Alcoholism

Alcoholism is addiction to alcohol. People who have alcoholism are called alcoholics.  

Alcoholism is a disease. It often gets worse over time, and can kill a person. However, alcoholism can be treated.

Alcohol is the most commonly used drug in the world. Around the world, there are at least 208 million people with alcoholism.  

Alcoholism is a condition with a social stigma. Because of this, alcoholics often feel ashamed of their drinking. They may try to hide their drinking, avoid getting help, or refuse to believe that they are alcoholics, because they are too ashamed.

Diagnosis

Being an alcoholic does not mean that a person just drinks a lot of alcohol. It means that they cannot control how much alcohol they drink. No matter how badly they want to, once they take one drink, they cannot stop drinking.

To be diagnosed with alcoholism, a person has to have three of these symptoms in the past year:
 They feel like they have to drink alcohol.
 They cannot control when they start. drinking; when they stop drinking; or how much they drink.
 They get alcohol withdrawal symptoms when they stop drinking.
 They have to drink more and more alcohol to feel drunk (this is called tolerance).
 They spend less time doing things they used to enjoy, because they are spending so much time drinking. They spend a lot of time getting alcohol, drinking alcohol, or feeling sick from drinking too much.
 They keep drinking even though they know it is causing serious problems in their life.
Drinking or being sick from drinking interfered with work, family responsibilities, school, or social engagements.
They  continue to drink despite changes to mood, such as depression or anxiety or drinking too much much began to affect other aspects of their mental or physical health. Alternately, the person suffered more than one memory blackout.
They drank even though doing so increased the chances of getting hurt, such as drinking before driving.
There is no medical test, like a blood test, that can say whether a person is an alcoholic. There are some questionnaires (lists of questions) that can help tell whether a person may be an alcoholic. These questionnaires include the CAGE questionnaire (for adults) and the CRAFFT Screening Test (for teenagers).

Alcoholism causes many problems

Problems in the body

Alcoholism can cause many health problems. For example, it can cause:
 Brain damage
 Liver disease (like cirrhosis) and liver failure
 Many types of cancer, including mouth, throat, esophageal, breast, and liver cancers
 Heart problems, including a weak heart muscle; abnormal heartbeat; high blood pressure; and stroke
 Problems with the pancreas
 A weak immune system, which makes it harder for the body to fight off diseases
 Depression and anxiety
 Deaths from drunk driving accidents or other injuries
Gastroesophageal Reflux Disease

If a person drinks too much at one time, they can get alcohol poisoning. This can cause breathing problems, coma, and even death.

In 2012, alcohol use caused 3.3 million deaths around the world. This means that in 2012, about 3 out of every 50 deaths in the world were caused by alcohol use.

Problems in life 
Alcoholism can also cause many problems in alcoholics' lives. These include:
 Not doing well at school or work
 Having family problems
 Not having enough money, because the alcoholic is spending so much money on alcohol
 Being unemployed
 Abusing or neglecting their children
 Abusing their wives or husbands
 Living in poverty or being homeless
Unplanned pregnancy
Financial instability

Alcohol withdrawal

If an alcoholic stops drinking suddenly, they can get alcohol withdrawal.

The most serious form of alcohol withdrawal is delirium tremens (often called "DTs"). Delirium tremens is a medical emergency. Many people who get the DTs die from them.

This does not mean that alcoholics should not stop drinking. It means that alcoholics should talk to a doctor or go to a hospital before they stop drinking. Doctors can give medications to make sure that a person is safe while they stop drinking.

Epidemiology

In 2010, the World Health Organization (WHO) estimated that there were 208 million people with alcoholism around the world. (This is 4.1% of the world's population over age 15.) In 2001, the WHO estimated that there were about 140 million alcoholics around the world. This means that in the nine years between 2001 and 2010, about 68 million people became alcoholics.

Around the world 
People in developed countries drink the most alcohol.p.4  

Alcoholism is more common in some areas than others. Here is a list of all the areas in the world. It is in order from the areas where alcoholism is most common to the areas where it is least common:p.21
 The European area
 The Americas
 The Western Pacific area (including China, Japan, Korea, Vietnam, Australia, New Zealand, and many islands in the Pacific Ocean)
 The Southeast Asian area
 Africa
 The Eastern Mediterranean area (including the Middle East and northeast Africa)

There are many reasons why alcoholism is more common in some areas than others. Some of these reasons include religion, culture, laws, and people's attitudes about drinking. For example, on average, people in Northern Africa, the Middle East, and islands in the Indian Ocean drink less than people anywhere else in the world.p.4 These are areas where many people are Muslims. Many Muslims in these areas do not drink any alcohol, because the Koran says not to.p.4 In some of these countries, drinking alcohol is illegal.  

However, in other areas, like Western Europe, alcohol is a part of daily life. It is legal and easy to get. People very commonly drink alcohol with meals. Very few people drink no alcohol.  People's attitudes about alcohol are very different than attitudes in mostly Muslim countries. This is an example of how differences in religion, culture, laws, and attitudes about drinking can affect the amount of alcohol use and alcoholism in different areas.

Men and women
Alcoholism is more common in men than in women. However, in the past few decades, the number of female alcoholics has increased. 

Female alcoholics are most common in the Americas and Europe. In the United States and Western Europe, five to ten percent of women will become alcoholics at some point in their lives.

In the Southeast Asian and Western Pacific areas, less than 1% of women are alcoholics. In Africa and the Eastern Mediterranean area, almost no women are alcoholics.p.21

Young people
In many countries, young people are using more and more alcohol. In a 2008 WHO survey, underage drinking had increased in 71% of countries. Drinking by young adults (ages 18-25) had increased in 80% of countries.p.10

Treatment options
Alcoholism can be treated. There are many forms of treatment for alcoholism.

Detoxification

Detoxification (detox) is often the first step in treating alcoholism. "Detoxification" means "getting toxins out of the body." Alcohol detoxification means that the alcoholic stops drinking, so that alcohol (a toxin) can get out of their body. The alcoholic also needs to give their body time to recover from not having alcohol any more.

It is not safe for an alcoholic to suddenly stop drinking on their own. The safest way to stop drinking is to go to a hospital that specializes in alcohol detoxification. These hospitals are often called "detoxes" or "rehabs." These places can make sure that an alcoholic has a safe detox. They can also give medications to make the alcoholic more comfortable, and to prevent symptoms of alcohol withdrawal. The most common medications that doctors give during alcohol detox are benzodiazepines.p.35

Once a person stops drinking alcohol, they are called sober. Most people need other treatments to help them stay sober.

Detox can be an intense process, and some people experience very strong emotions during it. This is complicated by the fact that, in the past, they may have used drugs or alcohol to help them handle strong emotions. In detox, the therapist helps them manage their emotions.

Therapy
Psychotherapy and group therapy can help alcoholics stay sober. For example, they can help alcoholics learn how to:
 Deal with stress without using alcohol
 Figure out what makes them want to drink, and learn how to deal with those things without drinking
 Plan what they will do if they are around people who are drinking
 Come up with reasons for why they want to stay sober, and use those things as motivation to stay sober (this is called Motivational Interviewing)
 Change their thoughts about drinking and how they react to those thoughts (this is called Cognitive-behavioral therapy)

Medications
Some medications can help alcoholics stay sober. These medications include:pp.130-144
 Antabuse: This medication makes a person very sick if they drink any alcohol. It can make an alcoholic not want to drink any more, because they do not want to get sick.
 Naltrexone: This medication causes changes in the brain. These changes make alcoholics not want to drink alcohol as much as they normally do. Also, if an alcoholic does drink alcohol, the naltrexone will block the alcohol from making them feel good, and they are more likely to stop drinking.
Acamprosate: Acamprosate, which goes by the brand name Campral, is the newest of the drugs to be approved for treating alcohol dependence. Like naltrexone, acamprosate works by altering brain’s response to alcohol so that person less likely to experience cravings. Acamprosate may also alleviate some of the long-term physical effects of withdrawing from alcohol, like edginess, sleep disturbances and depression. 
Benzodiazepines: Benzodiazepines are anti-anxiety medications commonly used as sedatives. They can be prescribed and used during alcohol detox to relieve symptoms of withdrawal. They reduce hallucinations, seizures, and delirium tremens. This is because the medication affects the same part of the brain as alcohol, allowing the body to continue its purge, while still feeling some of the effects it has grown to need. Common benzodiazepines include Xanax, Librium, Valium, and Ativan.

Vitamins
Many alcoholics do not have enough vitamins in their body. This can cause serious problems. For example, if an alcoholic does not have enough thiamine, they can get brain damage. Often, alcoholics are treated with thiamine to prevent brain damage. They may also be given other vitamins if needed.p.144

Groups for alcoholics
Alcoholics Anonymous (AA) is the biggest support and mutual aid group for alcoholics in the world. This means that in AA groups, alcoholics come together to support each other and help each other recover. AA uses a twelve-step program. This program is meant to help alcoholics fix the problems their alcoholism has caused.

There are also other groups for alcoholics, like:
 SMART Recovery
 Secular Organizations for Sobriety (SOS)
 Women for Sobriety
 LifeRing Secular Recovery
 Celebrate Recovery (based on Christianity and the Bible)

Related pages
 Addiction
 Drunkenness
 Fetal alcohol syndrome
 CIWA scale (used to measure how bad alcohol withdrawal is)
 CAGE questionnaire (used to test adults for alcoholism)
 CRAFFT Screening Test (used to test teenagers for alcohol and drug problems)

References

Other websites
 Fact sheets about alcohol (from the United States Centers for Disease Control)
 Information about alcohol for kids (from KidsHealth.org)
 Information about alcohol for teenagers (from GirlsHealth.gov)
Alcoholism & Drug Addiction Statistics in the United States

Help for alcoholism
 National Substance Abuse Hotline - find help for alcoholism, 24 hours a day, 7 days a week (run by SAMHSA.gov)
 Treatment for Alcohol Problems: Finding and Getting Help (by the National Institute on Alcohol Abuse and Alcoholism)
 Resources of Alcoholism Treatment

Groups for alcoholics and their families
 Alcoholics Anonymous
 Al-Anon (support group for people who have an alcoholic family member)
 Alateen (support group for teenagers who have an alcoholic family member)
 SMART Recovery
 Secular Organizations for Sobriety (SOS)
 Women for Sobriety
 LifeRing Secular Recovery
 Celebrate Recovery

Addiction
Alcohol drinking habits
Diseases