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Alcoholism Treatment Help

If you are asking yourself, "Am I an alcoholic?", it’s likely that you are struggling with some degree of alcohol abuse. The signs of alcoholism include an inability to control your drinking, withdrawal symptoms when you attempt to stop drinking, and continued cravings to drink even when it negatively affects your life.

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If you have a problem with alcohol, there are many treatment programs available to help. With some assistance, you can achieve sobriety and sustain it for life.

Diagnostic Terms

Terms like alcoholism and alcoholic have very little diagnostic value, but they are commonly used to describe individuals who have severe alcohol abuse problems and have developed physical dependence on alcohol.

The clinical diagnosis of an alcohol use disorder does not require that someone has a severe abuse issue, nor does the person need to have developed physical dependence on alcohol to satisfy the diagnosis. People with alcohol use disorders can have mild syndromes (two symptoms), moderate level syndromes (four or five symptoms) and severe syndromes (more than five symptoms).

Because people who develop more severe substance use disorders often begin with mild level syndromes that become progressively worse, it is important to recognize the signs of alcohol abuse early.

Alcohol Use Disorders

An alcohol use disorder represents a formal mental health diagnosis of a substance use disorder. Someone who is diagnosed with an alcohol use disorder must be experiencing significant problems with functioning or performing their daily activities and/or experiencing significant distress as a result of their use of alcohol.

There are no medical tests, laboratory tests, or imaging tests that can diagnose any substance use disorder. Instead, an evaluation of the person’s behavior and the effects of their alcohol use are used to make a diagnosis.

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The Substance Abuse and Mental Health Administration (SAMHSA) estimates that in 2017, approximately 15 million people qualified for a diagnosis of an alcohol use disorder.

Signs

The formal diagnosis of any substance use disorder can only be made by a professional mental health clinician or medical doctor. If you are concerned that you might be struggling with alcoholism, you should consult with your physician or a mental health clinician.

You may have an alcohol abuse issue if you exhibit two or more of these signs:
  • Your use of alcohol is affecting with your ability to function normally.
  • Your drinking is frequently causing you significant distress.
  • You have trouble controlling your drinking, such that often drink more than you intended to when you first started drinking.
  • You have made frequent attempts to stop or cut down on your use of alcohol but have been unable to do so.
  • You often drink alcohol in situations where it is dangerous to do so.
  • Your use of alcohol has caused you significant problems at work, at school, in your relationships, or in other areas of your life.
  • You have given up activities that you used to enjoy in favor of drinking.
  • You have significant cravings for alcohol.
  • You continue to drink even though you recognize it is causing you problems with your physical or emotional health.
  • You have developed significant tolerance to the effects of alcohol, such that you need more alcohol to get the effects you once achieved with lower amounts.
  • You develop withdrawal symptoms when you stop drinking.

Causes

There is no simple answer to the question of what causes any substance use disorder.

It is believed that the cause of any addiction is multifactorial. It includes influences from the following:
  • Genetic makeup
  • Upbringing
  • Peer relations
  • Personal experiences, particularly experiences with alcohol, trauma, or stressful conditions
  • Learning

No single situation or condition is necessary or sufficient to result in the development of an alcohol use disorder in any person. Instead, a combination of these factors probably triggers alcohol abuse in different people.

Health Risks

Even if consumed in light to moderate amounts, drinking is associated with many health risks. The more alcohol you consume, the greater the risks to your health.

For a man, heavy alcohol use is defined as more than 4 drinks a day, and more than 14 to 15 drinks per week. For a woman, heavy drinking is more than 3 drinks per day, or more than 7 to 8 in a week.
Heavy and even moderate alcohol use is associated with an increased risk to develop the following:
  • Heart disease
  • Stroke
  • Gastrointestinal issues, such as ulcers
  • Neurological disorders, such as dementia
  • Numerous types of cancer
  • Many different infectious diseases due to a weakened immune system and/or engaging in risky behaviors
  • Injuries due to serious accidents
  • Developmental difficulties in the children of women drank alcohol when they were pregnant
  • Lower levels of life achievement and life satisfaction
  • An increased risk of being diagnosed with an additional mental health disorder like depression, bipolar disorder, personality disorder, and others
People who abuse alcohol are more likely to be victims of crimes. They are also more likely to use other drugs like prescription medications, stimulants, and illicit drugs like heroin.

Chronic heavy alcohol use is associated with an increased risk of alcohol poisoning and overdosing on a combination of alcohol and drugs. Because alcohol is a central nervous system depressant and it slows down breathing and heart rates, heavy alcohol use can lead to organ damage as a result of hypoxia, decreased oxygen delivery to your organs (the brain). Although rare, it is possible to die from alcohol poisoning.

Is Mild or Moderate Drinking Good for You?

The question of whether mild alcohol use may have health benefits is debated in the medical confession. Some studies indicate positive effects of mild to moderate alcohol consumption, whereas other studies suggest detrimental effects of even mild alcohol use.

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There is that no professional health organization, such as the American Heart Association, that recommends that anyone begin drinking alcohol to improve their health. Even if there are mild benefits to mild alcohol use, all of these organizations suggest that you severely limit your use of alcohol for maximum health benefits.

Types of Alcoholics

There have been many attempts to distinguish between certain types of alcoholics or to define stages of alcoholism. None of these descriptions have been fully supported by research evidence (empirical evidence).

For instance, the term functional alcoholic is used to designate a type of alcoholic who is able to maintain a job and relatively stable family life. However, when cases of so-called functional alcoholics are actually investigated, it is clear that these individuals do not function normally and suffer from numerous areas of dysfunction that are consistent with the diagnostic criteria for alcohol use disorders.

One popular typology that remains in use by Alcoholics Anonymous is the stage model of alcoholism developed by the physiologist E.M. Jellinek. The Jellinek model proposes five stages of alcoholism and five or more types of alcoholics, but this model has never been supported by research.

The model of T.F. Babor classifies two major types of alcoholics:
Type I (or Type A)
These alcoholics are characterized by having less of a genetic contribution to their alcoholism and less severe psychological issues. This type occurs relatively equally in males and females.
Type II (Type B)
These alcoholics have stronger genetic connections, start drinking before age 25, have more severe psychological issues, and are more often men.

Babor’s model does have some research support, but in the end, the best way to classify types of alcoholics is by the severity of their alcohol abuse.

APA Classification

According to the American Psychiatric Association (APA), there are nine potential diagnostic criteria (symptoms) that can be used to diagnose an alcohol use disorder.

APA designates three different types of alcohol use disorders, which are based on the severity of the substance use disorder. Types are based on the number of symptoms a person expresses within a time period of one year.

  • A diagnosis of a mild alcohol use disorder can be made on the basis of satisfying two of these diagnostic criteria.
  • A moderate alcohol use disorder can be diagnosed if three to five of the criteria are met.
  • A severe alcohol use disorder is diagnosed when a person satisfies more than five of the diagnostic criteria.
  • An alcoholic could be defined as someone with a moderate or severe alcohol use disorder according to these standards.

Treatment for Alcohol Abuse

The treatment approach for anyone who is diagnosed with an alcohol use disorder is to first determine the severity of their alcohol abuse, if they are using any other drugs in conjunction with alcohol, and if they have any other diagnosable forms of mental illness. This determination is made as a result of thorough assessment of the person’s functioning.

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The results of the assessment should be used to develop an individualized treatment plan that focuses on integrating the principles of effective substance use disorder treatment with a person’s situation and needs.

If you are starting treatment for alcohol abuse, you will most likely be supervised by a physician in the early stages of your recovery. If you have a moderate or severe alcohol use disorder, you may be placed in a medical detox program.

This is because withdrawal from alcohol can be potentially fatal due to the development of delirium tremens (a combination of confusion, psychosis, and seizures that can occur during withdrawal associated with severe alcoholism) or seizures alone. Physician-assisted detox programs most often rely on the use of benzodiazepines, administered on a tapering schedule, to control these potentially fatal events. Other medications can also be used as needed.

In addition to the use of medication, behavioral intervention strategies are crucial to recovery. These strategies include substance use disorder therapy (usually cognitive behavioral therapy performed in both individual and group sessions), peer support group participation (such as Alcoholics Anonymous meetings), and other interventions.

Following the completion of a treatment program, you would be expected to remain in recovery-related activities for many years as you remain abstinent from alcohol. Continued participation in sober and supportive activities, such as support group meetings, increases the likelihood of sustained recovery.

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