Overview

Alcohol misuse means drinking excessively – more than the lower-risk limits of alcohol consumption.

Alcohol consumption is measured in units. A unit of alcohol is 10ml of pure alcohol, which is about:

  • Half a pint of normal-strength lager
  • A single measure (25ml) of spirits

Alcohol misuse can progress to alcoholism. Alcoholism is a disease characterized by chronic alcohol abuse that results in physical dependence on alcohol (withdrawal symptoms occur if alcohol consumption is abruptly stopped) and an inability to stop or limit drinking (“loss of control”).

Title
Alcohol misuse

Symptoms

Denial that an alcohol problem exists is common. Alcohol abuse can occur without physical dependence. Symptoms include repeated work, school, or home problems due to drinking; recurring trouble with the law, often including drinking and driving; continuing to drink despite alcohol-related difficulties.

Causes

Several factors can contribute to alcohol abuse and alcoholism. They include genes, social pressure, emotional stress, pain, depression and other mental health problems, problem drinking behaviors learned from family or friends.

Diagnosis

Is based on questions to assess possible alcohol-related problems, including:

  • Have you tried to reduce your drinking?
  • Have you felt bad about drinking?
  • Have you been annoyed by another person's criticism of your drinking?
  • Do you drink in the morning to steady your nerves or cure a hangover?
  • Do you have problems with a job, your family, or the law?
  • Do you drive under the influence of alcohol?

Tests may include blood tests to look at the size of red blood cells and to check for a substance called carbohydrate-deficient transferrin; and blood tests to check for alcohol-related liver disease and other health problems.

Treatment

How alcohol misuse is treated depends on how much alcohol a person is drinking. Treatment options include:

  • Counselling – including self-help groups and talking therapies, such as cognitive behavioural therapy (CBT)

  • Medication

    There are two main types of medicines to help people stop drinking. The first is to help stop withdrawal symptoms, and is given in reducing doses over a short period of time.

    The second is a medication to reduce any urge patient may have to drink. These are both given at a fixed-dose, and they are taken for 6 to 12 months.

    detoxification – this involves a health professional  supporting to safely stop drinking; this can be done by helping to slowly cut down over time or by giving  medicines to prevent withdrawal symptoms

    The first step in treatment is getting the patient to accept that he or she has a problem. A group intervention brings together important people in an individual's life. They confront him or her about how alcohol is affecting all of his or her relationships and functioning
Prevention

Realizing that alcohol causes problems helps some people to avoid it. Suggestions to decrease the risk of alcohol abuse and dependence include:

  • Socialize without alcohol.
  • Avoid going to bars.
  • Do not keep alcohol in your home.
  • Avoid situations and people that encourage drinking.
  • Make new nondrinking friends.
  • Do fun things that do not involve alcohol.
  • Avoid reaching for a drink when stressed or upset.
  • Limit your alcohol intake to a moderate level.

Most professionals who treat alcohol abuse and dependence believe that complete abstinence is the only effective “prevention”.

Complications

Alcohol abuse often progresses to alcohol dependence (alcoholism). Symptoms of alcohol dependence include:

  • Craving a drink
  • Unable to stop or limit drinking
  • Needing greater amounts of alcohol to feel the same effect
  • Giving up activities in order to drink or recover from alcohol's effects
  • Drinking that continues even when it causes or worsens health problems
  • Wanting to stop or reduce drinking, but not being able
  • Withdrawal symptoms if alcohol is stopped, include:
    • Nausea
    • Sweating
    • Shaking
    • Anxiety
    • Increased blood pressure
    • Seizures (delirium tremens, “DTs')
    • In addition to the brain, nervous system, heart, and liver, the stomach, gastrointestinal tract, and pancreas can also be damaged by alcoholism.
Risks

Risk factors of alcohol abuse include:

  • Sex: male
  • Family members who abuse alcohol (especially men whose fathers or brothers are alcoholic)
  • Using illicit drugs
  • Peer pressure
  • Easy access to alcoholic beverages
  • Psychiatric disorders, such as depression or anxiety  
  • Smoking
Recovery

Most people with alcohol problems do not decide to make a big change out of the blue or transform their drinking habits overnight. Recovery is usually a more gradual process. In the early stages of change, denial is a huge obstacle. Even after admitting having a drinking problem, people may make excuses and drag their feet. It’s important to acknowledge ambivalence about stopping drinking.