Alcoholism and Alcohol Abuse

Dr. Purushothaman
September 10, 2013

Did you grow up in a household where cocktail hour was a nightly affair? Do you cope with stress by having a glass of wine? Or two? Do your friends drink heavily?
The causes of alcoholism and alcohol abuse are not precisely known, but they usually result from a combination of factors like those above and more. Some racial groups, like native American Indians, for example, are more at risk than others. There is research that suggests some people have a biological predisposition to alcoholism, but it is not conclusive. Those suffering from mental health issues like anxiety, depression and bipolar disorder are particularly at risk as they often use alcohol to self-medicate. Even the designation of alcoholism as a disease is controversial, as there are some who believe the label of ‘disease’ makes it harder to treat alcoholics.
The Problem
The practice of consuming alcohol is so pervasive in so many societies that it’s often difficult to diagnose when a person has become an alcoholic. With people drinking all around them, the alcoholic can feel like his behavior is normal. But it’s easy to cross the line into problem drinking. The hard part is knowing where that line is and when you’ve stepped over it. A basic rule of thumb is this: if drinking alcohol causes you problems, then you have a drinking problem.
What Are the Warning Signs of Alcoholism?
There are a number of tests you can take to see if you’ve crossed the line. One of the oldest tests available is the Michigan Alcohol Screening Test (MAST) and is generally regarded as effective. Some of the MAST questions are along these lines:
Do you feel you are a normal drinker?
Do those close to you worry or complain about your drinking?
Do you feel guilty about your drinking?
Can you stop drinking when you want to?
Has your drinking created problems between you and your partner or relative?
Have you gotten into trouble at work because of drinking?
Have you neglected your obligations, family or work because of drinking?
Have you ever been arrested for driving under the influence?
Have you ever been arrested for drunken behaviors?
If any of these questions ring a bell with you, you probably have a drinking problem and should consider seeking help.
Substance Abuse v. Alcoholism
Experts make a distinction between alcohol abuse and alcoholism. Alcohol abusers seem to have some control over their drinking, and can set limits, while alcoholics cannot. Nevertheless, alcohol abusers’ behavior can be self-destructive and dangerous. Abusers sometimes neglect their responsibilities at home or work, continue to drink even though it creates problems in their relationships and sometimes encounter alcohol related legal problems. Many abusers’ problems begin with drinking as a means of calming themselves to relieve stress.
Although not all abusers become alcoholics, it’s an indication of a serious risk. As alcohol abusers continue to drink, their tolerance increases and their chances of developing alcoholism are great. Finally, they have to drink more and more to feel good, and their bodies depend on alcohol. When it’s taken away, they suffer severe withdrawal symptoms like shaking, sweating, nausea, vomiting, insomnia, depression, anxiety, fatigue, headaches and loss of appetite.
Even though the problems of alcohol abuse and alcoholism are great, many sufferers find a way to continue destructive behavior by denying they have a problem. If you find yourself rationalizing your drinking, counseling may help. I’ll talk more about this issue next week.

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