Alcoholism: Get Facts on Treatment, Symptoms and Outcome

Alcohol addiction or alcoholism is the compulsive and uncontrolled consumption of alcoholic beverages, usually to the detriment of the drinker’s health, personal relationships, and social standing. It is medically considered a disease, specifically an addictive illness.If you have alcoholism, you can’t consistently predict how much you’ll drink, how long you’ll drink, or what consequences will occur from your drinking.

Causes

Alcoholism and alcohol abuse are due to many interconnected factors, including genetics, how you were raised, your social environment, and your emotional health. Some racial groups, such as American Indians and Native Alaskans, are more at risk than others of developing alcohol addiction. People who have a family history of alcoholism or who associate closely with heavy drinkers are more likely to develop drinking problems.

Those who suffer from a mental health problem such as anxiety, depression, or bipolar disorder are also particularly at risk, because alcohol may be used to self-medicate.

The process of becoming addicted to alcohol occurs gradually, although some people have an abnormal response to alcohol from the time they start drinking. Over time, drinking too much may change the normal balance of chemicals and nerve tracks in your brain associated with the experience of pleasure, judgment and the ability to exercise control over your behavior. This may result in your craving alcohol to restore good feelings or remove negative ones.

Symptoms

Alcoholism involves all the symptoms of alcohol abuse, but also involves another element: physical dependence- tolerance and withdrawal.

Tolerance: Tolerance means that, over time, you need more alcohol to feel the same effect. Do you drink more than you used to? Do you drink more than other people without showing obvious signs of intoxication?

Withdrawal: As the effect of the alcohol wears off you may experience withdrawal symptoms: anxiety or jumpiness; shakiness or trembling; sweating, nausea and vomiting, insomnia, depression, irritability, fatigue or loss of appetite and headaches. Do you drink to steady the nerves, stop the shakes in the morning? Drinking to relieve or avoid withdrawal symptoms is a sign of alcoholism and addiction.

In severe cases, withdrawal from alcohol can be life-threatening and involve hallucinations, confusion, seizures, fever, and agitation. These symptoms can be dangerous and should be managed by a physician specifically trained and experienced in dealing with alcoholism and addiction.

Loss of Control: Drinking more than you wanted to, for longer than you intended, or despite telling yourself that you wouldn’t do it this time.
Desire to Stop- But Can’t: You have a persistent desire to cut down or stop your alcohol use, but all efforts to stop and stay stopped, have been unsuccessful.

Neglecting Other Activities: You are spending less time on activities that used to be important to you (hanging out with family and friends, exercising- going to the gym, pursuing your hobbies or other interests) because of the use of alcohol.

Alcohol Takes Up Greater Time, Energy and Focus: You spend a lot of time drinking, thinking about it, or recovering from its effects. You have few, if any, interests, social or community involvements that don’t revolve around the use of alcohol.

Continued Use Despite Negative Consequences: You drink even though they know it’s causing problems. As an example, you realize that your alcohol use is interfering with your ability to do your job, is damaging your marriage, making your problems worse, or causing health problems, but you continue to drink.

Risk Factors

Risk factors for alcoholism include:

• Steady drinking over time. Drinking too much on a regular basis for an extended period or binge drinking on a regular basis can produce a physical dependence on alcohol.
• Age. People who begin drinking at an early age are at a higher risk of problem drinking or physical dependence on alcohol.
• Family history. The risk of alcoholism is higher for people who have a parent or other close relatives who have problems with alcohol.
• Depression and other mental health problems. It’s common for people with a mental health disorder such as anxiety, depression or bipolar disorder to have problems with alcohol or other substances.
• Social and cultural factors. Having friends or a close partner who drinks regularly could increase your risk of alcoholism. The glamorous way that drinking is sometimes portrayed in the media also may send the message that it’s OK to drink too much.
• Mixing medication and alcohol. Some medications interact with alcohol, increasing its toxic effects. Drinking while taking these medications can either increase or decrease their effectiveness, or even make them dangerous.

Treatment

Treatments are varied because there are multiple perspectives of alcoholism. Those who approach alcoholism as a medical condition or disease recommend differing treatments from, for instance, those who approach the condition as one of social choice. Most treatments focus on helping people discontinue their alcohol intake, followed up with life training and/or social support to help them resist a return to alcohol use. Since alcoholism involves multiple factors which encourage a person to continue drinking, they must all be addressed to successfully prevent a relapse. An example of this kind of treatment is detoxification followed by a combination of supportive therapy, attendance at self-help groups, and ongoing development of coping mechanisms. The treatment community for alcoholism typically supports an abstinence-based zero tolerance approach; however, some prefer a harm-reduction approach.

Treatment for alcoholism may include:

• Detoxification and withdrawal. Treatment for alcoholism may begin with a program of detoxification, which generally takes two to seven days. You may need to take sedating medications to prevent shaking, confusion or hallucinations (delirium tremens), or other withdrawal symptoms. Detoxification is usually done at an inpatient treatment center or a hospital.
• Learning skills and establishing a treatment plan. This usually involves alcohol treatment specialists. It may include goal setting, behavior change techniques, use of self-help manuals, counseling and follow-up care at a treatment center.
• Psychological counseling. Counseling and therapy for groups and individuals help you better understand your problem with alcohol and support recovery from the psychological aspects of alcoholism. You may benefit from couples or family therapy — family support can be an important part of the recovery process.
• Oral medications. A drug called disulfiram (Antabuse) may help to prevent you from drinking, although it won’t cure alcoholism or remove the compulsion to drink. If you drink alcohol, the drug produces a physical reaction that may include flushing, nausea, vomiting and headaches. Naltrexone (Revia), a drug that blocks the good feelings alcohol causes, may prevent heavy drinking and reduce the urge to drink.
• Acamprosate (Campral) may help you combat alcohol cravings. Unlike disulfiram, naltrexone and acamprosate don’t make you feel sick after taking a drink.
• Injected medication. Vivitrol, a version of the drug naltrexone, is injected once a month by a health care professional. Although similar medication can be taken in pill form, the injectable version of the drug may be easier for people recovering from alcohol dependence to use consistently.
• Continuing support. Aftercare programs and support groups help people recovering from problem drinking or alcoholism to stop drinking, manage relapses and cope with necessary lifestyle changes. This may include medical or psychological care or attending a support group such as Alcoholics Anonymous.
• Treatment for psychological problems. Alcoholism commonly occurs along with other mental health disorders. You may need talk therapy (psychotherapy or psychological counseling), medications, or other treatment for depression, anxiety or another mental health condition, if you have any of these conditions.
• Medical treatment for other conditions. Common medical problems related to alcoholism include high blood pressure, high blood sugar, liver disease and heart disease. Many alcohol-related health problems improve significantly once you stop drinking.
• Spiritual practice. People who are involved with some type of regular spiritual practice may find it easier to maintain recovery from alcoholism or other addictions. For many people, gaining greater insight into their spiritual side is a key element in recovery.

Residential treatment programs
For a serious alcohol problem, you may need a stay at a residential treatment facility. Many residential treatment programs include individual and group therapy, participation in alcoholism support groups such as Alcoholics Anonymous, educational lectures, family involvement, activity therapy, and working with counselors, professional staff and doctors experienced in treating alcoholism.

Alternative Treatment
Several alternative medicine techniques may be helpful in addition to your treatment plan when recovering from alcoholism. Examples include:

• Yoga. Yoga’s series of postures and controlled breathing exercises may help you relax and manage stress.
• Meditation. During meditation, you focus your attention and eliminate the stream of jumbled thoughts that may be crowding your mind and causing stress.
• Acupuncture. With acupuncture, hair-thin needles are inserted under the skin. Acupuncture may help reduce anxiety and depression.

Self-Management
Coping with problem drinking or alcoholism requires that you change your habits and make different lifestyle choices.

• Consider your social situation. Make it clear to your friends and family that you are not drinking. You may need to distance yourself from friends and social situations that impair your recovery.
• Develop healthy habits. For example, good sleep, regular physical activity and eating well all can make it easier for you to recover from alcoholism.
• Do things that don’t involve alcohol. You may find that many of your activities involve drinking. Replace them with hobbies or pastimes that are not centered around alcohol.

Prevention
Early intervention can prevent alcoholism in teens. For young people, the likelihood of addiction depends on the influence of parents, peers and other role models; how much they’re influenced by advertising of alcohol; how early in life they begin to use alcohol; the psychological need for alcohol; and genetic factors that may increase their risk of addiction.

If you have a teenager, be alert to signs and symptoms that may indicate a problem with alcohol:

• Loss of interest in activities and hobbies and in personal appearance
• Bloodshot eyes, slurred speech, problems with coordination and memory lapses
• Difficulties or changes in relationships with friends, such as joining a new crowd
• Declining grades and problems in school
• Frequent mood changes and defensive behavior

You can help prevent teenage alcohol use. Start by setting a good example with your own alcohol use. Talk openly with your child, spend quality time together, and become actively involved in your child’s life. Let your child know what behavior you expect — and what the consequences will be if he or she doesn’t follow the rules.

Prognosis
How well a person does depends on whether they can successfully cut back or stop drinking.

It may take several tries to stop drinking for good. If you are struggling to quit, do not give up hope. Getting treatment, if needed, along with support and encouragement from support groups and those around you can help you remain sober.