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Alcohol Dependence

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Alcohol Dependence

Many people are able to drink socially at safe levels. Others develop alcohol abuse problems that interfere with their lives. And some will experience alcohol dependence. Alcohol dependence is a disease where the craving for alcohol can be as strong as the need for food and water. People who are dependent on alcohol often continue to drink even while their lives and health crumble around them. They may experience withdrawal symptoms when they don’t drink, and they need more and more alcohol to function.

Signs and symptoms of alcohol dependence

Healthcare providers and researchers distinguish between alcohol abuse and alcohol dependence. The following signs and symptoms are adapted from the American Psychiatric Association.

Signs that alcohol abuse could be interfering with your functioning include:

  • Drinking interferes with your work, school, or family responsibilities
  • You drive or operate machinery under the influence of alcohol
  • You have legal problems related to drinking, such as being arrested for driving under the influence or disorderly conduct
  • You have problems in your relationships due to drinking, such as arguments with your spouse or partner about how much you drink

Alcohol abuse can progress to alcohol dependence. Symptoms of dependence include:

  • Tolerance; you need to drink more to get the same effect
  • Withdrawal symptoms when drinking stops, such as sweating, nausea, rapid heart rate, tremors, and blackouts
  • Drinking more than you realized or intended
  • You want to cut down your drinking or stop, but haven’t been able to
  • Spending a great deal of time getting alcohol, drinking, and recovering from hangovers
  • Losing a job or work opportunities, losing friends, hurting family relationships, or giving up activities you previously enjoyed
  • Continuing to drink despite knowing that it is hurting your health and disrupting your life


What causes alcohol dependence?

Alcohol is legal and deeply engrained in our culture. Many people drink socially and responsibly, with no ill effects. Not everyone who drinks becomes dependent. Why are some able to drink responsibly, and others abuse alcohol or become dependent? There is no one reason; however, there are some risk factors for alcohol dependence.

Risk factors for alcohol dependence:

  • Family history of alcohol dependence; this risk factor includes both genetics and environmental factors
  • History of mental illness; many people with alcohol problems also experience other mental disorders, such as anxiety or depression
  • Peer pressure; there are many cultural and social pressures to join the crowd and drink
  • Stressful events and life changes

Effects of alcohol dependence

The effects of alcohol dependence can be devastating. Untreated alcohol dependence is a progressive disease during which a person’s health seriously deteriorates.

Possible physical effects of alcohol dependence:

  • Liver inflammation, which can lead to cirrhosis, a serious, irreversible liver condition
  • Increased risk of heart disease, stroke, and cancer
  • Stomach problems and nutritional deficiencies
  • Neurological problems such as confusion, numbness, and trouble with memory
  • Left untreated, alcohol dependence can lead to death

Effects of alcohol dependence on families and loved ones:

  • People with alcohol dependence are seven times more likely to separate or divorce
  • The risk of intimate partner or domestic violence is higher
  • Alcohol dependence takes an emotional toll on partners and children of people who are dependent on alcohol
  • Child abuse and neglect are more common

Costs to society
The costs to society are great as well. Annual healthcare expenditures for alcohol-related problems amount to $22.5 billion.

Driving under the influence
Each year, millions of people choose to drive while under the influence of alcohol, sometimes with devastating results. In 2009, almost 11,000 people were killed in crashes involving impaired drivers— nearly one-third of all traffic deaths.

Common misconceptions

People who use drugs and/or alcohol are choosing to do so.
People generally start out as occasional drug users or social drinkers. But over time, some people find that it is very difficult to stop drinking or using. Addiction leads to changes in the brain that make drug use compulsive and make it much more difficult to stop using.

Alcoholism or drug addiction is a character flaw.

Addiction is a medical and psychological disorder. Drugs become an extremely powerful motivator for people who are addicted, and addicted individuals will often do almost anything to get drugs. Drug and alcohol use have changed the person’s brain and its functioning in critical ways.

We should try to find the cure for addiction that will help everyone and solve the problem.

There is no “one size fits all” form of treatment, much less a magic bullet that suddenly will cure addiction. Different people have different addiction-related problems, and they respond differently to similar forms of treatment, even when they're addicted to the same drug. As a result, people who are addicted to drugs or alcohol need an array of treatments and services tailored to address their unique life and health needs.

A person needs to “hit bottom” before they can be helped.

Dr. Kathleen Brady, a professor at the Medical University of South Carolina, says one of the myths is “this whole idea that an individual needs to reach rock bottom before they can get any help. That is absolutely wrong. There is no evidence that that's true. In fact, quite the contrary. The earlier in the addiction process that you can intervene and get someone help, the more they have to live for, the more they have to get better for.”

People don't need treatment. They just need willpower.

It is extremely hard for people addicted to drugs and alcohol to achieve and maintain long-term sobriety. Research shows that addiction actually changes people’s brain function, making it increasingly difficult to quit without effective treatment. Providing effective prevention and early intervention to help stop substance abuse early is important, because children and teens become addicted to drugs faster than adults and risk greater physical, mental, and psychological harm.

Treatment just doesn't work.

There has been improvement in drug and alcohol treatment. Today, there are numerous effective addiction treatments available. Studies show that treatment reduces relapse rates and can significantly decrease criminal activity during and after treatment. There is also evidence that addiction treatment reduces the risk of infectious disease, hepatitis C, and HIV infection and improves the prospects for getting and keeping a job up to 40%.

People can successfully finish substance abuse treatment in a couple of weeks if they're truly motivated.

The right length of treatment for any individual depends on many factors. It is important to have a thorough evaluation with a qualified addiction professional. Research shows that failing to complete the length of treatment that is recommended for you is associated with a higher rate of relapse. Thus, if your treatment professional recommends a longer treatment based on their evaluation, it is important to follow her advice. Follow-up supervision and support are essential. In all recovery programs, the best predictor of success is completing the full treatment and continuing to attend aftercare.

People who continue substance abuse after treatment are hopeless.

Completing a treatment program is merely the first step in a recovery process that can last a lifetime. Addiction is a chronic disorder, and like other chronic illnesses, people may have relapses. Stress at work, family problems, and social and environmental cues can trigger a relapse. People who are addicted are most vulnerable to a relapse during the few months immediately following their release from treatment. Recovery is a long process and frequently requires multiple treatment attempts before complete and consistent sobriety can be achieved. Relapse prevention strategies learned in treatment can help people with addictions reduce the chance of a relapse, and help them manage relapses more effectively to get back on track sooner.

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