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Substance Abuse

Alcoholism

Definition


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."

Description


Alcoholism is characterized by:

  • a prolonged period of frequent, heavy alcohol use.
  • the inability to control drinking once it has begun.
  • physical dependence manifested by withdrawal symptoms when the individual stops using alcohol.
  • tolerance, or the need to use more and more alcohol to achieve the same effects.
  • a variety of social and/or legal problems arising from alcohol use.

The risk of developing alcoholism has a definite genetic component. Studies have demonstrated that close relatives of people with alcoholism are more likely to become alcoholics themselves. This risk exists even for children adopted away from their biological families at birth and raised in a non-alcoholic adoptive family with no knowledge of their biological family's alcohol use. However, no specific gene for alcoholism has been found, and environmental factors (e.g., stress) and social factors (e.g., peer behavior) are thought to play a role in whether a person becomes alcohol dependent.

Diagnosis


The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-T)R requires three of the following traits to be present for a diagnosis of alcohol dependence:

  • tolerance, meaning that a person becomes accustomed to consuming alcohol and must increase the amount in order to obtain the desired effect
  • withdrawal, meaning that a person experiences unpleasant physical and psychological symptoms when he or she does not drink alcohol
  • the tendency to drink more alcohol than one intends; being unable to avoid drinking or stop drinking once started
  • devoting large blocks of time to acquiring and consuming alcohol
  • unsuccessful attempts to reduce or stop alcohol use
  • choosing to use alcohol at the expense of other important tasks or activities such as work or family obligations
  • drinking despite evidence of negative effects on one's physical and/or mental health

One tool for initiating the diagnosis of alcoholism is the CAGE questionnaire. It consists of four questions, with the first letters of each key word spelling out the word CAGE. Answering yes two or more of these questions suggests an alcohol problem exists and should be addressed.

  • Have you ever tried to Cut down on your drinking?
  • Have you ever been Annoyed by anyone's comments about your drinking?
  • Have you ever felt Guilty about your drinking?
  • Do you ever need an Eye-opener (a morning drink of alcohol) to start the day)?

Treatment


Treatment begins by talking with a professional who can help access your alcohol use/abuse. This professional can help direct you to recovery groups such as Alcoholics anonymous, treatment programs – inpatient, outpatient and detox services. The most important step is to have the conversation about your alcohol use. This takes courage and willingness. Contact your Employee Assistance program for further information and assistance.

Resources


Websites


  • Alcoholism  MedlinePlus. [cited January 14, 2009].
  • Alcohol Abuse and Alcoholism MedicineNet.com. February 20, 2008 [cited January 14, 2009]. Thompson, Warren and R. Gregory Lande.
  • Alcoholism eMedicine.com. August 19, 2008 [cited January 14, 2009].

Organizations


Other