and must continue to avoid alcoholic beverages.

Are there any medications for alcoholism?

Yes. Two types of medication are commonly used to treat alcoholism. Tranquilizers known as benzodiazepines are used in the first few days of treatment to help patients safely withdraw from alcohol. Common brands of benzodiazepines include Valium® and Librium®. The other type of medication is used to help people remain sober. Naltrexone (ReVia®) has recently been approved for this purpose. This medication is used in conjunction with counseling to lessen cravings and prevent a return to heavy drinking.

Does alcoholism treatment work?

While not 100 percent effective in every case, studies have shown that a minority of alcoholics remain sober at least one year after treatment while others have periods of sobriety alternating with relapses. However, treatment outcomes for alcoholism compare favorably to outcomes for many other chronic medical conditions. The longer one abstains from alcohol, the better his or her chances of remaining sober. It is also important to remember that it often takes several attempts for people to achieve long-term sobriety. Relapses are common, and should not indicate failure or inability to overcome this disease.

If you or someone close to you answers "yes" to any of the following questions, a drinking problem is possible. More than one "yes" indicates that a problem is very likely, and that help should be sought immediately.

• Have you ever felt you should cut down on your drinking?
• Have people annoyed you by criticizing your drinking?
• Have you ever felt bad or guilty about your drinking?
• Have you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover?

If I have trouble with drinking, can't I simply reduce my alcohol use without stopping altogether?

Maybe, maybe not. If you are diagnosed with alcoholism, then the answer is "no." Studies have shown that nearly all alcoholics are unsuccessful when they attempt to cut back on drinking without stopping altogether. Cutting out alcohol entirely is almost always necessary for successful recovery. However, not all alcohol-related problems involve alcoholism, and people with some problems may be able to limit the amount they drink. However, if you cannot stay within your limit every time you drink, you will most likely need to stop drinking entirely.

Is there a difference in the way that alcohol affects your body as you age?

As a person grows older, some physical functions such as vision, hearing, and reaction time-tend to decline. Also, other physical changes associated with aging can cause older people to feel the immediate effects of alcohol after consuming fairly small amounts. These factors make older people more susceptible to alcohol-related falls and automobile accidents.

Also, since older people in general take more medicines than younger ones, the possibility of dangerous side effects when medication and alcohol are combined increases with age. In addition, medical conditions that are more common to older people, such as high blood pressure and peptic ulcers, can be made worse by consuming alcohol. Even if there is no medical reason to avoid alcohol, older men and women should limit their intake to one drink per day.

Are there differences between the effects of alcohol on women and men?

Even when differences in body weight are taken into account, studies show that women are more affected by alcohol than men and women become more intoxicated after drinking the same amount of alcohol as men. This is because of the difference in the percentage of water in men's and women's bodies. Since alcohol mixes with body water, the same amount of alcohol becomes more highly concentrated in a woman's body than in a man's. That is why the recommended drinking limit is lower for women than for men.

In addition, the long-term effects of alcohol abuse have shown to take a heavier physical toll on women than on men. Alcohol dependence and related problems, like brain and liver damage, progress more rapidly in women than in men.

Is it true that alcohol is good for your heart?

It is true that many studies have shown that people who drink alcohol in moderation. That is, one or two drinks per day are less likely to develop heart disease than people who do not drink any alcohol or those who drink larger amounts. It is speculated that small amounts of alcohol may help protect against coronary heart disease by raising levels of "good" HDL cholesterol and by reducing the risk of blood clots in the coronary arteries. However, this does not mean that drinking is "good for you." If you are a non-drinker, you should not start drinking just to benefit your heart. Protection against coronary heart disease is better obtained through regular physical activity and a low-fat diet. If you are advised to abstain from drinking for any other reason, you should not drink. And even for those who can drink safely and choose to do so, it is important to remember that moderation is a key. Heavy drinking can increase the risks of many conditions, including heart failure, stroke, high blood pressure and cirrhosis of the liver.

For More Information: Please ask your attending physician on your next visit.