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McKesson Clinical Reference Systems: Women's Health Advisor 2002.2
Spanish version
Alcohol Dependence (Alcoholism)
What is alcohol dependence?
Alcohol dependence (alcoholism) is a condition marked by
some combination of:
- physical dependence on alcohol
- loss of control over the use of alcohol
- continued use of alcohol despite knowing that it is
harmful to your mental and physical health.
If your body is dependent on alcohol, you might need to
drink more and more alcohol to feel as high as you used to
feel drinking less. Another sign of physical dependence is
that you have bodily changes such as shakes or sweats when
you stop drinking.
Signs that you have lost control over your use of alcohol
include:
- trying to limit your drinking but being unable to
- spending a lot of time and energy getting or using
alcohol or getting over its effects.
Alcoholism is one of the most common illnesses seen by
doctors.
How does it occur?
Many factors may lead to alcohol dependence. Examples of
such factors are:
- family members who are dependent on alcohol
- stress that is ongoing
- family environment
- mental illness such as depression, bipolar disorder,
schizophrenia, or anxiety
- the addictive nature of alcohol.
What are the symptoms?
Alcohol dependence takes many forms including:
- drinking from time to time
- drinking all the time
- binge drinking.
Many alcoholics become able to drink ever larger amounts of
alcohol before feeling or seeming drunk. Alcohol users
often drink to avoid withdrawal symptoms.
People who are dependent on alcohol may:
- try to hide evidence of drinking
- promise to give up drinking
- drink stronger alcoholic beverages or start to drink
earlier in the day
- have long periods of being drunk
- drink alone
- have problems at work
- miss work
- black out
- lose interest in food
- have mood changes (be angry, irritable, violent)
- have personality changes (be jealous, distrustful)
- repeatedly drive while drunk
- hurt themselves or others while drunk
- be careless about their appearance
- be confused and have memory problems, lose the ability to
think quickly or concentrate
- have money problems caused by drinking.
Physical symptoms may include:
- nausea or shaking in the morning
- poor eating habits
- stomach pain
- cramps or diarrhea
- numbness or tingling
- weakness in the legs and hands
- red eyes, face, or palms
- unsteady walking or falls
- new and worsening medical problems.
How is it diagnosed?
Many doctors may not consider the possibility of alcohol
dependence or they tend to overlook it. You or a family
member may need to bring up the subject.
The diagnosis of alcohol dependence is based on how you use
alcohol and the effects of alcohol on your life or family.
Your doctor will take a careful medical history of your
symptoms. Especially important are how and when you drink
alcohol. The doctor will ask about:
- your history of using drugs and alcohol
- your ability to function socially
- your work history
- your family history
- prior and current emotional or mental problems
- thoughts of suicide.
The doctor will examine you to look for medical problems
caused by alcohol use. Lab tests of your urine and blood
may be done. The most frequent and severe effects of
alcoholism are not medical problems, however, but problems
with emotions, relationships, accidents, and work.
How is it treated?
You must stop drinking alcohol. Your doctor can help you
quit drinking and recover from disorders related to alcohol.
Psychotherapy and social programs will also aid in your
recovery. It might help if family members are included in
your treatment program.
After immediate withdrawal from alcohol (detoxification),
may need long-term treatment. If you are able to or must
continue working, you can enter an outpatient treatment
program. Often counseling sessions can be set for before or
after your work hours. You will also need to go to
Alcoholics Anonymous (AA) meetings once or more per week, at
least at the beginning of treatment.
Your doctor may prescribe a drug for you called Antabuse
(disulfiram). This drug will cause you to have severe
nausea and vomiting if you drink alcohol and thus will
discourage you from drinking. Another drug approved by the
FDA for treating alcohol dependence is naltrexone. Both of
these drugs are most effective when you also get counseling,
for example, from 12-Step support groups.
How long will the effects last?
You may feel a need or desire for alcohol throughout your
life. One of the most important aspects of alcohol
counseling and treatment is to learn the behavior patterns
that usually cause you to start drinking. Recognizing these
patterns and changing them is important.
If you stop drinking, related health problems can often be
controlled or prevented. However, severe damage, such as
injury to your liver or pancreas, may be lasting and
possibly fatal.
How can I take care of myself?
Make sure you seek medical help. Recovery from alcohol
dependence almost always requires the help and support of
others. Make sure you get this support. People and
resources in your community that can help you include your
physician, pastor, AA, mental health centers, and alcohol or
substance abuse treatment programs.
Follow your doctor's advice for treatment of any other
medical problems. Avoid situations where alcohol is
consumed.
You should also work to improve your general health. Eating
a balanced diet and getting regular exercise are important
parts of being healthy.
For more information, contact:
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