Alcoholism: Getting the Facts

For many people, the facts about alcoholism are not clear. What is alcoholism, exactly? 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 who drink, 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-is not harmful for most adults.

Nonetheless, a large number of people get into serious trouble because of their drinking. Currently, nearly 14 million Americans - 1 in every 13 adults - abuse alcohol or are alcoholic. Several million more adults engage in risky drinking that could lead to alcohol problems. These patterns include binge drinking and heavy drinking on a regular basis. In addition, 53% 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 and 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). Heavy drinking 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 as well as recreational and on-the-job injuries. Furthermore, both homicides and suicides are more likely to be committed by persons who have been drinking.

Economic terms - Alcohol related problems cost society $185 billion/year
Human terms - Costs cannot be calculated

Alcoholism, also known as "alcohol dependence", is a disease that includes four symptoms:

• Craving: A strong need, or compulsion, to drink.
• Loss of control: The inability to limit one's drinking on any given occasion.
• Physical dependence: Withdrawal symptoms, such as nausea, sweating, shakiness, and anxiety, occur when alcohol use is stopped after a period of heavy drinking.
• Tolerance: The need to drink greater amounts of alcohol in order to "get high".

People who are not alcoholics sometimes do not understand why an alcoholic can't just "use a little willpower" to stop drinking. However, alcoholism has little to do with willpower. Alcoholics are in the grip of a powerful "craving", or uncontrollable need, for alcohol that overrides their ability to stop drinking. This need can be as strong as the need for food or water.
Alcohol abuse is defined as a pattern of drinking that results in 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;
• Having recurring alcohol-related legal problems, such as being arrested for driving under the influence of alcohol or for physically hurting someone while drunk; and
• Continued drinking despite having ongoing relationship problems that are caused or worsened by the drinking.

Alcohol abuse differs from alcoholism in that it does not include an extremely strong craving for alcohol, loss of control over drinking, or physical dependence.

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