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).
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
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.
Substance Abuse and Mental Health Services AdministrationThe
National Clearinghouse for Alcohol and Drug Information 800/729-6686 http://www.health.org and http://www.samhsa.org
National Institute on Alcohol Abuse and Alcoholismhttp://www.niaaa.nih.gov
Alcoholics Anonymous 212/870-3400 http://www.alcoholics-anonymous.org
Al-Anon Family Groups, Inc 888/425-2666 http://www.al-anon.alateen.org
To find this and previous JAMA Patient Pages, go to the Patient Page
link on JAMA's Web site at http://www.jama.com. 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.
TOPIC: SUBSTANCE ABUSE
Sarah Ringold, Tiffany J. Glass, Richard M. Glass. Alcohol Abuse and Alcoholism. JAMA. 2005;293(13):1694. doi:10.1001/jama.293.13.1694