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JAMA Patient Page
April 6, 2005

Alcohol Abuse and Alcoholism

JAMA. 2005;293(13):1694. doi:10.1001/jama.293.13.1694

Abuse of alcohol is a major cause of preventable deaths, and it is estimated that as many as 1 in 6 adults in the United States may have a problem with drinking. Excessive alcohol intake strains personal relationships and
may affect one's ability to hold a job. In addition, excessive alcohol intake may result in serious health problems, including damage to the liver and brain. The April 6, 2005, issue of JAMA includes a report of a clinical trial of a medication that may benefit some patients with alcoholism.

Alcohol abuse is a pattern of drinking that is accompanied by 1 or more of the following problems: (1) failure to fulfill major work, school, or home responsibilities because of drinking; (2) drinking in situations that are physically dangerous, such as while driving a car or operating machinery; (3) recurring alcohol-related legal problems, such as being arrested for driving under the influence of alcohol or for physically hurting someone while drunk; and (4) having social or relationship problems that are caused by or worsened by the effects of alcohol.

Alcoholism (alcohol dependence) is a more severe pattern of drinking that includes the problems of alcohol abuse and persistent drinking in spite of obvious physical, mental, and social problems caused by alcohol. Also typical are (1) loss of control — inability to stop drinking once begun; (2) withdrawal symptoms (symptoms associated with stopping drinking such as nausea, sweating, shakiness, and anxiety); and (3) tolerance (needing increased amounts of alcohol in order to feel drunk).

Possible treatments

There is no cure for alcoholism, but effective treatments are available. The type of treatment your doctor may recommend depends on the extent of alcohol use, whether there are associated medical problems, and your personal preferences.

  • Acute withdrawal and detoxification is used for individuals who use alcohol heavily and is designed to prevent and treat withdrawal symptoms, which can otherwise be severe and even life-threatening. This treatment may require a stay in a specialized facility in addition to close medical supervision.

  • Medications may be used to prevent relapse.

  • Individual or family counseling is also an important part of treatment. Because alcoholism may coexist with mental illness, including depression, it is important to undergo full evaluation for these illnesses. Counseling may also include families and partners who often need help coping with the stress of living with a family member with alcohol problems.

  • Mutual help groups include support groups such as Alcoholics Anonymous and Al-Anon. Individuals in these groups support each other by sharing personal experiences and advice.

For more information

Inform yourself

To find this and previous JAMA Patient Pages, go to the Patient Page link on JAMA's Web site at A JAMA Patient Page on the health benefits and dangers of alcohol use was published in the January 6, 1999, issue, and one on alcohol abuse and alcoholism was published in the April 14, 1999, issue. JAMA Patient Pages on drug abuse (March 8, 2000), cocaine addiction (February 2, 2002), and opioid abuse (September 15, 2004) are also available.

Source: National Institute on Alcohol Abuse and Alcoholism

The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. Any other print or online reproduction is subject to AMA approval. To purchase bulk reprints, call 718/946-7424.