A B C D E F G H I J K L M N O P R S T U V W

ALCOHOLISM

What is Alcoholism ?

Most people drink alcohol and small amounts are not harmful. However, the risk to health is increased as the quantity of alcohol consumed is increased. Alcohol is measured in units. One unit of alcohol is half a pint of beer, a single measure of spirits, or a standard glass of wine. Sensible drinking is keeping the number of units consumed in a week to 21 units in men and 14 units in women. If more than 36 units (in men) or 22 units (in women) are consumed per week, then damage to physical and mental health is likely. Women are more at risk from the harmful effects of alcohol than men because the water content of their body is less.

An alcoholic or a person with an alcohol problem is an excessive drinker who has become dependent on alcohol. This dependence may have affected physical and mental health. It may also have caused social problems which may be work related, marital difficulties or problems with the law. The dependence may lead to tolerance. This is where increasing amounts of alcohol are required to produce the desired effect.

After a period of time, blackouts or memory loss of what happened while drinking can occur. From then on, there is a steady downward decline. Problems with the family and work or trouble with the law may occur. Insomnia, depression, aggressive episodes and attempted suicide are possible. The damage to physical health can include serious liver problems (cirrhosis and alcohol hepatitis). There may be stomach problems and permanent damage to the brain, heart and nerves of the feet. If drinking is stopped abruptly a condition known as delirium tremens (the ``DTs'') may occur. This results in nausea and vomiting, shaking attacks, frightening hallucinations and fits. It is a serious condition and requires admission to hospital.

How does Alcoholism occur ?

The exact reason why some people become alcoholic and others do not is not known. Several factors are involved. The individual's personality, his environment and the chemical nature of alcohol as a dependence-producing agent are all relevant. There may be a hereditary factor involving the way the brain deals with addictive drugs like alcohol. Alcohol abuse often runs in families. Alcohol is also an acceptable part of our society: cultural factors play a part in encouraging drinking.

Why does Alcoholism occur ?

If alcohol is taken to relieve stress or worries, people soon get used to this routine. Gradually intake may have to be increased to produce the desired effect: dependence occurs. People who are divorced, separated or single are at higher risk. Certain jobs also seem to create a greater risk: publicans, seamen and journalists fall into this group.

Treatment Involved for Alcoholism

There are a number of different ways in which a problem drinker can be helped. There are organisations such as Alcoholics Annonymous (AA) who can provide help to the alcoholic and their family. In every area, there will be a community team that deals with alcohol addiction. A number of approaches may be tried. Psychotherapy or ``talking treatment'' can help. The problem drinker is given the opportunity and time to talk about his feelings and emotions. This will help provide him with an insight into what is going on within himself. It will help him understand how his need for alcohol arose.

The whole lifestyle is examined. This may involve looking at how stress is dealt with, teaching techniques for stress management, as well as improving diet and exercise patterns. Behaviour therapy or goal setting : for the problem drinker who is cared for in the community, a series of goals may be agreed. The object is either total abstinence or reducing drinking to ``safer'' levels. A programme is agreed with the doctor. The patient will need to attend regularly to ensure progress.

Support and guidance are offered to try to change the person's behaviour. Detoxification is needed if it proves impossible for the problem drinker to abstain. It is also necessary if attempts to stop drinking have failed because of withdrawal symptoms. A period of admission to hospital is involved. Under the supervision of medical staff, the problem drinker is ``dried out''. Any physical or mental problems which occur as a result of coming off alcohol can then be treated. At the same time, a programme of retraining or education about the problems of alcohol will be conducted with a counsellor either in groups or on an individual basis.

Drugs may be used to counteract any depression, anxiety, problems with delirium tremens or any vitamin deficiency. Alcohol-sensitizing drugs can be useful in helping people to stay off alcohol. Disulfiram (Antabuse) is taken daily: if alcohol is taken with it, then serious side-effects such as palpitations, nausea and faintness occur. These are very unpleasant and not without risk.

During Treatment for Alcoholism

To break the addiction is difficult. It requires a great deal of patience from all concerned. Friends, pressures at home or work or an underlying depression may tempt the problem drinker to opt out of the treatment programme and go back to drinking.

After Treatment for Alcoholism

Relapses can occur and without doubt the problem drinker will feel guilty about these. It is important, however, that he feels he is able to confide in his doctor or family. After treatment he will still need support and follow up, and should receive this from the doctor or organizations such as Alcoholics Anonymous.

If Alcoholism is Left Untreated

Alcoholism is a dangerous condition. Treatment can be successful, especially if sought early. If no treatment is sought, and the sufferer continues to drink, his health will suffer even more. He will gradually enter a downward spiral with serious consequences to his mental and physical health. Recovery may then prove impossible.

Effects on Family of Alcoholism

Family and friends have an important role to play in helping the problem drinker. They will need to provide support and encouragement. They themselves may be involved in the treatment programme. At times they will undoubtedly lose patience, especially when frequent relapses (break-outs) occur, promises are not kept, or abuse takes place. Sometimes the problem drinker attempts to recruit their help in ``cheating''. He or she may also plead to be allowed a drink, with empty promises or excuses. It is important to realize that families and friends may themselves need support, and this may be provided by the carers or specific organizations (e.g. AA).