The Workings of Alcoholism and Alcohol Treatment


The Workings of Alcoholism and Alcohol Treatment

“I haven’t had a drink in two months…I used to tell myself, one drink was ok, now I know that won’t work. I guess I am, um, an alcoholic.”

It’s an amazing thing when an inpidual is able to acknowledge and own up to a negative behavior. With alcohol and drug abuse it is usually a difficult thing to do perhaps with alcohol even more so than other recreational drugs because it is considered in many cultures to be socially acceptable.


After all real men have to be able to drink right? After work happy hour is a normal part of office culture, two for one deal exist everywhere.


Alcohol is perhaps one of the easiest liquid amnesia an inpidual can get. What’s liquid amnesia? Easy, it helps you to forget. If you cannot remember what is wrong in your life, there’s less chance of being upset goal accomplished. That is until you either do something while intoxicated that wrecks everything or stop drinking. Then the hard part starts a reality without alcohol use.


The Components of Alcoholism

So, what defines an alcoholic? That can be summarized with the following four symptoms:

  1. Craving: a strong desire or craving to drink.
  2. Tolerance: needing more alcohol to sustain a buzz or high.
  3. Physical Dependence: this includes symptoms such as:
  4. Loss of Control: not being able to control the amount of alcohol one drinks.


The reason one can refer to alcoholism as something having a symptom is because it is considered a disease. Why? Because a true alcoholic continues to drink regardless of what conspires. This means aside from dying the following problems can occur:

  • Health problems
  • Family problems
  • Legal problems


It does not matter these problems will not keep a drinker from his drink.


Why Would Anyone Start Drinking?

There is a risk for alcoholism associated with family history. This is not to say that having an alcoholic uncle in the family automatically predisposes one to drinking however; it does mean that one’s risk is increased. In addition work and family conflicts, lack of social support groups, monetary situations and improper coping mechanisms with life issues can all contribute to use of alcohol.


How Can Alcoholism be treated?

As with any substance abuse problem one needs the help of professionals in the form of counseling for possible controlled alcohol detox. There are medications that can help one to detox from alcohol. The reason medications are necessary for alcohol detox is that it can cause one to go into respiratory depression.


Three oral medications can be used during alcohol detoxification. They are as follows:

  1. Disulfiram: makes one sick after drinking which can help one not drink again.
  2. Naltrexone: used to help lower the chance of alcohol relapse by reducing cravings.
  3. Acamprosate: are currently approved to treat alcohol dependence.


Other withdrawal symptoms can occur such as:

  • Shakiness
  • Nausea
  • Sweating


So other medications should be considered in addition to constant supervision during the detox process.


How Can You Tell if Someone Has a Problem?

The best way to figure that out if an inpidual has a drinking problem is by asking questions such as:

  1. Do you have to drink first thing in the morning to feel stabilized?
  2. Do you feel as though you should cut down your drinking?
  3. Does your drinking make you feel bad or guilty?
  4. Have people annoyed you by criticizing your drinking?


As with 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 care provider right away. They can help you determine if a drinking problem exists and help you plan the best course of action.


Who is affected by Drinking?

Any population can be affected by alcohol use. However, when drinking in excess the people affected go beyond just the drinker. An alcoholic’s behavior affects friends, family and strangers as well.


Can one have alcohol during pregnancy?

The answer to that question would be no. It has been shown that heavy drinking most definitely affects mothers and their babies. As to whether moderate or light consumption of alcohol is dangerous, there is currently no research stating that it is safe to drink even a small amount, so it is best that pregnant women refrain. Otherwise, one is at risk for causing FAS (Fetal Alcohol Syndrome) which can result in the following problems:

  • Learning problems
  • Physical problems
  • Behavioral problems
 

Who is More Affected by Alcohol?

Alcohol affects people of varying age groups and genders differently because of the way the body metabolizes the alcohol. Women and older inpiduals tend to metabolize alcohol slower and therefore at risk for impairment more quickly than other groups. The elderly population often uses medications which when combined with alcohol can cause impairment. These things put people at risk for falls, car accidents, and other issues that are related to impaired reaction.


How serious is Alcoholism?

Alcoholism is serious enough to kill you. As mentioned prior, just detoxification from alcohol can cause death. Constant utilization of alcohol without cessation will eventually damage the liver which can cause a decrease in clotting factors which can lead to excessive bleeding. The side effects and possible illness of alcohol use could result in an article all of its own, but suffice to say if one has this issue or knows someone that does, immediate attention is required.



Rachel Hayon, MPH, RN



References
Spontaneous Recovery in Alcoholics: A Review and Analysis of the Available Research, by R. G. Smart Drug and Alcohol Dependence, Vol. 1, 1975-1976, p. 284.
Based on information from Dr. Mark Willenbring of the National Institue on Alcohol Abuse and Alcoholism, the February 2007 issue of Newsweek - Adler, Jerry; Underwood, Anne; Kelley, Raina; Springen, Karen; Breslau, Karen. "Rehab Reality Check" Newsweek, 2/19/2007, Vol. 149 Issue 8, p44-46, 3p, 4c
Dawson DA, Goldstein RB, Grant BF. 2007. Rates and correlates of relapse among inpiduals in remission from DSM-IV alcohol dependence: a 3-year follow-up. Alcohol Clin Exp Res. 2007 Dec;31(12):2036-45.
Krampe, H., Stawicki, S., Wagner, T., Bartels, C., Aust, C., Ru¨ ther, E., Poser, W., and Ehrenreich, H. 2006. Follow-up of 180 Alcoholic Patients for up to 7 Years After Outpatient Treatment: Impact of Alcohol Deterrents on Outcome. Alcohol Clin Exp Res,30(1):86-95.
Johnson, Bankole A., et al. Oral topiramate for treatment of alcohol dependence: a randomised controlled trial. The Lancet, 2003, 361(9370), 1677-1685: Swift, B. Topiramate for the treatment of alcohol dependence: initiating abstinence. The Lancet, 2003, 361(9370), 1666-1667
Johnson, Bankole A., et al. Topiramate for Treating Alcohol Dependence - A Randomized Controlled Trial. Journal of the American Medical Association, 2007 (October), 298(14), 1641-1651
CDC. (2004). Fetal Alcohol Syndrome: Guidelines for Referral and Diagnosis. Can be downloaded at http://www.cdc.gov/fas/faspub.htm.

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