Alcoholism

The National Institute on Alcohol Abuse and Alcoholism cites four main symptoms of alcoholism:

• Craving (strong urge to drink alcohol)

• Loss of control (inability to stop drinking once drinking has begun)

• Physical dependence (withdrawal symptoms after drinking cessation, such as nausea, anxiety, sweating, tremors or shakiness)

• Tolerance (need to drink greater amounts of alcohol to feel its effects). People with alcoholism may not appear intoxicated even after drinking large amounts of alcohol.

The following symptoms may occur with either alcoholism, in which there is a physical addiction to alcohol, or alcohol abuse, in which a person drinks excessively but is not physically addicted to alcohol. In addition to the symptoms listed below, another indication that a person is having trouble with alcoholism or alcohol abuse is arrest for DUI, other offenses, and legal problems. Symptoms include:

• Denial, defensiveness or anger when asked about drinking habits

• Drinking alone

• Drinking at certain times of the day and becoming irritable when that is not possible

• Hiding alcohol from other people

• Inability to maintain employment

• Loss of interest in relationships

• Memory loss, forgetting entire periods of time, or blacking out

• Neglecting basic needs, such as not eating, not maintaining basic hygiene, or not following treatment plans for other illnesses

• Quitting activities that used to be pleasurable, such as athletics or hobbies

• Social withdrawal and isolation

• Violent behaviors, such as domestic abuse and getting into physical fights, especially when drinking

Symptoms of alcohol-related diseases, disorders and conditions, such as alcoholic liver disease and depression include:

• Abdominal pain or swelling

• Agitation or problems paying attention

• Bleeding in the gums or nose

• Blood in the stool or vomit

• Excessive thirst

• Fatigue or sluggishness

• Mood problems, such as mood swings or extreme sadness

• Nausea

• Numbness, tingling or pain in the legs or arms

• Weight loss

• Withdrawal from activities or relationships

• Yellowing of the skin and whites of the eyes (jaundice)

If you are an alcoholic who attempts to quit drinking, you may experience symptoms of alcohol withdrawal. Alcohol withdrawal is a serious condition that can lead to a life-threatening condition called delirium tremens. If you drink heavily, seek prompt medical care before you attempt to quit drinking. Safe alcohol withdrawal requires medical care and monitoring. Seek immediate medical care (call 911) if you, or someone you are with, have serious symptoms of alcohol withdrawal including:

• Change in level of consciousness or alertness, such as passing out or lethargy

• Change in mental status, such as confusion, disorientation, hallucinations, delusions or delirium

• Chest pain

• Rapid heart rate or palpitations

• Seizure

• Tremors or shakiness

The above symptoms may occur with:

• Anxiety

• Depression, mood swings, and irritability

• Difficulty concentrating

• Fatigue

• Headache

• Nausea or loss of appetite

• Sleep disturbances

• Sweating or clammy skin

Alcoholism can also result in other serious and life-threatening diseases and conditions, such as liver disease, liver failure, and depression. Seek immediate medical care (call 911) if you, or someone you are with, have any of these potentially life-threatening symptoms:

• Chest pain, tightness or pressure

• Having or expressing feelings of wanting to hurt or kill oneself or another person

• Shortness of breath or difficulty breathing

• Vomiting blood, bloody stool, or heavy rectal bleeding

Like many other addictive substances, alcohol can trigger a series of biochemical reactions and pleasant sensations to which some people quickly become accustomed. People who regularly abuse alcohol can eventually develop a need to experience these sensations in order to feel normal.

Once started, drinking can be extremely difficult to stop for some people, while other people can enjoy small to moderate amounts of alcohol without ever developing a problem. The exact underlying cause of this difference is not known. However, there is significant understanding about the risk factors that lead a person to abuse alcohol. For example, health care experts know that alcoholism is more common in men than women and that it runs in families. Researchers have identified multiple biologic factors (neurotransmitters and brain cell receptors) and candidate genes that may, going forward, unlock the mystery of alcohol addiction.

Research shows that both alcoholism and alcohol abuse tend to run in families and statistics show that men are more likely than women to abuse alcohol. However, environmental factors, such as your peer group and stress level are also involved, meaning that you are not predestined to alcohol abuse or alcoholism solely based on your family history. Risk factors for alcoholism include:

• Alcohol consumption at age 14 or younger

• Exposure to heavy drinking as a lifestyle, such as being around family and friends who drink heavily on a routine basis

• Family history of alcoholism

• Heavy drinking on a regular basis, such as having five or more drinks on one occasion more than once per week

• Male gender

• Psychological disorders including depression, anxiety, bipolar disorder, or schizophrenia

• Psychological traits including impulsiveness and low self-esteem

• Young adulthood, particularly ages 18 to 29

Alcoholism is a chronic disease that cannot be cured. An alcoholic who no longer drinks is still considered an alcoholic. However, alcoholism can be successfully controlled. The goal of alcoholism treatment is complete abstinence from alcohol. This generally requires a multifaceted treatment program that includes any or all of the following:

• Medical detoxification (detox), which is a four- to seven-day process involving counseling and medication to mitigate withdrawal effects, often in an inpatient setting

• Medication to help prevent a relapse after detoxification

• Psychological therapy, support groups, such as Alcoholics Anonymous, and family and social support to maintain abstinence from alcohol. These interventions can help people understand why they abuse alcohol and develop plans and goals for maintaining abstinence. These therapies can also provide support to help control urges to drink and reduce the symptoms of psychological disorders that tend to occur with alcoholism, such as depression and anxiety.

• Treatment of alcohol-related diseases, such as liver disease and malnutrition

Complications and diseases associated with alcoholism and alcohol abuse can be progressive and even life threatening. It is important to contact your health care provider if you, or someone you are with, have symptoms of alcohol abuse, alcoholism, or alcohol-related disease. You can help minimize mental and physical complications of alcohol abuse and alcohol-related conditions by following the treatment plan outlined by your health care provider. Complications include:

• Alcoholic liver disease, such as cirrhosis of the liver and hepatitis

• Cardiovascular diseases, such as coronary artery disease, hypertension (high blood pressure), and stroke

• Delirium tremens (life-threatening type of alcohol withdrawal that may cause neurological damage)

• Digestive conditions, such as gastritis (inflammation of the stomach lining), pancreatitis (inflammation of the pancreas), and esophageal varices, which can rupture and cause life-threatening hemorrhage

• Increased risk of cancer

• Injuries or fatalities resulting from accidents involving motor vehicles, physical fights, domestic abuse, fires, and drowning

• Malnutrition

• Mental health conditions, such as anxiety disorders, depression, and suicide

• Neurological damage that leads to poor cognitive functioning, memory loss, dementia, and other problems

• Osteoporosis and bone fractures

• Sexual and reproductive problems, such as erectile dysfunction, irregular menstrual periods, low-birth-weight babies, birth defects, and sexually transmitted diseases due to reckless behavior associated with drinking and alcoholism