What is Alcohol Abuse?
I grew up in a home, where nobody drank alcohol. Quakers, all of us, for generations, we played Scrabble and not much else as the rules were strict all the way around. My dad died a few years back in his mid 80’s, never having tasted alcohol. So I still find it curious in ways, that after all that priming of the no-drinking pump, I suddenly had a taste for the drink, from that first drink at the age of 15 or so. Over time it was more or less troubling to my friends and family – the way I drank – but a couple things were for sure: I didn’t drink like most folks, and when I drank the outcome was unpredictable.
What’s too much? Why is two drinks for one person, worse than three for another person? How does alcohol fit into our living landscape socially, and in our private lives? Good questions, both – and there are some more to answer how having a drink at the end of the day works for so many Americans who choose to unwind and relax while it disrupts life of others.
It is important to understand how much is too much and when you have crossed the line. An occasional drink is not an issue if it is not impacting your life. The definition of moderate drinking includes no more than one drink for a woman and two drinks for a man per day. Not much compared to how I drank, but to clarify even further: one drink is just the equivalent of:
- 5 ounces of wine
- 1.5 ounces of liquor such as vodka, whiskey or rum
- 12 ounces of beer
Important too, is to look at the total amount of alcohol consumed over the whole week rather than on a given 24 hours, or one day. Gender matters too, as does body mass and more. For women as category, having more than 7 drinks in a week is considered in the “heavy” range. That means it is considered excessive or problem drinking while for men that “problem principle” comes to life whe the consumption tops more than 14 drinks in a week.
Alcohol Use Disorder
What is too much, and how can one tell? When is binge drinking too much, and when does drinking alcohol become a definition when it comes to a doctor or therapist? Good questions! When someone excessively drinks or has observable risky drinking habits, they may be at risk for alcohol use disorder (AUD) or already have it in real time. According to webmd.com more than 16 million people in the United States suffer from AUD. This is sometimes passed down through your genes or you can get it from your environment or psychological makeup. There are lots of signs that you have AUD and some of the most common ones include:
- Feeling out of control with drinking
- An uncontrollable need to drink
- Negative thoughts when alcohol is not consumed
- Continues to drink alcohol even when it causes problems
- Drinking in risky situations
- Stopping important activities as the result of alcohol use
Not So Odd, this AUD
There are mild, moderate and severe forms of AUD which is dependent on one’s symptoms. If you have more than one of the following symptoms, they are more likely to have AUD:
- Fails to stop thinking about drinking
- Gets behind the wheel of a car after drinking to drive
- During social situations, drinking is a necessity
- Mixing of alcohol with medications
- Drinking carelessly in spite of knowledge of risks such as while pregnant or caring for small kids
- Becomes aggressive and angry while drinking
- Finds it difficult to remember what has been done while drinking
- Failure at trying to stop and stay stopped alcohol consumption
The more of these that a person answers yes to, the more severe the realm of AUD teh self-test tells us.
Effects of AUD
AUD often creates a negative cycle of ignoring problems that one has, resulting in using alcohol to make the problem better. It can have a huge impact on one’s mental and physical health and without a doubt takes a toll on the entire body.
Short term AUD can cause:
- Memory Loss
- Hangovers
- Blackouts
Long term AUD can cause:
- Heart issues
- Stomach trouble
- Brain damage
- Variety of cancers
- High blood pressure
- Liver scarring
- Pancreatitis
- Irriversable memory loss
Another factor in considering the state of AUD is the risks one takes while drinking alcohol. Many people with AUD end up dying earlier than a normal lifespan, from other issues not organically tied to alcohol abuse such as:
- Car accidents
- Drowning
- Suicide
- Homicide
AUD not only affects the drinker but the people around her or him. Relationships are damaged due to the behavior stemming from alcohol use. Alcoholics are more likely to have anger problems, experience violence, neglect and abuse. People that are pregnant are more likely to expose their child to fetal alcohol syndrome and their babies have a higher chance of dying from SIDS.
Alcohol Abuse Treatment
About read for some good news? I sure am! The good news is that no matter the degree of one’s alcohol abuse disorder there are treatment options available to help. Most people do benefit from some sort of alcohol abuse treatment. From niaaa.nih.gov the data, and compiled research shows that about 1/3 of people treated for alcohol problems no longer have symptoms one year later. With stronger clinical care, and systems based case management, that number soars higher still. On top of this, many others significantly reduce their alcohol use and report fewer alcohol related problems.
Behavioral Treatments: Counseling that is led by a mental health professional to change your drinking behavior. A huge body of varied research shows how therapy, that is direct clinical intervention, can be successful at interrupting the drinking cycle. Other features offered in behavioral treatments include:
- Developing coping strategies to stop or reduce drinking habits
- Building a reliable and strong support system
- Setting obtainable goals and accountability partners
- Avoiding triggers that cause alcohol use
Support Groups: Alcoholics Anonymous (AA), Dharma Recovery and Refuge Recover – along with other 12-step programs provide support groups to those that are working to cut back their drinking habits. Finding support with one’s peers is a key for most who make sustainable and lasting change.
Medications: There are currently medications available in the United States to help people stop drinking and prevent relapse, including Antibuse and some other anti-craving medications. They are prescribed by a mental health professional and can be used on their own or in combination with counseling. The medications available are:
- Naltrexone: reduces episodes of heavy drinking
- Acamprosate: makes it easier to stay abstinent
- Disulfiram: blocks breakdown of alcohol by the body causing unpleasant symptoms such as nausea, vomiting and flushing of the skin. These unpleasant symptoms can cause people to avoid drinking alcohol
Where to Start
The first step is talking to your primary care physician or calling for a phone assessment with a skilled recovery advocate. They are a good source for referrals and necessary medications. A primary care physician can:
- Determine whether a patient’s drinking problem is a risk
- Help develop a treatment plan
- Evaluate the health and well-being of the patient
- Determine if medications are necessary for the person’s treatment
There are lots of people who can be involved during the treatment for alcohol disease. Many people play a role in the treatment process. Below is a list of providers and the type of care that they offer.
Primary Care Provider- M.D., D.O., medications, behavior treatment, referral to specialists
Psychiatrist- M.D., D.O., medications, behavior treatment
Psychologist- Ph.D., Psy.D, M.A. behavior treatment
Social Worker- M.S.W. behavior treatment
Alcohol Counselor- varies, some certifications are required. behavior treatment
Advice for Family and Friends
Caring for a loved one with alcohol disease can be very stressful and trying. It’s important to think about yourself during the process as well as the person with AUD. Your participation in your family’s health is essential in them successfully becoming sober or reducing their alcohol episodes.
It takes time for people to change their habits and sometimes they can’t do so. People experience failures trying to quit and often must come back and try again.
