What is alcoholism? According to the American Medical Association, “alcoholism is an illness characterized by significant impairment that is directly associated with persistent and excessive use of alcohol. Impairment may involve physiological, psychological or social dysfunction.” Psychologically speaking, alcoholism has less to do with “how much” someone is drinking, and more to do with what happens when they drink. If you have problems when you drink, you have a drinking problem.
The word alcohol comes from the Arabic “Al Kohl,” which means “the essence.” Alcohol has always been associated with rites of passages such as weddings and graduations, social occasions, sporting events and parties. The media has often glamorized drinking. Television viewers happily recount the Budweiser frog, the beach parties and general “good time” feeling of commercials selling beer. Magazine ads show beautiful couples sipping alcohol. Love, sex and romance are just around the corner as long as you drink the alcohol product being advertised.
The reality is that alcohol is often abused because it initially offers a very tantalizing promise. With mild intoxication, many people become more relaxed. They feel more carefree. Any preexisting problems tend to fade into the background. Alcohol can be used to enhance a good mood or change a bad mood. At first, alcohol allows the drinker to feel quite pleasant, with no emotional costs. As an individual’s drinking progresses, however, it takes more and more alcohol to achieve the same high. Eventually the high is hardly present.
How Common is Alcoholism?
Alcoholism is a complex disease, which has been misunderstood and stigmatized. According to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), Alcohol Dependence and Alcohol Abuse are among the most common mental disorders in the general population, with about eight percent of the adult population suffering from Alcohol Dependence and five percent from Alcohol Abuse.
It is widely accepted that there is a genetic predisposition toward alcoholism. According to DSM-IV, the risk for Alcohol Dependence is three to four times higher in close relative of people with Alcohol Dependence.
The Progression of the Disease
Alcoholism is a progressive disease and follows several phases:
The Social Drinker: Social drinkers have few problems with alcohol. A social drinker can basically take or leave it. There is no preoccupation with drinking. A social drinker is able to control the amount of alcohol consumed and rarely drinks to the point of intoxication. For these individuals, drinking is a secondary activity. It is the party, the meal, the wedding that interests the social drinker, not the opportunity to drink.
The Early Stage: An individual who is experiencing the early stages of alcoholism will begin to have an assortment of problems associated with drinking. In early stage alcoholism, a person may start to sneak drinks, begin to feel guilty about his or her drinking, and become preoccupied with alcohol. Blackouts, drinking to the point of drunkenness, and increased tolerance (needing more alcohol to achieve the same effect) are all signs of early alcoholism.
An individual who is entering the early stage of alcoholism will seek out companions who are heavy drinkers and lose interest in activities not associated with drinking. Family and friends may begin to express concern about the person’s consumption of alcohol. Work problems, such as missing work or tardiness, may also take place.
Middle Stage: By the time someone has entered the middle stages of alcoholism, his or her life has become quite unmanageable, although the alcoholic still denies that he or she has a problem. At this point, the alcoholic will often drink more than intended. He or she will drink in an attempt to erase feelings such as anger, depression and social discomfort. Drinking in the morning to relieve a bad hangover may also take place. The alcoholic’s health care provider may begin to suggest that the alcoholic stop drinking. The individual may try to stop drinking, but without success. Job loss, medical problems, and serious family conflicts occur during this phase.
Late Stage: At this stage, the alcoholic’s life has become completely unmanageable. Medical complications are numerous and include liver diseases such as cirrhosis or hepatitis. Acute pancreatitis (inflammation of the pancreas), high blood pressure, and bleeding of the esophageal lining can result from prolonged use. The heart and brain are compromised so that an alcoholic is at a higher risk for a heart attack or stroke. Depression and insomnia and even suicide are more prevalent at this stage.
A condition known as Wernicke-Korsakoff Syndrome, which involves memory loss, indicates that the individual has sustained brain damage from drinking. A child born to a woman who drinks during her pregnancy may have a condition called fetal alcohol syndrome, causing a number of birth defects.
An alcoholic at this stage has become physically addicted to alcohol and will experience seizures or delirium tremens (DTs) if he or she stops drinking. It is extremely important to seek out medical care at this point in the disease process.
If an individual is dependent on alcohol, he or she should be supervised medically during a detoxification process. Further treatment may include individual or group counseling.
Mental health professionals have been trained to treat substance abuse problems. You can seek out treatment with an individual counselor or by entering an inpatient or outpatient substance abuse treatment program.
Support groups such as Alcoholics Anonymous, Smart Recovery, and Rational Recovery have helped many alcoholics to stay sober, allowing them to live productive lives.
-Cynthia Mascott, LMHC