As an ADDICTION AND COMPULSIVE BEHAVIORS THERAPIST, COUNSELOR, AND COACH – If you experience addiction, or if you suspect or know you compulsively use drugs, alcohol, smoke, gamble, view pornography, eat, work, shop, or any number of other activities in which you believe you have lost control, I can help you find the motivation to either regain control or to stop the behavior. Did you know that the large majority of people who conquer addiction and compulsive behavior go through five stages of change? At some point on the road of recovery, everyone must make a decision. I will help you get to that decision. I use evidence based treatments such as Motivational Enhancement Therapy (MET) and Cognitive Behavioral Therapy (CBT). Support programs that are an adjunct to therapy may include SMART Recovery, Rational Recovery, and 12 Step programs specific to your addiction or compulsive behavior. I can also help you decide if you need intensive outpatient (IOP) or inpatient (IP) treatment, and provide appropriate referrals.
Signs, Symptoms, Effects, and Testing
Alcohol abuse is different from alcoholism. Alcohol abuse is a pattern of drinking that can be treated and cured. Alcoholism or alcohol dependence is a psychological and physiological dependence on alcohol that is very difficult to interrupt and change.
Nearly 14 million people in the U.S. - 7.4% of Americans - abuse alcohol. Five times more men than women become alcohol dependent.
Alcohol abuse vs. alcoholism
What is the difference between alcohol abuse and alcoholism? Alcohol abuse, also called “problem drinking,” is a pattern of excessive drinking that results in adverse health and social consequences to the drinker, and often to those around the drinker. Alcoholism, or alcohol dependence, is culturally referred to as alcohol addiction. Despite the severe physical, mental, emotional, and spiritual consequences, the alcoholic/alcohol dependent person does not stop drinking. Alcohol dependence often becomes chronic and progressive; in severe cases, it can be fatal.
People with an alcohol abuse problem:
Use alcohol to help them change the way they feel about themselves and/or some aspect(s) of their lives.
Experience some problems associated with their alcohol use but use those experiences to set appropriate limits on how much and how often they drink. Seldom, if ever, repeat the alcohol-related behaviors that have caused them problems in the past. Get complaints about their alcohol use and accept those complaints as expressions of concern for their well-being.
People who are addicted to alcohol:
Experience negative consequences associated with drinking but continue to drink despite those consequences. Set limits on how much or how often they will drink but unexpectedly exceed those limits. Promise themselves and/or other people that they will drink in moderation but break those promises. Feel guilty or remorseful about their drinking but still fail to permanently alter the way they drink. Get complaints about their drinking and resent, discount, and/or disregard those comments and complaints.
What are the signs and symptoms of alcohol abuse and alcoholism?
Drinking alone or in secret. Not remembering conversations or commitments—sometimes referred to as "blacking out" Making a ritual of having drinks before, with or after dinner and becoming annoyed when this ritual is disturbed or questioned Losing interest in activities and hobbies that used to bring pleasure Irritability as usual drinking time nears, especially if alcohol isn't available Keeping alcohol in unlikely places at home, at work or in the car Gulping drinks, ordering doubles, becoming intoxicated intentionally to feel good or drinking to feel "normal" Having legal problems or problems with relationships, employment or finances According to The National Institute on Alcohol Abuse and Alcoholism, the following four additional symptoms indicate that an alcohol abuse problem has developed into an addiction to alcohol:
Craving – A strong need, or urge, to drink. Loss of control – Not being able to stop drinking once drinking has begun. Physical dependence – Withdrawal symptoms, such as nausea, sweating, shakiness, and anxiety after stopping drinking. Tolerance – The need to drink greater amounts of alcohol to get "high." What are the causes or of alcoholism? Alcoholism has multiple causes that combine uniquely for every drinker who eventually becomes alcoholic. One or more of these causes may predominate, but in each case the risk factors are well known:
Brain chemistry imbalance – As a person engages in a regular habit of drinking, chemical changes in the brain take place. Alcohol consumption depletes gamma-aminobutyric acid (GABA), the chemical responsible for inhibiting impulsiveness, and it increases the production of glutamate (which excites the nervous system) and norepenephrine (a stress-producing hormone). Alcohol also acts in the system to release more dopamine and serotonin, chemicals that produce euphoria and a sense of well-being. Therefore, the active drinker is prone to seek more alcohol to accomplish two things: reduce the agitation brought on by hyperactivity in the brain; and restore the pleasure response in the brain stimulated by the alcohol. Genetics – It is estimated that half of all cases of alcoholism are primarily caused by genetics: that is, the alcoholic possesses certain genes which predispose him or her to the disease. One study showed that the amygdala—the area of the brain thought to play a role in emotional craving—was smaller in individuals with a family history of alcoholism. Similarly, some people with alcoholism may have an inherited dysfunction in the transmission of serotonin. Mental and emotional stress – Since alcohol blocks emotional pain, it is frequently resorted to as a “cover up” during times of temporary or ongoing stress or grief such as that experienced with the loss of a loved one or relationship, unresolved family tensions, and chronic work stress. Psychological factors – Low self-esteem and depression make one more vulnerable to excessive drinking and alcoholism. Social and cultural pressures – The media and popular culture are filled with messages and images that legitimize or even glamorize frequent or excessive drinking. Also, associating with people who are able to drink socially, and encourage the same behavior in those around them, is dangerous to the alcoholic trying to abstain from drinking.
What are the adverse health effects of alcohol abuse?
While some studies have shown that low to moderate alcohol consumption is beneficial for certain conditions, such as heart disease, regular and prolonged use of alcohol leads to a host of health problems, such as:
Impaired mental functioning – Loss of verbal memory and slower reaction times are associated with drinking, as are mild neurological impairments such as headaches and insomnia. Liver disorders – About 10% to 35% of heavy drinkers develop alcoholic hepatitis (damaging inflammation in the liver). And, between 10% to 20% of these individuals develop cirrhosis, a progressive scarring of the liver that can eventually be fatal. Gastrointestinal problems – Violent vomiting can produce tears in the junction between the stomach and esophagus. Alcoholism poses a high risk for diarrhea, hemorrhoids, and increases the risk for ulcers Heart disease and stroke – Heavy drinking is associated with abnormal blood clotting factors, high blood pressure, increased risk for stroke, irregular heart beats, and an enlarged heart. Lung disorders – Acute alcoholism is strongly associated with very serious pneumonia, and has also been shown as a strong contributing factor in acute respiratory distress syndrome (ARDS), a type of potentially fatal lung failure. Cancer – Alcoholics have a rate of carcinoma 10 times higher than that of the general population. Sustained heavy drinking has been implicated in upper digestive system and upper airway cancers, breast cancer (even with moderate intake), esophageal cancer, and vaginal and cervical cancers. Alcohol is not usually the direct cause, but evidence suggests that it increases other risk factors. Skin, muscle, and bone disorders – Severe alcoholism is associated with osteoporosis (loss of bone density), muscular deterioration, skin sores, and itching. Pregnancy and infant development complications – Even moderate amounts of alcohol can have damaging effects on the developing fetus, including low birth weight and an increased risk for miscarriage. High amounts can cause fetal alcohol syndrome, a condition that can cause mental and growth retardation. Increased risk for other addictions – Researchers have found common genetic links between alcoholics and smokers addicted to nicotine.
How do I know if I have a drinking problem?
If you suspect you may be developing a drinking problem, ask yourself these four questions:
Do you need a drink as soon as you get up?
Do you feel guilty about your drinking?
Do you think you need to cut back on your alcohol consumption, but cannot?
Are you annoyed when other people make comments about your drinking habits?
If your honest answer to two or more of these questions is yes, than you probably have an alcohol problem and should seek help right away. For information on alcohol dependence treatment, see Helpguide’s Alcohol Abuse and Addiction: Self-Help, Prevention, and Treatment Options.
How can I tell if my teen has a drinking problem?
Alcohol is the number one drug of choice among young people. Teens consume more alcohol than all the other illicit drugs combined. Knowing the warning signals of alcohol use in your teen can help lead to early intervention, and can make a huge difference in your child’s recovery.
Certain warning signs indicate that your child may have a drinking problem. One or two of these signs are common in all children, especially teens, as they are adjusting to the bodily and social changes that are a part of their stage of life. It is advisable to have a talk with your child, however, if you notice several of the following signs:
The odor of alcohol
Sudden change in mood or attitude Change in attendance or performance at school Loss of interest in school, sports, or other activities Discipline problems at school Withdrawal from family and friends Secrecy Association with a new group of friends and reluctance to introduce them to you Alcohol disappearing from your home Depression and developmental difficulties For helpful tips on talking about alcohol with your teenager, see Helpguide’s Alcohol Abuse and Addiction: Self-Help, Prevention, and Treatment Options
What tests determine alcohol abuse?
Recognizing the symptoms of alcoholism is not always an easy task because denial of the disease among alcoholics is widespread. Health care professionals use questionnaires designed to elicit patterns of behavior and health complaints that point to alcohol abuse. Blood alcohol tests, though useful for detection of recent episodes of drinking, are not valid indicators of chronic misuse. Blood tests that measure the red blood cell size, and those that measure a factor called carbohydrate-deficient transferrin are much more reliable. Tests that show evidence of typical alcohol-related health problems, such as liver damage or decreased testosterone in men, are also effective in convincing problem drinkers that they need help.
Gordon A. Gunnell, MS, PLC
15215 South 48th Street
Phoenix, AZ 85044
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