Alcoholism - Introduction

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Alcoholism can develop insidiously, and often there is no clear line between problem drinking and alcoholism. Eventually alcohol dominates thinking, emotions, and actions and becomes the primary means through which a person can deal with people, work, and life.

Definition of Alcohol Use and Abuse

In addition to alcohol dependence, experts are now defining alcohol use by levels of harm that it may be causing. This information is useful to determine possible interventions at earlier stages. The following categories of alcohol use and abuse use a definition of one drink as 12 ounces of beer, 5 ounces of wine, or 1.5 ounces (a jigger) of 90-proof liquor.

Moderate Drinking. Moderate drinking, particularly red wine, appears to offer health benefits. Moderate drinking is defined as equal to or less than 2 drinks a day for men and 1 drink a day for women.

Hazardous (Heavy) Drinking. Hazardous drinking puts people at risk for adverse health events. People who are heavy drinkers consume

• More than 14 drinks per week, or 4 - 5 drinks at one sitting, for men
• More than 7 drinks per week, or 3 drinks at one sitting, for women
• Frequent intoxication

Harmful Drinking. Drinking is considered harmful when alcohol consumption has actually caused physical or psychologic harm. This is determined by:

• There is clear evidence that alcohol is responsible for such harm.
• The nature of that harm can be identified.
• Alcohol consumption has persisted for at least a month or has occurred repeatedly for the past year.

Certain people are at much higher risk for harmful drinking, such as older individuals with high blood pressure or those taking medications for arthritis or pain.

Alcohol Abuse. People with alcohol abuse have one or more of the following alcohol-related problems over a period of 1 year:

• Failure to fulfill work or personal obligations
• Recurrent use in potentially dangerous situations
• Problems with the law
• Continued use in spite of harm being done to social or personal relationships

In a 2001 study, 55% of patients continued to meet these criteria after 5 years, but only 3.5% developed dependency, the next stage.