What is alcohol abuse?
Alcohol abuse refers to a condition in which a person keeps drinking alcohol again and again, despite knowing the negative physical, interpersonal and social consequences of the act. A person who is unable to control how much they drink (i.e., a person who is unable to stop drinking once they begin) is said to be suffering from alcoholism.
It is estimated that at least 30 percent of men and 5 percent of women in India, are regular users of alcohol. Most young people who begin consuming alcohol out of curiosity or peer pressure end up as habitual users. The average age of first-time alcohol use in India was 28 years in the 1980s. This age has now come down to 17 years.1
Apart from beer, wine and similar alcoholic beverages (consumed mostly in the cities), the consumption of toddy, arrack, daru, and other country liquors is widespread in the rural areas. All of these beverages contain ethyl alcohol, a mood-altering compound which affects the human body in several ways. Only the percentage of ethyl alcohol varies in each type of alcoholic beverage.
When a person drinks alcohol, it is absorbed into their bloodstream and then distributed throughout the body. A single alcoholic drink can affect the body for a couple of hours. This alcohol can make the person feel relaxed and happy. Gradually, as the effect wears off, the person feels confused and drowsy. Alcohol loosens inhibitions, makes a person’s movements less coordinated and increases sexual urge while bringing down sexual performance.
Alcohol addiction is a chronic relapsing illness of the brain and can have psychological as well as social implications.
What does 'getting drunk' mean?
The human body can break down about one drink per hour. When a person drinks more alcohol than their body can break down in a certain period of time, the alcohol circulates through the entire body. This makes the person feel drowsy, uncoordinated and causes them to lose control over their body.
How does alcohol affect the human brain?
Alcohol is known to affect the parts of the brain that are linked to speech, functioning and decision-making. In cases where the person drinks only occasionally, the brain is able to get over the effect and begin functioning normally. However, in the case of a person who is dependent on alcohol, the brain is unable to recover, well after the body has recovered from the effects of alcohol.
Long-term use of alcohol can lead to:
Irritability or mood swings
Damage to fetus
Increased risk of cancer
Increased risk of dementia
Shrinkage of brain tissue
Weakening of the heart muscles, arrhythmia and stroke
Loss of intellectual functioning
In addition to biological changes, alcohol also affects a person’s interpersonal relationships. In India, a majority of domestic violence cases and road accidents are related to the consumption of alcohol.
Facts about alcohol addiction
The World Health Organization (WHO) estimates that every other person who consumes alcohol is likely to develop a serious drinking issue.
Alcohol users are three times more likely to suffer significant health problems as compared to non-users
One in five hospital admissions in India is directly connected to the use of alcohol
One in five traumatic brain injuries, and two-thirds of all injuries in hospitals are related to the use of alcohol
Alcohol users are also more likely to be involved in violent acts, particularly with their partners. The violence could be physical, sexual, emotional or economic.
Alcohol users are more likely to attempt suicide or risky sexual behavior, or develop HIV infections, TB, esophageal cancer, liver disease, and duodenal ulcers
What is binge drinking?
Most people assume that only chronic alcoholism leads to health problems. Binge drinking can also cause memory loss, toxicity and alcohol poisoning, which may lead to death.
For men, drinking more than five units of alcohol (or five small glasses of wine) in one sitting (within two hours) qualifies as binge drinking. For women, the number of units is four. Binge drinkers tend to drink quickly, and drink with the intention of getting drunk. They are not addicted or dependent and can function without alcohol.
During a binge, the effect of the alcohol on the drinker increases with every additional drink. Binge drinking can cause the drinker to suffocate on their own vomit when the alcohol levels are higher than they can handle. It also disturbs the brain’s capacity to make sound judgments, making the drinker prone to unsafe sexual or risk-taking behavior.
Long-term binge drinking can lead to an increased risk of cancer, mental health disorders such as depression or anxiety, and permanent brain damage.
Identifying an alcohol addiction
Many people are able to limit themselves to just one or two drinks in a social setting without becoming heavily dependent on it. People who are addicted to alcohol may not realize how dependent they are on it. In such cases, there are some warning signs that can help a person or their loved one realize when the habit becomes an addiction.
A person who is addicted to alcohol may find that their tolerance to alcohol has increased. That means that a person who would get high on alcohol after two drinks may start to find that they need five or six drinks to achieve the same effect.
Withdrawal symptoms also indicate a possible addiction. When the person stops drinking, they may experience severe emotional and physical withdrawal symptoms such as shivering, nervousness, sweating, nausea or irritability. If you experience these symptoms, contact a doctor immediately.
Diagnosing an alcohol addiction
There are several tests that can help you identify whether you have an alcohol addiction. While some of these tests can be self-administered, others may need to be administered by a trained mental health professional.
The CAGE test for alcohol addiction is the simplest test you can administer yourself. It consists of four questions:
Have you ever felt you should Cut down on your drinking?
Do you feel Annoyed when someone criticizes your drinking habit?
Have you ever felt bad or Guilty about your drinking?
Have you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover (Eye-opener)?
If you have answered “yes” to two or more questions in this questionnaire, then you may be addicted and need professional help.
The Audit Test for Alcohol Addiction can also be used to diagnose alcohol problems.
The first step to getting over an alcohol addiction is to acknowledge that you have a problem, and to seek help. You could approach a doctor or speak to a family member or friend who will support you in this process. The doctor will first interview you to identify details that are relevant to your addiction, and gauge how severe the problem is. The doctor may also speak to your friends and family. These details will help the doctor create the right treatment plan for you.
The treatment for alcohol addiction has two goals: to help the patient stop using alcohol, and to help them create a lifestyle that supports their wish to live alcohol-free.
Treatment typically begins with a detoxification procedure, which may take approximately a week or more. During this period, the patient gives up drinking, and is given medication to help them manage the withdrawal symptoms that may occur. This period of abstinence helps the body get out of the pattern of addiction.
The next step is counseling or therapy, where the client is made aware of the nature and dangers of addiction, and how they can work towards recovery. During this stage, the counselor or psychiatrist may help the patient uncover any emotional issues that may be causing their alcohol dependence, and work through them. The patient also attends support group meetings. Group therapy offers them an opportunity to overcome their denial, speak about any mental health issues caused by their addiction, find support among others who are battling addiction, and be motivated to change their behavior. At the end of this stage, the patient is also trained to identify situations that may cause a relapse, and find ways to avoid these stressors.
During this stage, the patient’s family and friends may also be educated about the problem, and offered support group meetings to understand how they can help.
The third and final stage of treatment consists of follow-ups where the client gets help to stay alcohol-free as they go back to their regular lifestyle. The patient may also choose to attend regular support group meetings like those offered by Alcoholics Anonymous for additional help.
1. All statistics from: Gururaj G, Pratima Murthy, Girish N & Benegal V. Alcohol related harm: Implications for public health and policy in India, Publication No. 73, NIMHANS, Bangalore, India 2011
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