Just the Facts
Frequently Asked Questions
FAQ's on Alcohol Abuse and Alcoholism
Q #1: What is
alcoholism?
Alcoholism, also known as alcohol dependence, is a disease that includes
the following four symptoms:
- Craving--A strong need, or urge, to drink.
- Loss of control--Not being able to stop drinking
once drinking has begun.
- Physical dependence--Withdrawal symptoms,
such as nausea, sweating, shakiness, and anxiety after stopping drinking.
- Tolerance--The need to drink greater amounts
of alcohol to get "high."
For clinical and research purposes,
formal diagnostic criteria for alcoholism also have been developed. Such
criteria are included in the Diagnostic and Statistical Manual of Mental
Disorders, Fourth Edition, published by the American Psychiatric Association,
as well as in the International Classification Diseases, published
by the World Health Organization. (See also "Publications," Alcohol
Alert No. 30: Diagnostic
Criteria for Alcohol Abuse and Dependence.)
Q #2: Is alcoholism
a disease?
Yes, alcoholism is a disease. The craving that an alcoholic feels for
alcohol can be as strong as the need for food or water. An alcoholic will
continue to drink despite serious family, health, or legal problems.
Like many other diseases, alcoholism
is chronic, meaning that it lasts a person's lifetime; it usually follows
a predictable course; and it has symptoms. The risk for developing alcoholism
is influenced both by a person's genes and by his or her lifestyle. (See
also "Publications," Alcohol
Alert No. 30: Diagnostic
Criteria for Alcohol Abuse and Dependence.)
Q #3: Is alcoholism
inherited?
Research shows that the risk for developing alcoholism does indeed run
in families. The genes a person inherits partially explain this pattern,
but lifestyle is also a factor. Currently, researchers are working to
discover the actual genes that put people at risk for alcoholism. Your
friends, the amount of stress in your life, and how readily available
alcohol is also are factors that may increase your risk for alcoholism.
But remember: Risk is not destiny.
Just because alcoholism tends to run in families doesn't mean that a child
of an alcoholic parent will automatically become an alcoholic too. Some
people develop alcoholism even though no one in their family has a drinking
problem. By the same token, not all children of alcoholic families get
into trouble with alcohol. Knowing you are at risk is important, though,
because then you can take steps to protect yourself from developing problems
with alcohol. (See also "Publications," Alcohol
Alert No. 18: The
Genetics of Alcoholism.)
Q #4: Can alcoholism
be cured?
No, alcoholism cannot be cured at
this time. Even if an alcoholic hasn't been drinking for a long time,
he or she can still suffer a relapse. To guard against a relapse, an alcoholic
must continue to avoid all alcoholic beverages. (See also "Publications/Pamphlets
and Brochures," Alcoholism:
Getting the Facts.)
Q #5: Can alcoholism
be treated?
Yes, alcoholism can be treated.
Alcoholism treatment programs use both counseling and medications to help
a person stop drinking. Most alcoholics need help to recover from their
disease. With support and treatment, many people are able to stop drinking
and rebuild their lives. (See also "Publication," Alcohol
Alert No. 49: New
Advances in Alcoholism Treatment.)
Q #6: Which medications
treat alcoholism?
A range of medications is used to treat alcoholism. Benzodiazepines (Valium®
, Librium®) are sometimes used during the first days
after a person stops drinking to help him or her safely withdraw from
alcohol. These medications are not used beyond the first few days, however,
because they may be highly addictive. Other medications help people remain
sober. One medication used for this purpose is naltrexone (ReVia™).
When combined with counseling naltrexone can reduce the craving for alcohol
and help prevent a person from returning, or relapsing, to heavy drinking.
Another medication, disulfiram (Antabuse®), discourages
drinking by making the person feel sick if he or she drinks alcohol.
Through several medications help
treat alcoholism, there is no "magic bullet." In other words, no single
medication is available that works in every case and/or in every person.
Developing new and more effective medications to treat alcoholism remains
a high priority for researchers. (See also "News Releases," Jan.
17, 1995: Naltrexone
Approved for Alcoholism Treatment and "Publication," Alcohol
Alert No. 33: Neuroscience
Research and Medications Development.)
Q #7: Does alcoholism
treatment work?
Alcoholism treatment works for many people. But just like any chronic
disease, there are varying levels of success when it comes to treatment.
Some people stop drinking and remain sober. Others have long periods of
sobriety with bouts of relapse. And still others cannot stop drinking
for any length of time. With treatment, one thing is clear, however: the
longer a person abstains from alcohol, the more likely he or she will
be able to stay sober.
Q #8: Do you have
to be an alcoholic to experience problems?
No. Alcoholism is only one type
of an alcohol problem. Alcohol abuse can be just as harmful. A person
can abuse alcohol without actually being an alcoholic--that is, he or
she may drink too much and too often but still not be dependent on alcohol.
Some of the problems linked to alcohol abuse include not being able to
meet work, school, or family responsibilities; drunk-driving arrests and
car crashes; and drinking-related medical conditions. Under some circumstances,
even social or moderate drinking is dangerous--for example, when driving,
during pregnancy, or when taking certain medications. (See also "Publications/Pamphlets
and Brochures," Alcoholism:
Getting the Facts.)
Q #9: Are specific
groups of people more likely to have problems?
Alcohol abuse and alcoholism cut
across gender, race, and nationality. Nearly 14 million people in the
United States--1 in every 13 adults--abuse alcohol or are alcoholic. In
general, though, more men than women are alcohol dependent or have alcohol
problems. And alcohol problems are highest among young adults ages 18-29
and lowest among adults ages 65 and older. We also know that people who
start drinking at an early age--for example, at age 14 or younger--greatly
increase the chance that they will develop alcohol problems at some point
in their lives. (See also "News Releases," March
17, 1995: NIAAA
Releases Estimates of Alcohol Abuse and Dependence and Alcohol
Alert No. 23: Alcohol and Minorities.)
Q #10: How can you tell
if someone has a problem?
Answering the following four questions can help you find out if you or
a loved one has a drinking problem:
- Have you ever felt you should cut down on your drinking?
- Have people annoyed you by criticizing your drinking?
- Have you ever felt bad or guilty about your drinking?
- Have you ever had a drink first thing in the morning to steady your
nerves or to get rid of a hangover?
One "yes" answer suggests a possible alcohol problem. More than one "yes"
answer means it is highly likely that a problem exists. If you think that
you or someone you know might have an alcohol problem, it is important
to see a doctor or other health care provider right away. They can help
you determine if a drinking problem exists and plan the best course of
action.
Q #11: Can a problem drinker
simply cut down?
It depends. If that person has been
diagnosed as an alcoholic, the answer is "no." Alcoholics who try to cut
down on drinking rarely succeed. Cutting out alcohol--that
is, abstaining--is usually the best course for recovery. People who are
not alcohol dependent but who have experienced alcohol-related problems
may be able to limit the amount they drink. If they can't stay within
those limits, they need to stop drinking altogether. (See Question
13 which addresses the
issue, "What is a safe level of drinking?") (See also "Publications/Pamphlets
and Brochures," How
to Cut Down on Your Drinking.)
Q #12: If an alcoholic
is unwilling to get help, what can you do about it?
This can be a challenge. An alcoholic can't be forced to get help except
under certain circumstances, such as a violent incident that results in
court-ordered treatment or medical emergency. But you don't have to wait
for someone to "hit rock bottom" to act. Many alcoholism treatment specialists
suggest the following steps to help an alcoholic get treatment:
Stop all "cover ups." Family members often make excuses
to others or try to protect the alcoholic from the results of his or her
drinking. It is important to stop covering for the alcoholic so that he
or she experiences the full consequences of drinking.
Time your intervention. The best time to talk to the drinker
is shortly after an alcohol-related problem has occurred--like a serious
family argument or an accident. Choose a time when he or she is sober,
both of you are fairly calm, and you have a chance to talk in private.
Be specific. Tell the family member that you are worried
about his or her drinking. Use examples of the ways in which the drinking
has caused problems, including the most recent incident.
State the results. Explain to the drinker what you will
do if he or she doesn't go for help--not to punish the drinker, but to
protect yourself from his or her problems. What you say may range from
refusing to go with the person to any social activity where alcohol will
be served, to moving out of the house. Do not make any threats you are
not prepared to carry out.
Get help. Gather information in advance about treatment
options in your community. If the person is willing to get help, call
immediately for an appointment with a treatment counselor. Offer to go
with the family member on the first visit to a treatment program and/or
an Alcoholics Anonymous meeting.
Call on a friend. If the family member still refuses to
get help, ask a friend to talk with him or her using the steps just described.
A friend who is a recovering alcoholic may be particularly persuasive,
but any person who is caring and nonjudgmental may help. The intervention
of more than one person, more than one time, is often necessary to coax
an alcoholic to seek help.
Find strength in numbers. With the help of a health care
professional, some families join with other relatives and friends to confront
an alcoholic as a group. This approach should only be tried under the
guidance of a health care professional who is experienced in this kind
of group intervention.
Get support. It is important to remember that you are not
alone. Support groups offered in most communities include Al-Anon, which
holds regular meetings for spouses and other significant adults in an
alcoholic's life, and Alateen, which is geared to children of alcoholics.
These groups help family members understand that they are not responsible
for an alcoholic's drinking and that they need to take steps to take care
of themselves, regardless of whether the alcoholic family member chooses
to get help. (See Question 19 for referral to support groups.)
You can call the National
Drug and Alcohol Treatment Referral Routing Service (Center
for Substance Abuse Treatment)
at 1-800-662-HELP for information about treatment programs in your local
community and to speak to someone about an alcohol problem.
Q #13: What is a safe level
of drinking?
For most adults, moderate alcohol use--up to two drinks per day for men
and one drink per day for women and older people--causes few if any problems.
(One drink equals one 12-ounce bottle of beer or wine cooler, one 5-ounce
glass of wine, or 1.5 ounces of 80-proof distilled spirits.)
Certain people should not drink at all, however:
- Women who are pregnant or trying to become pregnant
- People who plan to drive or engage in other activities that require
alertness and skill (such as using high-speed machinery)
- People taking certain over-the-counter or prescription medications
- People with medical conditions that can be made worse by drinking
- Recovering alcoholics
- People younger than age 21.
(See also "Publications" Alcohol
Alert No. 16: Moderate
Drinking; Alcohol
Alert No. 27: Alcohol-Medication
Interactions; Alcohol
Alert No 50: Fetal
Alcohol Exposure and the Brain; and Alcohol
Alert No. 52: Alcohol and Transportation Safety)
Q #14: Is it safe to drink during
pregnancy?
No, drinking during pregnancy is
dangerous. Alcohol can have a number of harmful effects on the baby. The
baby can be born mentally retarded or with learning and behavioral problems
that last a lifetime. We don't know exactly how much alcohol is required
to cause these problems. We do know, however, that these alcohol-related
birth defects are 100-percent preventable, simply by not drinking alcohol
during pregnancy. The safest course for women who are pregnant or trying
to become pregnant is not to drink alcohol at all. (See also "Publications"
Alcohol
Alert No.50: Fetal
Alcohol Syndrome and the Brain; "Pamphlets and Brochures," Drinking
and Your Pregnancy.)
Q #15: Does alcohol affect older
people differently?
Alcohol's effects do vary with age. Slower reaction times, problems with
hearing and seeing, and a lower tolerance to alcohol's effects put older
people at higher risk for falls, car crashes, and other types of injuries
that may result from drinking.
Older people also tend to take more
medicines than younger people. Mixing alcohol with over-the-counter or
prescription medications can be very dangerous, even fatal. More than
150 medications interact harmfully with alcohol. (See Question
18 for more information.) In addition,
alcohol can make many of the medical conditions common in older people,
including high blood pressure and ulcers, more serious. Physical changes
associated with aging can make older people feel "high" even after drinking
only small amounts of alcohol. So even if there is no medical reason to
avoid alcohol, older men and women should limit themselves to one drink
per day. (See also "Publications/Pamphlets and Brochures" Age
Page: Aging and Alcohol Abuse
and Alcohol
Alert No. 40: Alcohol
and Aging.)
Q #16: Does alcohol affect women
differently?
Yes, alcohol affects women differently
than men. Women become more impaired than men do after drinking the same
amount of alcohol, even when differences in body weight are taken into
account. This is because women's bodies have less water than men's bodies.
Because alcohol mixes with body water, a given amount of alcohol becomes
more highly concentrated in a woman's body than in a man's. In other words,
it would be like dropping the same amount of alcohol into a much smaller
pail of water. That is why the recommended drinking limit for women is
lower than for men. (See Question
13 for recommended limits.)
In addition, chronic alcohol abuse
takes a heavier physical toll on women than on men. Alcohol dependence
and related medical problems, such as brain, heart, and liver damage,
progress more rapidly in women than in men. (See also "Publications,"
Alcohol
Alert No. 46: Are
Women More Vulnerable to Alcohol's Effects.)
Q #17: Is alcohol good for your
heart?
Studies have shown that moderate drinkers--men who have two or less
drinks per day and women who have one or less drinks per day--are less
likely to die from one form of heart disease than are people who do not drink
any alcohol or who drink more. It's believed that these smaller amounts
of alcohol help protect against heart disease by changing the blood's
chemistry, thus reducing the risk of blood clots in the heart's arteries.
If you are a nondrinker, however, you should not start drinking solely
to benefit your heart. You can guard against heart disease by exercising
and eating foods that are low in fat. And if you are pregnant, planning
to become pregnant, have been diagnosed as alcoholic, or have another
medical condition that could make alcohol use harmful, you should not
drink.
If you can safely drink alcohol
and you choose to drink, do so in moderation. Heavy drinking can actually
increase the risk of heart failure, stroke, and high blood pressure, as
well as cause many other medical problems, such as liver cirrhosis. (See
also "Publications," Alcohol
Alert No. 16:
Moderate Drinking and Alcohol
Alert No. 45: Alcohol Coronary Heart Disease.)
Q #18: When taking medications,
must you stop drinking?
Possibly. More than 150 medications
interact harmfully with alcohol. These interactions may result in increased
risk of illness, injury, and even death. Alcohol's effects are heightened
by medicines that depress the central nervous system, such as sleeping
pills, antihistamines, antidepressants, anti-anxiety drugs, and some
painkillers. In addition, medicines for certain disorders, including
diabetes, high blood pressure, and heart disease, can have harmful interactions
with alcohol. If you are taking any over-the-counter or prescription
medications, ask your doctor or pharmacist if you can safely drink
alcohol. (See also "Publications,"
Alcohol Alert No. 27:
Alcohol-Medication Interactions.)
Q #19:
How can a person get help for an alcohol problem?
There are many national and local
resources that can help. The National Drug and Alcohol Treatment Referral
Routing Service provides a toll-free telephone number, 1-800-662-HELP,
offering various resource information. Through this service you can speak
directly to a representative concerning substance abuse treatment, request
printed material on alcohol or other drugs, or obtain local substance
abuse treatment referral information in your State. See (Treatment
Referral Information.)
Many people also find support groups a helpful aid to recovery. The following
list includes a variety of resources:
Brought to you by the NIAAA, a part of the
NIH, a component of the U.S. DHHS.
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