Alcohol Dependence

Alcohol use disorder is the repeat and chronic abuse of alcohol. Alcohol use may be dangerous or self-destructive to yourself or those around you. Alcohol dependence (also called alcoholism) is alcohol use disorder in which patients also experience tolerance and withdrawal related to alcohol use.

People of all ages, life stages, and socioeconomic strata can be affected by alcoholism. A combination of genetic, environmental, and psychological factors likely contributes to and increases the risk of alcoholism.

You are more likely to experience an alcohol use disorder if you:

• Routinely consume several drinks at a time
• Have a parent with an alcohol use disorder
• Experience peer pressure to drink alcohol
• Have depression, bipolar disorder, anxiety disorders, or schizophrenia
• Have easy access to alcohol
• Have low self-esteem
• Have relationship problems
• Have many life stresses

Alcoholism can be treated, but there is no cure. It is a long-term disease that people must learn to manage. Most treatment plans for alcoholism involve behavioral changes, cognitive therapy, and rehabilitation programs. Most people who have a history of alcoholism need to stop using alcohol completely.

The hallmark symptom of alcoholism is the inability to stop or limit the use of alcohol.

You may also experience the following symptoms:

• You drink more or longer than you planned to
• You have wanted to, or tried to, cut down or stop drinking, but could not
• You spend a lot of time and effort to get alcohol, use it, or recover from its effects
• You crave alcohol or have a strong urge to use it
• Alcohol use is causing you to miss work or school, or you do not perform as well because of drinking
• You continue to drink, even when relationships with family and friends are being harmed
• You stop taking part in activities that you used to enjoy
• While or after drinking, you get into situations that can cause you to get hurt, such as driving, using machinery, or having unsafe sex
• You keep drinking, even though you know it is making a health problem caused by alcohol worse
• You need more and more alcohol to feel its effects or to get drunk (also known as tolerance)
• You get withdrawal symptoms when the effects of alcohol wear off, such as anxiety or jumpiness; shakiness or trembling; sweating, nausea and vomiting, insomnia, depression, irritability, fatigue or loss of appetite and headaches

See your doctor or health care provider if you think you have an alcohol use disorder or alcoholism.

There are no specific causes of alcohol use disorder or alcohol dependence. A combination of genetic, environmental, and psychological factors likely contributes to and increases the risk of alcoholism. There is no way to accurately predict who will become dependent on the use of alcohol.

Alcohol dependence is diagnosed on the basis of your symptoms, behaviors, medical history, and alcohol use. There are no specific tests to diagnose alcoholism.

Living with alcoholism is difficult and can be debilitating. Daily activities and relationships are negatively affected. However, help is available for the person suffering from alcoholism and the families. Many support services and organizations, such as Alcoholics Anonymous and Al-Anon, can help people live with and manage alcoholism. Living with and overcoming alocoholism is easier with encouragement, comfort, and guidance.

Alcoholism is treatable, though there is no cure. It is a life-long disease that requires consistent management to prevent relapses to unhealthy behaviors or new addictions. Most people seek treatment for alcoholism because a court ordered them to do so or family members encouraged them to obtain help. Fortunately, people can benefit from treatment programs regardless of the initial motivation for seeking treatment.

The first phase of treatment is withdrawal from alcohol. You will likely experience physical and/or psychological effects of withdrawal, including nausea, vomiting, chills, sweating, muscle cramps and aches, sleeplessness, changes in heart rate, fever, anxiety, depression, irritability, and mood swings. Medications can be used to treat alcohol dependence, including naltrexone (Revia, Vivtrol), acamprosate (Campral), and disulfiram (Antabuse).

Behavioral therapy and counseling helps identify, avoid, and cope with situations that make you want to use alcohol. Family therapy teaches the family of the person suffering from alcoholism to provide a safe and supportive environment.

Rehabilitation programs help people who are overcoming alcoholism to regain life skills.

No single treatment approach is appropriate for every person or every addiction. Treatment for alcohol dependence should be individualized and continually assessed to ensure that it meets the changing needs of the person with alcoholism.