Alcoholism

Alcoholism is when someone keeps drinking alcohol even though it causes problems in their life. They might feel they need to drink to feel okay, or they can’t stop even when they want to. People have known about this for a very long time, and many people around the world struggle with it today.

Drinking a lot over a long time can hurt many parts of the body, especially the brain, heart, and liver. It can cause trouble sleeping and memory problems. It can also make the heart beat irregularly and weaken the immune system.

Alcoholism can shorten a person’s life. Drinking while pregnant can harm the baby, and drinking while driving can lead to accidents. Both family history and environment play roles in whether someone develops alcoholism. Stress, anxiety, and easy access to alcohol also increase the risk.

Treating alcoholism often needs careful medical help. Some medicines can help, and counseling or support groups like Alcoholics Anonymous are often used to help people stay sober. These groups help many people stay healthy and avoid drinking.

Signs and symptoms

Drinking too much alcohol can cause big problems. When someone drinks a lot all at once, it is called binge drinking. Many people struggle with drinking too much.

If someone drinks too much over time, their body can get used to it. They might need more alcohol to feel the same way, and it can become hard to stop. This can make them feel very eager to drink and can hurt their mind and body. They might also feel very sad.

There are signs that show someone might be drinking too much. They might drink more than they plan to, forget things they did while drinking, or keep promising to stop but can’t. They might also have trouble at work or school, feel worse about themselves, or have problems with family and friends.

Drinking too much can cause problems right away. It can make someone feel very happy at first, but as they drink more, they might feel sleepy, have trouble balancing, or even pass out. Very high levels of alcohol in the blood can be very dangerous.

Over time, drinking too much can hurt many parts of the body, like the liver, heart, and brain. It can also cause problems with memory and mood. Women often experience these problems faster than men.

People who struggle with alcohol might also have other mental health issues. These can make it even harder to stop drinking. Alcohol can also cause problems in relationships and at work.

Causes

A mix of genes and life experiences can affect the chances of someone developing alcoholism. Genes change how the body handles alcohol, and having family members with alcoholism can raise risk. Starting to drink when very young can also raise the chances of depending on alcohol later.

Hard times in childhood can make someone more likely to struggle with alcohol. Not having good support from family or friends can increase this risk. How genes work in teenage years can make the brain more sensitive to the bad effects of drinking too much alcohol for a long time.

Diagnosis

Because there is disagreement on the definition of the word alcoholism, it is not a recognized diagnosis. The use of the term alcoholism is discouraged due to its heavily stigmatized meanings. It is called alcohol use disorder in the DSM-5 or alcohol dependence in the ICD-11. In 1979, the World Health Organization discouraged the use of alcoholism due to its unclear meaning, preferring alcohol dependence syndrome.

Misuse, problem use, abuse, and heavy use of alcohol refer to improper use of alcohol, which may cause harm to the drinker. The Dietary Guidelines for Americans, issued by the United States Department of Agriculture (USDA) in 2005, defines "moderate use" as no more than two alcoholic drinks a day for men and no more than one alcoholic drink a day for women. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines binge drinking as the amount of alcohol leading to a blood alcohol content (BAC) of 0.08.

The term alcoholism is commonly used, but the word is not clearly defined.

In professional and research, the term alcoholism is not favored, but rather alcohol abuse, alcohol dependence, or alcohol use disorder are used.

In the United States, the Diagnostic and Statistical Manual of Mental Disorders (DSM) is the most common diagnostic guide for mental disorders, whereas most countries use the International Classification of Diseases (ICD) for administrative and diagnostic purposes.

Attitudes and social stereotypes can create barriers to the detection and treatment of alcohol use disorder.

While screening for alcohol misuse is recommended among those over the age of 18, the screening interval is not well established.

The CAGE questionnaire, named for its four questions, is one such example that may be used to screen patients quickly in a doctor's office.

Two "yes" responses indicate that the respondent should be investigated further.

The questionnaire asks the following questions:

1. Have you ever felt you needed to cut down on your drinking?
2. Have people annoyed you by criticizing your drinking?
3. Have you ever felt guilty about drinking?
4. Have you ever felt you needed a drink first thing in the morning (eye-opener) to steady your nerves or to get rid of a hangover?

Prevention

Further information: Alcohol education

The World Health Organization, the European Union, and other groups have made rules to reduce the harm from drinking too much alcohol. Some of these rules include making it harder for younger people to buy alcohol, like raising the age needed to purchase it, and limiting alcohol ads. Another way is to make alcohol more expensive, because when prices go up, people often drink less.

Good information on TV, radio, and other media can help people learn why drinking too much can be bad. Parents can also learn tips to help their children avoid drinking too much. Since some people drink when they are worried or stressed, reducing stress can also help prevent alcohol problems.

Management

Treatments for alcoholism are different because people think about it in many ways. Some see it as a health problem, while others think it is a choice. Most treatments help people stop drinking and then support them to avoid starting again. Because many things can encourage drinking, all of these things need to be addressed to help someone stay alcohol-free.

One common way to manage alcoholism is to stop drinking completely and then join support groups or learn new skills to cope. Some people choose ways to reduce harm instead of stopping entirely. Medical help may include special medicines or therapy to manage withdrawal symptoms and support staying alcohol-free.

Research

Topiramate can help people who want to stop drinking or drink less. It changes how the brain works.

Baclofen, a GABA_B receptor medicine, is being studied to help with drinking problems, but more research is needed.

Some medicines might be used with alcohol treatment. For example, benzodiazepine dependence is common among people with alcohol problems. These medicines can make people want to drink more. Careful steps are needed when stopping these medicines.

People with alcohol problems might also use other substances like opiates or illegal drugs, which can make things more difficult.

Epidemiology

The World Health Organization says that in 2016, about 380 million people around the world drank too much alcohol. This affects about 5.1% of people over 15 years old, especially more men and younger adults. It is least common in Africa but most common in Eastern Europe.

In the United States in 2015, about 17 million adults and around 700,000 teenagers between 12 and 17 years old drank too much. Many people in the United States and Western Europe have had drinking problems at some point in their lives. Scientists agree that drinking too much can be a health issue, influenced by both genes and environment, often starting in teenage years or early adulthood.

Prognosis

Alcoholism can shorten a person's life. The biggest health risks come from problems with the heart. Many people struggle with strong feelings that can lead to difficult decisions.

Some people with alcohol dependence can return to drinking in a safer way after a year, though many need support to stay healthy.

History

Alcohol has been used and sometimes misused for a very long time. Ancient writings from places like Egypt and Babylon talk about problems with drinking too much. Some cultures even worshipped alcohol, while others warned against drinking too much.

A long time ago, people began to notice that drinking too much alcohol could hurt the body. In the 1700s, a doctor named Benjamin Rush said that alcohol could cause health problems. Later, doctors started looking at both the alcohol and the person drinking to understand these problems better. The word alcoholism was first used in 1852 by a doctor named Magnus Huss to describe the bad effects of alcohol on the body.

In the early 1900s, many people joined groups that wanted to stop alcohol use, which led some countries to ban alcohol for a time. These bans helped reduce some health problems related to alcohol. Today, the cost of alcohol misuse is very high, affecting health and the economy.

Evolution

Alcoholism is a problem that goes far back in human history. Scientists study this by looking at how humans changed over time. Early humans sometimes ate fruits that had turned into wine by themselves. These fruits had a kind of alcohol called ethanol. This ethanol gave them extra energy and nutrients, helping those who could find these fruits. Over time, some people may have naturally liked these fermenting fruits better. This might explain why some people today find it harder to avoid too much alcohol.

As humans changed, they lived in places where fruits turned into wine quickly. This made them prefer ethanol. Even tiny amounts of ethanol might have helped their health, just like a little stress can sometimes be good. But today, alcohol is easy to find and drink in big amounts, which can cause problems. Just like how easy access to sugary and fatty foods can cause weight problems, easy access to alcohol can cause alcoholism.

Society and culture

Drinking alcohol for a long time can cause many problems for society. It can lead to lost work hours, medical costs from injuries, and expenses for treatment centers. Alcohol use can contribute to head injuries, car accidents, and violence.

The costs of alcohol misuse can be very high, using a lot of a country's money. In some places, these costs are a big part of all the money spent on drug misuse. For example, in the United Kingdom, the cost was estimated to be a large amount of money in 2001, and in the United States, it was even higher in 2006.

The idea of "hitting rock bottom" means reaching a very low point in life because of alcohol misuse. This might involve losing a job, harming relationships, or facing health problems. Some groups and researchers talk about this idea when helping people change their behavior.

Stereotypes about alcohol use appear in stories and popular culture. For example, the "town drunk" is a common character. These stereotypes can sometimes be based on unfair views about different groups of people. Studies show that alcohol use varies in different countries and cultures.

Some natural substances, like peyote, have been studied for their possible help in treating alcohol misuse.