Alcohol dependence is an illness characterized by habitual, compulsive, long-term, heavy alcohol consumption and the development of withdrawal symptoms when drinking is stopped suddenly.
Causative factors that interact in the development of alcohol dependence include: personality, environment, and addictive nature of alcohol. People of an inadequate, insecure, or immature personality are at greater risk. Environmental factors are important, especially the ready availability, affordability, and widespread social acceptance of alcohol.
Development of dependence
Alcohol dependence usually develops in four main stages that occur over a number of years and merge imperceptibly. In the first phase, tolerance (being able to drink more alcohol before experiencing its effects) develops in the heavy social drinkers. In the second phase, the drinker experiences memory lapses relating to events during the drinking episodes. In the third phase, there is loss of control over alcohol consumption. The final phase is characterized by prolonged binges of intoxication, and mental of physical complications.
Symptoms and effects
Behavioral symptoms of alcohol dependence are varied, and they can include grandiose, aggressive, or furtive behavior; personality changes (such as irritability, jealousy, or uncontrolled anger); neglect of food intake and personal appearance; and lengthy periods of intoxication.
Physical symptoms of the condition may include nausea, vomiting, or shaking in the morning; abdominal pain; cramps; numbness or tingling; weakness in the legs and hands; enlarged blood vessels in the face; irregular pulse; unsteadiness; confusion; memory lapses; and incontinence. Sudden withdrawal from alcohol may lead to delirium tremens (severe shakes, hallucinations, and convulsions). Alcohol dependant persons are more susceptible than others to a variety of physical and mental disorders.
Many problem drinkers require medical help in overcoming their physical withdrawal symptoms (detoxification) when they stop drinking alcohol, followed by long term treatment. There are different methods of treatment, which may be combined.
Psychological treatments for alcohol dependence involve psychotherapy and are commonly carried out as group therapy. Social treatments may offer practical help, such as with problems at work, and tend to involve family members in the process. Physical treatment includes the use of disulfiram, a drug that sensitizes the drinker to alcohol so that he or she experiences unpleasant side effects when drinking, or acamprosate, which helps to reduce craving.
Alcoholics Anonymous and other self help organizations can provide support and advice.