Understanding Alcohol Abuse -- the Basics

    People have been brewing and fermenting alcoholic drinks since the dawn of civilization. Consumed in moderate amounts, alcoholic beverages are relaxing and in some cases may even have beneficial effects on heart health. Consumed in excess, alcohol is poisonous and is considered a drug. It is estimated that between 18 million -- or one in 12 adults -- in the U.S. abuse alcohol or are chronic alcoholics. Nearly 100,000 Americans die each year as a result of alcohol abuse, and alcohol is a factor in more than half of the country's homicides, suicides, and traffic accidents. Alcohol abuse also plays a role in many social and domestic problems, from job absenteeism and crimes against property to spousal and child abuse.


    The immediate physical effects of drinking alcohol range from mild mood changes to complete loss of coordination, vision, balance, and speech -- any of which can be signals of acute alcohol intoxication, or drunkenness. These effects usually wear off in a matter of hours after a person stops drinking. Many law-enforcement agencies regard a .08 percentage of alcohol in the bloodstream as evidence of intoxication. Larger amounts of blood alcohol can impair brain function and eventually cause unconsciousness. An extreme overdose, alcohol poisoning, can be fatal.

    Chronic alcoholism is a progressive, potentially fatal disease, characterized by an incessant craving for, increased tolerance of, physical dependence upon, and loss of control over drinking alcohol. The physical dependence on alcohol may or may not be obvious to other people. While some chronic alcoholics get very drunk, others exercise enough control to give the appearance of coping with everyday affairs in a near-normal way. However, alcoholism can lead to a number of physical ailments, including hypoglycemia, high blood pressure, brain and heart damage, end-stage liver damage, enlarged blood vessels in the skin, pneumonia, tuberculosis, chronic gastritis, and recurrent pancreatitis.

    Alcoholism can also lead to impotence in men, damage to the fetus in pregnant women, and an elevated risk of cancer of the larynx, esophagus, liver, breast, stomach, pancreas, and upper gastrointestinal tract. Because alcoholics seldom have adequate diets, they are likely to have nutritional deficiencies. Heavy drinkers typically have impaired liver function, and up to one in five develops cirrhosis.

    The alcoholic's continual craving for alcohol makes abstinence -- an important goal of treatment -- extremely difficult. The condition is also complicated by denial: Alcoholics employ a range of psychological maneuvers to blame their problems on something other than alcohol, creating significant barriers to recovery. Historically, alcoholic behavior was blamed on a character flaw or weakness of will; many authorities now consider chronic alcoholism a disease that can afflict anyone.

Alcoholism is particularly insidious among young people and the elderly, in part because the symptoms are not easily recognized until the affected person becomes truly alcohol dependent.

What Causes Alcoholism?
    The cause of alcoholism seems to be a blend of genetic, physical, psychological, environmental, and social factors that vary among individuals. Genetic factors are considered crucial: A given person's risk of becoming an alcoholic is three to four times greater if a parent is alcoholic. Some children of alcohol abusers, however, overcome the hereditary pattern by not drinking any alcohol at all.