Alcohol Addiction - Are You an Alcoholic?

Nearly 20 million people in the United States may be said to abuse alcohol, or to be an alcoholic. The World Health Organization estimates that over 140 million people worldwide are afflicted by alcohol dependence. The condition (whether you believe it to be a disease or not) is progressive. A drinker may start out "abusing" alcohol, and then end up dependent on it over time. Alcoholism strikes more men than women: 5-10% of the male population have a drinking problem, whereas only 3-5% of females do.

Generally, if you are a man, you should consume no more than 3 drinks a day, or 14 drinks total a week. More than that, and you may have a problem. For non-pregnant women, the limit is 2 drinks a day, or 12 drinks total a week. These are very generous numbers. If you are pregnant, or planning to become pregnant, there is no known safe limit of alcohol. You should completely abstain.

What if there is no family history? Are you immune? Absolutely not! Alcoholism or alcohol dependency can arise in any person. There may be a genetic link; that is, some people may be more predisposed to addiction. On the other hand, simply because no one else in your family has been diagnosed with the condition does not mean that you will not be either. The better question is: "Do I have any of the symptoms (set forth to the right)?" If you exhibit two or more of these signs, you are advised to discuss matters with your doctor to see if treatment should be pursued.

One of the most obvious red flags is if you have to ask yourself, am I an alcoholic? If so, you may already be an alcoholic.

You can try to deceive yourself that you are not hurting anyone when you drink. However, excessive alcohol consumption leads to many lost days of work due to hangovers and other ailments. Moreover, drunk drivers are exceptionally dangerous, particularly if they are not caught. To reach the legal limit of 0.08 blood alcohol limit, it takes only 2 drinks for women and 3 drinks for men, over a 2-3 hour period. Finally, the cost of drinking regularly and frequently adds up quickly. Expect anywhere from $100-200/week, or more, just for booze. Add in medical costs, lost work time and -God forbid - legal costs, and you could be out quite a bit of "pocket change.

If you do not wish to see your medical doctor, then there are a number of self-help organizations, including Alcoholics Anonymous (AA) and Women for Sobriety (WFS) that you may join for assistance. Most recovering addicts will tell you not to try to get sober alone. Be prepared to attend frequent meetings, in person and/or online.

Because it can be difficult to distinguish the "heavy social drinker" with the alcohol abuser or alcoholic, a test has been developed by psychologists, commonly known as the "CAGE" questionnaire. Two "yes" responses indicate a need for further investigation:

1. Have you ever felt you needed to Cut down on your drinking?
2. Have people Annoyed you by criticizing your drinking?
3. Have you ever felt Guilty about drinking?
4. Have you ever felt you needed a drink first thing in the morning (Eye-opener) to steady your nerves or to get rid of a hangover?

There are generally three stages of alcoholism, early, mid and end-stage. The rate of progression is individualized. One person may quickly advance to end-stage, while another may remain in an early stage for many years, or even decades.

Early: Moving beyond the "normal" range of number of drinks per day or week, this person is drinking to escape from problems or to get relief. They may begin thinking about alcohol more often. Tolerance may increase, which means that it takes more for the person to feel the effects of drinking alcoholic beverages.

Mid-Level: Drinking becomes more frequent and earlier in the day. Tolerance actually decreases because the alcoholic's body is losing the ability to process alcohol as it once did. If the person does not drink, withdrawal symptoms are noticeable, if not severe. Blackouts occur regularly. It is difficult for the person and everyone around him or her to deny what is occurring.

End-Stage: The alcoholic thinks of little else. Organs are seriously comprised, as is the immune system. Everything seems to be breaking down as the affected person is probably unable to hold a job, pay bills or do little else at this point. Eventually, if untreated, death will result. It is not surprising to see suicide, accidents or serious nutrition deficiencies (basically starving themselves to death).

Not everyone who drinks alcohol will become an alcoholic. However, some people with a predisposition to the condition may quickly develop an addiction after only a few episodes of drinking.

Scientists are studying a genetic link to what they have determined to be a disease of alcoholism. Other factors include social environment (think college fraternity parties) and mental health. Some people with undiagnosed conditions such as anxiety, bipolar disorder, and depression may self-medicate with alcohol or other drugs.

The bottom line is that, even though genetics account for 50-60% of the cases of alcoholism, an astounding 40-50% are the result of other factors.

For a sad, true story of the effects of family alcoholism, read my fellow hubber, In the Doghouse's story here.

The earlier a person starts drinking, the higher the risk of alcoholism. Those that start imbibing by age 16 or earlier are at much greater risk than those that wait before enjoying an alcoholic beverage until a later age.

The odds are in your favor if you seek help. Of those that try to quit drinking on their own, 4% are successful a year later. With treatment, the number climbs to 50%!

If you or your loved one has been heavily drinking on a regular basis, supervised detoxification may first be necessarily. This can take up to a week. Tremors and seizures will need to be managed.

• Antabuse (disulfiram): This drug will not stop the urge to drink, but will result in a severe physical reaction when the patient does drink alcohol. Vomiting, flushing and illness will result soon afterwards. As a result, a deterrent effect is achieved. This is one of the first drug treatments used for alcoholism. Today, it is not used as frequently, except as a treatment of last resort. Severe side effects can result with combinations of other drugs, including (of course), alcohol.
• Naltrexone: Blocks the high associated with drinking. Over time, the patient does not desire to continue consuming alcohol. This drug is considered much safer than Antabuse. Marketed under the trade name, Vivitrol, it is taken by injection and lasts up to 30 days. It may also treat cocaine addictions and help patients stop smoking cigarettes.
• Campral (acamprosate): Anti-craving medicine, and one of the most recently approved medications for alcoholism. This drug is said to restore the balance of chemicals in the brain that have become unbalanced through alcohol abuse. Taken by pills in a variety of dosages, prescribed by your doctor, it can be taken even while drinking. It is best used while in a support treatment system that includes counseling.
• Topamax (topiramate): Usually prescribed for migraine headaches. This drug is not FDA-approved for alcoholism, but it is showing promise in trials in reducing cravings, withdrawal symptoms and the potential for relapse. There are some side effects and more studies to follow. Read more here.

Despite the availability of drugs to help a recovering addict, none of these are a "magic bullet." In other words, long-term therapy will usually be required. The alcoholic will have to work to resist cravings when they arise. Triggers cannot be quashed with medication.

Wouldn't it be nice if you could just pop a pill and the drinking would be gone? Well, think again. The potential for relapse is so much higher if you go it alone, either "white knuckling" it, or with medication. You will need to try to get at the root of the drinking with professional therapy. A counselor and/or group therapy that will provide support and to whom you will have to answer should provide better results long term.

Start with your medical doctor, if you wish and ask for a referral to a qualified counselor. If that does not appeal to you, AA (Alcoholics Anonymous) can be found in virtually every community in the United States and in many other developed countries in the world. There are other groups that have sprung up that are similar to AA, with different philosophies (i.e. - we are not "powerless" over alcohol), or that cater to a specific population (i.e. women). Women for Sobriety has a wonderful North American presence, with an active forum, posts and chats every night of the week. Check out SMART recovery, or Rational recovery as alternatives. NOTE: I am not endorsing any of these alternatives! The one thing I will say, however, is that I do not believe in "Moderation Management."

Do you need to check into rehab? Only your doctor can answer that question. That said, I understand that the primary benefit that inpatient rehab offers is supervised detoxification. If you do not need that service, then you may be able to start your journey to sobriety in an outpatient setting through any of these groups discussed above, or through a rehab facility without having to pay the very high cost of actually checking in for 30 or more days. Discuss this matter with your doctor before making the final decision though.

You have probably already waited too long to start your new sober life. Pick up a book, check into some of these options and get rid of all the alcohol in your house (booze makes a great drain cleaner!) I wish you all the best.

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