Questions and Answers on Alcohol
Alcoholism, also known as "alcohol dependence," is a disease that includes alcohol craving and continued drinking despite repeated alcohol-related problems, such as losing a job or getting into trouble with the law. It includes four symptoms:
- Craving--A strong need, or compulsion, to drink.
- Impaired control--The inability to limit one's drinking on any given occasion.
- Physical dependence--Withdrawal symptoms, such as nausea, sweating, shakiness, and anxiety, when alcohol use is stopped after a period of heavy drinking.
- Tolerance--The need for increasing amounts of alcohol in order to feel its effects.
Yes. Alcoholism is a chronic, often progressive disease with symptoms that include a strong need to drink despite negative consequences, such as serious job or health problems. Like many other diseases, it has a generally predictable course, has recognized symptoms, and is influenced by both genetic and environmental factors that are being increasingly well defined.
No. Even if you are not alcoholic, abusing alcohol can have negative results, such failure to meet major work, school, or family responsibilities because of drinking; alcohol-related legal trouble; automobile crashes due to drinking; and a variety of alcohol-related medical problems. Under some circumstances, problems can result from even moderate drinking--for example, when driving, during pregnancy, or when taking certain medicines.
A good first step is to answer the brief questionnaire below, developed by Dr. John Ewing. (To help remember these questions, note that the first letter of a key word in each question spells "CAGE.")
Have you ever felt you should Cut down on
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 (Eye opener)?
One "yes" answer suggests a possible alcohol problem. More than one "yes" answer means it is highly likely that a problem exists. If you think that you or someone you know might have an alcohol problem, it is important to see a doctor or other health provider right away. He or she can determine whether a drinking problem exists and, if so, suggest the best course of action.
That depends. If you are diagnosed as an alcoholic, the answer is "no." Studies show that nearly all alcoholics who try to merely cut down on drinking are unable to do so indefinitely. Instead, cutting out alcohol (that is, abstaining) is nearly always necessary for successful recovery. However, if you are not alcoholic but have had alcohol-related problems, you may be able to limit the amount you drink.
This can be a challenging situation. An alcoholic cannot be forced to get help except under certain circumstances, such as when a violent incident results in police being called or following a medical emergency. This doesn't mean, however, that you have to wait for a crisis to make an impact. Based on clinical experience, many alcoholism treatment specialists recommend the following steps to help an alcoholic accept treatment:
Stop all "rescue missions." Family members often try to protect an alcoholic from the results of his or her behavior by making excuses to others about his or her drinking and by getting him or her out of alcohol-related jams. It is important to stop all such rescue attempts immediately, so that the alcoholic will fully experience the harmful effects of his or her drinking--and thereby become more motivated to stop.
Time your intervention. Plan to talk with the drinker shortly after an alcohol-related problem has occurred--for example, a serious family argument in which drinking played a part or an alcohol-related accident. Also choose a time when he or she is sober, when both of you are in a calm frame of mind, and when you can speak privately.
Be specific. Tell the family member that you are concerned about his or her drinking and want to be supportive in getting help. Back up your concern with examples of the ways in which his or her drinking has caused problems for both of you, including the most recent incident.
State the consequences. Tell the family member that until he or she gets help, you will carry out consequences--not to punish the drinker, but to protect yourself from the harmful effects of the drinking. These may range from refusing to go with the person to any alcohol-related social activities to moving out of the house. Do not make any threats you are not prepared to carry out.
Be ready to help. Gather information in advance about local treatment options. If the person is willing to seek help, call immediately for an appointment with a treatment program counselor. Offer to go with the family member on the first visit to a treatment program and/or AA meeting.
Call on a friend. If the family member still refuses to get help, ask a friend to talk with him or her, using the steps described above. A friend who is a recovering alcoholic may be particularly persuasive, but any caring, nonjudgmental friend may be able to make a difference. The intervention of more than one person, more than one time, is often necessary to persuade an alcoholic person to seek help.
Find strength in numbers. With the help of a professional therapist, some families join with other relatives and friends to confront an alcoholic as a group. While this approach may be effective, it should only be attempted under the guidance of a therapist who is experienced in this kind of group intervention.
Get support. Whether or not the alcoholic family member seeks help, you may benefit from the encouragement and support of other people in your situation. Support groups offered in most communities include Al-Anon, which holds regular meetings for spouses and other significant adults in an alcoholic's life, and Alateen, for children of alcoholics. These groups help family members understand that they are not responsible for an alcoholic's drinking and that they need to take steps to take care of themselves, regardless of whether the alcoholic family member chooses to get help.
For meeting locations, call your local Al-Anon chapter (check your local phone book under "Alcoholism") or call the following toll-free numbers: 1-800-344-2666 (United States) or 1-800-443-4525 (Canada).
No. Drinking during pregnancy can have a number of harmful effects on the newborn, ranging from mental retardation, organ abnormalities, and hyperactivity to learning and behavioral problems. Moreover, many of these disorders last into adulthood. While we don't yet know exactly how much alcohol is required to cause these problems, we do know that they are 100-percent preventable if a woman does not drink at all during pregnancy. Therefore, for women who are pregnant or are trying to become pregnant, the safest course is to abstain from alcohol.
Yes. Women become more intoxicated than men after drinking the same amount of alcohol, even when differences in body weight are taken into account. This is because women's bodies have proportionately less water than men's bodies. Because alcohol mixes with body water, a given amount of alcohol becomes more highly concentrated in a woman's body than in a man's. That is why the recommended drinking limit for women is lower than for men.
In addition, chronic alcohol abuse takes a heavier physical toll on women than on men. Alcohol dependence and related medical problems, such as brain and liver damage, progress more rapidly in women than in men.
For more information contact:
National Institute on Alcohol Abuse and Alcoholism
6000 Executive Boulevard - Willco Building
Bethesda, Maryland 20892-7003