What factors lead to alcoholism? People who are not alcoholic sometimes do not understand why an alcoholic can’t just “use a little willpower” to stop drinking. However, alcoholism has little to do with willpower. Alcoholics are in the grip of a powerful “craving,” or uncontrollable need, for alcohol that overrides their ability to stop drinking. This need can be as strong as the need for food or water.
Although some people are able to recover from alcoholism without help, the majority of alcoholics need assistance. With treatment and support, many individuals are able to stop drinking and rebuild their lives.
Many people wonder why some individuals can use alcohol without problems but others cannot. One important reason has to do with genetics. Scientists have found that having an alcoholic family member makes it more likely that if you choose to drink you too may develop alcoholism. Genes, however, are not the whole story. In fact, scientists now believe that certain factors in a person’s environment influence whether a person with a genetic risk for alcoholism ever develops the disease. A person’s risk for developing alcoholism can increase based on the person’s environment, including where and how he or she lives; friends and culture; peer pressure; and even how easy it is to get alcohol. Researchers also believe a person’s risk increases if he or she is in a family with the following difficulties:
- An alcoholic parent is depressed or has other psychological problems;
- Both parents abuse alcohol and other drugs;
- The parents’ alcohol abuse is severe; and
- Conflicts lead to aggression and violence in the family.
If you are among the millions of people in this country who have a parent, grandparent, or other close relative with alcoholism, you may have wondered what your family’s history of alcoholism means for you. Are problems with alcohol a part of your future? Is your risk for becoming an alcoholic greater than for people who do not have a family history of alcoholism? If so, what can you do to lower your risk?
What Is Alcohol Abuse?
Alcoholism, also known as “alcohol dependence,” is a disease that includes four symptoms:
- Craving: A strong need, or compulsion, to drink.
- Loss of control: The inability to limit one’s drinking on any given occasion.
- Physical dependence: Withdrawal symptoms, such as nausea, sweating, shakiness, and anxiety, occur when alcohol use is stopped after a period of heavy drinking.
- Tolerance: The need to drink greater amounts of alcohol in order to “get high.”
Alcohol abuse differs from alcoholism in that it does not include an extremely strong craving for alcohol, loss of control over drinking, or physical dependence. Alcohol abuse is defined as a pattern of drinking that results in one or more of the following situations within a 12-month period:
- Failure to fulfill major work, school, or home responsibilities;
- Drinking in situations that are physically dangerous, such as while driving a car or operating machinery
- Having recurring alcohol-related legal problems, such as being arrested for driving under the influence of alcohol or for physically hurting someone while drunk
- Continued drinking despite having ongoing relationship problems that are caused or worsened by the drinking
Although alcohol abuse is basically different from alcoholism, many effects of alcohol abuse are also experienced by alcoholics.
What Are the Signs of a Problem?
How can you tell whether you may have a drinking problem? Answering the following four questions can help you find out:
- Have you ever felt you should cut down on your drinking?
- Have people annoyed you by criticizing your drinking?
- Have you ever felt bad or guilty about your drinking?
- Have you ever had a drink first thing in the morning (as an “eye opener”) to steady your nerves or get rid of a hangover?
One “yes” answer suggests a possible alcohol problem. If you answered “yes” to more than one question, it is highly likely that a problem exists. In either case, it is important that you see your doctor or other health care provider right away to discuss your answers to these questions. He or she can help you determine whether you have a drinking problem and, if so, recommend the best course of action.
Even if you answered “no” to all of the above questions, if you encounter drinking-related problems with your job, relationships, health, or the law, you should seek professional help. The effects of alcohol abuse can be extremely serious, even fatal-both to you and to others.
What Do I Do If I Think I’m at Risk?
If you are worried that your family’s history of alcohol problems or your troubled family life puts you at risk for becoming alcoholic, here is some common–sense advice to help you:
Avoid underage drinking—First, underage drinking is illegal. Second, research shows that the risk for alcoholism is higher among people who begin to drink at an early age, perhaps as a result of both environmental and genetic factors.
Drink moderately as an adult—Even if they do not have a family history of alcoholism, adults who choose to drink alcohol should do so in moderation—no more than one drink a day for most women, and no more than two drinks a day for most men, according to guidelines from the U.S. Department of Agriculture and the U.S. Department of Health and Human Services. Some people should not drink at all, including women who are pregnant or who are trying to become pregnant, recovering alcoholics, people who plan to drive or engage in other activities that require attention or skill, people taking certain medications, and people with certain medical conditions.
People with a family history of alcoholism, who have a higher risk for becoming dependent on alcohol, should approach moderate drinking carefully. Maintaining moderate drinking habits may be harder for them than for people without a family history of drinking problems. Once a person moves from moderate to heavier drinking, the risks of social problems (for example, drinking and driving, violence, and trauma) and medical problems (for example, liver disease, brain damage, and cancer) increase greatly.
Talk to a health care professional—Discuss your concerns with a doctor, nurse, nurse practitioner, or other health care provider. They can recommend groups or organizations that could help you avoid alcohol problems. If you are an adult who already has begun to drink, a health care professional can assess your drinking habits to see if you need to cut back on your drinking and advise you about how to do that.