Alcoholism is a chronic, often progressive disease in which a person continues to crave alcohol and drink despite repeated alcohol-related problems, such as losing a job or getting into trouble with the law. Alcoholism affects 10 to 20 percent of men and 3 to 10 percent of women. Nearly 14 million people in the United States—1 in every 13 adults—abuse alcohol or are alcoholic. This disease contributes to over 50 percent of car and industrial fatalities, drownings, and child or domestic abuse.
Signs and SymptomsAlcoholism is often accompanied by the following signs and symptoms. Symptoms vary with the amount of alcohol taken and how long it has been abused.
- Craving for alcohol
- Inability to control drinking habits
- Withdrawal symptoms, such as nausea, sweating, shakiness, and anxiety, when alcohol use is stopped after a period of heavy drinking
- Tolerance (the need for increasing amounts of alcohol in order to feel its effects)
- Psychological, social, occupational dysfunction
- Malnutrition, anorexia
- Cardiovascular symptoms (leading cause of death)
- Increased levels of cancer (second leading cause of death)
- Repeated infections—for example, tuberculosis, urinary tract infections
- Lung conditions—complicated by smoking; for example, respiratory failure, pneumonia
- Central nervous system disorders—unsteady gait or stance; cognitive impairment; psychiatric manifestations (for example, mood, anxiety, psychotic disorders); blackouts; coma; sleep disruptions
- Diarrhea, vomiting
- Gastrointestinal bleeding
- Men—increased sexual drive with decreased ability to maintain an erection
- Women—miscarriage, stopping of menstrual periods
- Inflammation of the pancreas
- Hepatitis (a disease of the liver)
- Poor wound healing
- Buildup of fluid in the body
- Swollen, painful muscles, paralysis, lack of reflexes
- Increased bone fractures
- Hypoglycemia (low blood sugar)
- Hypothermia (reduction of body temperature)
What Causes It?Alcoholism is caused by chronic over-consumption of alcohol.
Who's Most At Risk?People with the following conditions or characteristics are at a higher-than-average risk for developing alcoholism.
- Genetically predisposed
- Preexisting psychiatric disorder
- Began consuming alcohol at an early age
What to Expect at Your Provider's OfficeIf you or someone you care for is experiencing symptoms associated with alcoholism, you should see your health care provider. He or she can help make a diagnosis and guide you in determining which treatment or combination of therapies will work best.
Your provider will take a history and do a physical exam to look for specific organ damage or trauma and to evaluate if your muscles are tender or weak. Laboratory tests will reveal any indicators of alcoholism, such as high blood alcohol. Imaging techniques may be used to diagnose alcohol-related disorders or to screen for repeated bone fractures.
The best prevention is to stop drinking alcohol completely. Medications are sometimes prescribed to curb alcohol cravings.
Treatment must address both medical issues and rehabilitation, such as motivational techniques for abstaining from drinking, psychotherapy, and Alcoholics Anonymous (or other support groups).
Your provider may prescribe the following medications.
- Tranquilizers called benzodiazepines which are used during the first few days of treatment to help patients safely withdraw from alcohol
- Antipsychotic medications for people who do not respond to benzodiazepines
- Naltrexone, a recently approved medication to help people remain sober. When used in combination with counseling, this medication may lessen the craving for alcohol and help prevent a return to heavy drinking.
- Disulfiram, an older medication, which discourages drinking by causing nausea, vomiting, and other unpleasant physical reactions when alcohol is used
- Medications for specific organ damage or for symptoms associated with alcohol withdrawal
A well-balanced, nutritionally adequate diet helps to stabilize alcohol-induced blood-sugar fluctuations and decrease cravings. Following these tips can help reduce symptoms.
- Eliminate simple sugars.
- Increase complex carbohydrates.
- Consume adequate protein.
- Increase essential fatty acids.
- Decrease saturated fats and fried foods.
- Avoid caffeine.
- Vitamin A (25,000 IU a day)
- Vitamins B1 (50 to 100 mg a day), B2 (50 mg a day), B3 (25 mg a day), B5 (100 mg a day), B6 (50 to 100 mg a day), B12 (100 to 1,000 mcg a day)
- Vitamin C (250 to 500 mg two times a day)
- Vitamin E (400 IU a day) to protect the heart
- Magnesium (250 mg bid) to decrease withdrawal symptoms
- Selenium (200 mcg a day) to protect the liver
- Zinc (15 mg a day) to aid metabolism
- Amino acids: carnitine (500 mg two times a day) to protect the liver, glutamine (1 g a day) to decrease cravings, glutathione (300 mg a day) to protect liver and heart
- Chromium (250 to 500 mcg twice a day) helps reduce sugar cravings and reduces low blood sugar related to alcohol cravings.
Prognosis/Possible ComplicationsPossible complications associated with alcoholism include mental confusion or delirium, severe amnesia, an unsteady gait, and loss of sperm cells, as well as ailments resulting from repeated, violent vomiting. Typically, there are periods of remission followed by periods of abuse. Life expectancy is decreased by about 15 years. About a fifth of alcoholics permanently abstain. During pregnancy, abstinence from alcohol is the only completely safe measure.
Following UpAfter initial care, medical follow-up should continue for 6 to 12 months.
Alcohol addiction. NIH. Accessed at https://ghr.nlm.nih.gov/ on July 15, 2018.
Alcohol use disorder. Symptoms and causes. MFMER. Accessed at https://www.mayoclinic.org/ on July 15, 2018.
Alcoholism. NMIHI. Accessed at http://www.nmihi.com/a/alcoholism.htm on July 15, 2018.
Alcoholism and Alcohol Abuse. MedlinePlus. Accessed at https://medlineplus.gov/ on July 15, 2018.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association; 1994.
Bartram T. Encyclopedia of Herbal Medicine. Dorset, England: Grace Publishers;1995:13.
Carr AC, Frei B. Toward a new recommended dietary allowance for vitamin C based on antioxidant and health effects in humans. Am J Clin Nutr. 1999;69(6):1086-1107.
Baclofen. NMIHI. Accessed at http://www.nmihi.com/b/baclofen.html on July 15, 2018.
Bullock ML, Umen MS, Culliton PD, Olander RT. Acupuncture treatment of alcoholic recidivism: a pilot study. Alcohol Clin Exper Res. 1987;11(3):292-295.
Bullock ML, Culliton PD, Olander RT. Controlled trial of acupuncture for severe recidivist alcoholism. Lancet. 1989;1:1435-1439.
Dambro MR. Griffith's 5-Minute Clinical Consult. 1999 ed. Baltimore, Md: Lippincott Williams & Wilkins, Inc.: 1999.
Fauci AS, Braunwald E, Isselbacher KJ, et al, eds. Harrison's Principles of Internal Medicine. 14th ed. New York, NY: McGraw-Hill; 1998.
Gabapentin. NMIHI. Accessed at http://www.nmihi.com/f/gabapentin.html on July 15, 2018.
Gruenwald J, Brendler T, Jaenicke C, et al, eds. PDR for Herbal Medicines. Montvale, NJ: Medical Economics Company; 1998:1128-1129.
Goroll A, ed. Primary Care Medicine. 3rd ed. Philadelphia, Pa: Lippincott-Raven Publishers; 1995.
JAMA Patient Page. How much vitamin C do you need? JAMA. 1999;281(15):1460.
Johnston CS. Recommendations for vitamin C intake. JAMA. 1999;282(22):2118-2119.
Johnson JL, Leff M. Children of substance abusers: overview of research findings. Pediatrics. 1999;103(5).
Kaplan HW, ed Comprehensive Textbook of Psychiatry. 6th ed. Baltimore, Md: Williams & Wilkins; 1995.
Levine M, Rumsey SC, Daruwala R, Park JB, Wang Y. Criteria and recommendations for vitamin C intake. JAMA. 1999;281(15):1415-1453.
Morrison R. Desktop Guide to Keynotes and Confirmatory Symptoms. Albany, Calif: Hahnemann Clinic Publishing; 1993:39-44, 272-276, 215-218.
Murray MT, Pizzorno JE. Encyclopedia of Natural Medicine. 2nd ed. Rocklin, Calif: Prima Publishing; 1998:122-127.
Paroxetine. NMIHI. Accessed at http://www.nmihi.com/p/paroxetine.html on July 15, 2018.
Rosen P, ed. Emergency Medicine: Concepts and Clinical Management. 4th ed. St. Louis, Mo: Mosby-Year Book; 1998.
Sapir-Weise R, Berglund M, Frank A, Kristenson H. Acupuncture in alcoholism treatment: a randomized out-patient study. Alcohol Alcohol. 1999;34(4):629-635.
Sertraline. NMIHI. Accessed at http://www.nmihi.com/s/sertraline.html on July 15, 2018.
Werbach M. Nutritional Influences on Illness. New Canaan, Conn: Keats Publishing Inc; 1987:11-22.
Worner TM, Zeller B, Schwarz H, Zwas F, Lyon D. Acupuncture fails to improve treatment outcome in alcoholics. Drug Alcohol Depend. 1992;30:169-173.