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1. What do we mean by alcoholism?
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:
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Craving: A strong need, or compulsion, to drink. |
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Impaired control: The inability to limit one's drinking on any given occasion. |
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Physical dependence: Withdrawal symptoms, such as nausea, sweating, shakiness, and anxiety, when alcohol use is stopped after a period of heavy drinking. |
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Tolerance: The need for increasing amounts of alcohol in order to feel its effects. |
For clinical and research purposes, formal diagnostic criteria for alcoholism also have been developed. Such criteria are included in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, published by the American Psychiatric Association, as well as in the International Classification Diseases, published by the World Health Organization.
2. Is alcoholism a disease?
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.
3. Is alcoholism inherited?
Alcoholism tends to run in families, and genetic factors partially explain
this pattern. Currently, researchers are on the way to finding the genes
that influence vulnerability to alcoholism. A person's environment, such
as the influence of friends, stress levels, and the ease of obtaining
alcohol, also may influence drinking and the development of alcoholism.
Still other factors, such as social support, may help to protect
even high-risk people from alcohol problems.
Risk, however, is not destiny. A child of an alcoholic parent will not
automatically develop alcoholism. A person with no family history of alcoholism
can become alcohol dependent.
4. Can alcoholism be cured?
Not yet. Alcoholism is a treatable disease, and medication has also
become available to help prevent relapse, but a cure has not yet been
found. This means that even if an alcoholic has been sober for a long
time and has regained health, he or she may relapse and must continue
to avoid all alcoholic beverages.
5. Are there any medications
for alcoholism?
Yes. Two different types of medications are commonly used to treat alcoholism.
The first are tranquilizers called benzodiazepines (e.g., Valium®,
Librium®), which are used only during the first few days
of treatment to help patients safely withdraw from alcohol.
A second type of medication is used to help people remain sober. A recently
approved medicine for this purpose is naltrexone (ReVia TM).
When used together with counseling, this medication lessens the craving
for alcohol in many people and helps prevent a return to heavy drinking.
Another older medication is disulfiram (Antabuse®), which
discourages drinking by causing nausea, vomiting, and other unpleasant
physical reactions when alcohol is used.
6. Does alcoholism treatment
work?
Alcoholism treatment is effective in many cases. Studies show that a
minority of alcoholics remain sober 1 year after treatment, while others
have periods of sobriety alternating with relapses. Still others are unable
to stop drinking for any length of time. Treatment outcomes for alcoholism
compare favorably with outcomes for many other chronic medical conditions.
The longer one abstains from alcohol, the more likely one is to remain
sober.
It is important to remember that many people relapse once or several
times before achieving long-term sobriety. Relapses are common and do
not mean that a person has failed or cannot eventually recover from alcoholism.
If a relapse occurs, it is important to try to stop drinking again and
to get whatever help is needed to abstain from alcohol. (See Question
12.) Ongoing support from family members and others can be important
in recovery.
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