ad info
 Diet & Fitness

 Headline News brief
 news quiz
 daily almanac

 video archive
 multimedia showcase
 more services

Subscribe to one of our news e-mail lists.
Enter your address:
Get a free e-mail account

 message boards

CNN Websites
 En Español
 Em Português


Networks image
 more networks

 ad info


  health > story page AIDSAlternative MedicineCancerDiet & FitnessHeartMenSeniorsWomen

When alcohol becomes a problem

September 7, 1999
Web posted at: 6:12 PM EDT (2212 GMT)

In this story:

The scourge of alcohol

Recognizing and dealing with AUDs

Getting help


By Ronald Pies, M.D.

(WebMD) -- Alcohol-use disorders (AUDs) are probably the most common mental disorders in the United States: Nearly one in every seven people suffers from an AUD at some time in his or her life. The prevalence of AUDs among men is about three-to-five times greater than among women. Nevertheless, alcohol can have serious consequences in women, since they are more sensitive to alcohol's damaging effects on the liver, heart and brain. Women also end up with higher blood levels of alcohol than men given the same amount consumed -- probably due to sex differences in how alcohol is broken down and distributed in body tissues.

The scourge of alcohol

Alcohol abuse and dependence does incalculable harm, accounting for about 5 percent of all deaths each year in the United States. This includes the main health hazard associated with AUDs, cirrhosis of the liver, which was the ninth-leading cause of death in the United States in 1988. Alcohol use disorders are also associated with driving accidents, violence and suicide. Very often, AUDs are accompanied by another psychiatric disorder such as a depression, anxiety or personality disorder. In some cases, AUDs can arise from attempts to "self-medicate" one of these other disorders with alcohol -- but in many cases the AUD is the primary, underlying disorder. Nevertheless, when an individual has both an AUD and a major mood or anxiety disorder, both problems must be addressed in treatment.

What causes "alcoholism" -- the common but poorly defined term usually applied to AUDs? This has been a source of controversy for decades, even among health-care professionals. The emerging consensus is that AUDs result from a complex interaction between biological and psychosocial factors. While the precise role of heredity in AUDs is not known, some types of AUDs appear to run in families, and are at least partly related to genetic factors. While blaming someone for having an AUD may be unjustified, holding the person responsible for getting help is critical. After all, diabetes is a biological disorder, but diabetics are still held accountable for taking their insulin.

Recognizing and dealing with AUDs

How do you know when you or a loved one has developed a serious drinking problem? The actual amount of alcohol he or she drinks is not a good basis for answering this. Neither is the person's insistence that, "I can stop drinking anytime I want to." Most chronic alcoholics have stopped drinking for extended periods at one time or another, but that does not mean that they can control the problem without help: Almost always, the abstinent alcoholic will relapse unless he or she remains in some form of substance-abuse treatment. You should suspect an AUD when the person in question:

  • Drinks larger amounts of alcohol than intended -- for example, the individual says, "I'm just going to have one for the road" and winds up downing five beers.
  • Spends a great deal of time drinking or recovering from drinking.
  • Has trouble meeting social, occupational or other important obligations.
  • Continues to drink even though alcohol has repeatedly caused physical or psychological problems.
  • Gradually needs more and more alcohol to get the same kick.
  • Experiences withdrawal symptoms (shaking, sweating, "seeing things") upon discontinuing alcohol use.
  • Constantly expresses annoyance when others express concern about his or her drinking, or has been told by a physician, employer or family member that he or she has a drinking problem.
  • Getting help

    The treatment of AUDs requires a thorough medical and psychological assessment. Concurrent physical disorders, vitamin deficiencies and potential psychiatric problems must be addressed. In some cases, a mood stabilizer or antidepressant may be part of the overall treatment plan. The medication naltrexone (ReVia) may help reduce the urge to drink and enhance abstinence in some patients but should be used in concert with psychotherapy or support groups.

    A few studies support the use of disulfiram (Antabuse), a medication that induces nausea and other unpleasant reactions if the individual drinks. For families who must deal with a loved one's AUD, support groups for families can be helpful. The key to success is helping the individual accept the need for help and insisting that he or she gets it.

    Copyright 1999 WebMD, Inc. All rights reserved.

    Avoiding Drug Abuse

    National Institute on Alcohol Abuse and Alcoholism
    Note: Pages will open in a new browser window
    External sites are not endorsed by CNN Interactive.

    China SARS numbers pass 5,000
    Report: Form of HIV in humans by 1940
    Fewer infections for back-sleeping babies
    Pneumonia vaccine may help heart, too
    Enter keyword(s)   go    help

    Back to the top   © 2001 Cable News Network. All Rights Reserved.
    Terms under which this service is provided to you.
    Read our privacy guidelines.