Physical addiction to ethanol. Withdrawal can be very dangerous, including delerium tremens, a condition characterized by shaking and hallucination.

Alcoholism is
A vacation to Mexico which begins every day at noon. The destination is actually not important, as long as you're heading somewhere warm. You are driving a classic Cadillac convertible. Your beautiful and witty friends are stretched out on the leather seats like cats in the sun. They never bore you. Dust from the highway never blows in your face. You can always find a filling station which has full-service and a smiling attendant. Daylight slides down the highway, and though you feel like you will never need to sleep again...

You wake up in a ditch amid a few battered silver hubcaps. Occasionally with an equally battered companion, who (hopefully) is still alive.

Effects of chronic alcoholism

In the brain, alcoholism can result in cognitive problems, Wernicke's and Korsakoff's syndromes and cerebellar damage.

In the gastrointestinal system, alcohol can cause fatty change in the liver which progresses to cirrhosis, pancreatitis, and, secondary to portal hypertension from liver cirrhosis, oesophageal varices.

Alcohol also causes red blood cells to become macrocytic, decrease the production of white blood cells and cause deranged platelet function.

In women of child-bearing age, fetal alcohol syndrome may arise if mothers drink heavily during pregnancy.

Chronic alcoholics are also prone to malnutrition, giving rise to vitamin deficiencies. Thiamine deficiency in particular is the cause of Korsakoff's syndrome, while a folic acid deficiency will accentuate the hematological effects of alcohol.

This is all separate, of course, from the direct intoxicating effects of alcohol itself which cause numerous road accidents and fights in pubs worldwide.

September 2001 - A patient of mine died from the effects of chronic alcoholism. She was only in her 40s and had 5 children but had been drinking at least one to two bottles of wine a day for years. She declined quite rapidly over the course of a few weeks with worsening jaundice and ascites. She had a liver that extended below her umbilicus. She succumbed to renal failure secondary to the hepatorenal syndrome.

Some of this information from Harrison's Textbook of Internal Medicine

Alcoholism falls under the category of toxic diseases.

When a person is drunk, he/she develops a disturbance of co-ordination. This results in double vision, slurring of speech (dysarthria), unsteadiness of the arms and legs, and ataxia of gait. These develop during a bout of drinking, and clear up some hours afterwards (usually with a hang over).

If excessive alcohol is taken over a long period of time, however, the effects differ. The toxin acts directly on the brain and liver, and also causes sufficient damage to the stomach to prevent the absorption of vitamins. The direct effects consist of gross tremulousness of the whole body, followed a few days later by wild confusion and agitation with terrifying visual and auditory hallucinations, and absolute wakefulness. This is delirium tremens (D.Ts.), and occurs in chronic alcoholics who have had a heavy bout of drinking and then stopped.

Treatment is by sedation, and not by giving more alcohol, though this practice dies hard.

After years of heavy drinking, the deficiency of Vitamins causes severe damage to the brain stem. This results in mental confusion, paralysis of eye movements, double vision, ataxia of arms and legs, and in addition a polyneuropathy (i.e. the condition called Wernicke's encephalopathy) and must be treated with massive doses of Vitamin B.

A small tug at the base of my skull while at my desk at work... A dull ache behind my eyes that I know aspirin will not cure... A thirst that a trip to the water fountain doesn't seem to quench.. I know the symptoms, and there is only one cure, only one thing in this pile of shit we call life that will bring even momentary satisfaction... Maybe I'll quit this week? I'll start over, I'll be healthy and likeable.. I'll go to the gym tomorrow, maybe take some vitamins... This one drink won't do any harm! Maybe I'll have another just to top it off...

And thus into the stupor I recreate for myself every night...

One day, when I can pull myself up from this haze of self hate and confusion perhaps I will stop this horrible cycle... Maybe one day the multiple sclerosis that is eating my brain will loosen its grip... Maybe one day this will end.

Who knows...

08/23/06 - I've been dry and healthy for several years now. No, I didn't find religion and join AA. I just fucking stopped torturing myself.
Alcoholism FAQ, written by myself for Biology 1 class

1. What is alcoholism? It is the disorder of the abuse of alcohol. See symptoms below.

2. How is alcoholism influenced by environmental factors? Environmental Factors:

  • The social acceptance of alcohol
  • The people he or she associates with
  • The availability and affordability of alcohol
  • The amount of stress or bereavement

3. How is alcoholism influenced by genetics? Children of alcoholics (COAs):

Children who live with alcoholics are at increased risk because of genetic and/or environmental factors. They may be at more risk for alcoholism just as children of diabetics are at higher risk for diabetes. Children living with alcoholics often develop unhealthy living patterns. They may not learn how to trust themselves or others, how to handle uncomfortable feelings, or how to build positive relationships. COAs who lack these skills are also at higher risk for school failure, depression, increased anxiety, as well as trouble with alcohol and other drugs.

6. How does alcohol affect the body? Short-term effects of alcohol use include:

Long-term effects of heavy alcohol use include:

7. How does an alcoholic differ from an occasional drinker? Alcoholics have a problem with drinking. They drink excessively, develop tolerance, and become dependent on it.

9. What are the signs/symptoms of alcoholism? Here are some quick clues:

  • Inability to control drinking--it seems that regardless of what you
  • decide beforehand, you frequently wind up drunk
  • Using alcohol to escape problems
  • A change in personality--turning from Dr. Jekyl to Mr. Hyde
  • A high tolerance level--drinking just about everybody under the
  • table
  • Blackouts--sometimes not remembering what happened while
  • drinking
  • Problems at work or in school as a result of drinking
  • Concern shown by family and friends about drinking
  • Interveiwee (Relative wishing to remain anonymous)

    1. What is alcoholism? Alcoholism is for anybody that drinks alcohol that has made your life unmanagable.

    2. How is alcoholism influenced by environmental factors? I think sometimes our friends drink so we try it. I think advertising on TV also does this. Peer-pressure too. And maybe in some cases, when our parents drink, it influences what we do later on.

    3. How is alcoholism influenced by genetics? It absolutely is influenced by genetics. Scientists found that we actually inherit the gene that makes us alcoholics.

    4. There are two types of alcoholism. What are the two types and who is affected? There is many types of acholism. There are functioning alcoholics. Those are the ones that are able to take care of their lives to a point, but they still hurt themselves and their family. And all their loved ones. A non-functioning alcoholic can't do anything because of the drinking.

    5. Does gender (male or female) play a role in alcoholism? Not really. There are just as many women alcoholics as there are men alcoholics. Historically, it is harder for the women to admit they have a problem.

    6. How does alcohol affect the body? It's very damaging to the body. It's a solvent which means it actually deteriates our body tissue and causes ulcers. It can destroy your liver. It also can injure your brain. (How?) It shuts off the oxygen supply to the brain

    7. How does an alcoholic differ from an occasional drinker? An alcoholic, once he takes a drink, can't stop. Because he's allergic to the alcohol. (Allergy to the alcohol?) The strange thing about this allergy is that it creates a phenomenon called craving. The occasional drinker would have a drink, maybe two drinks, and not want anymore.

    8. What can people do to prevent alcoholism? I think they should become more educated. First of all, they need to understand what their family history is. And to also have information avaliable so they can understand that they may have a drinking problem. If there is a family history of alcoholism.

    10. When did you start drinking? I started drinking when I was eighteen, seventeen. No, I'm lying. The first time I drank, I was fifteen. I was in high school. It was before a halloween party.

    11. What made you realize you had a drinking problem? Hm, my life started becoming unmanagable. (That sounds a lot like the AA. Have you been to AA?) Yes, I've been there. In fact, I still go there.

    12. How did alcoholism affect your relationship with your family? It destroys relationships with our family. Our personalities change when we drink. Usually we're like Dr. Jekyll and Mr. Hyde.

    13. How did alcoholism affect your job? Well, it made me lose a couple jobs. (Cause a lot of stress?) Oh, yes, it caused a lot of stress.

    14. How did alcoholism affect your relationships with friends? It also damaged relationships with my friends. (How?) I just wasn't a dependable friend anymore.

    15. Why did you start drinking? I guess I was curious.

    16. What is AA? AA is a fellowship of men and women who share their experience, strength, and hope that they may someday solve their commmon problem and recover from alcoholism.

    17. How can people become members of AA? All they have to do is show up at a meeting. There are no dues or fees. The only requirement is the desire to stop drinking.

    18. What age do most alcoholics begin drinking? I'd say at a young age. Fifteen or younger.

    Q. What is the difference between being an alcoholic and an alcohol abuser? Is the latter a "functioning alcoholic?" Do they both need the same kind of treatment? -- J.

    A. Technically, the difference between an alcoholic and an alcohol abuser is the difference between alcohol DEPENDENCE and alcohol ABUSE. Alcohol dependence (or alcoholism) is a more severe problem than alcohol abuse. However, alcohol abuse is also unhealthy, and it can develop into alcohol dependence.

    The essential feature of both alcohol dependence and alcohol abuse is continued drinking despite significant alcohol-related problems. In alcoholics, the drinking pattern may include tolerance (the need for greatly increased amounts of alcohol to become intoxicated or to achieve the desired effect, or markedly diminished effects with continued use of the same amount of alcohol) and withdrawal (physiological, behavioral and cognitive changes that occur when the body levels of alcohol decline in someone who has maintained prolonged heavy drinking). Alcohol-dependent individuals will often drink to relieve or avoid withdrawal symptoms.

    You don't have to demonstrate alcohol tolerance or withdrawal to meet diagnostic criteria for alcohol dependence -- although if you demonstrate both tolerance and withdrawal, you've got two of the three criteria required for a diagnosis of alcohol dependence according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (or DSM-IV), the "bible" of psychiatric diagnosis. An individual can be diagnosed as alcohol dependent if he or she demonstrates any three of the following (or one of the following if both tolerance and withdrawal are present):

    • -- He or she drinks in larger amounts or over a longer period than he or she planned.
    • -- He or she expresses a desire to cut down or control drinking, and has tried unsuccessfully to do so.
    • -- He or she spends a great deal of time obtaining alcohol, drinking or recovering from the effects of drinking.
    • -- He or she reduces or completely gives up important work or social activities because of alcohol use.
    • -- He or she continues to drink despite recognizing that drinking causes or worsens physical and/or psychological problems.

    Alcohol abuse, in contrast, is characterized by a problematic pattern of drinking in which drinking causes recurrent and significant adverse consequences. Those consequences may include:

    • -- failure to fulfill major responsibilities such as work, school or domestic tasks
    • -- recurrent drinking in hazardous situations (such as while driving)
    • -- recurrent drinking-related legal problems (such as arrests for disorderly conduct while drinking)
    • -- continued drinking despite persistent or recurrent social or interpersonal problems caused or worsened by drinking (such as fights or marital arguments)

    Perspectives on the appropriate treatment for alcoholics and alcohol abusers vary. The majority opinion is that alcoholics should stop drinking altogether, through addiction treatment programs or community support groups such as Alcoholics Anonymous or Rational Recovery. I suspect most mental health professionals would also recommend that an alcohol abuser with a family history of alcoholism stop drinking altogether, to avoid developing alcohol dependence.

    Some psychologists, however, believe that alcohol abusers or "problem drinkers" can learn to modify their drinking to healthy levels, a process called "controlled drinking." Thus, they provide counseling and education to teach alcohol abusers skills to lessen their drinking and prevent adverse consequences. There is some controversy about controlled drinking, however, with many mental health professionals believing it may feed into the typical abuser's denial of having a real problem.

According to the DSM in psychology, there are three stages of alcoholism:
  • Prealcoholic Phase: This includes social drinking, an increase in tolerance, and alcohol is primarily used as a release from anxiety, boredom and stress.
  • Initial Alcoholic Phase: Studies have shown that alcoholics in this phase actually take bigger swigs of alcohol when drinking. There is a switch to harder liquors and disruptive behaviors start to occur. Tolerance increases. The alcoholic tends to feel a lack of self esteem and depression over his or her behavior.
  • Chronic Alcoholic Phase: There is now a lack of ability to control drinking. The alcoholic gets inadequate nutrition, and even after a few short hours without alcohol, they begin to show withdrawal symptoms.

Alcohol is involved in half of all car deaths, and is a factor in one third of suicides, homicides, rapes, and accidental deaths.
Alcoholism is a disease (a relatively recent definition) that is indicated by a progressive addiction toward the intake of alcohol. There are many measures of alcoholism, from simple “When was the last time you had five or more drinks in a session?” to “Do you regularly drink alcohol? (Daily)”, to “Do you wake in the morning and have to have a drink to stop shaking and feel ‘normal’?”. The physical effects of alcohol on a person can also be measured to determine if the intake of alcohol constitutes a determined problem (e.g., a liver enzyme test to evaluate damage caused by alcohol).

But the true indication of alcoholism is whether the consumption of alcohol by an individual is negatively, and progressively, affecting their life. This too is arbitrary because mitigating circumstances can lead to an increase of alcohol use that are not defined as “alcoholism,” rather they’re symptoms of an emotional cause that led to a temporary increase in alcohol use that is orthogonal to a diagnoses of alcoholism.

Some people don’t drink. Most others drink in moderation. And others make it a daily, progressive “habit” that envelops their life and takes over. “Addiction” is the simple definition, whether a person can drink alcohol without it impacting their function is the cut-line toward whether someone is actually an alcoholic, or a “drinker.”

The notion that someone who drinks daily is an alcoholic is well established, but waning in support. And the metrics used to define a “normal” drinking level tend to be arbitrary and rarely are they scaled to the individual under question. “More than two drinks per day” is a measure that disregards body type, gender, or effect. Yet it is a metric that is commonly applied and believed because it’s, simply, “measurable”. It is known that certain European descendants can metabolize alcohol at two or more times the rate of “standard” people, but this is rarely, if ever, accounted for in the typical models used to evaluate whether a person is an “alcoholic”.

Simply put, if you can’t stop drinking, and that drinking is causing real and tangible problems in your life, then you are almost certainly an alcoholic, and need to attend to it lest the progression continue and lead to your demise. The “problems” do NOT include concerns by family members or friends; third-party definitions of what a person “should” or “should not” do are not valid, and are in fact too subject to individual beliefs as to make them invalid measures of another’s actions. (This is a common and standard measure, but lacks in measurable and standardized accountability). The proper measure is whether the intake of alcohol is affecting your life, and whether it is progressive. If both criteria are not met, the diagnoses may be “Alcohol abuse,” a common condition based on individual patterns, or due to external influences such as impending divorce, work crisis, or any host of unusual stress that lead someone to drink abnormally, but not lead them to an addictive and progressive behavior that defines alcoholism.

The DSM-IV criteria for alcoholism is probably the most certain and accurate, but it too fails to account for individuals. The determination of these criteria is left to those who specialize in evaluating for alcoholism, but there is little rigor or training that is standard and accountable for such evaluators. Often, and unfortunately, it is left up to the personal impressions and biases of the evaluator.

The “bottom line” is whether the disease is existent, progressive, and affecting the individual. If it is, it is critically important that they first, and MOST importantly, decide that a problem exists. "Denial" is a hallmark of alcoholism. Once this is accepted, and hopefully so, they must enter into a treatment program that addresses the addiction, a treatment that is able to address, and ultimately stop it. Without such intervention, the progressive nature of alcoholism will eventually overwhelm the individual, and devastation will result.

Al"co*hol*ism (#), n. [Cf. F. alcoolisme.] Med.

A diseased condition of the system, brought about by the continued use of alcoholic liquors.


© Webster 1913.

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