Alcohol Help

(Alcohol Dependence; Alcohol Use Disorder)

Definition

Alcohol abuse is excessive or problematic alcohol consumption. It can progress to alcoholism.

Alcoholism is chronic alcohol abuse that results in a physical dependence on alcohol (withdrawal symptoms) and an inability to stop or limit drinking.

Causes

Several factors can contribute to alcohol abuse and alcoholism, including:

# Genes
# Brain chemicals that may be different than normal
# Social pressure
# Emotional stress
# Pain
# Depression and other mental health problems
# Problem drinking behaviors learned from family or friends

Risk Factors

These factors increase your chance of developing alcoholism. Tell your doctor if you have any of these risk factors:

# Sex: male
# Family members who abuse alcohol (especially men whose fathers or brothers are alcoholic)
# Starting to use alcohol at an early age (younger than 14)
# Using illicit drugs or non-medical use of prescription drugs
# Peer pressure
# Easy access to alcoholic beverages
# Psychiatric disorders, such as depression or anxiety
# Smoking

It is common to deny an alcohol problem. Alcohol abuse can occur without physical dependence.

Alcohol abuse symptoms include:

# Repeated work, school, or home problems due to drinking
# Risking physical safety
# Recurring trouble with the law, often including drinking and driving
# Continuing to drink despite alcohol-related difficulties

Symptoms of alcoholism include:

# Craving a drink
# Unable to stop or limit drinking
# Needing greater amounts of alcohol to feel the same effect
# Giving up activities in order to drink or recover from alcohol
# Drinking that continues even when it causes or worsens health problems
# Wanting to stop or reduce drinking, but not being able

Withdrawal symptoms if alcohol is stopped include:

# Nausea
# Sweating
# Shaking
# Anxiety
# Increased blood pressure
# Seizures ( delirium tremens [DTs])

The brain, nervous system, heart, liver, stomach, gastrointestinal tract, and pancreas can all be damaged by alcoholism.

Diagnosis

Doctors ask a series of questions to assess possible alcohol-related problems, including:

# Have you tried to reduce your drinking?
# Have you felt bad about drinking?
# Have you been annoyed by another person’s criticism of your drinking?
# Do you drink in the morning to steady your nerves or cure a hangover?
# Do you have problems with a job, your family, or the law?
# Do you drive under the influence of alcohol?

Blood tests may be done to:

# Look at the size of your red blood cells and to check for a substance called carbohydrate-deficient transferrin
# Check for alcohol-related liver disease and other health problems

Treatment

Treatment for alcohol abuse or dependence is aimed at teaching patients how to manage the disease. Most professionals believe that this means giving up alcohol completely and permanently.

The first and most important step is recognizing a problem exists. Successful treatment depends on your desire to change. Your doctor can help you withdraw from alcohol safely. This could require hospitalization in a detoxification center. They will carefully monitor you for side effects. You may need medication while you are undergoing detoxification.

Treatments include:

Medications

Drugs can help relieve some of the symptoms of withdrawal and help prevent relapse. The doctor may prescribe medication to reduce cravings for alcohol.

Medications used to treat alcoholism and to try to prevent drinking include:

# Naltrexone (ReVia, Vivitrol)—blocks the high that makes you crave alcohol
# Disulfiram (Antabuse)—makes you very sick if you drink alcohol
# Acamprosate (Campral)—reduces your craving for alcohol

A study showed that an anticonvulsant drug, topiramate (Topamax), may reduce alcohol dependence.
Education and Counseling

Therapy helps you to recognize alcohol’s dangers. Education raises awareness of underlying issues and lifestyles that promote drinking. In therapy, you work to improve coping skills and learn other ways of dealing with stress or pain.
Mentoring and Community Help

Alcoholics Anonymous (AA) helps many people to stop drinking and stay sober. Members meet regularly and support each other. Your family members may also benefit from attending meetings of Al-Anon. Living with an alcoholic can be a painful, stressful situation.

Here are some general statistics on treatment outcomes of individuals one year after attempting to stop drinking:

# 1/3 remained abstinent
# 1/3 resumed drinking but at a lower level
# 1/3 relapsed completely

If you are diagnosed with alcohol abuse or alcoholism, follow your doctor’s instructions .

Prevention

Realizing that alcohol causes problems helps some people avoid it. Suggestions to decrease the risk of alcohol abuse and dependence include:

# Socialize without alcohol.
# Avoid going to bars.
# Do not keep alcohol in your home.
# Avoid situations and people that encourage drinking.
# Make new nondrinking friends.
# Do fun things that do not involve alcohol.
# Avoid reaching for a drink when stressed or upset.
# Limit your alcohol intake to a moderate level.
# Moderate is two or fewer drinks per day for men and one or fewer for women and older adults
# A 12-ounce bottle of beer, a five-ounce glass of wine, or 1.5 ounces of liquor is considered one drink
# If you are a parent, having a good relationship with your children may reduce their risk of alcohol abuse.

Most professionals who treat alcohol abuse and dependence believe that complete abstinence is the only effective “prevention.”

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. Call Your Healthcare Provider Immediately If You Think You May Have A Medical Emergency. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

NYU Langone Medical Center and School of Medicine
550 First Avenue
New York, NY 10016
United States

(212) 263-7300

# Researchers know that the use of various substances is associated with reduced educational attainment.
# A new study has examined substance use and education among male twins from a veteran population.
# Results indicate a strong relationship among early alcohol use, alcohol dependence, daily nicotine use, and fewer years of educational attainment.

Although various kinds of substance use are associated with reduced educational attainment, these associations have been mixed and may also be partially due to risk factors such as socioeconomic disadvantages. A study of substance use and education among male twins from a veteran population has found a strong relationship among early alcohol use, alcohol dependence, daily nicotine use, and fewer years of educational attainment.

Results will be published in the August 2012 issue of Alcoholism: Clinical & Experimental Research and are currently available at Early View.

“Evidence for an association between substance use/abuse/dependence and reduced lifetime educational attainment is mixed,” said Julia D. Grant, research assistant professor of psychiatry at Washington University School of Medicine as well as corresponding author for the study.

“In addition,” said Matt McGue, a professor in the department of psychology at the University of Minnesota, “what is missing is an explanation for the basis of the association. We might consider two possibilities. One, adolescent substance use results in diminished educational achievement because substance use is neurotoxic to the developing adolescent brain, or because adolescents who use substances have experiences that reduce the likelihood they will pursue higher education.”

Another possibility, he added, is that “individuals who use substances in adolescence differ from those who do not on a range of risk factors prior to substance use exposure, which not only lead to their use of substances but also reduce the likelihood they achieve a college education. This possibility means that adolescent substance use is merely an indicator of the risk factors that diminish the likelihood of college attainment.”

“Because our participants were in their late 30s when their educational attainment was assessed, we were better able to address lifetime educational attainment than most previous studies, which have focused on high school dropouts or educational attainment in 18-25 year-olds,” said Grant. “We also examined educational attainment in a veteran cohort that had access to education via benefits of the G.I. bill, thereby alleviating some of the economic barriers to higher education that might otherwise be confounded with alcohol and drug outcomes.”

Grant and her colleagues examined data collected from two points in time: a 1987 questionnaire, and a 1992 telephone diagnostic interview of 6,242 male twins (n=3,121 pairs with a mean age of 41.9 years in 1992) who had served in the U.S. military during the Vietnam-era and were therefore eligible for educational benefits after military service. Specific factors addressed were reduced educational attainment – defined as less than 16 years – as well as early alcohol and cannabis use, daily nicotine use, lifetime cannabis use, and alcohol, nicotine, cannabis, and any illicit drug dependence.

“Although all substance use measures were associated with lower educational attainment in preliminary analyses,” said Grant, “only early alcohol use, alcohol dependence, and daily nicotine use remained significantly associated with reduced educational attainment in twin pairs discordant for substance use. In contrast, the associations between cannabis/other illicit drugs and educational attainment were not significant, suggesting that this association may be attributable to familial influences shared by the two measures.”

“In this study, they conclude that within twin pairs discordant for adolescent substance use, the unexposed twin was more likely to complete college than his/her exposed cotwin,” said McGue. “This provides much stronger support for a causal influence than a standard epidemiological study because of the control afforded by comparing the discordant twins. However, it is important to recognize that it does not prove causality.”

“It is possible that early alcohol use and alcohol dependence impede later educational attainment,” noted Grant. “Possible mechanisms for this include cognitive and motivational changes stemming from early alcohol use/dependence that hinder academic success. Although daily nicotine use is not likely to impair cognitive functioning, it may lead to motivational changes that affect academic performance. It is also possible that the association between these substances and lower educational attainment remains because both are attributable to a factor that we did not control for in our present analyses, such as personality characteristics and cognitive ability prior to substance use.”

Grant said these findings underscore the complicated relationship between substance use and educational attainment.

“By controlling for all familial influences that contribute to both substance use and educational attainment, through our discordant twin design, we have a much stronger indicator of the direct association between substance use and educational attainment,” she said. “However, because we were studying higher levels of education – 16+ years – in high school graduates, we may have understated the true effect of alcohol on education. It may be that these effects are more pronounced at even lower levels of education. Nonetheless, our findings lend credence to ongoing public health efforts to reduce adolescent smoking and drinking, which in turn may have beneficial effects on school dropout and lifelong educational attainment.”

Alcoholism: Clinical & Experimental Research
International Society for Biomedical Research on Alcoholism
ISBRA Office
PO Box 202332
Denver CO 80220-8332
United States

vox 303 355 6420

Alcoholic beverages have already been recognized as carcinogens, that is, using them can increase cancer risk. Now a new study in the journal, Pediatrics confirms that teenage girls drinking alcohol are at higher risk for benign breast disease, which is known to be associated with high risk for breast cancer.

You may hear doctors saying that drinking alcohol may help reduce the heart risk. That is not the case, in fact some researchers deliberately classified drinkers who had health problems and quit because of their health conditions as non-drinkers in a way that non-drinkers had more health problems than drinkers did.

Studies have shown that 10 grams of alcohol per day increases the risk for breast cancer by 7 to 10 percent in adult women. That is, drinking one can of beer or 4-ounce wine gets the drinker at least 11 grams of alcohol.

The current study found a dose-dependent relationship between alcohol drinking during adolescence and the development of proliferative benign breast disease, which is known to elevate the risk for breast cancer four times.

Some researchers speculated that alcohol intake may lower the serum levels of folate, a vitamin which is involved in gene expression and DNA repair. Left unrepaired, injured DNA can become cancerous.

Breast cancer kills about 50,000 women in the United States each year and the disease is diagnosed in about 200,000 women each year in the country, according to the National Cancer Institute. Breast cancer is in many cases preventable. There are many things men and women can do to reduce the risk.

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Phone: 503 512-5193