The use of alcohol in our culture is pervasive. For most people their use of alcohol is social or recreational and is secondary to the event and situations they are engaging in. For about 10% of the American population their use of alcohol becomes abusive or has already reached the level of dependence. There are four levels of alcohol use: abstinence, social use, abuse, and dependence. Social use pertains to people who drink for the taste rather than the effect (glass of wine with dinner or a dessert drink). It can be difficult to differentiate between those who abuse and those who have crossed the line to dependence, both of which are problematic. One benchmark of problematic drinking stipulates that men who drink more than 4 drinks in one sitting or more than 14 drinks in a week and women who drink more than 3 drinks in one sitting or more than 7 drinks in a week, likely have abuse or dependence problems.
Alcohol abuse and dependence fall on a spectrum. The more symptoms a person endorses, they can move from abuse to dependence. Alcohol abuse is suggested if a person endorses 2-3 of the symptoms, and alcohol dependence is likely present if a person endorses 4 or more of the following symptoms:
1) tolerance (a need for an increase in the amount of alcohol to get the same desired effect), 2) withdrawal (shakes, sweats, etc. in the absence of drinking, 3) drinking in larger amounts or over longer time than intended, 4) a persistent desire to cut down, control, or quit, 5) great deal of time spent in obtaining alcohol or recovering from its effects, 6) important social, occupational, and recreational activities are reduced or given up for alcohol, 7) drinking despite physical/medical problems that may be worsened by drinking. 8) cravings to drink alcohol, 9) Alcohol use is causing you to fail to fulfill major role obligations at work, home, or school, 10) Continued alcohol use despite having persistent or recurrent social and interpersonal problems, 11) Recurrent alcohol use it situations where it is physically hazardous.
How alcohol abuse and dependence are treated can differ. Alcohol abuse is often intervened upon with educational programs intended to deter and reduce consumption before abuse develops into dependence. Alcohol dependence is typically treated with abstinence based treatment programs. Sometimes detoxification is required in the case of withdrawal symptoms to prevent serious complications such as seizures, heart attacks, or delirium tremens. People are either directed to in-patient (28 days typically) or out-patient (60 hours occurring 3-4X weekly for 4-5 weeks) chemical dependency programs. Treatment occurs in a group therapy format with focus on breaking through denial of one’s problem, education around the disease of alcoholism, and providing people with tools to remain abstinent. There are also some medicinal treatment aids that are occasionally used such as Antabuse, which causes alcohol consumers to become violently ill if they drink, or Campral, designed to reduce cravings for alcohol.
If you think you may have a drinking problem you should get an assessment by a specialist who performs chemical dependency evaluations. I.P.C. has trained clinicians who can help you figure out if you have a problem. Additionally, if you are concerned about a loved one and think they may have a problem, we encourage you to come in and talk with a clinicians about options and ways to make sure you are taking care of yourself and not falling into codependent patterns. Call now if you need help: 763-416-4167.
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