Alcoholism is a chronic, often progressive disease in which a person
continues to crave alcohol and drink despite repeated alcohol-related problems
(like losing a job or getting into trouble with the law). Approximately 18
million people in the United States abuse alcohol. Teen drinking is on the rise
with over 4 million adolescents between the ages of 14 and 17 having trouble at
school, at home, or even with the law because of alcohol use. This disease
contributes to more than 50 percent of car and industrial fatalities, drownings,
and child or domestic abuse.
|Signs and Symptoms|
- Craving for alcohol
- Inability to control drinking habits
- Withdrawal symptoms, such as nausea, sweating, shakiness, and anxiety,
when alcohol use is stopped
- Tolerance (the need for increasing amounts of alcohol in order to feel
- Psychological, social, and occupational dysfunction
- Malnutrition, weight loss, and poor appetite
- Repeated infections—for example, urinary
tract infections or pneumonia
- Lung conditions—complicated by smoking
- Central nervous system disorders—unsteady
gait or stance; cognitive impairment; psychiatric manifestations (for example,
depression, mood swings, anxiety, or psychotic behavior); blackouts; coma
- Impaired concentration and performance at school and work
- Bad judgment - for example, engaging in risky
sexual behavior or driving while drunk
- Irritability, hostility, even aggression
- Sleep disruptions
- Diarrhea, vomiting, gastrointestinal bleeding
- Men—increased sexual drive with decreased
ability to maintain an erection
- Women—miscarriage, stopping of menstrual
- Inflammation of the pancreas
- Liver disease
- Poor wound healing
- Buildup of fluid in the body
- Hypoglycemia (low blood sugar)
- Hypothermia (reduction of body temperature)
If you have a family history of alcohol abuse, you are more likely to develop
the condition than someone without a family history. Other factors that may
increase your risk include:
- Drinking more than one to two drinks per day
- Smoking cigarettes (particularly teenagers)
- Starting to consume alcohol at an early age
- Being under a lot of stress
- Having a preexisting psychiatric disorder
If you or someone you care for is experiencing symptoms associated with
alcoholism, you should see your health care provider. He or she can help make a
diagnosis and guide you in determining which treatment or combination of
therapies will work best.
Your provider will take a history and do a physical exam to look for specific
organ damage or trauma and to evaluate if your muscles are tender or weak.
Questions that he or she may ask include:
- Have you ever thought that you needed to cut back on the amount of
alcohol you drink?
- Has a spouse, friend or coworker ever annoyed you by asking you to
- Do you ever feel guilty about the amount that you drink?
- Do you ever drink in the morning or early in the day to soothe a
hangover, get the day started, or get rid of the shakes?
Laboratory tests will reveal recent alcohol use if you have a high blood
alcohol level. Liver function tests will be done to see if there has been damage
to your liver from alcohol. Imaging techniques may be used to look for
alcohol-related damage to bones or other organs.
If you don't drink now, don't start. If you do drink, do so ONLY in
moderation. This means no more than two drinks per day if you are a man and no
more than one drink per day if you are a woman.
To prevent teen drinking, consider the following:
- Stay involved and interested in your teenager's life.
- Talk openly to your children, especially pre-teens and teens, about
the widespread presence and dangers of alcohol and drugs.
- Have clear, non-negotiable rules about NOT using alcohol and drugs.
- Act as a role model - DON'T drink
excessively, use other drugs or smoke.
- Strongly urge your children to NOT smoke.
- Encourage your children to become active in sports, music, the arts,
or other activities.
- Know where your children and teens are at all times and make sure that
there is always appropriate adult supervision.
- Monitor your teenager for aggressive behavior, feelings of anger or
depression, and poor school performance. If any of these develop, consider
whether alcohol may be a reason.
NEVER drink and drive or allow your teenager to be driven in the car by
someone who has been drinking.
The first and most important step in getting appropriate treatment for
alcoholism is recognizing that you have a problem. Often, family members and
close friends initiate treatment for the person with the addiction.
Treatment must address both existing medical issues and rehabilitation, such
as motivational techniques for abstaining from drinking, psychotherapy, and
Alcoholics Anonymous (or other support groups). For rehabilitation, referred to
as "recovery" or staying sober, there are both outpatient and inpatient programs
available. Talk to a health care provider about what is best for you or your
- Attend Alcoholics Anonymous.
- Family members should attend Al Anon to learn how best to help the
person with the addiction and to get help and support themselves.
- Exercise regularly to help reduce cravings.
- Quit smoking.
Your provider may prescribe the following medications.
- Tranquilizers called benzodiazepines are used during the first few
days of treatment to help with safe withdraw from alcohol. Alcohol withdrawal
can be life-threatening; therefore, inpatient treatment may be necessary.
- Antipsychotic medications for people who do not respond to
- Naltrexone, used in combination with counseling, may lessen the
craving for alcohol and help prevent a return to drinking. It is only used after
detoxification - that is, once you are no longer
physically addicted to alcohol.
- Disulfiram, an older medication, which discourages drinking by causing
nausea, vomiting, and other unpleasant physical reactions when alcohol is used.
- Medications for specific organ damage or for symptoms associated with
|Nutrition and Dietary Supplements|
A well-balanced, nutritionally adequate diet can help stabilize fluctuations
in blood sugar due to alcohol and decrease cravings. Follow these tips and work
with a nutritionist to evaluate if these steps are helping:
- Eliminate simple sugars.
- Increase complex carbohydrates.
- Consume adequate protein.
- Increase essential fatty acids.
- Decrease saturated fats and fried foods.
- Avoid caffeine.
Because chronic use of alcohol decreases your appetite and interferes with
absorption of vital nutrients, taking supplements may be necessary. Potentially
beneficial supplements include vitamin B complex, vitamin C, selenium,
magnesium, and zinc. A combination of amino acids -
namely, carnitine, glutamine, and glutathione - may
help reduce cravings, blood sugar fluctuations, and stress related to alcohol
Thiamine (vitamin B1) is of particular importance if you drink heavy
amounts of alcohol on a regular basis. Thiamine deficiency can lead to a brain
disorder called Wernicke-Korsakoff syndrome. Replacing thiamine alleviates the
symptoms of this syndrome. Wernicke-Korsakoff is actually two disorders in one:
(1) Wernicke's disease which involves damage to nerves in the central and
peripheral nervous systems and is generally caused by malnutrition associated
with habitual alcohol abuse, and (2) Korsakoff syndrome which is characterized
by memory impairment along with symptoms of nerve damage. High doses of thiamine
can improve confusion and muscle coordination and confusion associated with this
disease, but only rarely improves the memory loss.
Gamma-aminobutyric acid (GABA)
Brown rice extracts rich in GABA seem to protect animals from the
liver-damaging effects of alcohol. Whether this same benefit would be safe or
effective in people requires research.
The use of herbs is a time-honored approach to strengthening the body and
treating disease. Herbs, however, contain active substances that can trigger
side effects and interact with other herbs, supplements, or medications. For
these reasons, herbs should be taken with care and only under the supervision of
a practitioner knowledgeable in the field of herbal medicine.
Evening Primrose (Oenothera biennis)
Although more conclusive research is needed, there is some evidence to
suggest that this herb may lessen cravings for alcohol. Evening primrose is
often used as an oil extracted from the seed of this herb. This is commonly
called EPO. The main active ingredient of EPO is gamma-linolenic acid (GLA), an
omega-6 fatty acid that can also be found in borage and black currant oils.
American and Asian ginseng (Panax quinquefolium and Panax ginseng
respectively) may help treat alcohol intoxication because each of these herbs
speed up the metabolism (break down) of alcohol. Faster break down clears
alcohol from your body more quickly. In addition, animal research suggests that
Asian ginseng may reduce the amount of alcohol that is absorbed from the
Milk Thistle (Silybum marianum)
Some studies evaluating milk thistle for the treatment of alcoholic liver
disease have found significant improvements in liver function with use of this
herb. People with the mildest form of alcohol-related liver damage seem to
improve the most. Milk thistle is less effective for those with severe liver
disease such as cirrhosis. (Cirrhosis is characterized by scarring and
permanent, non-reversible damage to the liver. It is often referred to as
end-stage liver disease.)
St. John's Wort (Hypericum perforatum)
Those with depression and alcoholism share certain similarities in brain
chemical activity. In addition, some people (especially men) who are depressed
may mask their feelings or try to cope with their low mood by drinking alcohol.
For these reasons, researchers have considered whether St. John's Wort, often
used to treat depression, may help reduce alcohol consumption. Animal studies
suggest that this may prove to be an appropriate use of this herb. St. John's
Wort interacts with many different medications. It is particularly important,
therefore, that you check with your doctor before using.
Additional herbs that an herbal specialist might consider to support you
while undergoing treatment for alcoholism include:
- Dandelion (Taraxacum officinale): Traditionally used for
liver-related problems and as a nutritional support because it is rich in
vitamins and minerals. Tends to work well with milk thistle.
- Skullcap (Scutellaria lateriflora): Traditionally used for
tension and anxiety, this herb may help ease the withdrawal process.
There have been few studies examining the effectiveness of specific
homeopathic remedies. Professional homeopaths, however, may recommend a
treatment for alcoholism based on their knowledge and clinical experience.
Before prescribing a remedy, homeopaths take into account a person's
constitutional type. In homeopathic terms, a person's constitution is his or her
physical, emotional, and intellectual makeup. An experienced homeopath assesses
all of these factors when determining the most appropriate remedy for a
particular individual. The following are a few examples of remedies that an
experienced homeopath might consider for symptoms related to alcohol abuse or
- Arsenicum album for anxiety and compulsiveness, with nausea,
vomiting, and diarrhea
- Nux vomica for irritability and compulsiveness with
constipation, nausea, and vomiting
- Lachesis for cravings for alcohol, headaches, and difficulty
- Staphysagria for angry individuals who tend to suppress their
emotions and may have been abused physically, sexually, or psychologically in
Cognitive-behavioral therapy with a psychologist or psychiatrist is a very
effective treatment approach for alcohol addiction. This type of therapy, which
is geared toward restructuring your beliefs and thought process about drinking,
can help you cope with stress and control your behavior. Talk to your health
care provider about finding a qualified cognitive-behavioral therapist.
Acupuncture has shown potential as an effective treatment for addiction,
according to a 1997 Consensus Statement by the National Institutes of Health.
While some but not all studies of acupuncture for the treatment of alcohol abuse
have shown benefit, many addiction programs that currently offer acupuncture
report that people appear to "like acupuncture" and, in many cases, want to
continue with their detox program for longer periods of time when acupuncture is
provided as a treatment option. This is very important since attendance is
essential for the success of treatment.
Acupuncturists treat people with alcoholism based on an individualized
assessment of the excesses and deficiencies of qi located in various meridians.
In the case of alcoholism, a qi deficiency is usually detected in the liver
meridian, while the gallbladder meridian tends to contain excess qi. In addition
to performing needling treatment, acupuncturists may employ other methods such
as moxibustion (a technique in which the herb mugwort is burned over specific
acupuncture points). Although not all studies agree, auricular acupuncture may
be particularly beneficial.
|Traditional Chinese Medicine|
Kudzu (Pueraria lobata)
Although a modern day scientific study suggests that this Chinese herb does
not reduce cravings for alcohol or improve one's chances of staying sober,
traditional use does include treatment of alcoholism. This one study was quite
small; therefore, this traditional use of kudzu requires more thorough research
to determine whether it is safe and effective or not.
Drinking alcohol while you are pregnant can seriously damage the fetus by
causing failure to grow, reduced IQ, or malformed facial features. The only
foolproof way to protect your fetus from the devastating effects of alcohol is
to completely abstain from drinking alcohol throughout your pregnancy and even
when you are trying to become pregnant.
|Prognosis and Complications|
Possible complications associated with heavy alcohol use include:
- Mental confusion or delirium
- Severe amnesia
- An unsteady gait
- Loss of sperm cells
- Repeated vomiting, ulcers, gastointestinal bleeding
In addition, long-term use of alcohol decreases life expectancy by about 15
years and puts you at significant risk for:
- Liver damage, even liver failure (called cirrhosis)
- High blood pressure, heart disease, and heart failure
- Brain and nerve damage
- Certain types of cancer including mouth, throat, laryngeal (voice
box), esophageal, and breast
- Nutritional deficiencies
- Infections, including pneumonia and tuberculosis
The good news is, however, that even though alcohol abuse is a very serious
condition with potentially dire consequences, it is treatable. If you or someone
you love has a problem, seek the help and advice of a health care professional
as early as possible.
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|Review Date: April 2004|
|Reviewed By: Participants in the review process include: Shiva Barton, ND,Wellspace,
Cambridge, MA; Jacqueline A. Hart, MD, Department of Internal Medicine,
Newton-Wellesley Hospital, Boston, Ma., and Senior Medical Editor, A.D.A.M,
Inc.; Peter Hinderberger, MD, PhD, Ruscombe Mansion Community Health Center,
Baltimore, MD; Marcellus Walker, MD, LAc, (Acupuncture section October 2001) St.
Vincent's Catholic Medical Center, New York, NY; Leonard Wisneski, MD, FACP,
George Washington University, Rockville, MD; Ira Zunin, MD, MPH, MBA,
(Acupuncture section October 2001) President and Chairman, Hawaii State
Consortium for Integrative Medicine, Honolulu,
Copyright © 2004 A.D.A.M., Inc
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