Alcoholism in the Family: Now What?
Alcoholism Is a Disease
Alcoholism is a disease that changes the reward system in the brain. Based on decades of scientific research, the leading organizations in the field – the National Institute of Mental Health, the National Institute on Drug Abuse and the American Medical Association, among others – have come to recognize addiction as a disease rather than a sign of moral weakness or lack of willpower.
Although more socially acceptable than other drugs, alcohol abuse is exceedingly dangerous. The immediate health risks associated with excessive alcohol use include injuries, violence, high-risk sex and alcohol poisoning (overdose). Chronic heavy drinking can affect nearly every system in the body, increasing the risk of neurological, gastrointestinal and cardiovascular problems, depression, liver diseases, and certain types of cancer.
Different people consuming the same amount of alcohol might react differently, depending on their age, gender, weight, race, overall physical health, family history and other factors. In addition, the same person can have different reactions one drink to the next. These differences can be attributed to how much they ate before drinking, how quickly they drank, and whether they used other drugs including prescription or over-the-counter medications.
Alcohol Abuse or Dependence?
Historically, there have been separate criteria in the Diagnostic and Statistical Manual for abuse and dependence. Substance abuse is a harmful pattern of use that continues in spite of recurrent legal problems, personal problems, or failure to fulfill major role obligations at work, school or home. Dependence is more severe. It is characterized by tolerance, withdrawal and an inability to stop using, among other factors. Substance abuse may or may not escalate into dependence.
In practical terms, the distinction between substance abuse and dependence has been of little use to clinicians or the general public. Many people erroneously use these terms interchangeably and find it difficult to determine when substance abuse crosses the line into dependence. It is expected that the DSM-V, due to be released this May, will no longer distinguish between abuse and dependence, replacing these categories with one overarching “addictions and related disorders” category.
Mitigating the Risk of Alcoholism
Children of alcoholics are up to four times more likely to struggle with alcoholism and other drug abuse than other kids. They also exhibit more symptoms of depression, anxiety, and other emotional and behavioral disorders and score lower on academic achievement tests and have other difficulties in school. The problems of their youth follow them into adulthood; as many as 50 percent go on to marry an alcoholic.
The good news is biology is not destiny. Environment, upbringing and other factors make up the other half of the risk of developing addiction and are, at least to some extent, within our control. The only sure-fire way to avoid addiction is to abstain from drugs and alcohol. If you’re going to drink or use, bolster your defenses: get educated about the signs of addiction, get involved in activities that build your self-esteem, nurture a spiritual connection, volunteer, exercise or practice yoga or meditation to manage stress. The goal is to make sure the protective factors outweigh the risk factors.