Alcoholism

Alcoholism devastates the body and mind as it wreaks havoc on personal and professional relationships. Left untreated, alcoholism is a fatal disease - but with appropriate treatment, this disease can be managed and permanent remission achieved.

Learn to spot the warning signs of alcoholism, learn the difference between alcohol abuse and alcoholism and learn more about the effective treatments that can get you, or a loved one, sober, happy and healthy once again!

An alcoholic is a person without control over their drinking. A person who drinks despite the harms it does to them and who feels a strong desire to drink alcohol.

According to the National Institute of Health, Alcoholism is a disease with four main components:

1. Alcoholics crave alcohol and these cravings can be very strong
2. Alcoholics lose control over their drinking and can never know how much they will consume in a session once they start drinking
3. Alcoholics become physically dependent on alcohol and will experience withdrawal symptoms if they try to stop drinking suddenly
4. Alcoholics build an alcohol tolerance, and need to consume ever greater amounts to get drunk¹

Alcoholism is a chronic disease that has no cure. Although alcoholics can achieve remission and sobriety, they generally cannot ever drink in moderation, even after years of abstinence. Alcoholism is considered a disease because:

1. It lasts for a lifetime
2. The course of the disease follows a predictable pattern
3. The disease has predictable symptoms

• Drinking alone, or hiding the extent of your drinking from others
• Hiding alcohol around the house
• Developing daily rituals, such as drinks before dinner, or wine with dinner
• Feeling irritated or annoyed when people question you about your drinking
• Curtailing your participation in activities that you used to enjoy to spend more time drinking
• Avoiding events or activities without alcohol
• Losing control over how much you drink
• Experiencing blackouts
• Needing ever greater amounts of alcohol to get drunk (tolerance)
• Experiencing alcohol withdrawal symptoms when you can’t get a drink¹

Alcoholism Self Test

This quiz is based on the American Psychological Association’s criteria for alcohol dependence (Alcoholism) - Answering yes to 3 or more of the following indicates alcoholism.

1. Do you have an alcohol tolerance?
2. Do you ever experience alcohol withdrawal symptoms (or take another substance to avoid withdrawal symptoms?
3. Do you often drink more or for longer than you’d planned on?
4. Do you try, or feel like you should try, to cut down on your drinking?
5. Do you spend a lot of time, using, procuring, procuring money for drinking or recovering from alcohol use?
6. Have you stopped or reduced your participation in important social, work related or recreational events due to your alcohol use?
7. Do you keep drinking even though you know that drinking does you physical or mental harm (for example, worsens the symptoms of your anxiety, or worsens the condition of your damaged liver)?²

Put most simply, if your use of alcohol is causing you problems in life and you continue to drink, then you have an alcohol abuse problem. Alcohol abusers may or may not drink daily. The quantity or frequency of alcohol use is less relevant in making a diagnosis of alcohol abuse than the consequences that occur after alcohol use.

Alcohol abusers who continue to drink alcohol run the risk of progressing to alcoholism.

Alcohol Abuse Self Test

Health workers will often use the CAGE alcohol test to screen for problems. Ask yourself the following 4 questions, and if you answer yes to 2 or more, there is a strong likelihood that you have an unhealthy relationship with alcohol.

The CAGE Test¹

• Have you ever felt you should Cut down on your drinking?
• Have people Annoyed you by criticizing your drinking?
• Have you ever felt bad or Guilty about your drinking?
• Have you Ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover?

Alcohol withdrawal symptoms can include:

• Shaking or tremors
• Anxiety
• Irritability
• Insomnia
• Nausea and vomiting
• Sweatiness
• Headache
• Depression
• Clammy skin
• A quick heart beat
• Confusion
• Hallucinations
• Seizures
• Delirium tremens
• Heart failure
• Coma
• Death

Alcohol withdrawal symptoms, in severe cases, can be fatal, but a medicated detox is a safe and relatively comfortable period. No one should attempt an alcohol withdrawal without medical supervision.

Alcohol withdrawal symptoms can last with some intensity for a week or more. Less severe secondary symptoms of withdrawal, such as insomnia, mood fluctuations and lethargy can last for months after abstinence.¹

• 37% of alcohol abusers have a mental illness
• 50% of those with severe mental illness are affected by substance abuse

When alcoholism and mental health disorders co-occur, treatment must occur concurrently and in an integrated manner for the 2 conditions.¹

• People who have a close family member that is an alcoholic (there is a genetic link to alcoholism)
• Men (men are statistically far more likely than women to become alcoholics)
• People who start drinking in their early teens
• People who need a lot of alcohol to start feeling intoxicated
• People who drink heavily/daily

I’ve Got a Good Job and Take Care of My Family – I’m Not a Drunk or a Bum

Although we often think of the homeless when we envision a ‘typical’ alcoholic, this skid-row image is far from typical. In fact, very few alcoholics end up homeless, most have jobs and families and some even excel professionally – so called high functioning alcoholics.

Although alcohol can harm a person’s work performance, career success does not prove the non-existence of alcoholism, and although you may excel at work despite your drinking habits, career success does not protect your body, mind and relationships from the eventual toll of chronic heavy drinking.

You may also argue that you only drink beer or wine - not hard liquor, so how can you be a drunk? Well, the type of alcohol you consume matters far less than the amount and frequency you imbibe, and as far as your body’s concerned, an ounce of alcohol from liquor does about the same as an ounce of alcohol from a couple of beers or a big glass of wine.

Some of the health deficits/diseases associated with chronic alcoholism include:

• Heart disease
• Gastritis
• Pancreatitis
• High blood pressure
• Liver disease (cirrhosis)
• An increased incidence rate for a host of cancers, including esophageal, stomach, liver, lung and mouth cancers
• Wernicke Korsakoff Syndrome (Wet Brain)
• Cognitive declines
• Anemia
• Sexual Deficits
• Weight gain (and diabetes)
• Infertility
• An increased risk of/worsening of mental health conditions, such as depression, anxiety, panic disorder and others
• Many more

Women, unfairly, seem more severely harmed by the chronic abuse of alcohol, being more prone to alcohol caused liver, heart, kidney and brain damage than men, as well as at an increased risk of certain alcohol related cancers.

The symptoms of "Wet Brain" include:

• Confusion
• An inability to form new memories or retrieve past memories
• Vision problems
• Ataxia (a short stepped but wide stance walk)
• others

Chronic heavy drinkers are at risk of wet brain because:

• They do not get adequate nutrition (they consume most of their energy as alcohol calories, which provides no vitamins
• They suffer gastro-intestinal inefficiencies, leaving them lass able to process vitamins
• They suffer liver damage (B1 is processed in the liver)

Wet brain is treatable with high doses of vitamins in the early stages of the disease. Later stages are incurable.

Alcoholism Treatment options available for alcoholics include:

• Residential addiction treatment
• Outpatient addiction treatment programs
• Specialty addiction treatment programs, such as Christian alcoholism treatment, Gender specific treatment, treatment for seniors, etc.
• Private counseling
• Medication (Antabuse, naltrexone, acamprosate)
• Participation in AA, and/or other peer support groups
• Residency in a sober living house (halfway house)

Alcoholism Treatment Medications

In addition to support groups, counseling and other professional addiction treatments, medication can also play a role in the recovery process. No medication for alcoholism works as a stand alone treatment, but when combined with other forms of professional treatment, medications can reduce the intensity of cravings and withdrawal symptoms and improve the chances of lasting sobriety.

The FDA has approved 3 medications for the treatment of alcoholism:

1. Disulfiram (Antabuse) – People taking disulfiram cannot drink alcohol without getting violently ill. This form of negative reinforcement helps people maintain abstinence while taking the medication.
2. Naltrexone – Works by reducing blocking dopamine receptors in the brain, thereby reducing the pleasure typically experienced while drinking. In addition to taking a lot of the fun out of drinking, naltrexone also seems to reduce alcohol cravings, although how or why it does this remains poorly understood. Naltrexone can be taken as a daily medication (Revia) or as a monthly injection (Vivitrol). It cannot be used by people who are opiate users (or abusers) or those with liver damage.
3. Acamprosate (Campral) – Acamprosate helps to reduce the long term withdrawal symptoms of alcohol.

Another drug Topirimate, which is an epilepsy medication, is currently under investigation for the treatment of alcoholism. Initial clinical trials indicate that it works well to reduce drinking by reducing the amount of dopamine released in the brain.¹