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Alcoholism - A Basic Overview

Is it alcohol abuse or alcoholism? What's the difference and what can be done?

Alcohol Abuse and Alcoholism

Moderate and controlled drinking can turn to alcohol abuse, and alcohol abuse can turn to alcoholism; and once a person crosses into alcoholism they can never go back, will never again be able to drink in moderation, and will very likely need professional help and support to stop drinking.

It can be difficult to differentiate between alcohol abuse and alcoholism, and there is no single symptom that indicates one over the other, but it is important to get an accurate diagnosis as the treatment needs for the two conditions are quite different. Alcohol abusers may require only minimal therapy to stop drinking or to cut down to a healthy and moderate level, alcoholics will need far more intensive therapies and will never again be able to drink in moderation.

Alcohol Abuse

Alcohol abusers drink at a level that causes them harm. They are not often physically addicted to alcohol although they may be, but most fundamentally they retain control over their drinking, and are generally able to stop drinking for periods when they choose to, or are otherwise compelled to.


Alcoholics are usually addicted to alcohol and they have lost the ability to control their drinking behaviors. Alcoholics are not able to stop drinking for long periods, and will continue to drink even in the face of extreme personal harms caused by their alcohol consumption.

Some signs of alcoholism include:

  • Symptoms of withdrawal (sweating, shaking, nausea) when you don’t or can’t drink
  • Needing a drink first thing in the morning, or needing a drink at any time of the day
  • Feeling guilty about your level of use or trying to stop or cut down, and being unable to
  • Feeling annoyed when other people question your drinking.
  • Losing control over how much alcohol you drink

If you experience two or more of the preceding signs you are very likely an alcoholic.

What Causes Alcoholism?

There is both a genetic and environmental component to alcoholism, although the environmental effect seems to be stronger. However, even those people with very strong family histories of alcoholism are not necessarily destined to become alcoholics.

Some of the factors that can cause alcoholism are:

  • Genetics: The more close relatives that you have that are alcoholics, the greater your predisposition to the disease
  • Stress: People living in very stressful situations often use alcohol as an escape, and put themselves at an increased risk for alcoholism. Additionally, the stress hormone cortical seems linked to the development of the disease.
  • Environment: Living with an alcoholic or alcohol abuser increases your odds of developing the disease.
  • Social factors: The more exposure to positive marketing and social persuasions towards alcohol, the higher your probability to drink at a problem level.
  • Low self esteem or a lack of confidence can also promote excessive drinking as a coping mechanism, and increase the risk of alcoholism
  • Co occurring psychiatric disorders greatly increase the risks of substance abuse in general. If you experience depression, ADHD, anxiety, borderline personality disorder or psychosis, you are more likely to have a problem with alcohol.

There is no one casual factor to the development of alcoholism, and it seems that a complex mixture of factors and causes combine to influence the disease in most people. No one needs to become an alcoholic, and if you don’t drink, you are at no risk to develop the disease. Those people with close alcoholic relatives need to be very cautious in monitoring their alcohol consumption.

The Harms of Alcoholism

Few drugs are as harmful to the mind and body as alcohol when consumed in quantity and over a long period.

Some of the risks to the body include:

  • Liver disease
  • Cognitive declines and early dementia
  • Nutritional deficits
  • Heart disease
  • Pancreatic cancer
  • Diabetes
  • Osteoporosis
  • Cancers of the stomach and mouth
  • Kidney disease
  • And many others

Alcohol corrodes the body and it accelerates the aging process, and alcoholics cannot hope to live as long, or with the same quality of life and health.

In addition to the social harms, alcohol causes great personal and familial pain and is associated with family violence, the rupturing of family units, poor work performance and the loss of employment, societal harms such as driving under the influence, disorderly and violent conduct and greatly increased public health care expenses.

Alcoholics need and deserve effective and timely treatment, they can get better and it's in everyone's best interest to ensure that they do.

Alcoholism Treatment

Few alcoholics can stop drinking without intervention and treatment. Unfortunately, a hallmark of the disease is a personal denial of the problem, and very few alcoholics ever concede to the need for treatment.

In society a lingering myth of the need for "rock bottom" and that only the alcoholic can decide when to get better stops too many concerned family members from intervening on the alcoholic's behalf. In reality, there is no need to wait, family can convince of a need for treatment, the longer the alcoholic drinks the more difficult it is for them to stop, and those people who are compelled to get help seem to do just about as well as those people who initiated treatment of their own accord.

Alcoholics can receive treatment on an in or outpatient basis, although for the best chance of success, residential treatment is preferable.

Some of the therapies that have proven effective in the treatment of the disease include:

  • AA or 12 steps style meetings
  • Group support therapies
  • Individual counseling
  • Cognitive behavioral education and therapy
  • Relapse prevention medications
  • Nutritional classes
  • Peripheral programs such as yoga or meditation

No one form of therapy works well for all, and for the best chance at success and sobriety, alcoholics should receive a comprehensive base of different therapeutic interventions and education.

There is always hope, millions have beaten this determined and entrenched disease, and there is no reason why anyone can’t get better.

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