Alcoholism

The National Council on Alcoholism and Drug Dependence and The American Society of Addiction Medicine define alcoholism:

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“A primary, chronic disease characterized by impaired control over drinking, preoccupation with the drug alcohol, use of alcohol despite adverse consequences, and distortions in thinking.”

The DSM-IV (the diagnostic statistical manual in psychiatry and psychology) defines alcohol abuse as repeated use despite recurrent adverse consequences.  It further defines alcohol dependence as alcohol abuse combined with tolerance, withdrawal, and an uncontrollable drive to drink. Within psychology and psychiatry, alcoholism is the popular term for alcohol dependence.

The legal definition of alcoholism is much narrower than the criteria for a diagnosis of alcoholism. Most states in the United States considered a person to be under the influence of alcohol if his or her blood-alcohol level is above 0.05 or 0.10. Deficits in attentions, reaction time and coordination arise even with the first deink and can interfere with the ability to operate a car or machinery safely and to perform other tasks requiring a steady hand, coordination, clear thinking and clear vision. These deficits are not always readily observable even to trained observers. People often leave parties or bars with blood-alcohol levels well above the legal limit and dangerous deficits in their ability to drive without appearing drunk.

Alcohol increases the activity of gamma-aminobutyric acid (GABA), the main inhibitory neurotransmitter in the brain. By increasing the action of an inhibitory neurotransmitter, alcohol dampens down neural firing. Alcohol also decreases the activity of glutamate, a major excitatory neurotransmitter. At higher doses, the brain’s control centers become increasingly disrupted, thinking and physical coordination become disorganized, fatigue and psychological depression may occur.

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There are at least three distinct patterns of alcohol used by alcohol users and dependents.

• Some people drink large amount of alcohol every day and plan their days around their drinking.

• Binge drinking is defined as consuming five or more drinks within a couple of hours of each other. They may stop drinking when faced crises they must deal with such as illness of their children, or with threat of sanctions for a while but it may soon escalate until severe problems develop. Binge drinking is especially common among members of fraternities and sororities.

• Others are sober during the weekdays but drink heavily during the evenings or perhaps only on weekends.

Alcohol is the most widely used recreational drug in numerous countries. A national survey of 51,000 American college students found that they averaged 4 drinks per week, with 36 percent bingeing in 2 work period (Leichliter et al., 1998). Tolerance develops gradually and can lead to physiological dependence. About 1 in 7 Americans has been or is currently addicted to alcohol (Anthony et al., 1997).

One critical determinant of how quickly people become intoxicated with alcohol is whether their stomach is full or empty. When the stomach is empty, alcohol is more quickly delivered from the stomach to the small intestine, where it is rapidly absorbed into the body. The person with a full stomach may drink significantly more drinks before reaching a dangerous blood – alcohol level or showing clear signs of intoxication people in countries where alcohol is almost always consumed with meals show lower rate of alcohol related substance disorders than do people in countries where alcohol is often consumed in an empty stomach.

Another distinction has been made is between negative affect alcoholism and other alcoholisms. People with negative affect alcoholism tend to have had depressive and anxiety symptoms in childhood and adolescence and to have only begun severe alcohol use and abuse in adulthood. This pattern appears to be more common in women than in men.

Drinking large quantities of alcohol can result in death, even in people who are not chronic abusers of alcohol. About one third of these deaths occur as a result of respiratory paralysis, usually as a result of a final large dose of alcohol in people who are already intoxicated. Alcohol can also interact fatally with a number of substances, for example, antidepressant drugs. (Winger et al., 1992)

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2. Diagnosis for Alcoholism
3. Alcohol Addiction
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