Alcoholism

**Alcoholism** is the 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:
1. They feel like they have to drink alcohol.
1. They cannot control when they start drinking, when they stop drinking, or how much they drink.
1. They get alcohol withdrawal symptoms when they stop drinking.
1. They have to drink more and more alcohol to feel drunk (this is called tolerance).
1. 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.
1. They keep drinking even though they know it is causing serious problems in their life.
1. Drinking or being sick from drinking interfered with work, family responsibilities, school, or social engagements.
1. They continue to drink despite changes to mood, such as depression or anxiety or drinking too much began to affect other aspects of their mental or physical health. Alternately, the person suffered more than one memory blackout.
1. 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).

### Problems in the body

Alcoholism can cause many health problems. For example, it can cause:
- Brain damage
- Liver disease (like cirrhosis and alcoholic hepatitis) 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

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 alcoholics spend so much money on alcohol
- Being unemployed
- Abusing or neglecting their children
- Abusing their wives or husbands
- Living in poverty or being homeless

## 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.<sup>p.4</sup>

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:<sup>p.21</sup>
1. The European area
1. The Americas
1. The Western Pacific area (including China, Japan, Korea, Vietnam, Australia, New Zealand, and many islands in the Pacific Ocean)
1. The Southeast Asian area
1. Africa
1. 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.<sup>p.4</sup> These are areas where many people are Muslims. Many Muslims in these areas do not drink any alcohol, because the Koran says not to.<sup>p.4</sup> 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.<sup>p.21</sup>

### 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.<sup>p.10</sup>

## Controls

Lots of things have been tried to get people to drink less alcohol. In 1920 selling alcohol was made illegal in the United States. Less alcohol was drunk but there was more crime. Minimum unit pricing has been tried more recently. The cost of these cheapest alcohol goes up. Fewer people end up in hospital.

## 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 an alcoholic stops drinking, so that alcohol (a toxin) can get out of their body. An alcoholic also needs to give the 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 a detoxing alcoholic more comfortable, and to prevent symptoms of alcohol withdrawal. The most common medications that doctors give during alcohol detox are benzodiazepines.<sup>p.35</sup>

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:<sup>pp.130-144</sup>
- 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.

#### 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.<sup>p.144</sup>

### 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)

## 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)

### 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

## Infobox (disease)

- **name**: Alcoholism (Alcohol use disorder)
- **image**: William Hogarth - Gin Lane.jpg
- **caption**: _Gin Lane_: anti-alcohol visual propaganda by William Hogarth, 1751
- **field**: Psychiatry
- **icd10**: .2
- **omim**: 103780
- **medlineplus**: 000944
- **emedicinesubj**: article
- **emedicinetopic**: 285913
- **meshid**: D000437