November 19, 2000
One out of thirteen adults are considered to be an alcoholic or suffer from a drinking problem. Today, fourteen million Americans suffer from a disease that is caused by a combination of physiological, psychological, social, and genetic factors. Alcoholism is a developmental disease that progresses slowly over a number of years and is based on both the physical and emotional dependency on alcohol. In many cases it leads to brain damage and/or early death.
Early symptoms include putting excessive importance on the availability of alcohol, which influences a persons choice pastimes and friends. Alcoholics use alcohol more as a personality changing drug rather than a beverage served with food or as a social custom. An alcoholic usually has a high tolerance to alcohol, which means being able to drink more and show fewer side effects than others. The person begins to drink even though it may not be in her/his best interest. Alcohol comes to be more important than personal relationships, family, work, or even health. People are unable to predict how much an alcoholic will drink at a certain occasion or if the alcoholic is practicing abstaining from alcohol, when the drinking will resume again. Physical addiction will lead to drinking around the clock to avoid withdrawal symptoms.
Ethyl alcohol, the alcohol used in alcoholic beverages, consists of C2H5OH. It is a clear liquid with a burning taste and a pleasant smell. It has toxic and sedative effects on the body. Alcohol can have major effects on major organ systems. For example, it can cause ulcers, inflammation or the pancreas, and cirrohosis of the liver. It can permanently damage the central nervous system and the peripheral nervous system. Withdrawal from alcohol, in severe cases, can cause shaking limbs, hallucinations, and blackouts: which can be fatal if not properly treated. Even withdrawal from hard drugs such as heroin rarely results in death.
The liver is the largest internal organ in the body. In a healthy adult, it weighs about 3 pounds and holds about thirteen percent of the bodys blood supply. Blood flowing from the stomach and intestines goes into the liver where it extracts nutrients and toxins. The blood is then pumped back to the heart. The liver performs over 500 vital functions. It processes all of the nutrients that the body requires, including proteins, glucose, vitamins, cholesterol, and fats. It also makes potentially toxic substances, including alcohol, ammonia, nicotine, drugs, and harmful by-products of digestion non-toxic.
The liver is particularly harmed by alcohol. In the body, alcohol breaks down into various chemicals which are very toxic in the liver. Alcoholic cirrhosis is the most common cause of cirrhosis in the U.S. and is estimated to be responsible for 44% of deaths from cirrhosis in North America. However, one Canadian study found alcohol to be the major contributor to 80% of all cirrhosis deaths. About 10% to 35% of heavy drinkers develop alcoholic hepatitis. After years of drinking, liver damage can be very severe, leading to cirrhosis in about 10% to 20% of cases. Not eating when drinking and consuming a variety of alcoholic beverages are also factors that increase the risk for liver damage. People with alcoholism are also at higher risk for hepatitis B and C. People with alcoholism should be immunized against hepatitis Band they may need a larger dose of the vaccine for it to be effective.
Recent evidence shows that even moderate drinking in women during pregnancy can result in serious damage to the child. For example, it may cause physical or mental retardation, and in some cases, fetal alcohol syndrome.
Fetal alcohol syndrome is caused by alcohol consumption of pregnant women. The consumption of alcohol greatly increases the risk of abnormalities for the unborn child. Some of these abnormalities include: growth deficiencies (head, weight, length etc.), facial abnormalities (small head, small jaw, small, narrow unusual-looking eyes), heart disease, and limb abnormalities.
Recognizing that one has a problem is the first step in treatment. For most alcoholics, the next step is detoxification, which is the medical management of severe alcohol withdrawal symptoms. Patients undergoing detox (detoxification), which usually requires less than a week, usually stay in a specialized residential treatment facility or a special unit of a hospital.
Alcoholics also have the option of involving themselves in a treatment group, which may consist of individual counseling and group therapy. Alcoholics Anonymous (AA) is one of these support groups. AA is a worldwide fellowhip of man and women who meet together to attain and maintain sobriety (AA webpage). There are no requirements for joining AA, only the need to stop drinking. AA was started in 1935 when two men, Bill W. and Dr. Bob S. met in Akron, Ohio to help each other stay sober. Today, AA has grown to over 87,000 groups in more than 130 countries, with more than two million members. Their motto is to stay away from one drink at a time, one day at a time.
A board of trustees, seven whom are not alcoholics and fourteen who AA members organize activities in the US and Canada and an international conference is held every five years.
AA uses the twelve step method in approaching sobriety:
Step 1We admitted we were powerless over alcohol-that our lives had became unmanageable.
Step 2Came to believe that a Power greater than ourselves could restore us to sanity
Step 3Made a decision to turn our will and our lives over to the care of Gad as we understood him.
Step 4Made a searching and fearless moral inventory of ourselves
Step 5Admitted to God, to ourselves and to other human being the exact nature of our wrongs.
Step 6Were entirely ready to have God remove all these defects of character.
Step 7Humbly asked Him to remove our shortcomings.
Step 8Made a list of all persons we had harmed, and become willing to make amends to them all.
Step 9Made direct amends to such people wherever possible, except when to do so we would injure them or others.
Step 10Continued to take personal inventory and when we were wrong promptly admitted it.
Step 11Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge or His will for us and the power to carry that out.
Step 12Having had a spiritual awakenings as the result of these steps, we tried to carry this message to alcoholics and to practice these principals in all our affairs.
New comers are not forced to follow all of these steps in they are unwilling or unable to do so because of religious or personal beliefs. They will however be asked to keep an open mind, to attend meetings, and to read AA literature describing the AA program.
Other treatments involve doctor prescribed medication that may help some alcoholics lessen their craving for alcohol. These medications, when taken with alcoholic beverages, cause vomiting, nausea, and severe headaches. Through classical conditioning the alcoholics begin to subconsciously relate the side effects to the alcohol therefore, making their drinking seem extremely unpleasant. Such drugs are antabase, naltrexone, and acamprosate.
Although there have been many advances in the treatment of alcoholism, there are still many deaths, more than 100,000 in the US, resulting from the excess abuse of alcohol.
Levels of Drinking
Moderate drinking: equal to or less than two drinks a day for men and equal to or less than one drink a day for women.
At-risk drinking: more than 14 drinks per week or 4 drinks at one sitting for men and more than seven drinks a week or three drinks at one sitting for women.
Alcohol abuse: one or more of the following alcohol-related problems over a period of one year: failure to fulfill work or personal obligations; recurrent use in potentially dangerous situations; problems with the law; and continued use in spite of harm being done to social or personal relationships.
Alcohol dependence: The individual experiences three or more of the following alcohol-related problems over a period of one year: increased amounts of alcohol needed to produce an effect; withdrawal symptoms; drinking more over a given period than intended; unsuccessful attempts to quit or cut down; giving up significant leisure or work activities; continuing drinking in spite of the knowledge of its physical or psychological harm to oneself or others.