According to the National Institute on Alcohol Abuse and Alcoholism, more than 172 million adults ages 18 and older consume alcohol within a year. Americans as young as 12 years old reported that they drank alcohol at some point. Understanding alcoholism provides insight for those seeking assistance with alcohol misuse or abuse.
What is alcoholism?
Alcoholism, also known as alcohol dependence, is a disease that includes the following four symptoms:
Craving – A strong need, or urge, to drink
Loss of control – Not being able to stop drinking once drinking has begun
Physical dependence – Withdrawal symptoms, such as nausea, sweating, shakiness and anxiety after stopping drinking
Tolerance – The need to drink greater amounts of alcohol to get "high"
Is alcoholism a disease?
Yes. The craving that an alcoholic feels can be as strong as the need for food or water. A person with alcoholism will continue to drink despite serious family, health or legal problems.
Like many other diseases, alcoholism is chronic, meaning that it lasts a person's lifetime; it usually follows a predictable course, and it has symptoms. The risk of developing alcoholism is influenced both by a person's genes and by their lifestyle.
Is alcoholism inherited?
Research shows that the risk of developing alcoholism does indeed run in families. The genes a person inherits partially explain this pattern, but lifestyle is also a factor. Your friends, the amount of stress in your life and how readily available alcohol is also are factors that may increase your risk for alcoholism.
But remember: Risk is not destiny. Just because alcoholism tends to run in families doesn't mean that a child of an alcoholic parent will automatically develop alcoholism, too. Some people develop alcoholism even though no one in their family has a drinking problem. Not all children of alcoholic families get into trouble with alcohol. Knowing you are at risk is essential because then you can take steps to protect yourself from developing problems with alcohol.
Can alcoholism be cured?
No, alcoholism cannot be cured at this time. Even if a person with alcoholism hasn't been drinking for a long time, they can still suffer a relapse. Not drinking is the safest course for most people with alcoholism.
Can alcoholism be treated?
Yes, alcoholism can be treated. Alcoholism treatment programs use both counseling and medications to help a person stop drinking. Treatment has helped many people stop drinking and rebuild their lives.
Does alcoholism treatment work?
Alcoholism treatment works for many people. But like other chronic illnesses, such as diabetes, high blood pressure and asthma, there are varying levels of success when it comes to treatment. Some people stop drinking and remain sober. Others have long periods of sobriety with bouts of relapse. And still, others cannot stop drinking for any length of time. With treatment, one thing is clear, however: the longer a person abstains from alcohol, the more likely they will be able to stay sober.
Do you have to have alcoholism to experience problems?
No. Alcoholism is only one type of alcohol problem. Alcohol misuse can be just as harmful. A person can misuse alcohol without actually having alcoholism – that is, they may drink too much and too often but still not be dependent on it. Some of the problems linked to alcohol misuse include not being able to meet work, school or family responsibilities; drunk-driving arrests and car crashes and drinking-related medical conditions. Under some circumstances, even social or moderate drinking is dangerous – for example, when driving, during pregnancy or when taking certain medications.
How can you tell if someone has an alcohol concern?
If you think that you or someone you know might have an alcohol problem, it is important to see a doctor or other health care provider right away. Start by taking the Addiction Care Navigator questionnaire to evaluate risk and get connected to care.
Can someone who has an alcohol problem simply cut down?
It depends. If that person has been diagnosed with alcoholism, the answer is "no." Alcoholics who try to cut down on drinking rarely succeed. Cutting out alcohol – that is, abstaining – is usually the best course for recovery. People who are not alcohol dependent but who have experienced alcohol-related problems may be able to limit the amount they drink. If they can't stay within those limits, they need to stop drinking altogether.
Is it safe to drink during pregnancy?
No, alcohol can harm the baby of a mother who drinks during pregnancy. Although the highest risk is to babies whose mothers drink heavily, it is not clear yet whether there is any completely safe level of alcohol during pregnancy. For this reason, it's best practice for women who are pregnant or may become pregnant to abstain from alcohol. The damage caused by prenatal alcohol includes a range of physical, behavioral and learning problems in babies. Babies most severely affected have what is called fetal alcohol syndrome (FAS). These babies may have abnormal facial features and severe learning disabilities. Babies also can be born with mild disabilities without the facial changes typical of FAS.
If a person with alcoholism is unwilling to get help, what can I do about it?
This can be a challenge because an alcoholic can't be forced to get help except under certain circumstances, such as a traffic violation or arrest that results in court-ordered treatment. But you don't have to wait for someone to "hit rock bottom" to act. Many alcoholism treatment specialists suggest the following steps to help an alcoholic get treatment:
Stop all "cover-ups." Family members often make excuses to others or try to protect the alcoholic from the results of their drinking. It is important to stop covering for the alcoholic so that they experience the full consequences of drinking.
Time your intervention. The best time to talk to the drinker is shortly after an alcohol-related problem has occurred – like a serious family argument or an accident. Choose a time when they are sober, when both of you are fairly calm, and you can talk privately.
Be specific. Tell the family member that you are worried about their drinking. Use examples of how the drinking has caused problems, including the most recent incident.
State the results. Explain to the drinker what you will do if they don't seek help – not to punish the drinker, but to protect yourself from their problems. What you say may range from refusing to go with the person to any social activity where alcohol will be served to moving out of the house. Do not make any threats you are not prepared to carry out.
Get help. Gather information in advance about treatment options in your community. If the person is willing to get help, call immediately for an appointment with a treatment counselor. Offer to go with the family member on the first visit to a treatment program and/or an Alcoholics Anonymous meeting.
Call on a friend. If the family member still refuses help, ask a friend to talk with them using the steps described. A friend who is a recovering alcoholic may be particularly persuasive, but any person who is caring and nonjudgmental may help. The intervention of more than one person, more than one time, is often necessary to coax an alcoholic to seek help.
Find strength in numbers. With the help of a health care professional, some families join with other relatives and friends to confront an alcoholic as a group. This approach should only be tried under the guidance of a healthcare professional experienced in this kind of group intervention.
Get support. It is important to remember that you are not alone. Support groups offered in most communities include Al-Anon, which holds regular meetings for spouses and other significant adults in an alcoholic's life, and Alateen, which is geared toward children of alcoholics. These groups help family members understand that they are not responsible for an alcoholic's drinking and that they need to take steps to take care of themselves, regardless of whether the alcoholic family member chooses to get help.
Source: The Los Angeles County Department of Mental Health
