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Alcoholism Medical Overview

Alcoholism is a condition where there is a physical addiction to alcohol and the individual has tolerance to alcohol and withdrawal when there isn't alcohol available. The patient will continue to drink, even though they have problems with health issues, mental health problems, family, social or job difficulties.

There isn't any cause for alcoholism. No one knows why some people can drink and never get addicted while others get addicted readily and give up their other responsibilities in order to drink.

Risk factors for alcoholism include a woman who drinks more than 12 drinks per week or a man who drinks more than 15 drinks per week or more. If you drink at least five or more alcoholic beverages at one time at least once per week, you are at risk for alcoholism. Other risk factors include having a family member who is alcoholic and those who are under peer pressure to drink. Those with mental disorders are more likely to become alcoholic and if you have easy access to alcohol, it is more than likely you'll become alcoholic. If you live a stressful life, you can become alcoholic and if you have problems with relationships and a low self esteem, alcoholism is more readily in your reach.

Genetics plays a role in alcoholism; however, the exact genes that cause the disease to occur are unknown. About 15 percent of individuals in the US have problems drinking too much and about 5-10 percent of males are alcoholic, while the same is true of 3-5 percent of women.

Signs and symptoms of alcoholism include a need for increased doses of alcohol to get the same effect, a condition called alcohol tolerance. There can be blackouts following heavy drinking and withdrawal symptoms when the alcohol is taken away. Other symptoms include ongoing drinking even when there are lifestyle problems, violence when drinking, drinking alone, lack of control over drinking, hostility when confronted regarding a person's drinking, making excuses regarding drinking, drinking rather than eating, need for daily alcohol drinking in order to feel normal, and secretive behaviour around alcohol use.

Physical symptoms around alcoholism include alcoholic liver disease and cirrhosis of the liver.

Tests for alcohol abuse include asking the patient about their alcohol use to see if they exhibit any of the signs or symptoms of the disease. A toxicological screen can show an elevated blood alcohol level. A CBC can show changes and liver function tests can show elevations of liver enzymes. Doctors should also check a magnesium level and a folate level to see whether these need to be replaced in alcoholism.

Treatment for alcoholism includes getting the patient sober and abstinent of alcohol. They need to stay away from where alcohol is served or is present. Moderation of alcohol use rarely works. There may need to be an intervention to help an alcoholic understand the ramifications of their drinking. Withdrawal is best done in a controlled environment and it usually takes 4 to 7 days. Medications can be given to control withdrawal symptoms, including Valium and Librium. Fatalities have been known from having alcohol withdrawal, including the DTs. The individual with alcoholism may have masked depression or anxiety that is found upon alcohol withdrawal and which needs to be treated.

Rehabilitation from alcohol can take from thirty to 90 or more days. Programs are available that offer mental health support, nursing care, medical care and counselling. Some people use the 12 step program to overcome alcoholism. Many counsellors of alcoholism are recovering alcoholics themselves. Cognitive behavioural therapy is another way of treating alcoholism and involves homework and coping exercises.

Medications are prescribed to help a person improve their chances of sobriety. These medications include acamprosate, Antabuse, and Naltrexone, which decreases cravings for alcohol. The person should also live in a living situation, such as a halfway house that can prevent return to alcohol drinking. Support groups are especially helpful to alcoholics, including groups like Alcoholics Anonymous.

As to the prognosis of alcoholism, there are only about 15 percent of alcoholics that receive treatment. It is fairly common to relapse after treatment for the disease and it sometimes takes several tries to become abstinent from alcohol.