For many people, the facts about alcoholism are not clear. What is alcoholism, exactly? How does it differ from alcohol
abuse? When should a person seek help for a problem related to his or her drinking?
The Botswana Alcohol Aids Project has prepared this passout to help individuals and families answer these and other common
questions about alcohol problems. The following information explains alcoholism and alcohol abuse, the symptoms of each, when
and where to seek help, treatment choices, and additional helpful resources.
A Widespread Problem
For most people who drink, alcohol is a pleasant accompaniment to social activities. Moderate alcohol use; up to two drinks
per day for men and one drink per day for women and older people, is not harmful for most adults. (A standard drink is one
12-ounce bottle or can of either beer or wine cooler, one 5-ounce glass of wine, or 1.5 ounces of 80-proof distilled spirits.)
Nonetheless, a large number of people get into serious trouble because of their drinking.
Currently, nearly 14 million Americans, 1 in every 13 adults abuse alcohol or are alcoholic. Several million more adults
engage in risky drinking that could lead to alcohol problems. These patterns include binge drinking and heavy drinking on
a regular basis. In addition, 53 percent of men and women in the United States report that one or more of their close relatives
have a drinking problem. The consequences of alcohol misuse are serious and, in many cases, life threatening. Heavy drinking
can increase the risk for certain cancers, especially those of the liver, esophagus, pancreas, throat, and larynx (voice box).
Heavy drinking can also cause liver cirrhosis, immune system problems, brain damage, and harm to the fetus during pregnancy.
In addition, drinking increases the risk of death from automobile crashes as well as recreational and on-the-job injuries.
Furthermore, both homicides and suicides are more likely to be committed by persons who have been drinking.
In purely economic terms, alcohol-related problems cost society approximately $185 billion per year. In human terms, the
costs cannot be calculated. Statistics like this are yet to be developed for Botswana but, all the Rapid Assessments which
have been done assessing drinking patterns and behaviors indicate that Botswana is in serious trouble with Alcohol, especially
as it is linked with HIV/AIDS via unsafe sexual behavior while under the influence.
What Is Alcoholism?
Alcoholism, also known as alcohol dependence, is a disease that includes four symptoms:
*Craving: A strong need, or compulsion, to drink.
*Loss of control: The inability to limit ones drinking on any given occasion.
*Physical dependence: Withdrawal symptoms, such as nausea, sweating, shakiness, and anxiety, occur when alcohol use is
stopped after a period of heavy drinking.
*Tolerance: The need to drink greater amounts of alcohol in order to get high.
People who are not alcoholic sometimes do not understand why an alcoholic can't just use a little willpower to stop drinking.
However, alcoholism has little to do with willpower. Alcoholics are in the grip of a powerful craving, or uncontrollable need
for alcohol that overrides their ability to stop drinking. This need can be as strong as the need for food or water.
Although some people are able to recover from alcoholism without help, the majority of alcoholics need assistance. With
treatment and support, many individuals are able to stop drinking and stay stopped. They may then rebuild their lives.
Many people wonder why some individuals can use alcohol without problems but others cannot. One important reason has to
do with genetics. Scientists have found that having an alcoholic family member (Parent, Grandparent, Great Grandparent, Uncle,
Aunt) makes it 4 times more likely that if you choose to drink you too may develop alcoholism. Genes, however, are not the
whole story. In fact, scientists now believe that certain factors in a persons environment can influence whether a person
with a genetic risk for alcoholism ever develops the disease. A persons risk for developing alcoholism can increase based
on the person's environment, including where and how he or she lives; family, friends, and culture; peer pressure; and even
how easy it is to get alcohol. i.e. Growing up in the dysfunction of an alcoholic damaged family can leave a child emotionally
set up to find the mood change provided by Alcohol and others drugs irresistable.
What Is Alcohol Abuse?
Alcohol abuse differs from alcoholism in that it does not include an extremely strong craving for alcohol, loss of control
over drinking, or physical dependence. Alcohol abuse is defined as a pattern of drinking that results in one or more of the
following situations within a 12-month period:
*Failure to fulfill major work, school, or home responsibilities;
*Drinking in situations that are physically dangerous, such as while driving a car or operating machinery;
*Having recurring alcohol-related legal problems, such as being arrested for driving under the influence of alcohol or
for physically hurting someone while drunk; and
*Continued drinking despite having ongoing relationship problems that are caused or worsened by the drinking.
Although alcohol abuse is basically different from alcoholism, many effects of alcohol abuse are also experienced by alcoholics.
What Are the Signs of a Problem?
How can you tell whether you may have a drinking problem? Answering the following four questions can help you find out:
1.Have you ever felt you should cut down on your drinking?
2.Have people annoyed you by criticizing your drinking?
3.Have you ever felt bad or guilty about your drinking?
4.Have you ever had a drink first thing in the morning (as an eye opener) to steady your nerves or get rid of a hangover?
One yes answer suggests a possible alcohol problem.
If you answered yes to more than one question, it is highly likely that a problem exists.
In either case, it is important that you see your doctor or other health care provider (Like Safe Haven Counseling Center)
right away to discuss your answers to these questions. They can help you determine whether you have a drinking problem and,
if so, recommend the best course of action.
Even if you answered no to all of the above questions, if you encounter drinking-related problems with your job, relationships,
health, or the law, you should seek professional help.
The effects of alcohol abuse can be extremely serious & even fatal, both to you and to others.
If you are really wondering IF you have a problem you probably do. Normal drinkers do not ask themselves that question.
The Decision To Get Help
Accepting the fact that help is needed for an alcohol problem may not be easy. But keep in mind that the sooner you get
help, the better are your chances for a successful recovery.
Any concerns you may have about discussing drinking-related problems with your health care provider may stem from common
misconceptions about alcoholism and alcoholic people.
In our society, the myth prevails that an alcohol problem is a sign of moral weakness. As a result, you may feel that
to seek help is to admit some type of shameful defect in yourself.
In fact, alcoholism is a disease that is no more a sign of weakness than is asthma. Moreover, taking steps to identify
a possible drinking problem has an enormous payoff - a chance for a healthier, more rewarding life.
When you visit your health care provider, he or she will ask you a number of questions about your alcohol use to determine
whether you are having problems related to your drinking. Try to answer these questions as fully and honestly as you can.
You also will be given a physical examination. If your health care provider concludes that you may be dependent on alcohol,
he or she may recommend that you see a specialist (like Safe Haven Counseling Center) in treating alcoholism. You should be
involved in any referral decisions and have all treatment choices explained to you.
The type of treatment you receive depends on the severity of your alcoholism and the resources that are available in your
community. Treatment may include detoxification (the process of safely getting alcohol out of your system); taking doctor-prescribed
medications, such as disulfiram (Antabuse®) or naltrexone to help prevent a return (or relapse) to drinking once drinking
has stopped; and individual and/or group counseling. There are promising types of counseling that teach alcoholics to identify
situations and feelings that trigger the urge to drink and to find new ways to cope that do not include alcohol use. This
approach to treatment is called Relapse Prevention.
These treatments are often provided on an outpatient basis.
Because the support of family members is important to the recovery process, many programs also offer brief marital counseling
and family therapy as part of the treatment process. Programs may also link individuals with vital community resources, such
as legal assistance, job training, childcare, and parenting classes.
Virtually all alcoholism treatment programs also include Alcoholics Anonymous (AA) meetings. AA describes itself as a
worldwide fellowship of men and women who help each other to stay sober. Even people who are helped by AA usually find that
AA sometimes works best in combination with other forms of treatment, including counseling and medical care.
Can Alcoholism Be Cured?
Although alcoholism can be treated, a cure is not yet available. In other words, even if an alcoholic has been sober for
a long time and has regained health, he or she remains susceptible to relapse and must continue to avoid all alcoholic beverages.
Cutting down on drinking doesn't work. Cutting out alcohol completely and permenantly is necessary for a successful recovery.
The American Medical Association refers to Alcoholism as "a fatal illness for which there is no known cure". The
Alcoholic who enters recovery and practices abstinence is not cured meaning a regained ability to drink without problems,
rather, the Alcoholic in recovery has, by practicing continuous abstinence, acquired the ability to stay sober one day at
a time. As long as Alcohol does not enter the body it cannot reactivate the characteristics of the illness. Lifelong abstinence
is the only answer and AA helps the recovering person maintain that abstinence.
However, even individuals who are determined to stay sober may suffer one or several slips, or relapses, before achieving
long-term sobriety. Relapses are very common and do not mean that a person has failed or cannot recover from alcoholism. Keep
in mind, too, that every day that a recovering alcoholic has stayed sober prior to a relapse is extremely valuable time, both
to the individual and to his or her family.
If a relapse occurs, it is very important to try to quickly stop drinking once again, one day at a time, and to get whatever
additional support you need to abstain from drinking by returning to your AA Home Group and/or seeing your Counselor.
Help for Alcohol Abuse
If your health care provider determines that you are not alcohol dependent but are nonetheless involved in a pattern of
alcohol abuse, he or she can help you to:
*Examine the benefits of stopping an unhealthy drinking pattern.
*Set a drinking goal for yourself. Some people choose to abstain from alcohol. Others prefer to limit the amount they
*Examine the situations that trigger your unhealthy drinking patterns, and develop new ways of handling those situations
so that you can maintain your drinking goal.
Some alcohol abusing individuals who have stopped drinking after experiencing alcohol-related problems choose to attend
AA meetings for information and support, even though they have not been diagnosed as alcoholic.
Link to Safe Haven Counseling Center
Link to AA Meeting Information