What is alcoholism and how does it differ from alcohol abuse? When should a person seek help for a problem related to his or her drinking? For most people, alcohol is a pleasant accompaniment to social activities. Moderate alcohol use -- up to two drinks per day for men and one drink per day for women and older people (A standard drink is one 12-ounce bottle of beer or wine cooler, one 5-ounce glass of wine, or 1.5 ounces of 80-proof distilled spirits) -- is not harmful for most adults. Nonetheless, a substantial number of people have serious trouble with their drinking. Currently, nearly 14 million Americans (1 in every 13 adults) abuse alcohol or suffer from alcoholism.
Several million more adults engage in risky drinking patterns that could lead to problems with alcohol and alcoholism. In addition, approximately 53 percent of men and women in the United States report that one or more of their close relatives have a drinking problem. The consequences of alcohol misuse are serious--in many cases, life-threatening. Heavy drinking can increase the risk for certain cancers, especially those of the liver, esophagus, throat, and larynx (voice box). It can also cause liver cirrhosis, immune system problems, brain damage, and harm to the fetus during pregnancy. In addition, drinking increases the risk of death from automobile crashes, recreational accidents, and on-the-job accidents. It also increases the likelihood of homicide and suicide. In purely economic terms, alcohol-use problems cost society approximately $100 billion per year. In human terms, the costs are incalculable.
Alcoholism, which is also known as "alcohol dependence syndrome," is a problem that is characterized by the following elements:
- Craving: A strong need, or compulsion, to drink.
- Loss of control: The frequent inability to stop drinking once a person has begun.
- Physical dependence: The occurrence of withdrawal symptoms, such as nausea, sweating, shakiness, and anxiety, when alcohol use is stopped after a period of heavy drinking. These symptoms are usually relieved by drinking alcohol or by taking another sedative drug.
- Tolerance: The need for increasing amounts of alcohol in order to get "high."
Alcoholism has little to do with what kind of alcohol one drinks, how long one has been drinking, or even exactly how much alcohol one consumes. What it does have a great deal to do with is the person's uncontrollable need for alcohol. This description of alcoholism helps us understand why most alcoholics can't just "use a little willpower" to stop drinking. He or she is frequently in the grip of a powerful craving for alcohol, a need that can feel as strong as the need for food or water.
While some people are able to recover without help, the majority of alcoholic individuals need outside assistance to recover. With support and treatment, many individuals are able to stop drinking and rebuild their lives. Many people wonder: Why can some individuals use alcohol without problems, while others are utterly unable to control their drinking? Recent research supported by NIAAA has demonstrated that for many people, a vulnerability to alcoholism is inherited.
Yet it is important to recognize that aspects of a person's environment, such as peer influences and the availability of alcohol, also are significant influences. Both inherited and environmental influences are called "risk factors." But risk is not destiny. Just because alcoholism tends to run in families does not mean that a child of an alcoholic parent will automatically develop alcoholism.
What is alcohol abuse vs. alcoholism?
Alcohol abuse differs from alcoholism in that it does not include an extremely strong craving for alcohol, loss of control, or physical dependence. In addition, alcohol abuse is less likely than alcoholism to include tolerance (the need for increasing amounts of alcohol to get "high"). Alcohol abuse is defined as a pattern of drinking that is accompanied by one or more of the following situations within a 12-month period:
- Failure to fulfill major work, school, or home responsibilities
- Drinking in situations that are physically dangerous, such as while driving a car or operating machinery
- Recurring alcohol-related legal problems, such as being arrested for driving under the influence of alcohol or for physically hurting someone while drunk
- Continued drinking despite having ongoing relationship problems that are caused or worsened by the effects of alcohol
While alcohol abuse is basically different from alcoholism, it is important to note that many effects of alcohol abuse are also experienced by alcoholics.
What are the signs of alcoholism and how can you tell whether you, or someone close to you, may have a drinking problem? Answering the following four questions can help you find out. (To help remember these questions, note that the first letter of a key word in each of the four questions spells "CAGE.")
- 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 (Eye opener)?
One "yes" response suggests a possible alcohol problem. If you responded "yes" to more than one question, it is highly likely that a problem exists. In either case, it is important that you contact us for further information and guidance. We can help you determine whether you or your loved one has a drinking problem and, if so, recommend the best course of action for you. The effects of alcohol abuse can be extremely serious -- even fatal -- both to you and to others. Additionally, even if you answered "no" to all of the above questions, if you are encountering drinking-related problems with your job, relationships, health, or with the law, please contact us for information on how we can be of assistance to you.