Friday, March 20, 2009

Alcohol and Alcoholism

Alcoholism is a chronic, progressive and potentially fatal disease characterized by significant impairment that is directly associated with persistent and excessive use of alcohol.

There is disagreement about how to define alcoholism. Basically, it is defined by:
Length, amount and pattern of drinking
Social problems because of drinking
Psychological dependence
Physiological dependence
Medical diseases caused by alcohol such as liver damage

Dependence on alcohol is defined by tolerance and withdraw symptoms. There are two types of dependence: Psychological and Physical.

Psychological dependence is based on the degree of psychological discomfort experienced when alcohol is unavailable.

Physical dependence is based on the presence of physical symptoms in the absence of alcohol after prolonged heavy drinking. Some of those physical symptoms are:
o Increased heart rate
o Sweating
o Elevated blood pressure
o Tremors

Withdraw symptoms are generally the opposite of the drug’s direct effects lasting a few hours to a few days

What are the signs of Addiction?
Signs of alcohol addiction are:
• Tolerance and withdraw
o 50% more needed for high
o withdraw symptoms when stopping
o take more to avoid withdraw
• Loss of control
o larger amounts
o persistent desire or effort to cut down
• Time involvement
o a great deal of time spent thinking about, obtaining & using
• Social dysfunction
o avoiding work from hangovers, going to work high, driving
o avoid social events because of use
• Knowledge of adverse effects
o continues use despite family dysfunctions and arguments

An alcohol addiction begins with an individual experiencing short term gratification from drinking alcohol much as it does for most people. It causes us to feel that the substance can be good for us. This first experience is usually a positive one. As a result, we gain a sense of comfort with it when we are out socially.

The individual that runs the risk of having a problem with alcohol takes a turn from the general population at this point. This individual begins to use alcohol as a form of self-medication. They begin to use it to ease anxiety and stress. They begin to increase their use of alcohol and as a result, their tolerance to alcohol begins to increase resulting in even more alcohol use.

Problems such as memory loss, sneaking extra drinks, guilt about drinking behavior all begin to appear. In the process, they do not recognize that there is a problem beginning. Denial is freely used by the individual who becomes lost in the world of alcoholism. At this point, they feel they can stop anytime they want to… they just don’t want to.

Now, the blackouts begin. The alcoholic rationalizes it’s use and blames others for the problems it is creating in their life. More and more alcohol becomes the center of the alcoholic’s life. As it progresses, the alcoholic experiences reverse tolerance where instead of taking four drinks to become drunk, it only takes half a drink.

The tolerance drops and intoxication may be day long. They have physical effects such as tremors and not attending work more frequently. Usually they feel they have hit bottom and become willing to accept suggestions for treatment. Marked by physical and moral deterioration, they will drink poison if alcohol is not available.

Many times job performance is the last thing to be affected by the illness because of the need to maintain economic support and to continue the illusion that everything is fine.

The alcoholic personality exhibits:
• Exaggerated self-importance
• Charming & Charismatic
• Grandiose behavior
• “I” as opposed to “we” thinking
• Denial
• A rigid, judgmental outlook
• Lack of solid logic in thinking
• Black and white thinking
• All or nothing thinking
• Obsessive thinking and thought patterns
• Impatience
• Childish behavior
• Irresponsible behavior
• Irrational rationalization
• Projection
• Overreaction

There are some predictors for possible problems with alcohol. Those are:
• Solitary drinking
• over-permissive norms of drinking
• lack of specific drinking norms
• tolerance of drunkenness
• adverse social behavior tolerated when drinking
• alcohol used to reduce tension and anxiety
• alcohol used apart from social affiliate functions
• alcohol use separated from overall eating patterns
• drinking with strangers, which increases violence

Here is a self-evaluation questionnaire developed by the National Institute of Alcohol Abuse and Alcoholism.
• Do you drink alone when you feel angry or sad?
• Dose your drinking ever make you late for work?
• Dose your drinking worry your family?
• Do you drink after telling yourself you won’t?
• Do you ever forget what you did while you were drinking?
• Do you have headaches or have a hangover after you have been drinking?

If you can answer yes to any of those questions, then you may have a problem with alcohol. Understand that chronic alcohol use can lead to dementia and organic brain disease.

What is safe & Moderate Drinking?
The USDA defines moderate drinking as no more than one or two drinks per day for men, and no more than one drink per day for women. One drink is considered to be 12 oz of beer, 5 oz of wine, or 1.5 oz of liquor.

Who can drink?
Those who already drink in moderation and do not have a history of substance abuse or psychiatric disorder or have a direct relative with a drinking problem

Who Can’t Drink?
• Children & adolescents
• alcoholics
• Those with family members with alcohol problems
• Women pregnant or trying to get pregnant
• on medications
• planning on driving or requiring full attention

Frequently, families will deny the problem and try to hide the problem from public view. When one or both parents are alcoholic, the family becomes chaotic and then organizes roles to leave out the alcoholic. Eventually, they will attempt to leave the alcoholic or have the alcoholic leave the family.

If someone you love has a problem with alcohol, concern, sympathy, cajoling, threatening, and other natural responses will have little effect on their behavior. The best way to intervene between an alcoholic and the bottle is to do an intervention that confronts the addict. An intervention organized by a trained professional is probably the best way to go.

The intervention presents the reality to the addict in a way they can hear it. An intervention is two or more persons who are close to the addict and have witnessed his behavior under the influence. It is made up of two or more of the following: spouse, employer, parents, siblings, children, close friends, co-workers, clergy, therapist, drug/alcohol counselor or other significant persons.

The goal is to break down the addict’s defenses so that reality can be seen long enough for the addict to accept it. Present facts about the addict’s behavior and consequences of that behavior in an objective, nonjudgmental and caring way. Pile up the episodes of the effects of the addict’s behavior describing them in explicit detail. Have those they love/respect express the anguish his/her actions have caused them. This should shock them into facing the truth about their condition.

At the end of the intervention, they are then presented with several treatment options that have been worked out in advance with a qualified drug/alcohol counselor, therapist or physician.

Good resources for more information on alcohol and drug addiction/treatment can be found at:
•AA – mutual support to stay sober found at
•Al-Anon – for individuals affected by an alcoholic found at
•Alateen – ages 12 to 20 found at
•ACA – Help for growing up with alcoholic parents found at
•Cocaine Anonymous found at
•Narcotics Anonymous found at

For more information log onto For free clips and self-help audios, log onto the Dr. Walton Series at

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