More About Alcohol Addiction
Courtesy of www.mayoclinic.com
Causes
Alcohol addiction — physical dependence on alcohol — occurs gradually as drinking alcohol alters the balance of some chemicals in your brain, such as gamma-aminobutyric acid (GABA), which inhibits impulsiveness, and glutamate, which excites the nervous system. Alcohol also raises the levels of dopamine in the brain, which is associated with the pleasurable aspects of drinking alcohol. Excessive, long-term drinking can deplete or increase the levels of some of these chemicals, causing your body to crave alcohol to restore good feelings or to avoid negative feelings.
Other factors can lead to excessive drinking that contributes to the addiction process. These include:
- Genetics. Certain genetic factors may cause a person to be vulnerable to alcoholism or other addictions.
- Emotional state. High levels of stress, anxiety or emotional pain can lead some people to drink alcohol to block out the turmoil. Certain stress hormones may be associated with alcoholism.
- Psychological factors. Having low-self esteem or depression may make you more likely to abuse alcohol. Having friends or a close partner who drinks regularly — but who may not abuse alcohol — could promote excessive drinking on your part. It may be difficult for you to distance yourself from these "enablers" or at least from their drinking habits.
- Social and cultural factors. The glamorous way that drinking alcohol is portrayed in advertising and in the media may send the message that it's OK to drink excessively.
Rick Factors
Steady drinking over time can produce a physical dependence on alcohol. Drinking more than 15 drinks a week for men or 12 drinks a week for women increases the risk of developing dependence on alcohol. However, drinking by itself is just one of the risk factors that contribute to alcoholism. Other risk factors include:
- Age. People who begin drinking at an early age — by age 16 or earlier — are at a higher risk of alcohol dependence or abuse.
- Genetics. Your genetic makeup may increase your risk of alcohol dependency.
- Sex. Men are more likely to become dependent on or abuse alcohol than are women.
- Family history. The risk of alcoholism is higher for people who had a parent or parents who abused alcohol.
- Emotional disorders. Being severely depressed or having anxiety places you at a greater risk of abusing alcohol. Adults with attention-deficit/hyperactivity disorder also may be more likely to become dependent on alcohol.
When to seek medical advice
Because denial is frequently a characteristic of alcoholism, it's unlikely that people who are dependent on or who abuse alcohol will seek medical treatment on their own. Often it takes family members, friends or co-workers to persuade them to undergo screening for alcoholism or to seek treatment.
If you feel that your drinking is a problem — you feel guilty about your drinking and just can't control it — talk with your doctor about treatment options. Also talk with your doctor if you find that you need a drink first thing in the morning and that you need an increasing amount of alcohol before you start feeling its effects.
Screening and Diagnosis
It's often difficult for doctors to decide which people to screen for an alcohol problem. For example, signs and symptoms such as memory loss or falling might be the result of aging rather than indications of alcohol abuse. Or people may complain to doctors about digestive problems or pain or weakness, but never reveal their abuse of alcohol.
A doctor who suspects an alcohol problem may ask a number of questions regarding drinking habits in order to get an indication of the amount of drinking. If answers to those questions indicate possible alcoholism or alcohol abuse, the doctor may do a short screening test using a standardized questionnaire.
Blood alcohol tests aren't useful in diagnosing alcoholism because the tests indicate consumption only at that particular time. They don't offer clues about long-term alcohol use. Other blood tests that measure the size of red blood cells, which increase with long-term alcohol use, and a factor known as carbohydrate-deficient transferrin may indicate heavy alcohol consumption. Sometimes other tests indicate health problems that may be alcohol related, such as tests showing liver damage or reduced testosterone levels in men.
Denial is a hallmark of alcoholism and people with alcohol dependence tend to minimize the extent of their drinking. The doctor may ask for permission to speak with family members or friends. Concerned family members may also contact the doctor on their own to discuss their concerns. However, confidentiality rules prevent the doctor from giving out any information without consent.
Complications
Alcohol depresses your central nervous system. In some people, the initial reaction may be stimulation. But as you continue to drink, you become sedated. Alcohol lowers your inhibitions and affects your thoughts, emotions and judgment. In sufficient amounts, alcohol impairs speech and muscle coordination. Too much alcohol can severely depress the vital centers of your brain. A heavy drinking binge may even cause a life-threatening coma.
Over time, excessive alcohol use can cause fatigue and short-term memory loss, as well as weakness and paralysis of your eye muscles. Other severe health effects may include:
- Liver disorders. Drinking heavily can cause alcoholic hepatitis, an inflammation of the liver. Signs and symptoms may include loss of appetite, nausea, vomiting, abdominal pain and tenderness, fever, yellowing of the skin (jaundice) and sometimes confusion. After years of drinking, hepatitis may lead to cirrhosis, the irreversible and progressive destruction and scarring of liver tissue.
- Gastrointestinal problems. Alcohol can result in inflammation of the lining of the stomach (gastritis) and interfere with absorption of the B vitamins — particularly folic acid and thiamin — and other nutrients. Heavy drinking can also damage your pancreas, which produces the hormones that regulate your metabolism and the enzymes that help digest fats, proteins and carbohydrates.
- Cardiovascular problems. Excessive drinking can lead to high blood pressure and damage your heart muscle (cardiomyopathy). These conditions can increase your risk of heart failure or stroke.
- Diabetes complications. Alcohol prevents the release of glucose from your liver and can increase the risk of low blood sugar (hypoglycemia). This is dangerous if you have diabetes and are already taking insulin to lower your blood sugar level.
- Sexual function and menstruation. Alcohol abuse can cause erectile dysfunction in men. In women, it can interrupt menstruation.
- Birth defects. Alcohol use during pregnancy may cause fetal alcohol syndrome. This condition results in birth defects, including a small head, heart defects, a shortening of the eyelids and various other abnormalities. Developmental disabilities are likely as well.
- Bone loss. Alcohol may interfere with the production of new bone. This can lead to thinning bones and an increased risk of fractures.
- Neurological complications. Excessive drinking can affect your nervous system, causing numbness of your hands and feet, disordered thinking and dementia.
- Increased risk of cancer. Chronic alcohol abuse has been linked to a higher risk of cancer of the esophagus, larynx, liver and colon.
Other complications of alcoholism and alcohol abuse may include:
- Domestic abuse and divorce
- Poor performance at work or school
- Increased likelihood of motor vehicle fatalities and arrest for drunken driving
- Greater susceptibility to accidental injuries from other causes
- Higher incidence of suicide and murder
Treatment
Most people with alcoholism or those who abuse alcohol enter treatment reluctantly because they deny that they have a problem. Health problems or legal difficulties may prompt treatment. Intervention helps some people recognize and accept the need for treatment. If you're concerned about a friend or family member, discuss intervention with a professional.
Various treatments are available to help people with alcohol problems. Depending on the circumstances, treatment may involve an evaluation, a brief intervention, an outpatient program or counseling, or a residential inpatient stay.
Determining your level of dependence
The first step in treatment is to determine whether you're alcohol dependent. If you haven't lost control over your use of alcohol, treatment may involve reducing your drinking. If you're dependent on alcohol, simply cutting back is ineffective. Abstinence must be part of your treatment goal.
If you aren't dependent on alcohol but are experiencing the adverse effects of drinking, the goal of treatment is to reduce alcohol-related problems — often through counseling or a brief intervention, which usually involves alcohol-abuse specialists who can establish a specific treatment plan. Interventions may include goal setting, behavioral modification techniques, use of self-help manuals, counseling and follow-up care at a treatment center.
Residential treatment programs
Many residential alcoholism treatment programs in the United States include abstinence, individual and group therapy, participation in alcoholism support groups, such as Alcoholics Anonymous (AA), educational lectures, family involvement, work assignments, activity therapy and the use of counselors and professional staff experienced in treating alcoholism.
Prevention
Knowing and recognizing a family history of alcoholism for you or others is an important step toward seeking treatment before alcohol use or alcohol abuse progresses to alcoholism.
Early intervention is particularly important to prevent alcohol dependence in teenagers. Alcohol use among teens increases dramatically during the high-school years, and leads to serious consequences for many teens. Each year in the United States, alcohol-related automobile accidents are a major cause of teen deaths. Alcohol also is often a cause in other teenage deaths, including drownings, suicides and homicides. Teens who drink are more likely to become sexually active, have sex more frequently and engage in risky, unprotected sex than teens who don't drink.
For young people, the likelihood of addiction depends on the influence of parents, peers and other role models, susceptibility to advertising, how early in life they begin to use alcohol, the psychological need for alcohol and genetic factors that may predispose them to addiction.
If you have a teenager, be alert to signs and symptoms that may indicate a problem with alcohol:
- Less or no interest in activities and hobbies
- Bloodshot eyes, slurred speech and memory lapses
- Difficulties or changes in relationships with friends, often characterized by 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 and spend quality time together, but respect your child's need for independence. Let your child know what behavior you expect — and what the consequences will be if he or she doesn't follow the rules. Make sure your child understands the legal and medical consequences of drinking.
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