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Alcoholism

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"Alcoholic" redirects here. For alcoholic beverages, see Alcoholic drink. For alcohol consumption by people in general, see Alcohol (drug). For the chemical compound in general, see Alcohol (chemistry).
Alcoholism (Alcohol use disorder)
Classification and external resources
Gin Lane: anti-alcohol visual propaganda by William Hogarth, 1751
ICD-10F10..2
ICD-9303
OMIM103780
MedlinePlus000944
eMedicinearticle/285913
MeSHD000437

Alcoholism is the addiction to alcohol. People who have alcoholism are called alcoholics.

Alcoholism is a disease.[1][2][3] It often gets worse over time and can kill a person. However, alcoholism can be treated.[3]

Alcohol is the most commonly used drug in the world.[4] Around the world, there are at least 208 million people with alcoholism.[5][6]

Alcoholism is a condition with a social stigma. Because of this, alcoholics often feel ashamed of their drinking. They may try to hide their drinking, avoid getting help, or refuse to believe that they are alcoholics because they are too ashamed.

Diagnosis

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Alcoholism is a prison

Being an alcoholic does not mean that a person just drinks a lot of alcohol. It means that they cannot control how much alcohol they drink. No matter how badly they want to, once they take one drink, they cannot stop drinking.[7]

To be diagnosed with alcoholism, a person has to have three of these symptoms in the past year:[7]

  1. They feel like they have to drink alcohol.
  2. They cannot control when they start drinking, when they stop drinking, or how much they drink.
  3. They get alcohol withdrawal symptoms when they stop drinking.
  4. They have to drink more and more alcohol to feel drunk (this is called tolerance).
  5. They spend less time doing things they used to enjoy because they are spending so much time drinking. They spend a lot of time getting alcohol, drinking alcohol, or feeling sick from drinking too much.
  6. They keep drinking even though they know it is causing serious problems in their life.
  7. Drinking or being sick from drinking interfered with work, family responsibilities, school, or social engagements.
  8. They continue to drink despite changes to mood, such as depression or anxiety or drinking too much much began to affect other aspects of their mental or physical health. Alternately, the person suffered more than one memory blackout.[8]
  9. They drank even though doing so increased the chances of getting hurt, such as drinking before driving.

There is no medical test, like a blood test, that can say whether a person is an alcoholic. There are some questionnaires (lists of questions) that can help tell whether a person may be an alcoholic. These questionnaires include the CAGE questionnaire (for adults) and the CRAFFT Screening Test (for teenagers).

Side effects

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Problems in the body

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What Alcohol Does to Your Body

Alcoholism can cause many health problems. For example, it can cause:[9][10]

If a person drinks too much at one time, they can get alcohol poisoning. This can cause breathing problems, coma, and even death.

Possible long term side effects in humans

In 2012, alcohol use caused 3.3 million deaths around the world. This means that in 2012, about 3 out of every 50 deaths in the world were caused by alcohol use.[11]

Problems in life

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Alcoholism can also cause many problems in alcoholics' lives. These include:[12]

Alcohol withdrawal

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Main articles: Alcohol withdrawal and Delirium tremens

If an alcoholic stops drinking suddenly, they can get alcohol withdrawal.

The most serious form of alcohol withdrawal is delirium tremens (often called "DTs"). Delirium tremens is a medical emergency. Many people who get the DTs die from them.[13][14]

This does not mean that alcoholics should not stop drinking. It means that alcoholics should talk to a doctor or go to a hospital before they stop drinking. Doctors can give medications to make sure that a person is safe while they stop drinking.[14]

Epidemiology

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Map showing average amounts of alcohol drunk per year. People in yellow countries drink the most alcohol. People in green countries drink medium amounts of alcohol. People in blue countries drink very little alcohol.[15]
Map showing how many years of healthy life every 100,000 people lost because of alcoholism in 2004
* Yellows: Under 50 to 410 * Oranges: 410 to 770 * Reds: 770 to 1250 * Dark red: Over 1250

In 2010, the World Health Organization (WHO) estimated that there were 208 million people with alcoholism around the world. (This is 4.1% of the world's population over age 15.)[5][6] In 2001, the WHO estimated that there were about 140 million alcoholics around the world.[16][17] This means that in the nine years between 2001 and 2010, about 68 million people became alcoholics.

Around the world

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People in developed countries drink the most alcohol.[15]p.4

Alcoholism is more common in some areas than others. Here is a list of all the areas in the world. It is in order from the areas where alcoholism is most common to the areas where it is least common:[15]p.21

  1. The European area
  2. The Americas
  3. The Western Pacific area (including China, Japan, Korea, Vietnam, Australia, New Zealand, and many islands in the Pacific Ocean)
  4. The Southeast Asian area
  5. Africa
  6. The Eastern Mediterranean area (including the Middle East and northeast Africa)

There are many reasons why alcoholism is more common in some areas than others. Some of these reasons include religion, culture, laws, and people's attitudes about drinking. For example, on average, people in Northern Africa, the Middle East, and islands in the Indian Ocean drink less than people anywhere else in the world.[15]p.4 These are areas where many people are Muslims. Many Muslims in these areas do not drink any alcohol, because the Koran says not to.[15]p.4 In some of these countries, drinking alcohol is illegal.

However, in other areas, like Western Europe, alcohol is a part of daily life.[18] It is legal and easy to get. People very commonly drink alcohol with meals. Very few people drink no alcohol.[18] People's attitudes about alcohol are very different than attitudes in mostly Muslim countries. This is an example of how differences in religion, culture, laws, and attitudes about drinking can affect the amount of alcohol use and alcoholism in different areas.

Men and women

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Alcoholism is more common in men than in women. However, in the past few decades, the number of female alcoholics has increased.[19]

Female alcoholics are most common in the Americas and Europe. In the United States and Western Europe, five to ten percent of women will become alcoholics at some point in their lives.[20]

In the Southeast Asian and Western Pacific areas, less than 1% of women are alcoholics. In Africa and the Eastern Mediterranean area, almost no women are alcoholics.[15]p.21

Young people

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In many countries, young people are using more and more alcohol. In a 2008 WHO survey, underage drinking had increased in 71% of countries. Drinking by young adults (ages 18-25) had increased in 80% of countries.[15]p.10

Controls

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Lots of things have been tried to get people to drink less alcohol. In 1920 selling alcohol was made illegal in the United States. Less alcohol was drunk but there was more crime. Minimum unit pricing has been tried more recently. The cost of these cheapest alcohol goes up. Fewer people end up in hospital.[21]

Treatment options

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Alcoholism can be treated. There are many forms of treatment for alcoholism.

Detoxification

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Before stopping alcohol suddenly, a person should see a doctor to come up with a safe plan

Detoxification (detox) is often the first step in treating alcoholism.[22] "Detoxification" means "getting toxins out of the body." Alcohol detoxification means that an alcoholic stops drinking, so that alcohol (a toxin) can get out of their body. An alcoholic also needs to give the body time to recover from not having alcohol any more.

It is not safe for an alcoholic to suddenly stop drinking on their own.[14] The safest way to stop drinking is to go to a hospital that specializes in alcohol detoxification. These hospitals are often called "detoxes" or "rehabs[23]." These places can make sure that an alcoholic has a safe detox. They can also give medications to make a detoxing alcoholic more comfortable, and to prevent symptoms of alcohol withdrawal. The most common medications that doctors give during alcohol detox are benzodiazepines.[24]p.35

Once a person stops drinking alcohol, they are called sober. Most people need other treatments to help them stay sober.[25] [24]

Detox can be an intense process, and some people experience very strong emotions during it. This is complicated by the fact that, in the past, they may have used drugs or alcohol to help them handle strong emotions. In detox, the therapist helps them manage their emotions.[26]

Therapy

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Psychotherapy and group therapy can help alcoholics stay sober. For example, they can help alcoholics learn how to:[24]

  • Deal with stress without using alcohol
  • Figure out what makes them want to drink, and learn how to deal with those things without drinking
  • Plan what they will do if they are around people who are drinking
  • Come up with reasons for why they want to stay sober, and use those things as motivation to stay sober (this is called Motivational Interviewing)
  • Change their thoughts about drinking and how they react to those thoughts (this is called Cognitive-behavioral therapy)

Medications

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Some medications can help alcoholics stay sober. These medications include:[24]pp.130-144

  • Antabuse: This medication makes a person very sick if they drink any alcohol. It can make an alcoholic not want to drink any more, because they do not want to get sick.
  • Naltrexone: This medication causes changes in the brain. These changes make alcoholics not want to drink alcohol as much as they normally do. Also, if an alcoholic does drink alcohol, the naltrexone will block the alcohol from making them feel good, and they are more likely to stop drinking.

Vitamins

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Many alcoholics do not have enough vitamins in their body. This can cause serious problems. For example, if an alcoholic does not have enough thiamine, they can get brain damage. Often, alcoholics are treated with thiamine to prevent brain damage. They may also be given other vitamins if needed.[24]p.144

Groups for alcoholics

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Alcoholics Anonymous (AA) is the biggest support and mutual aid group for alcoholics in the world.[27] This means that in AA groups, alcoholics come together to support each other and help each other recover. AA uses a twelve-step program. This program is meant to help alcoholics fix the problems their alcoholism has caused.[28]

There are also other groups for alcoholics, like:[29]

  • SMART Recovery
  • Secular Organizations for Sobriety (SOS)
  • Women for Sobriety
  • LifeRing Secular Recovery
  • Celebrate Recovery (based on Christianity and the Bible)
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References

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  1. ↑ "ICD-10 Classification of Mental and Behavioral Disorders". WHO Programmes: Management of Substance Abuse. World Health Organization. Retrieved February 20, 2016.
  2. ↑ Morse RM, Flavin DK (1992). "The Definition of Alcoholism". Journal of the American Medical Association. 268 (8). The American Medical Association: 1012–1014. doi:10.1001/jama.1992.03490080086030.
  3. ↑ 3.0 3.1 Mersy DJ (2003). "Recognition of Alcohol and Substance Abuse". American Family Physician. 67 (7). American Association of Family Physicians: 1529–1532. PMID 12722853. Retrieved February 20, 2016.
  4. ↑ Winstock, Adam (June 7, 2015). "The Global Drug Survey 2014 Findings: Reflections on the results of the world's biggest ever drug survey by Dr. Adam Winstock". Global Drug Survey. Retrieved January 21, 2016.
  5. ↑ 5.0 5.1 World Health Organisation (2010). "Alcohol".
  6. ↑ 6.0 6.1 "Global Population Estimates by Age, 1950–2050". Retrieved 10 May 2015.
  7. ↑ 7.0 7.1 "The ICD-10 Classification of Mental and Behavioral Disorders: Clinical Descriptions and Diagnostic Guidelines" (PDF). World Health Organization Programmes: Management of Substance Abuse. World Health Organization. Retrieved February 21, 2016.
  8. ↑ "How to Stop Drinking Alcohol - Learn to Quit Alcohol & Get Help". Alcohol.org. Retrieved 2020-11-11.
  9. ↑ "Beyond Hangovers: Understanding Alcohol's Impact On Your Health" (PDF). National Institute on Alcohol Abuse and Alcoholism. United States National Institutes of Health, Department of Health and Human Services. Archived from the original (PDF) on April 6, 2016. Retrieved February 20, 2016.
  10. ↑ Caan, Woody; Belleroche, Jackie de, eds. (April 11, 2002). Drink, Drugs and Dependence: From Science to Clinical Practice (1st ed.). Routledge. pp. 19–20. ISBN 978-0-415-27891-1.
  11. ↑ "Alcohol". World Health Organization Programmes: Management of Substance Abuse. World Health Organization. 2016. Retrieved February 21, 2016.
  12. ↑ World Health Organization (2004). "Part I: Consequences of Alcohol Use: Social Problems Associated with Alcohol Use." In Global Status Report on Alcohol 2004 (PDF) (Report). World Health Organization. pp. 59–64. Retrieved January 20, 2016.
  13. ↑ Michael James Burns, MD, FACEP, FACP (April 14, 2015). "Delirium Tremens (DTs)". medscape.com. Medscape. Retrieved December 27, 2015.
  14. ↑ 14.0 14.1 14.2 National Institute for Health and Care Excellence (2010). Alcohol Use Disorders: Diagnosis and Clinical Management of Alcohol-Related Physical Complications - NICE Clinical Guidelines, No. 100 (Report). Royal College of Physicians. Retrieved December 27, 2015.
  15. ↑ 15.0 15.1 15.2 15.3 15.4 15.5 15.6 World Health Organization (2011). Global Status Report on Alcohol and Health (PDF). WHO Press. ISBN 978-92-4-156415-1.
  16. ↑ Dr Gro Harlem Brundtland (19 February 2001). "WHO European Ministerial Conference on Young People and Alcohol". World Health Organisation.
  17. ↑ Riley, Leanne (31 January 2003). "WHO to meet beverage company representatives to discuss health-related alcohol issues". World Health Organisation.
  18. ↑ 18.0 18.1 Bloomfield, Kim; Stockwell, Tim; Gmel, Gerhard; Rehn, Nina (December 2003). "International Comparisons of Alcohol Consumption". Alcohol Research & Health : The Journal of the National Institute on Alcohol Abuse and Alcoholism. 27 (1). United States National Institute of Health: 95–109. PMC 6676703. PMID 15301404. Archived from the original on May 7, 2016. Retrieved February 21, 2016.
  19. ↑ Walter H, Gutierrez K, Ramskogler K, Hertling I, Dvorak A, Lesch OM (November 2003). "Gender-specific differences in alcoholism: implications for treatment". Archives of Women's Mental Health. 6 (4): 253–8. doi:10.1007/s00737-003-0014-8. PMID 14628177. S2CID 6972064.
  20. ↑ Keller, Mark (February 8, 2016). "alcoholism". Encyclopædia Britannica. Retrieved January 21, 2016.
  21. ↑ Maharaj, Tobias; Angus, Colin; Fitzgerald, Niamh; Allen, Kathryn; Stewart, Stephen; MacHale, Siobhan; Ryan, John D. (2023-02-01). "Impact of minimum unit pricing on alcohol-related hospital outcomes: systematic review". BMJ Open. 13 (2): e065220. doi:10.1136/bmjopen-2022-065220. ISSN 2044-6055. PMC 9950069. PMID 36737089.
  22. ↑ "Treatment Strategies for Alcohol Abuse". Spiritual River. 21 May 2015. Archived from the original on 27 January 2016. Retrieved 31 August 2016.
  23. ↑ "Long Term Drug Rehab Facilities and How to Find One". Drug Rehab Options. Retrieved 2020-11-11.
  24. ↑ 24.0 24.1 24.2 24.3 24.4 Raistrick, Duncan; Heather, Nick; Godfrey, Christine. Review of the Effectiveness of Treatment for Alcohol Problems (PDF) (Report). National Health System of the United Kingdom. Archived from the original (PDF) on December 3, 2011. Retrieved February 21, 2016.
  25. ↑ "What to do if You Have Blown Your Sobriety Efforts". Spiritual River. 29 June 2015. Archived from the original on 16 October 2016. Retrieved 31 August 2016.
  26. ↑ American Addiction Centers Editorial StaffLast updated on June 23, 2020 (2014-01-10). "3-Day, 5-Day, and 7-Day Detox Programs and What They Offer". DrugAbuse.com. Retrieved 2020-11-11.
  27. ↑ Pagano ME, Friend KB, et al. (2004). "Helping Other Alcoholics in Alcoholics Anonymous and Drinking Outcomes: Findings from Project MATCH". Journal of Studies on Alcohol and Drugs. 65 (6): 766–773. doi:10.15288/jsa.2004.65.766. ISSN 0096-882X. PMC 3008319. PMID 15700515.
  28. ↑ Wilson, Bill (June 2001). Alcoholics Anonymous (4th ed.). Alcoholics Anonymous World Services. ISBN 1-893007-16-2. OCLC 32014950. Retrieved February 21, 2016.
  29. ↑ Horvath, Tom (July 20, 2012). "If Not AA, Then What? SMART Recovery and the AA Alternatives". Huffington Post Online. TheHuffingtonPost.com Inc. Retrieved February 21, 2016.

Other websites

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Help for alcoholism

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Groups for alcoholics and their families

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