Alcoholism

Alcoholism (alcohol dependence) and alcohol abuse are two different forms of problem drinking.

• Alcoholism is when you have signs of physical addiction to alcohol and continues to drink, despite problems with physical health, mental health, and social, family, or job responsibilities. Alcohol may control your life and relationships.

• Alcohol abuse is when your drinking leads to problems, but not physical addiction.

Causes and risk factors

There is no known cause of alcohol abuse or alcoholism. Research suggests that certain genes may increase the risk of alcoholism, but which genes and how they work are not known.

How much you drink can influence your chances of becoming dependent. Those at risk for developing alcoholism include:

• Men who have 15 or more drinks a week

• Women who have 12 or more drinks a week

• Anyone who has five or more drinks per occasion at least once a week

One drink is defined as a 12-ounce bottle of beer, a 5-ounce glass of wine, or a 1 1/2-ounce shot of liquor.

You have an increased risk for alcohol abuse and dependence if you have a parent with alcoholism.

You may also be more likely to abuse alcohol or become dependent if you:

• Are a young adult under peer pressure

• Have depression, bipolar disorder, anxiety disorders, or schizophrenia

• Have easy access to alcohol

• Have low self-esteem

• Have problems with relationships

• Live a stressful lifestyle

• Live in a culture alcohol use is more common and accepted

Alcohol abuse is rising. Around 1 out of 6 people in the United States have a drinking problem.

Symptoms

People who have alcoholism or alcohol abuse often:

• Continue to drink, even when health, work, or family are being harmed

• Drink alone

• Become violent when drinking

• Become hostile when asked about drinking

• Are not able to control drinking -- being unable to stop or reduce alcohol intake

• Make excuses to drink

• Miss work or school, or have a decrease in performance because of drinking

• Stop taking part in activities because of alcohol

• Need to use alcohol on most days to get through the day

• Neglect to eat or eat poorly

• Do not care about or ignore how they dress or whether they are clean

• Try to hide alcohol use

• Shake in the morning or after periods when they have not a drink

Symptoms of alcohol dependence include:

• Memory lapses after heavy drinking

• Needing more and more alcohol to feel "drunk"

• Alcohol withdrawal symptoms when you haven't had a drink for a while

• Alcohol-related illnesses such as alcoholic liver disease

Signs and tests

The health care provider will perform a physical exam and ask questions about your medical and family history, including use of alcohol.

The following questions are used by the National Institute on Alcohol Abuse and Alcoholism to screen for alcohol abuse or dependence:

• Do you ever drive when you have been drinking?

• Do you have to drink more than before to get drunk or feel the desired effect?

• Have you felt that you should cut down on your drinking?

• Have you ever had any blackouts after drinking?

• Have you ever missed work or lost a job because of drinking?

• Is someone in your family worried about your drinking?

Tests that may be done include:

• Blood alcohol level (this can tell whether someone has recently been drinking alcohol, but it does not necessarily confirm alcoholism)

• Complete blood count (CBC)

• Liver function tests

• Magnesium blood test