International Independent University of Environmental
and Political Sciences (IIUEPs)
Done by: Alexander V Myskin, Group 201
Getting the Facts
For many people, the facts about alcoholism are not
clear. What is alcoholism, exactly? How does it differ from alcohol abuse? When
should a person seek help for a problem related to his or her drinking? This
information will explain alcoholism and alcohol abuse, symptoms of each, when
and where to seek help, treatment choices, and additional helpful resources.
A Widespread Problem
For most people, alcohol is a pleasant accompaniment
to social activities. Moderate alcohol use--up to two drinks per day for men
and one drink per day for women and older people (A standard drink is one
bottle of beer or wine, one glass of wine) - is not harmful for most adults.
Nonetheless, a substantial number of people have serious trouble with their
drinking. Currently, nearly 30 million Russians - abuse alcohol or are
alcoholic. Several million more adults engage in risky drinking patterns that
could lead to alcohol problems. In addition, approximately 53 percent of men
and women in Russian Federation report that one or more of their close
relatives have a drinking problem.
The consequences of alcohol misuse are serious--in
many cases, life-threatening. Heavy drinking can increase the risk for certain
cancers, especially those of the liver, esophagus, throat, and larynx (voice
box). It can also cause liver cirrhosis, immune system problems, brain damage,
and harm to the fetus during pregnancy. In addition, drinking increases the
risk of death from automobile crashes, recreational accidents, and on-the-job
accidents and also increases the likelihood of homicide and suicide.
What Is Alcoholism?
Alcoholism, which is also known as "alcohol
dependence syndrome," is a disease that is characterized by the following
Craving: A strong need, or compulsion, to drink.
Loss of control: The frequent inability to stop
drinking once a person has begun.
Physical dependence: The occurrence of withdrawal
symptoms, such as nausea, sweating, shakiness, and anxiety, when alcohol use is
stopped after a period of heavy drinking. These symptoms are usually relieved
by drinking alcohol or by taking another sedative drug.
Tolerance: The need for increasing amounts of alcohol
in order to get "high."
Alcoholism has little to do with what kind of alcohol
one drinks, how long one has been drinking, or even exactly how much alcohol
one consumes. But it has a great deal to do with a person's uncontrollable need
for alcohol. This description of alcoholism helps us understand why most
alcoholics can't just "use a little willpower" to stop drinking. He
or she is frequently in the grip of a powerful craving for alcohol, a need that
can feel as strong as the need for food or water. While some people are able to
recover without help, the majority of alcoholic individuals need outside
assistance to recover from their disease. With support and treatment, many
individuals are able to stop drinking and rebuild their lives.
Many people wonder: Why can some individuals use
alcohol without problems, while others are utterly unable to control their
drinking? Yet it is important to recognize that aspects of a person's
environment, such as peer influences and the availability of alcohol, also are
significant influences. Both inherited and environmental influences are called
"risk factors." But risk is not destiny. Just because alcoholism
tends to run in families doesn't mean that a child of an alcoholic parent will
automatically develop alcoholism.
What Is Alcohol Abuse?
Alcohol abuse differs from alcoholism in that it does
not include an extremely strong craving for alcohol, loss of control, or
physical dependence. In addition, alcohol abuse is less likely than alcoholism
to include tolerance (the need for increasing amounts of alcohol to get
"high"). Alcohol abuse is defined as a pattern of drinking that is
accompanied by one or more of the following situations within a 12-month
Failure to fulfill major work, school, or home
Drinking in situations that are physically dangerous,
such as while driving a car or operating machinery;
Recurring alcohol-related legal problems, such as
being arrested for driving under the influence of alcohol or for physically
hurting someone while drunk;
Continued drinking despite having ongoing relationship
problems that are caused or worsened by the effects of alcohol.
While alcohol abuse is basically different from
alcoholism, it is important to note that many effects of alcohol abuse are also
experienced by alcoholics.
What Are the Signs of a Problem?
How can you tell whether you, or someone close to you,
may have a drinking problem? Answering the following four questions can help
you find out. (To help remember these questions, note that the first letter of
a key word in each of the four questions spells "CAGE.")
Have you ever felt you should Cut down on your
Have people Annoyed you by criticizing your drinking?
Have you ever felt bad or Guilty about your drinking?
Have you ever had a drink first thing in the morning
to steady your nerves or to get rid of a hangover (Eye opener)?
One "yes" response suggests a possible
alcohol problem. If you responded "yes" to more than one question, it
is highly likely that a problem exists. In either case, it is important that
you see your doctor or other health care provider right away to discuss your
responses to these questions. He or she can help you determine whether you have
a drinking problem and, if so, recommend the best course of action for you.
Even if you answered "no" to all of the
above questions, if you are encountering drinking-related problems with your
job, relationships, health, or with the law, you should still seek professional
help. The effects of alcohol abuse can be extremely serious--even fatal--both
to you and to others.
The Decision To Get Help
Acknowledging that help is needed for an alcohol
problem may not be easy. But keep in mind that the sooner a person gets help,
the better are his or her chances for a successful recovery.
Any reluctance you may feel about discussing your
drinking with your health care professional may stem from common misconceptions
about alcoholism and alcoholic people. In our society, the myth prevails that
an alcohol problem is somehow a sign of moral weakness. As a result, you may
feel that to seek help is to admit some type of shameful defect in yourself. In
fact, however, alcoholism is a disease that is no more a sign of weakness than
is asthma or diabetes. Moreover, taking steps to identify a possible drinking
problem has an enormous payoff--a chance for a healthier, more rewarding life.
When you visit your health care provider, he or she
will ask you a number of questions about your alcohol use to determine whether
you are experiencing problems related to your drinking. Try to answer these
questions as fully and honestly as you can. You also will be given a physical
examination. If your health care professional concludes that you may be
dependent on alcohol, he or she may recommend that you see a specalist in
diagnosing and treating alcoholism. You should be involved in making referral
decisions and have all treatment choices explained to you.
The nature of treatment depends on the severity of an
individual's alcoholism and the resources that are available in his or her
community. Treatment may include detoxification (the process of safely getting
alcohol out of one's system); taking doctor-prescribed medications, such as
disulfiram or naltrexone, to help prevent a return to drinking once drinking
has stopped; and individual and/or group counseling. There are promising types
of counseling that teach recovering alcoholics to identify situations and
feelings that trigger the urge to drink and to find new ways to cope that do
not include alcohol use. Any of these treatments may be provided in a hospital
or residential treatment setting or on an outpatient basis.
Because the involvement of family members is important
to the recovery process, many programs also offer brief marital counseling and
family therapy as part of the treatment process. Some programs also link up
individuals with vital community resources, such as legal assistance, job
training, child care, and parenting classes.
Virtually all alcoholism treatment programs also
include meetings of Alcoholics Anonymous (AA), which describes itself as a
"worldwide fellowship of men and women who help each other to stay
sober." While AA is generally recognized as an effective mutual help
program for recovering alcoholics, not everyone responds to AA's style and
message, and other recovery approaches are available. Even those who are helped
by AA usually find that AA works best in combination with other elements of
treatment, including counseling and medical care.
Can Alcoholism Be Cured?
While alcoholism is a treatable disease, a cure is not
yet available. That means that even if an alcoholic has been sober for a long
while and has regained health, he or she remains susceptible to relapse and
must continue to avoid all alcoholic beverages. "Cutting down" on
drinking doesn't work; cutting out alcohol is necessary for a successful
However, even individuals who are determined to stay
sober may suffer one or several "slips," or relapses, before
achieving long-term sobriety. Relapses are very common and do not mean that a
person has failed or cannot eventually recover from alcoholism. Keep in mind,
too, that every day that a recovering alcoholic has stayed sober prior to a
relapse is extremely valuable time, both to the individual and to his or her
family. If a relapse occurs, it is very important to try to stop drinking once
again and to get whatever additional support is needed to abstain from
Help for Alcohol Abuse
If your health care provider determines that you are
not alcohol dependent but are nonetheless involved in a pattern of alcohol
abuse, he or she can help you:
Examine the benefits of stopping an unhealthy drinking
Set a drinking goal for yourself. Some people choose
to abstain from alcohol, while others prefer to limit the amount they drink.
Examine the situations that trigger your unhealthy
drinking patterns, and develop new ways of handling those situations so that
you can maintain your drinking goal.
Some individuals who have stopped drinking after
experiencing alcohol-related problems choose to attend AA meetings for
information and support, even though they have not been diagnosed as alcoholic.
Genetic research: Scientists are now studying 3,000
individuals from several hundred families with a history of alcoholism in order
to pinpoint the location of genes that influence vulnerability to alcoholism.
This new knowledge will help identify individuals at high risk for alcoholism
and also will pave the way for the development of new treatments for
alcohol-related problems. Other research is investigating the ways in which
genetic and environmental factors combine to cause alcoholism.
New medications: Studies have led to the Food and Drug
Administration's approval of the medication naltrexone for the treatment of
alcoholism. When used in combination with counseling, this prescription drug
lessens the craving for alcohol in many people and helps prevent a return to
heavy drinking. Naltrexone is the first medication approved in 45 years to help
alcoholics stay sober after they detoxify from alcohol.
Together, these investigations will help to prevent
alcohol problems; identify alcohol abuse and alcoholism at earlier stages; and
make available new, more effective treatment approaches for individuals and
The availability and accessibility of alcohol may
influence employee drinking. More than two-thirds of the 984 workers surveyed
at a large manufacturing plant said it was "easy" or "very
easy" to bring alcohol into the workplace, to drink at work stations, and
to drink during breaks (14). Twenty-four percent reported any drinking at work
at least once during the year before the survey (15). In a survey of 6,540
employees at 16 worksites representing a range of industries, 23 percent of
upper-level managers reported any drinking during working hours in the previous
Restricting workers' access to alcohol may reduce
Limited work supervision, often a problem on evening
shifts, has been associated with employee alcohol problems (2,18). In one study
of 832 workers at a large manufacturing plant, workers on evening shifts,
during which supervision was reduced, were more likely than those on other
shifts to report drinking at work (15).
There is wide variation in the existence of alcohol
policies, in employees' awareness of them, and in their enforcement in
workplaces across the country. Researchers found that most managers and
supervisors in one large manufacturing plant had little knowledge of the
company's alcohol policy. In addition, supervisors were under constant pressure
to keep production moving and were motivated to discipline employees for
drinking only if the drinking was compromising production or jeopardizing
safety. Workers' knowledge that policies were rarely enforced seemed to
encourage drinking (14).
Effects of Employee Drinking
Alcohol-related job performance problems are caused
not only by on-the-job drinking but also by heavy drinking outside of work
(15,19). Ames and colleagues (15) found a positive relationship between the
frequency of being "hungover" at work and the frequency of feeling
sick at work, sleeping on the job, and having problems with job tasks or
co-workers. The hangover effect was demonstrated among pilots whose performance
was tested in flight simulators. Yesavage and Leirer (20) found evidence of
impairment 14 hours after pilots reached blood alcohol concentrations (BACs) of
between 0.10 percent and 0.12 percent. Morrow and colleagues (21) found that
pilots were still significantly impaired 8 hours after reaching a BAC of 0.10
percent. Drinking at work, problem drinking, and frequency of getting
"drunk" in the past 30 days were positively associated with frequency
of absenteeism, arriving late to work or leaving early, doing poor work, doing
less work, and arguing with co-workers (19).
Preventing Alcohol Problems in the Workplace
Health promotion programs offered in the workplace may
reduce employees' alcohol-related problems (22). An employee health promotion
program delivered in three 2-hour sessions at one manufacturing plant was
designed to increase participants' awareness of the health risks related to
stress and drinking. More than one-half of the 294 workers attended the
sessions. Researchers based their results on data from 120 employees who
completed prestudy and poststudy evaluations. After 6 months, 76 percent of the
heaviest drinkers reportedly reduced their alcohol consumption. Moderate
drinkers also reduced their consumption, and participants reported changes in their
attitudes toward drinking and drinking and driving, knowledge about problem
drinking, and recognition of signs of a drinking problem (23).
A 15-session worksite coping-skills intervention
designed to reduce work- and family-related risk, to enhance protective
factors, and to reduce negative health outcomes was conducted among 136 female
secretaries (24). Six months later, participants reported less work-related
stress, higher social support, and less alcohol use compared with a control
group. Twenty-two months later, participants reported greater use of coping
strategies and less drinking.