HAVING A CRISIS
DO YOU KNOW SOMEONE WHO IS SUFFERING FROM ALCOHOLISM?
Sooner or later, almost everyone witnesses the out of control behavior of a problem drinker. But here's the important question: Is problem drinking the same as alcoholism, or to put it differently, at what point does problem drinking become alcoholism?
In general, problem drinking qualifies as alcoholism when the person in question:
- drinks compulsively;
- keeps drinking in spite of adverse consequences; and
- gets upset when alcohol is not readily available.
Not everyone who ever gets drunk is an alcoholic. Many people drink to experiment, to act sociable, or to show off. Alcoholics, however, do not plan to get drunk; their drinking is an uncontrollable urge.
In any randomly selected group of Americans, 10 to 15 of every 100 people either are alcoholics or will someday become alcoholics. Ten million Americans are alcoholics, and another 10 million are problem drinkers who may be on their way to becoming alcoholics.
Alcoholism is by no means a male disease: between one-third and one-half of all alcoholics are women. Many alcoholics are teenagers; some are even pre-teenagers.
Abuse of alcohol is the number two killer of Americans, after cancer. In a typical general medical practice, 25 to 50 percent of the patients have significant medical, psychological, or social problems related to their use of alcohol.
Most alcoholics are alcoholics for life, meaning they will always be in danger of relapsing if they take even a single drink. But recovering alcoholics learn how to cut this daunting problem down to manageable size. They make the decision not to drink -- but they make it "one day at a time."
Although alcoholism is a common and serious problem, large numbers of alcoholics can and do recover. For anyone with a drinking problem, a properly certified, professional, medically supervised treatment program offers a chance for a lasting recovery.
Doctors believe the tendency toward alcoholism is an inherited physical characteristic, possibly involving liver enzymes. Other theories indicate that message-carrying chemicals within the nervous system may make a person more vulnerable to the disease. Individual reactions to alcohol vary widely:
- Certain people dislike and avoid alcohol because even small amounts disagree with them.
- Many others enjoy a certain amount of alcohol, but instinctively stop drinking as soon as they get dizzy or sleepy.
- Still others love the high they get from alcohol, but have no sense of when they should stop drinking. When they drink, they get drunk, even though they've had enough experience with alcohol to know better.
The people in this third group are said to be predisposed to alcoholism. This predisposition is not a moral weakness, but an inborn part of their body chemistry.
Medically speaking, you can't. To date there is no diagnostic test that can single out people who have an inherited predisposition to alcoholism. Practically speaking, however, there are two important clues:
- Children of alcoholics have a two to four times greater risk of developing alcoholism than children of non-alcoholics.
- People who are drinking ever-increasing amounts of alcohol, and who become irritable when they don't drink, are clearly at risk for alcoholism
As their disease progresses, alcoholics need to drink more, and more often, just to feel normal. Increasingly they notice that once they start to drink, they can't stop. Yet they desperately want to keep from getting drunk, both to avoid embarrassment and to avoid unpleasant withdrawal symptoms such as trembling, irritability, nausea, or insomnia. They may try different strategies to regain control over their drinking, maybe switching from liquor to wine, or perhaps even going "on the wagon" for weeks at a time.
No strategy works for long, however. Inwardly disgusted with themselves, alcoholics vacillate between anger and depression. Personal relationships deteriorate. Job performance suffers.
In addition, physical problems gradually develop. Alcoholics suffer from disturbing memory lapses called blackouts. Feeling edgy and anxious, some may discover and become addicted to tranquilizers. Alcoholics eat poorly, because their irritated liver and inflamed digestive system give them heartburn, nausea, and gas. Sex drives dwindle. Insomnia robs them of needed sleep.
Alcoholics hurt other people, not just themselves.
- Women who drink heavily during pregnancy are inadvertently giving alcohol to the unborn baby, too. The baby may be born with fetal alcohol syndrome, an incurable condition that involves stunted growth, physical abnormalities, and mental retardation.
- Active alcoholics often have marital problems. As long as they're still drinking, they can't be committed marriage partners: their compulsion to drink makes them self-centered, irresponsible, and perhaps abusive.
- Likewise, active alcoholics may also have difficulties fulfilling their parental responsibilities. Alcohol-abusing mothers and fathers have been known to neglect or abuse their children. For a child, growing up in a household with an alcoholic parent is often a painful experience that usually leaves lasting emotional scars.
People with advanced alcoholism drink almost constantly, have trouble keeping a job, relate poorly to other people, and may have self-destructive impulses including frequent thoughts of suicide. Some of the serious physical consequences of late-stage alcoholism are:
- Mental confusion
- Partial paralysis
- Cirrhosis of the liver
The good news is that alcoholism is treatable. With the right kind of help, most alcoholics can learn to lead a deeply satisfying life without alcohol.
If you believe that drinking is a problem for you, help is available. To talk with someone about your drinking, call 713-HOTLINE (713-468-5463).
People used to think the only way an alcoholic could quit drinking was to go "cold turkey." However sudden withdrawal from alcohol is difficult, painful, and dangerous. Possible hazards include hallucinations, convulsions, and potentially life-threatening shifts in blood pressure, temperature, and heart rate.
A safer way is medically supervised detoxification in a specialized hospital setting. "Detox," which starts with a thorough physical exam, involves bed rest, nursing care, short-term tranquilizers, a balanced diet, and vitamin and mineral supplements.
After a few days of "detox," when the acute withdrawal period is over, the alcoholic moves into the second stage of treatment. This stage, called rehabilitation, can be structured into a period of hospitalization, or it can take the form of frequent visits to an outpatient clinic. In either case, rehabilitation involves ongoing medical monitoring, nutritional therapy, a program of moderate physical exercise, thorough education about alcoholism, and an introduction to a 12-step self-help support group for alcoholics.
The third stage of professional treatment for alcoholism is a return to full independence, monitored through a series of medical follow-up visits and guided by ongoing participation in a support group. Alcoholics who maintain close ties with a support group such as Alcoholics Anonymous greatly increase their chances for a solid, lasting recovery.
Popular magazines occasionally publish questionnaires to help people determine whether they are alcoholics. Quizzes like these can be misleading, however, because people unconsciously tend to answer them in ways that suggest they don't have a drinking problem.
If you have ever had the slightest suspicion that your own drinking might be turning into a problem, ask yourself only these three questions:
- Am I drinking more than I used to?
- Once I start drinking, am I sometimes unable to stop?
- Do I get irritated when I'm in a place where I can't drink?
Answering "yes" to even one of these questions suggests that your use of alcohol may be unhealthy or problematic. To delve deeper, make an appointment for an evaluation at an alcohol or drug treatment center. A licensed physician will be able to determine if you are dependent on alcohol. Or attend a 12-step meeting of Alcoholics Anonymous. These meetings are free and confidential. For more information about finding a 12-step meeting or treatment center in your area call 713-HOTLINE (713-468-5463).
When someone you love has a drinking problem, the crucial first step is getting that person to acknowledge that the problem exists. This won't be easy. Typically, alcoholics insist that they can control their alcohol intake and reject any suggestion that they should quit drinking.
If your loved one is employed, find out if his or her workplace provides a benefit called "employee assistance." Such a program can provide a smooth, confidential link between a person who drinks too much and an appropriate alcoholism treatment center.
You might also consider asking your family doctor for advice. Or you could check your phone book to get in touch with a nearby alcohol and drug treatment center. Such a facility will probably offer "intervention counseling," which can help you and other family members or friends plan how to confront a person about his or her problem drinking.
The more you learn about alcoholism the better you will understand that it is an illness and it is treatable. By reaching out for help you can have a healthier and more fulfilling life. Sobriety and treatment can make a difference.