|Alcohol and Alcohol Dependence|
At some time in their lives, 90% of adults in the United States have had some experience with alcohol. Use of alcohol varies widely from total abstinence to alcohol dependence (alcoholism). Approximately 56% of U.S. adults aged 18 or older are either abstinent or infrequent drinkers (less than 12 drinks a year).
About 12% of the population drinks within healthy, moderate limits. For men, moderate drinking is defined as no more that 14 drinks a week and no more than 4 drinks on any one occasion. Women and everyone over age 65 are advised to drink no more than 7 drinks a week and never more than 3 on any one occasion. A standard drink is considered about 14 grams (0.6 fluid ounces) of pure alcohol. This is the equivalent of 12 ounces of beer, 5 ounces of table wine or 1.5 ounces of liquor.
Another 22% of Americans are binge drinkers, keeping their weekly limit in line with recommendations but occasionally or frequently exceeding the number of drinks on any one occasion. Many of these are young adults who abstain during the week but drink heavily on weekends.
Finally, about 8% to 10%, or 17 million adult Americans, either abuse alcohol or are dependent on alcohol. The diagnostic criteria for these alcohol use disorders are described below.
Is defined as one or more of the following, occurring in past year.
Failure to fulfill major role obligations at work, school or home because of recurrent drinking
Recurrent drinking in hazardous situations (for example, while driving)
Recurrent legal problems related to alcohol
Continued use despite recurrent interpersonal or social problems
Is defined as 3 or more of the following in the past year
Tolerance (needing more alcohol to achieve the same effect)
Withdrawal syndrome or drinking to relieve withdrawal
Impaired control (trying to cut down but not succeeding)
Drinking more or longer than intended
Spending a lot of time drinking or getting over the bad effects of drinking
Continuing to drink despite recurrent psychological or physical symptoms
Alcohol misuse can have devastating consequences. Heavy drinking can cause cirrhosis of the liver, damage to the body’s immune system and harm to the fetus during pregnancy (known as fetal alcohol syndrome). Excessive alcohol use also increases the risk for hypertension, stroke, diabetes, cardiomyopathy, cardiac arrhythmias, pancreatitis, gastric reflux (GERD), oral cancer and breast cancer. In addition, drinking increases the risk of automobile accidents and on-the-job injuries. Alcohol related problems cost society approximately 185 billion dollars a year. The costs to individual and family well-being and happiness cannot be measured.
Treatment for alcohol abuse and alcohol dependence typically includes a combination of 12-step self-help groups (Alcoholics Anonymous), psychosocial therapies, and medications. Specific psychosocial therapies that can be effective include motivational enhancement therapy, couples therapy, brief interventions, and cognitive behavior therapy.
More recently, clinical research has focused on the development of medications that act on brain chemicals to reduce cravings and aid in preventing relapse. One such drug, naltrexone, was approved by the FDA in 1995 and is used along with psychosocial therapies to treat alcoholics. Other medications are currently under investigation at CDAP and other research centers.
- Frequently Asked Questions about Alcoholism
- Treatment Options