Alcoholism is a chronic, often progressive disease. A person with alcoholism typically craves alcohol and drinks despite repeated alcohol-related problems, such as multiple drunk-driving violations, job loss, or relationship problems. Alcoholism involves a physical dependence on alcohol, but other factors include genetic, psychological, and cultural influences.
Alcoholism is characterized by cravings for alcohol and an inability to stop drinking. It is accompanied by a physical dependence (meaning that the person experiences withdrawal symptoms when not drinking) and an increased tolerance for alcohol (meaning the person needs to drink greater amounts to feel "good"). Before entering recovery, most alcoholics deny they have a problem. People who abuse alcohol, but are not dependent on it, may have similar symptoms, but they do not feel the same craving to drink and usually do not experience withdrawal symptoms.
About 17 million people in the United States abuse alcohol, and estimates suggest that more than 70 million Americans have faced alcoholism in their families. Alcohol abuse is one of the 4 most common causes of death in the U.S., and it is involved in almost half of all traffic deaths in the U.S.
Symptoms of alcoholism include:
If you have a family history of alcohol abuse, you are more likely to develop the condition than someone without a family history of alcohol abuse. Other factors that may increase your risk include:
If you have symptoms associated with alcoholism, you should see your doctor. Your doctor can help make a diagnosis and guide you in selecting an appropriate treatment or combination of therapies. Most alcoholics deny they have a problem, and they are often unlikely to seek treatment by themselves. If you suspect that a friend or a loved one has an alcohol problem, you and other friends and family members may need to convince them to seek help.
Your doctor will take a history and do a physical exam. Questions may include:
Blood tests generally are not helpful because they only show recent alcohol consumption. Your doctor may order liver function tests to see if alcohol has damaged your liver.
If you drink, do so only in moderation -- no more than 2 drinks per day for men, and no more than 1 drink per day for women.
Early intervention is important, especially with teenagers. To prevent teen drinking, consider the following:
The first and most important step in getting treatment for alcoholism is recognizing that you have a problem. Family members and close friends often convince persons with alcohol addiction to seek treatment.
Treatment and ongoing recovery must address both physical and psychological addiction, and may include inpatient treatment and/or Alcoholics Anonymous (AA). In an inpatient or residential program, the person generally stays in a hospital or center for 28 days, undergoing first detoxification (usually 4 to 7 days) and then individual and group therapy sessions that emphasize abstinence. Talk to a doctor about what is best for you or your loved one.
Your doctor may prescribe the following medications:
For alcohol withdrawal:
Benzodiazepines are tranquilizers used during the first few days of treatment to help you withdraw safely from alcohol. These drugs include:
Anticonvulsants may also help with withdrawal symptoms, and do not have the potential for abuse (as benzodiazepines do). They include:
To prevent relapse:
Naltrexone (Revia, Vivitrol): It is used in combination with counseling. It may lessen the craving for alcohol, and help prevent a return to drinking. Taking Revia or Vivitrol blocks receptors in your brain so that you do not get "high" from drinking. It is only used after detoxification, which means it is only used after you are no longer physically addicted to alcohol.
Acamprosate (Campral): May help restore the chemical balance in the brain. It is best used in combination with counseling.
Disulfiram (Antabuse): It is an older medication that discourages drinking by causing nausea, vomiting, and other unpleasant physical reactions when alcohol is used.
Because chronic use of alcohol decreases your appetite and keeps your body from absorbing vital nutrients, you may be deficient in a number of vitamins and minerals. Your doctor may tell you to take supplements while you are regaining your health. Beneficial supplements may include vitamin B complex, vitamin C, selenium, magnesium, and zinc. A combination of amino acids, such as carnitine, glutamine, and glutathione, may help reduce cravings, blood sugar fluctuations, and stress that is related to alcohol use.
Thiamine (vitamin B1): Your doctor may prescribe a thiamine supplement during withdrawal. Heavy use of alcohol causes thiamine deficiency, which can lead to a serious brain disorder called Wernicke-Korsakoff syndrome.
People who abuse alcohol are often deficient in vitamin A. Take supplements beyond the recommended daily allowance only under a doctor's supervision. High doses of vitamin A can damage the liver, and may cause alcoholic liver disease to develop more quickly in people who drink heavily.
Some members of the alcohol recovery community recommend a heavier, nutritionally-oriented approach. This includes intravenous (IV) nutritional therapies, along with targeted amino acid supplementation, to modulate brain function. The mainstream alcoholism treatment community considers some of these approaches controversial, so make sure you work with a reputable doctor and update every member of your recovery team on the type of therapies you are using.
The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, can trigger side effects and can interact with other herbs, supplements, or medications. For these reasons, you should take herbs with care, under the supervision of a health care provider. However, you should not use herbs alone to treat alcoholism. Counseling and peer groups such as AA are also needed.
Few studies have examined the effectiveness of specific homeopathic remedies. Professional homeopaths, however, may recommend a treatment for alcoholism based on their knowledge and clinical experience. Before prescribing a remedy, homeopaths take into account a person's constitutional type. In homeopathic terms, a person's constitution is his or her physical, emotional, and intellectual makeup. An experienced homeopath assesses all of these factors when determining the most appropriate remedy for a particular individual. Homeopathy alone should not be used to treat alcoholism, but can be a supportive therapy along with counseling and groups such as AA. The following are a few examples of remedies that an experienced homeopath might consider for symptoms related to alcohol abuse or withdrawal:
Arsenicum album: For anxiety and compulsiveness, with nausea, vomiting, and diarrhea
Nux vomica: For irritability and compulsiveness with nausea, vomiting, and constipation
Lachesis: For alcohol cravings, headaches, and difficulty swallowing
Staphysagria: For angry individuals who tend to suppress their emotions and may have been abused physically, sexually, or psychologically in the past
Cognitive behavioral therapy with a psychologist or psychiatrist is a very effective treatment approach for alcohol addiction. This type of therapy, which is geared toward changing your beliefs and thought process about drinking, can help you cope with stress and control your behavior. Talk to your doctor about finding a qualified cognitive behavioral therapist.
In some cases, acupuncture may be a useful supportive therapy for addiction. Some, but not all studies of acupuncture for the treatment of alcohol abuse have shown that it can reduce cravings and symptoms of withdrawal. However, acupuncture alone should not be used to treat alcohol addiction, but it may be used in combination with counseling and groups such as AA.
Drinking alcohol while pregnant can seriously damage the baby, causing a condition known as fetal alcohol syndrome. Fetal alcohol syndrome causes irreversible physical and mental disabilities. The only safe way to protect against damage to the baby is not to drink during pregnancy, or even if you are trying to become pregnant.
Possible complications associated with heavy alcohol use include:
In addition, long-term use of alcohol decreases life expectancy by about 15 years and puts you at significant risk for:
Relapse in alcoholism is common. Risk factors for relapse can include environment cues, any mood-altering substance, and stress. Even though alcohol abuse is a serious condition with potentially dire consequences, it is treatable. If you or someone you love has a problem, seek the help and advice of a health care professional as early as possible.
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