A sober subject: The many challenges of alcoholism

Internal Medicine

By Madhavi Challagulla, M.D.
Internal Medicine in Wilmington, MA

Internal Medicine

Dr. Challagulla works with patients to treat a variety of conditions, including alcohol dependency.

Treating some conditions can be equally frustrating for patients and doctors. Alcoholism is one of those problems.

In 2014, Massachusetts treatment facilities saw about 33,250 admissions for alcohol use treatment, according to the Massachusetts Department of Health’s Bureau of Substance Abuse Services. But this is just the tip of the iceberg.

The National Institute on Alcohol Abuse and Alcoholism reports that about 7.2 percent of the U.S. adult population — about 17 million people — had an alcohol use disorder in 2012. That’s about one out of every 17 adults in the United States that year.

But national data say nearly 92 percent of people with alcoholism do not seek help. Even using the most optimistic estimates, I would say perhaps one out of five people — 20 percent — comes to a doctor’s office and asks for help. Even at best, that means we never see 80 percent of the people who need help for alcohol use.

National data say nearly 92% of people with alcoholism do not seek help. -Dr. Challagulla Click To Tweet

Nevertheless, it’s important to keep discussing alcoholism. This is a major problem, both for our area and nationally. Alcohol abuse causes many problems — and not just to the patient — but the patient must take the first step toward recovery.

The effects of alcoholism

Alcoholism costs an estimated $33 billion to $68 billion nationally each year. Employers, families, and members of the community are hit with these costs through:

  • Traffic accidents
  • Lost wages and productivity
  • Increased costs of health care

I see the strain on our health care system week after week. But the patients with alcohol addictions pay the highest costs. Many have trouble keeping jobs or maintaining relationships. Unstable work and home lives can lead to difficulty keeping a place to live. For some patients, every last dime goes toward alcohol. I’ve seen some people who won’t pick up $2 or $3 prescriptions because they use the money to feed their addictions.

Even though we see only a fraction of the people who need help with alcohol addiction, the services available to treat the patients we do see are stretched to the limit. Patients with alcoholism often need resources like Alcoholics Anonymous meetings, behavioral health services, detox facilities, and so on. The problem is that these places often are full. In the weeks it can take to get people the help they need, many patients relapse, are no longer interested in recovery, or simply can’t be tracked down.

Recovery from alcohol addiction

Alcohol, like any drug, is hard to stop using once you’ve become addicted. One of the problems we have with treating substance abuse is that the effects of drugs can be very different from patient to patient. Two people can drink the same drinks every day, and one person may be able to stop immediately while the other person struggles.

I haven’t seen one type of alcohol that’s more likely than another to cause alcohol addiction. For some people, the problem is beer; for others, it’s hard liquor. I’ve seen people who drink 15 beers a day, people who drink several bottles of wine, and people who drink pints of vodka or whiskey. People are affected by — and addicted to — different things.

Right now, we don’t know exactly why alcohol affects people differently. There might be a time when we can genetically map a person and know who could become addicted to what substance, but we can’t do that yet. We know there’s a genetic predisposition toward addiction in some people with family histories of alcoholism, and we’re still learning about this area of medicine. Perhaps the subjectivity is what makes recovery a challenge. Genetics certainly plays a role but there are many other factors that contribute to addiction.

In my experience, a patient has to realize that there is a problem and want to make a change. Very rarely do I see patients for alcohol addiction because someone else forced them to come.

If you’ve decided to get help for an addiction to alcohol, there are treatments available to support your success, including:

  • Behavioral therapy
  • Group meetings, such as Alcoholics Anonymous
  • Medication to help you stay sober

Ultimately, something has to give in your own mind for you to get help for alcoholism. No one can make that choice for you. You have to want to get help for it to be successful. But if you’re ready, we’re here to help you.

Tags: alcoholism

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