Alcohol Abuse and Dependence

What is alcohol abuse and dependence?

Alcohol abuse and dependence are patterns of drinking that lead to serious personal, family and health problems. Abuse is when you keep drinking alcohol even though it causes a problem such as:

  • Showing up late or missing work or school and not caring about things that used to matter to you
  • Breaking rules or breaking the law
  • Not keeping promises, arguing, or even getting violent with other people
  • Doing things that are dangerous, such as driving while under the influence of alcohol

If you continue to abuse alcohol, you can become dependent. When you are dependent on alcohol, you:

  • Need to use more alcohol, or use it more often to get the same effects
  • Lose control, which means you keep drinking alcohol even though you know that it is harmful to you or others, or you can’t stop drinking when you try
  • Crave alcohol so much that you spend a lot of time and energy getting alcohol, using alcohol, and getting over the effects of drinking
  • Have withdrawal symptoms when you stop drinking

Alcohol abuse and alcohol dependence, also called alcoholism, takes many forms including:

  • Drinking all the time
  • Hiding your drinking by drinking in private
  • Binge drinking, which is drinking at least 4 to 5 drinks over about 2 hours

Alcohol abuse is the cause of many health problems. Many violent crimes, such as sexual abuse, assault, and murders are related to alcohol abuse. Drunk drivers cause many of the deaths from car accidents in the US.

What is the cause?

Alcohol changes the way your body and brain work. When you drink regularly and drink a lot, there are changes in the nerve cells and blood flow in your brain. As a result, you think about alcohol all the time and you don’t feel good unless you drink more alcohol. When you stop drinking suddenly, there are changes in your brain, which cause the symptoms of alcohol withdrawal.

If you are a man under age 65, you may be at risk for abusing alcohol if you have more than 14 drinks per week, or more than 4 drinks per day.

If you are older than 65, or you are a woman, you may be at risk for abusing alcohol if you have more than 7 drinks per week, or more than 3 drinks per day. Examples of 1 drink are:

  • 12 ounces of beer
  • 5 ounces of wine
  • 1.5 ounces of 80-proof distilled spirits such as whiskey or vodka.

You have a higher risk of becoming dependent on alcohol if you:

  • Have a family history of drug or alcohol abuse
  • Have abused alcohol or drugs in the past
  • Are easily frustrated, have trouble dealing with stress, or feel like you aren’t good enough
  • Are regularly around people who use alcohol or drugs
  • Have a mental health problem
  • Have constant pain

What are the symptoms?

The symptoms of alcohol abuse and dependence depend on how much and how often you drink. The symptoms can be mild to very severe, such as:

  • Trouble walking, double vision, nausea, vomiting
  • Loss of appetite, stomach pain, or diarrhea
  • Shaking, often starting several hours after your last drink
  • Mood changes, such as getting angry or irritable
  • Blacking out
  • Trouble breathing, coma, death

You may also have symptoms of new or worse health problems caused by long-term alcohol use. Health problems caused by alcohol include poor nutrition, cancer, stomach, heart, or liver problems.

The symptoms of alcohol withdrawal can be mild to severe. You may have some of these symptoms when you stop drinking:

  • Shaking, sweating, or being restless
  • Having trouble sleeping or trouble paying attention
  • Seeing, hearing, or feeling something that is not there
  • Craving alcohol
  • Having seizures

Some people who are dependent on alcohol have life-threatening symptoms called delirium tremens (DTs) when they stop drinking alcohol. The symptoms are similar to withdrawal symptoms, but more severe. This is a medical emergency.

How is it diagnosed?

Your healthcare provider will ask how much and how often you drink. Be honest about your drinking. Your provider needs this information to give you the right treatment. He will also ask about your symptoms and medical history and examine you. You may have blood or urine tests.

How is it treated?

Alcohol abuse and dependence can be treated. For any treatment to be successful, you must want to stop drinking.

Your healthcare provider may prescribe a medicine that will help you quit drinking. One type of medicine causes severe nausea and vomiting if you drink alcohol. Other medicines block the feelings of pleasure that drinking gives you. These medicines often work best when used while you are in therapy and in a support group. Do not try to use other prescription medicines or illegal drugs to help you stop drinking alcohol.

If you are dependent on alcohol, you may need treatment known as detoxification, also called “detox” or “drying out.” Detoxification can be done while you are in a hospital or drug treatment center, or you may be able to stay at home and go to a clinic or hospital several times a week for treatment. The right choice for you depends on how much and how long you have been drinking. It also depends on other medical problems that you may have. You will need to stop using alcohol completely during treatment. Treatment for withdrawal symptoms may include medicines, vitamins, and IV fluids. Detoxification may take 3 to 4 days.

If you are abusing or dependent on alcohol and want to quit, get help.

Self-help groups such as Alcoholics Anonymous, support groups, and therapy may be helpful. You might be treated in a substance abuse treatment program. Your healthcare providers and counselors will work with you to develop a treatment program. If this therapy does not work, you may need treatment in a hospital or a treatment center. You may need to stay for several weeks, or you may be able to go in each day.

Recovery from dependence is a long-term process. Follow-up treatment is very important so that you don’t go back to drinking alcohol.

If you have overdosed, or are having severe withdrawal symptoms you will need to be treated in a hospital. You will also be treated for any health problems such as a heart attack, stroke, or other life-threatening problems.

How can I take care of myself?

The best way to help yourself is to see your healthcare provider and make plans to stop drinking. If you are already seeing a healthcare provider, it is important to take the full course of treatment he or she prescribes.

Get support. Talk with family and friends. Consider joining a support group in your area.

Learn to manage stress. Ask for help at home and work when the load is too great to handle. Find ways to relax, for example take up a hobby, listen to music, watch movies, or take walks. Try deep breathing exercises when you feel stressed.

Take care of your physical health. Try to get at least 7 to 9 hours of sleep each night. Eat a healthy diet. Limit caffeine. If you smoke, quit. Don’t use alcohol or drugs. Exercise according to your healthcare provider’s instructions.

Avoid situations where people are likely to use alcohol or drugs.

Check your medicines. To help prevent problems, tell your healthcare provider and pharmacist about all the medicines, natural remedies, vitamins, and other supplements that you take.

Contact your healthcare provider or therapist if you have any questions or your symptoms seem to be getting worse.

Keep trying. Many people try more than once to quit drinking before they finally succeed. So, never say, “I can’t.” You CAN learn to live without alcohol in your daily life.

People and resources in your community that can help you include your healthcare providers, therapists, support groups, mental health centers, and alcohol or substance abuse treatment programs. You may want to contact:

Developed by RelayHealth.
Adult Advisor 2015.1 published by RelayHealth.
Last modified: 2014-05-01
Last reviewed: 2014-03-14
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Copyright ©1986-2015 McKesson Corporation and/or one of its subsidiaries. All rights reserved.

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