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Alcohol Dependence (Alcoholism)

What is alcohol dependence?

Alcohol dependence (alcoholism) is a disease that includes:

the need to drink greater amounts of alcohol to get high
a strong urge to drink
not being able to control your drinking even though you know that it is harmful
withdrawal symptoms, such as nausea, sweating, and shakiness when you stop drinking.

Signs that you have lost control over your use of alcohol include:

not being able to limit your drinking even when you try
having problems at work or with friends or family because of your alcohol use
spending a lot of time and energy drinking alcohol or getting over its effects.

Alcoholism is one of the most common illnesses seen by health care providers.

How does it occur?

The cause of alcohol dependence is not known. It is more likely if you have:

family members who are dependent on alcohol
stress that is ongoing
feeling pressured by family and friends
mental illness such as depression, bipolar disorder, schizophrenia, or anxiety.

What are the symptoms?

Alcohol dependence takes many forms including:

drinking from time to time
drinking all the time
binge drinking.

When you drink alcohol regularly, it changes how your body works. Your liver processes the alcohol faster. You need to drink more to keep the same amount of alcohol in the blood. 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 but not follow through
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 health care providers 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 health care provider will take a careful medical history of your symptoms. Especially important are how and when you drink alcohol. Your health care provider 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.

Your health care provider will examine you to look for medical problems caused by alcohol use. Lab tests of your urine and blood may be done.

How is it treated?

You must stop drinking alcohol. Your health care provider can help you quit drinking and recover from problems caused by 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), you may need long-term treatment. You may need to stay in the hospital at first or you may be treated as an outpatient. You will also need to go to Alcoholics Anonymous (AA) meetings one or more times per week, at least at the beginning of treatment.

Your health care provider 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 for treating alcohol dependence is naltrexone. Naltrexone can help you overcome cravings for alcohol. It blocks the feelings of pleasure that drinking gives you. These medicines 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. Alcohol counseling and treatment can help you recognize and change the behavior patterns that usually cause you to start drinking.

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 health care provider, pastor, AA, mental health centers, and alcohol or substance abuse treatment programs.

Follow your health care provider's advice for treatment of any other medical problems. Stay away from places where people drink alcohol.

You should also work to improve your general health. Eat a healthy diet and get regular exercise.

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

HIA File BHV3304F.HTM Release 9.0/2006