Alcoholism

Definition

Alcoholism is drinking alcoholic beverages at a level that interferes with physical health, mental health, and social, family, or job responsibilities.

Alternative Names

Causes

Alcoholism is a type of drug addiction. There is both physical and mental dependence on alcohol.

Alcoholism is divided into 2 categories: dependence and abuse. People who are dependent on alcohol spend a great deal of time drinking alcohol, and getting it.

Physical dependence involves:

• A need for increasing amounts of alcohol to get drunk or achieve the desired effect (tolerance)
• Alcohol-related illnesses
• Memory lapses (blackouts) after drinking episodes
• Withdrawal symptoms when alcohol use is stopped

The most severe drinking behavior includes long drinking binges that lead to mental or physical problems. Some people are able to gain control over their dependence in earlier phases before they totally lose control. But no one knows which heavy drinkers will be able to regain control and which will not.

There is no known common cause of alcoholism. However, several factors may play a role in its development. A person who has an alcoholic parent is more likely to become an alcoholic than a person without alcoholism in the immediate family.

Research suggests that certain genes may increase the risk of alcoholism, but which genes or how they work is not known.

Psychological factors may include:

• A need for anxiety relief
• Conflict in relationships
• Depression
• Low self-esteem

Social factors include:

• Ease of getting alcohol
• Peer pressure
• Social acceptance of alcohol use
• Stressful lifestyle

The incidence of alcohol intake and related problems is rising. Data indicate that about 15% of people in the United States are problem drinkers, and about 5% to 10% of male drinkers and 3% to 5% of female drinkers could be diagnosed as alcohol dependent.

References

Goldman L, Ausiello D. Cecil Textbook of Medicine. 22nd ed. Philadelphia, Pa: WB Saunders; 2004:79-80.

Pettinati HM, O'Brien CP, Rabinowitz AR, Wortman SP, Oslin DW, Kampman KM, Dackis CA. The status of naltrexone in the treatment of alcohol dependence: specific effects on heavy drinking. J Clin Psychopharmacol, 2006;26:610-625.

Assanangkornchai S, Srisurapanont M. The treatment of alcohol dependence. Curr Opin Psychiatry, 2007;20:222-227.

Laaksonen E, Koski-Jännes A, Salaspuro M, Ahtinen H, Alho H. A randomized, multicentre, open-label, comparative trial of disulfiram, naltrexone and acamprosate in the treatment of alcohol dependence. Alcohol Alcohol, 2008;43:53-61.