734,175
edits
Changes
mLine 1:
Line 1: − [[File:Imlauer Ihr zu Fuessen 1883.jpg|thumb|A drawing from 1883, showing the problems of alcoholism; the drawing is called ''at her feet'']]+ − '''Alcoholism''' is the medical condition of people who often drink too much [[alcoholic drink|alcohol]]. Some people who suffer from alcoholism feel that they have to drink alcohol, even when it causes health and social problems. Alcoholism means [[addiction]] to alcohol. People who suffer from it are called ''alcoholics''. As the condition goes on, those who suffer from it change their habits: obtaining alcohol and consuming it becomes more important. Very often, other interests disappear. Many alcoholics do not think they have a problem with drinking alcohol. With time, they better support bigger quantities, and their personality changes. + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + − Medically, there are two different conditions:+ − #Drinking too much alcohol, and seeing the negative effects of this behaviour+ − #Being dependent on alcohol+ − According to the [[WHO|World Health Oranization]], there are approximately 140 million people with alcoholism worldwide.<ref name="whoemcoypaa">{{Cite web|url=http://www.who.int/director-general/speeches/2001/english/20010219_youngpeoplealcohol.en.html |title=WHO European Ministerial Conference on Young People and Alcohol |author=Dr Gro Harlem Brundtland |authorlink=Gro Harlem Brundtland |date=19 February 2001 |publisher=[[World Health Organisation]] }}</ref><ref name="whotmbcrtdhrai">{{Cite web|url=http://www.who.int/mediacentre/news/releases/2003/pr6/en/index.html |title=WHO to meet beverage company representatives to discuss health-related alcohol issues |author=Ms Leanne Riley |date=31 January 2003 |publisher=[[World Health Organisation]] }}</ref> In the United States and Western Europe, ten to twenty percent of men and five to ten percent of women at some point in their lives will meet criteria for alcoholism.<ref>{{Cite web|url=http://www.britannica.com/EBchecked/topic/13448/alcoholism |title=alcoholism |year=2010 |publisher=Encyclopædia Britannica }}</ref>+ + + + + + − Alcoholism is called a "dual disease": There are both [[psychiatry|mental]] and [[medicine|physical]] components.<ref>{{Cite web|url=http://www.ama-assn.org/ama1/pub/upload/mm/388/alcoholism_treatable.pdf |title=DEFINITIONS |first= |last= |author=American Medical Association |authorlink=American Medical Association |publisher=AMA |location=USA |format=PDF }}</ref> The biological mechanisms that cause alcoholism are not well understood. [[Social environment]], [[Stress (biological)|stress]],<ref name="Glavas">{{Cite book| author = Glavas MM, Weinberg J| year = 2006 | chapter = Stress, Alcohol Consumption, and the Hypothalamic-Pituitary-Adrenal Axis | title = Nutrients, Stress, and Medical Disorders| editor = Yehuda S, Mostofsky DI| publisher = Humana Press | location = Totowa, NJ | isbn = 978-1-58829-432-6 | pages = 165–183}}</ref> [[mental health]], [[genetic predisposition|family history]], age, ethnic group, and gender all influence the risk for the condition.<ref name="Agarwal-Kozlowski-2000">{{Cite journal| last1 = Agarwal-Kozlowski | first1 = K. | last2 = Agarwal | first2 = DP. | title = [Genetic predisposition for alcoholism] | journal = Ther Umsch | volume = 57 | issue = 4 | pages = 179–84 | month = Apr | year = 2000 | pmid = 10804873 }}</ref><ref>{{Cite journal| last1 = Chen | first1 = CY. | last2 = Storr | first2 = CL. | last3 = Anthony | first3 = JC. | title = Early-onset drug use and risk for drug dependence problems | journal = Addict Behav | volume = 34 | issue = 3 | pages = 319–22 | month = Mar | year = 2009 | doi = 10.1016/j.addbeh.2008.10.021 | pmid = 19022584 | pmc = 2677076 }}</ref> Consuming large amounts of alcohol produces changes in the brain's structure and chemistry. Some changes occur very early, even when small amountas of alcohol are consumed, in a short time. Examples are [[Drug tolerance|tolerance]] and [[physical dependence]]. Because of the changes, it is very difficult for an alcoholic to stop drinking, as this would result in [[alcohol withdrawal syndrome]] if the person stops.<ref name="Hoffman-1996">{{Cite journal |last1=Hoffman |first1=PL. |last2=Tabakoff | first2=B. |title=Alcohol dependence: a commentary on mechanisms |journal=Alcohol Alcohol |volume=31 |issue=4 |pages=333–40 |month=Jul |year=1996 |pmid=8879279 }}</ref> Alcohol damages almost every organ in the body, including the brain. Chronic alcohol abuse can cause both medical and psychiatric problems.<ref>{{Cite book|editor1-first=Woody |editor1-last=Caan |editor2-first=Jackie de |editor2-last=Belleroche |title=Drink, Drugs and Dependence: From Science to Clinical Practice |url=http://books.google.com/?id=nPvbDUw4w5QC |edition=1st |date=11 April 2002 |publisher=Routledge |isbn=978-0-415-27891-1 |pages=19–20}}</ref>+ + + − Alcoholism is a condition with a [[social stigma]]. As a result, people suffering from it, avoid being diagnosed or treated, as this may be shameful, or have social consequences. The evaluation responses to a group of standardized questioning is a common method for diagnosing alcoholism. These can be used to identify harmful drinking patterns, including alcoholism.<ref name="Kahan-1996">{{Cite journal| last1 = Kahan | first1 = M. | title = Identifying and managing problem drinkers | journal = Can Fam Physician | volume = 42 | issue = | pages = 661–71 | month = Apr | year = 1996 | doi = | pmid = 8653034 | pmc = 2146411 }}</ref> In general, problem drinking is considered alcoholism when the person continues to drink despite experiencing social or health problems caused by drinking.<ref name="DSMIV">{{Cite book| title = Diagnostic and statistical manual of mental disorders: DSM-IV | url = http://books.google.com/?id=W-BGAAAAMAAJ | date = 31 July 1994 | publisher = American Psychiatric Association | location = Washington, DC | isbn = 978-0-89042-025-6 | pages = }}</ref>+ − ==Stages==+ − − Step 1. A glass with a friend.<br /> − Step 2. A glass to keep the cold out.<br /> − Step 3. A glass too much.<br /> − Step 4. Drunk and riotous.<br /> − Step 5. The summit attained. Jolly companions. A confirmed drunkard.<br /> − Step 6. Poverty and disease.<br /> − Step 7. Forsaken by Friends.<br /> − Step 8. Desperation and crime.<br /> − Step 9. Death by suicide.]] − Generally, there are different stages to alcoholism.+ − #Drinking alcohol starts in a social setting, on occasion, together with friends. With time progressing, the potential alcoholic feels relieved when he drinks. This relief is usually attributed to the situation, or the people, not the alcohol. With the time people seek out occasions where "social drinking" occurs. People also develop tolerance. This means over time, they need a larger quantity of alcohol to get the same feeling of relief.+ − + − #The alcoholic is no longer able to control his drinking. He may not drink for a long time, but once he gets a tiny bit of alcohol, he is unable to stop until he is either drunk, or too sick to continue; this is called ''craving''. The patient thinks this is just a lack of resolve, but in truth he is dependent on alcohol. Excuses are found for the drinking habit. To the patient it is important to be able to explain, because except for alcohol, there are no other solutions to problems. Because of this behaviour there are problems with the rest of his family. There are whole families who get isolated, because they try to hide the drinking problem of a family member. This is called [[co-dependence]].+ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + − The overuse of alcohol has different causes, and there are different forms of treatment available. Some of these treatments are:+ − * ''Detoxification'': Alcohol use is stopped abruptly. The alcohol is sometimes replaced with other [[drug]]s that have similar effects, to prevent withdrawal symptoms.+ − * ''Therapy'': Various therapies are available.+ − * ''Moderation'': Alcohol use is lowered and lowered.+ − * ''Drugs'': Some drugs can help the transition to drinking less, or are very dangerous if they are consumed with alcohol. − ==Detoxification==+ − Treatment of alcoholism takes several steps. Direct withdrawal leads to medical problems. For this reason, the process of withdrawal needs to be controlled carefully. [[Alcohol detoxification]] often involves the use of special [[drug]]s; [[benzodiazepines]] such as [[diazepam]] are used frequently.<ref name="Blondell-2005">{{Cite journal| last1 = Blondell | first1 = RD. | title = Ambulatory detoxification of patients with alcohol dependence | journal = Am Fam Physician | volume = 71 | issue = 3 | pages = 495–502 | month = Feb | year = 2005 | pmid = 15712624 }}</ref> Sometimes, people with alcoholism also have other addictions. Benzodiazepines are addictive. If the person is addicted to both alcohol, and benzodiazepines, this step gets more complicated.<ref name="dolpdaa">{{Cite journal|author=Johansson BA, Berglund M, Hanson M, Pöhlén C, Persson I |title=Dependence on legal psychotropic drugs among alcoholics |journal=Alcohol Alcohol. |volume=38 |issue=6 |pages=613–8 |year=2003 |pmid=14633651 |doi= 10.1093/alcalc/agg123|url=http://alcalc.oxfordjournals.org/cgi/reprint/38/6/613 |format=PDF |month= November|issn=0735-0414}}</ref> After detoxification, other support such as group therapy or self-help groups are used to help the person remain sober.<ref name="Morgan-Lopez-2006">{{Cite journal| last1 = Morgan-Lopez | first1 = AA. | last2 = Fals-Stewart | first2 = W. | title = Analytic complexities associated with group therapy in substance abuse treatment research: problems, recommendations, and future directions | journal = Exp Clin Psychopharmacol | volume = 14 | issue = 2 | pages = 265–73 | month = May | year = 2006 | doi = 10.1037/1064-1297.14.2.265 | pmid = 16756430 }}</ref><ref name="Soyka-2001">{{Cite journal| last1 = Soyka | first1 = M. | last2 = Helten | first2 = C. | last3 = Scharfenberg | first3 = CO. | title = [Psychotherapy of alcohol addiction—principles and new findings of therapy research] | journal = Wien Med Wochenschr | volume = 151 | issue = 15–17 | pages = 380–8; discussion 389 | month = | year = 2001 | doi = | pmid = 11603209 }}</ref> Thombs (1999) states according to behavioural sciences alcoholism is described as a “maladaptive behaviour”. He explains this must not be confused with “misbehaviour”. Behavioural scientists explain that addicts have a behaviour pattern that may lead to destructive consequences for themselves, their families and society. This does not label addicts as bad or irresponsible.<ref>{{cite book|last=Thombs|first=Dennis L. Thombs|title=Introduction To Addictive Behaviors 2ed|year=1999|publisher=The Guildford Press|location=London|pages=8–9}}</ref> Compared with men, women are more sensitive to alcohol's harmful physical, cerebral, and mental effects. − == Different types of alcoholics==+ − [[Elvin Morton Jellinek]] identified different types of people drinking alcohol:<ref>E. M. Jellinek: ''The Disease Concept of Alcoholism'', Hillhouse, (New Haven) 1960</ref>+ − *''Alpha-type'': these people drink alcohol to cope with difficult situations. The amount of alcohol consumed mainly depends how difficult the situation is perceived. Alpha-types are not alcoholics, but they run they risk of psychical addiction. − *''Beta type'': Given the right occasion, these people drink a large quantity of alcohol. Socially and psychically speaking, they usually do not get noticed easily. They simply have a lifestyle which often gives the opportunities to drink. They suffer some consequences from their frequent alcohol consumption. They are neither psychically nor physically dependent, but often at risk of becoming so. − *''Gamma-type'': These people have longer phases of being abstinent. These phases alternate with phases of being very drunk. One of the characteristic of people o this type is the loss of control: Such people cannot stop drinking, even when they have the feeling to have drunk enough. They feel safe because of the longer phases of not drinking alcohol, but they are in fact alcohol-dependent. − *''Delta-type'': People of this type try to keep a "level" of alcohol during the day, and the night. The level is usually quite low, but increases as the illness progresses. This is also because a kind of tolerance develops; in other words, the same amount of alcohol will not have the same effect, after some time. For a long time, addicts can function in society, because they rarely "look drunk". There is a strong physical dependence; these people need to constantly drink alcohol to counter [[withdrawal symptoms]]. There are health problems related to the constant drinking. Delta types are not capable of being without alcohol, and of alcohol-dependent. − *''Epsilon-type'': These people drink alcohol excessively, in irregular intervals. When drinking, they lose control. These intervals can last days to months. Between two intervals, usually no alcohol is consumed. Epsilon-types are alcohol dependent. − + − + − + + + + + − S. Y. Hill added a third type in 1992:<ref>S. Y. Hill: ''Absence of Paternal Sociopathy in the Etiology of Severe Alcoholism: Is There a Type III Alcoholism?'' Journal of Studies Alcohol 1992; 53: S. 161–169</ref>+ − * ''Type-III'': Very much influenced by genetic disposition, as Type II. Unlike Type II, Type III does not show antisocial behavior.+ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + − [[Category:Psychology]] − − {{Link FA|hr}} − {{Link GA|en}} − {{Link GA|n
KS update 1.1
{{disputed|January 2016}}
{{Infobox disease
| Name = Alcoholism (Alcohol Use Disorder)
| Image = GinLane.jpg
| Caption = ''Gin Lane'': anti-alcohol visual [[propaganda]] by [[William Hogarth]], 1751
| Field =[[Psychiatry]]
| DiseasesDB =
| ICD10 = {{ICD10|F|10||f|10}}.2
| ICD9 = {{ICD9|303}}
| ICDO =
| OMIM =103780
| MedlinePlus = 000944
| eMedicineSubj =article
| eMedicineTopic =285913
| MeshID = D000437
}}
'''Alcoholism''' is [[addiction]] to [[Alcoholic drink|alcohol]]. People who have alcoholism are called '''alcoholics'''.
Alcoholism is a [[disease]].<ref>{{cite web |url=http://www.who.int/substance_abuse/terminology/icd_10/en/ |title=ICD-10 Classification of Mental and Behavioral Disorders |author=<!--Staff writer(s); no by-line.--> |website=WHO Programmes: Management of Substance Abuse |publisher=[[World Health Organization]] |accessdate=February 20, 2016 |quote=}}</ref><ref>{{cite journal |author=Morse RM; Flavin DK 1992 |title=The Definition of Alcoholism |url= |journal=Journal of the American Medical Association |publisher=The American Medical Association |volume=268 |issue=8 |pages=1012-1014|doi=10.1001/jama.1992.03490080086030 |accessdate=February 20, 2016}}</ref><ref name=afp>{{cite journal |author=Mersy DJ 2003 |title=Recognition of Alcohol and Substance Abuse |url=http://www.aafp.org/afp/2003/0401/p1529.html |journal=American Family Physician |publisher=American Association of Family Physicians |volume=67 |issue=7 |pages=1529-1532 |doi= |pmid=12722853 |accessdate=February 20, 2016}}</ref> It often gets worse over time, and can kill a person. However, alcoholism can be treated.<ref name=afp/>
Alcohol is the most commonly used [[drug]] in the world.<ref name=gds>{{cite web |url=http://www.globaldrugsurvey.com/the-global-drug-survey-2014-findings/ |title=The Global Drug Survey 2014 Findings: Reflections on the results of the world’s biggest ever drug survey by Dr. Adam Winstock |last1=Winstock |first1=Adam |last2= |first2= |date=June 7, 2015 |website= |publisher=Global Drug Survey |accessdate=January 21, 2016 |quote=}}</ref> Around the world, there are at least 208 million people with alcoholism.<ref name="alchwho2010">{{Cite web|url=http://www.who.int/topics/alcohol_drinking/en/ |title=Alcohol |author=World Health Organisation |year=2010 }}</ref><ref name=Pew2015>{{cite web|title=Global Population Estimates by Age, 1950–2050|url=http://www.pewglobal.org/2014/01/30/global-population/|accessdate=10 May 2015}}</ref>
Alcoholism is a condition with a [[social stigma]]. Because of this, alcoholics often feel [[shame|ashamed]] of their drinking. They may try to hide their drinking, avoid getting help, or [[denial|refuse to believe that they are alcoholics]], because they are too ashamed.
==Diagnosis==
[[File:Alcoholism_is_a_Prision.JPG|thumb|right|300px|Alcoholism is a prison]]
Being an alcoholic does not mean that a person just drinks a lot of alcohol. It means that they cannot control how much alcohol they drink. No matter how badly they want to, once they take one drink, they cannot stop drinking.<ref name=icd/>
To be [[medical diagnosis|diagnosed]] with alcoholism, a person has to have three of these [[symptom]]s in the past year:<ref name=icd>{{cite web |url=http://www.who.int/substance_abuse/terminology/ICD10ClinicalDiagnosis.pdf?ua=1 |title=The ICD-10 Classification of Mental and Behavioral Disorders: Clinical Descriptions and Diagnostic Guidelines |author=<!--Staff writer(s); no by-line.--> |website=World Health Organization Programmes: Management of Substance Abuse |publisher=World Health Organization |accessdate=February 21, 2016 |quote=}}</ref>
# They feel like they have to drink alcohol.
# They cannot control when they start. drinking; when they stop drinking; or how much they drink.
# They get [[alcohol withdrawal]] symptoms when they stop drinking.
# They have to drink more and more alcohol to feel [[drunkenness|drunk]] (this is called [[Alcohol tolerance|tolerance]]).
# They spend less time doing things they used to enjoy, because they are spending so much time drinking. They spend a lot of time getting alcohol, drinking alcohol, or feeling sick from drinking too much.
# They keep drinking even though they know it is causing serious problems in their life.
There is no medical test, like a [[blood test]], that can say whether a person is an alcoholic. There are some questionnaires (lists of questions) that can help tell whether a person ''may'' be an alcoholic. These questionnaires include the [[CAGE questionnaire]] (for [[adults]]) and the [[CRAFFT Screening Test]] (for [[teenagers]]).
== Alcoholism causes many problems ==
===Problems in the body===
[[File:What Alcohol Does to Your Body.webm|thumb|What Alcohol Does to Your Body]]
[[File:What Alcohol Does to Your Body.webm|thumb|What Alcohol Does to Your Body]]
Alcoholism can cause many health problems. For example, it can cause:<ref name=beyondhangovers>{{cite web |url=http://pubs.niaaa.nih.gov/publications/Hangovers/beyondHangovers.pdf |title=Beyond Hangovers: Understanding Alcohol’s Impact On Your Health |author=<!--Staff writer(s); no by-line.--> |website=National Institute on Alcohol Abuse and Alcoholism |publisher=United States National Institutes of Health, Department of Health and Human Services |accessdate=February 20, 2016 |quote=}}</ref><ref>{{Cite book|editor1-first=Woody |editor1-last=Caan |editor2-first=Jackie de |editor2-last=Belleroche |title=Drink, Drugs and Dependence: From Science to Clinical Practice |url=https://books.google.com/?id=nPvbDUw4w5QC |edition=1st |date=April 11, 2002 |publisher=Routledge |isbn=978-0-415-27891-1 |pages=19–20}}</ref>
* [[Brain damage]]
* [[Liver disease]] (like [[cirrhosis]]) and [[liver failure]]
* Many types of [[cancer]], including [[Oral cancer|mouth]], [[Throat cancer|throat]], [[Esophageal cancer|esophageal]], [[Breast cancer|breast]], and [[Liver cancer|liver cancers]]
* Heart problems, including a [[Cardiomyopathy|weak heart muscle]]; [[Cardiac arrhythmia|abnormal heartbeat]]; [[High Blood Pressure|high blood pressure]]; and [[stroke]]
* Problems with the [[pancreas]]
* A weak [[immune system]], which makes it harder for the body to fight off diseases
* [[Depression (mental illness)|Depression]] and [[anxiety]]
* Deaths from [[drunk driving]] [[Motor vehicle accident|accidents]] or other [[injury|injuries]]
If a person drinks too much at one time, they can get [[alcohol poisoning]]. This can cause breathing problems, [[coma]], and even death.
In 2012, alcohol use caused 3.3 [[million]] deaths around the world. This means that in 2012, about 3 out of every 50 deaths in the world were caused by alcohol use.<ref name=whoetoh>{{cite web |url=http://www.who.int/substance_abuse/facts/alcohol/en/ |title=Alcohol |author=<!--Staff writer(s); no by-line.--> |date=2016 |website=World Health Organization Programmes: Management of Substance Abuse |publisher=World Health Organization |accessdate=February 21, 2016 |quote=}}</ref>
=== Problems in life ===
Alcoholism can also cause many problems in alcoholics' lives. These include:<ref name=whosocial>{{Cite report |author=World Health Organization |date=2004 |title=“Part I: Consequences of Alcohol Use: Social Problems Associated with Alcohol Use.” In Global Status Report on Alcohol 2004 |url=http://www.who.int/substance_abuse/publications/globalstatusreportalcohol2004_socproblems.pdf |publisher=World Health Organization |pages=59-64 |docket= |accessdate=January 20, 2016 |quote= }}</ref>
* Not doing well at school or work
* Having family problems
* Not having enough money, because the alcoholic is spending so much money on alcohol
* Being [[unemployment|unemployed]]
* [[Child abuse|Abusing]] or [[neglect]]ing their children
* [[Domestic violence|Abusing their wives or husbands]]
* Living in [[poverty]] or being [[homelessness|homeless]]
===Alcohol withdrawal===
{{Main|Alcohol withdrawal|Delirium tremens}}
If an alcoholic stops drinking suddenly, they can get [[alcohol withdrawal]].
The most serious form of alcohol withdrawal is [[delirium tremens]] (often called "DTs"). Delirium tremens is a [[medical emergency]]. Many people who get the DTs die from them.<ref name=Study>{{cite web |url=http://emedicine.medscape.com/article/166032-overview#showall |title=Delirium Tremens (DTs) |last1=Burns, MD, FACEP, FACP |first1=Michael James |last2= |first2= |date=April 14, 2015 |website=medscape.com |publisher=Medscape |accessdate=December 27, 2015 |quote=}}</ref><ref name=AAH>{{Cite report |author=National Institute for Health and Care Excellence |authorlink= |date=2010 |title=Alcohol Use Disorders: Diagnosis and Clinical Management of Alcohol-Related Physical Complications - NICE Clinical Guidelines, No. 100 |url=https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0047840/ |publisher=Royal College of Physicians |page= |docket= |accessdate=December 27, 2015 |quote= }}</ref>
This does not mean that alcoholics should not stop drinking. It means that alcoholics should talk to a [[Medical doctor|doctor]] or go to a [[hospital]] before they stop drinking. Doctors can give [[medication]]s to make sure that a person is safe while they stop drinking.<ref name=AAH/>
[[File:The Drunkard's Progress 1846.jpg|thumb|400px|The drunkards progress, an illustrationfrom 1846: The stages:<br />
==Epidemiology==
[[File:Alcohol by country.svg|thumb|[[Map]] showing [[average]] amounts of alcohol drunk per year. People in yellow countries drink the most alcohol. People in green countries drink medium amounts of alcohol. People in blue countries drink very little alcohol.<ref name=whoglobal/>]]
#In the next phase, the drinker has problems [[amnesia|remembering]] things. The alcoholic may be completely normal, but they cannot remember certain events, or how certain events occurred. This is independent of a feeling of drunkenness. The patient also begins to see that he drinks more alcohol than other people. For this reason, drinking is often done in secret. The first glasses are consumed more quickly; this is done so as to not stand out, and to get the feeling quicker. There are feelings of guilt; the patient tries to avoid talking about alcohol for this reason.
[[Image:Alcohol use disorders world map - DALY - WHO2004.svg|thumb|[[Map]] showing how many years of healthy life every 100,000 people lost because of alcoholism in 2004<br>
* Yellows: Under 50 to 410
* Oranges: 410 to 770
* Reds: 770 to 1250
* Dark red: Over 1250]]
In 2010, the [[World Health Organization]] (WHO) [[estimate]]d that there were 208 million people with alcoholism around the world. (This is 4.1% of the world's population over age 15.)<ref name="alchwho2010">{{Cite web|url=http://www.who.int/topics/alcohol_drinking/en/ |title=Alcohol |author=World Health Organisation |year=2010 }}</ref><ref name=Pew2015>{{cite web|title=Global Population Estimates by Age, 1950–2050|url=http://www.pewglobal.org/2014/01/30/global-population/|accessdate=10 May 2015}}</ref> In 2001, the WHO estimated that there were about 140 million alcoholics around the world.<ref name="whoemcoypaa">{{Cite web|url=http://www.who.int/director-general/speeches/2001/english/20010219_youngpeoplealcohol.en.html |title=WHO European Ministerial Conference on Young People and Alcohol |author=Dr Gro Harlem Brundtland |authorlink=Gro Harlem Brundtland |date=19 February 2001 |publisher=[[World Health Organisation]] }}</ref><ref name="whotmbcrtdhrai">{{Cite web|url=http://www.who.int/mediacentre/news/releases/2003/pr6/en/index.html |title=WHO to meet beverage company representatives to discuss health-related alcohol issues |author=Riley, Leanne |date=31 January 2003 |publisher=[[World Health Organisation]] }}</ref> This means that in the nine years between 2001 and 2010, about 68 million people became alcoholics.
=== Around the world ===
People in [[developed country|developed countries]] drink the most alcohol.<ref name=whoglobal>{{Cite report |author=World Health Organization |authorlink= |coauthors= |date=2011 |title=Global Status Report on Alcohol and Health |url=http://www.who.int/substance_abuse/publications/global_alcohol_report/msbgsruprofiles.pdf |publisher=WHO Press |page= |docket= |accessdate= |quote=| isbn=978-92-4-156415-1}}</ref><sup>p.4</sup>
Alcoholism is more common in some areas than others. Here is a list of all the areas in the world. It is in order from the areas where alcoholism is most common to the areas where it is least common:<ref name=whoglobal/><sup>p.21</sup>
# The [[Europe]]an area
# The [[Americas]]
# The Western [[Pacific Ocean|Pacific]] area (including [[China]], [[Japan]], [[Korea]], [[Vietnam]], [[Australia]], [[New Zealand]], and many islands in the Pacific Ocean)
# The [[Southeast Asia]]n area
# [[Africa]]
# The Eastern [[Mediterranean region|Mediterranean area]] (including the [[Middle East]] and northeast [[Africa]])
There are many reasons why alcoholism is more common in some areas than others. Some of these reasons include [[religion]], [[culture]], [[law]]s, and people's attitudes about drinking. For example, on [[average]], people in [[Northern Africa]], the Middle East, and [[island]]s in the [[Indian Ocean]] drink less than people anywhere else in the world.<ref name=whoglobal/><sup>p.4</sup> These are areas where many people are [[Muslim]]s. Many Muslims in these areas do not drink any alcohol, because the [[Koran]] says not to.<ref name=whoglobal/><sup>p.4</sup> In some of these countries, drinking alcohol is [[illegal]].
However, in other areas, like [[Western Europe]], alcohol is a part of daily life.<ref name=intl>{{cite web |url=http://pubs.niaaa.nih.gov/publications/arh27-1/95-109.htm |title=International Comparisons of Alcohol Consumption |author=Bloomfield, Kim; Stockwell, Tim; Gmel, Gerhard; Rehn, Nina |date=December 2003 |website=National Institute on Alcohol Abuse and Alcoholism |publisher=United States National Institute of Health |accessdate=February 21, 2016 |quote=}}</ref> It is legal and easy to get. People very commonly drink alcohol with meals. Very few people drink no alcohol.<ref name=intl/> People's attitudes about alcohol are very different than attitudes in mostly Muslim countries. This is an example of how differences in religion, culture, laws, and attitudes about drinking can affect the amount of alcohol use and alcoholism in different areas.
===Men and women===
Alcoholism is more common in men than in women. However, in the past few [[decade]]s, the number of female alcoholics has increased.<ref name="Walter H., Gutierrez K., Ramskogler K., Hertling I., Dvorak A., Lesch O.M., et al. 2003 253–268">{{cite journal | author = Walter H, Gutierrez K, Ramskogler K, Hertling I, Dvorak A, Lesch OM | title = Gender-specific differences in alcoholism: implications for treatment | journal = Archives of Women's Mental Health | volume = 6 | issue = 4 | pages = 253–8 | date = November 2003 | pmid = 14628177 | doi = 10.1007/s00737-003-0014-8 }}</ref>
Female alcoholics are most common in the Americas and Europe. In the [[United States]] and Western Europe, five to ten [[percent]] of women will become alcoholics at some point in their lives.<ref>{{Cite web|url=http://www.britannica.com/EBchecked/topic/13448/alcoholism |title=alcoholism |author=Keller, Mark |date=February 8, 2016 |accessdate=January 21, 2016 |publisher=Encyclopædia Britannica }}</ref>
In the Southeast Asian and Western Pacific areas, less than 1% of women are alcoholics. In Africa and the Eastern Mediterranean area, almost no women are alcoholics.<ref name=whoglobal/><sup>p.21</sup>
===Young people===
In many countries, young people are using more and more alcohol. In a 2008 WHO [[survey]], underage drinking had increased in 71% of countries. Drinking by young adults (ages 18-25) had increased in 80% of countries.<ref name=whoglobal/><sup>p.10</sup>
==Treatment options==
==Treatment options==
Alcoholism can be treated. There are many forms of treatment for alcoholism.
===Detoxification===
[[File:Doctor examines patient.jpg|thumb|Before stopping alcohol suddenly, a person should see a doctor to come up with a safe plan]]
Detoxification (detox) is often the first step in treating alcoholism.<ref>{{cite web|title=Treatment Strategies for Alcohol Abuse|url=http://www.spiritualriver.com/alcoholism/treatment-strategies-alcohol-abuse/|publisher=Spiritual River|accessdate=31 August 2016|date=21 May 2015}}</ref> "Detoxification" means "getting [[toxin]]s out of the body." Alcohol detoxification means that the alcoholic stops drinking, so that alcohol (a toxin) can get out of their body. The alcoholic also needs to give their body time to recover from not having alcohol any more.
It is not safe for an alcoholic to suddenly stop drinking on their own.<ref name=AAH/> The safest way to stop drinking is to go to a hospital that specializes in alcohol detoxification. These hospitals are often called "detoxes" or "rehabs." These places can make sure that an alcoholic has a safe detox. They can also give medications to make the alcoholic more comfortable, and to prevent symptoms of alcohol withdrawal. The most common medications that doctors give during alcohol detox are [[benzodiazepine]]s.<ref name=tx>{{Cite report |author=Raistrick, Duncan; Heather, Nick; Godfrey, Christine |authorlink= |coauthors= |date= |title=Review of the Effectiveness of Treatment for Alcohol Problems |url=http://www.nta.nhs.uk/uploads/nta_review_of_the_effectiveness_of_treatment_for_alcohol_problems_fullreport_2006_alcohol2.pdf |publisher=National Health System of the United Kingdom |page= |docket= |accessdate=February 21, 2016 |quote= }}</ref><sup>p.35</sup>
Once a person stops drinking alcohol, they are called ''[[wikt:sober|sober]]''. Most people need other treatments to help them stay sober.<ref>{{cite web|title=What to do if You Have Blown Your Sobriety Efforts|url=http://www.spiritualriver.com/alcoholism/blown-sobriety-efforts/|publisher=Spiritual River|accessdate=31 August 2016|date=29 June 2015}}</ref>
<ref name=tx/>
[[C. Robert Cloninger]] only listed two types, in 1981:<ref>C. R. Cloninger, M. Bohman, S. Sigvardsson: ''Inheritance of alcohol abuse: cross-fostering analysis of adopted men.'' In: ''[[Archives of General Psychiatry]]'' 1981, 38: pp 861–869.</ref>
===Therapy===
* ''Type-I'': Also called [[milieu]]-determined alcoholism: Sufferers can be of either sex. Alcohol abuse can be mild or heavy. The illness usually gets wors rapidly. People with a lower social status suffer more markedly. Those who suffer try to "keep harm away", they are dependent on a "reward". Usually, people suffer from [[Clinical depression]] and [[phobia]]s, which they try to fight with drinking alcohol. There is little genetic disposition towards alcohol-dependence.
[[Psychotherapy]] and group therapy can help alcoholics stay sober. For example, they can help alcoholics learn how to:<ref name=tx/>
*''Type-II'': This type only affects men. Alcohol abuse is moderate, but shows early. Mothers of such alcoholics tend to be non-nondescript, but their fathers usually developed alcohol dependence before they turned 25. In addition, such people are often [[criminal]]s. Those affected often show antisocial behavior; they also like to take risks. Usually they use alcohol to get euphoric, but often also have a problem with other drugs. Probably genetic dispostion is more important in this type, than social factors.
* Deal with stress without using alcohol
* Figure out what makes them want to drink, and learn how to deal with those things without drinking
* Plan what they will do if they are around people who are drinking
* Come up with reasons for why they want to stay sober, and use those things as [[motivation]] to stay sober (this is called [[Motivational Interviewing]])
* Change their thoughts about drinking and how they react to those thoughts (this is called [[Cognitive-behavioral therapy]])
===Medications===
Some medications can help alcoholics stay sober. These medications include:<ref name=tx/><sup>pp.130-144</sup>
* [[Antabuse]]: This medication makes a person very sick if they drink any alcohol. It can make an alcoholic not want to drink any more, because they do not want to get sick.
* [[Naltrexone]]: This medication causes changes in the brain. These changes make alcoholics not want to drink alcohol as much as they normally do. Also, if an alcoholic does drink alcohol, the naltrexone will block the alcohol from making them feel good, and they are more likely to stop drinking.
====Vitamins====
Many alcoholics do not have enough [[vitamin]]s in their body. This can cause serious problems. For example, if an alcoholic does not have enough [[thiamine]], they can get brain damage. Often, alcoholics are treated with thiamine to prevent brain damage. They may also be given other vitamins if needed.<ref name=tx/><sup>p.144</sup>
===Groups for alcoholics===
[[Alcoholics Anonymous]] (AA) is the biggest support and mutual aid group for alcoholics in the world.<ref>{{cite journal |author=Pagano ME, Friend KB et al. 2004 |title=Helping Other Alcoholics in Alcoholics Anonymous and Drinking Outcomes: Findings from Project MATCH |url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3008319/ |journal=Journal of Studies on Alcohol and Drugs |publisher= |volume=65 |issue=6 |pages=766-773|doi= |pmcid=PMC3008319 |accessdate=February 21, 2016}}</ref> This means that in AA groups, alcoholics come together to support each other and help each other recover. AA uses a [[twelve-step program]]. This program is meant to help alcoholics fix the problems their alcoholism has caused.<ref name="BIGBOOK">{{cite book |title=Alcoholics Anonymous |publisher=Alcoholics Anonymous World Services |date=June 2001 |edition=4th |isbn=1-893007-16-2 |oclc=32014950 |url=http://www.aa.org/bigbookonline/ |author=Wilson, Bill |accessdate=February 21, 2016}}</ref>
There are also other groups for alcoholics, like:<ref>{{cite web |url=http://www.huffingtonpost.com/tom-horvath-phd/addiction-treatment_b_1663494.html |title=If Not AA, Then What? SMART Recovery and the AA Alternatives |last1=Horvath |first1=Tom |last2= |first2= |date=July 20, 2012 |website=Huffington Post Online |publisher=TheHuffingtonPost.com Inc. |accessdate=February 21, 2016 |quote=}}</ref>
* SMART Recovery
* [[Secularism|Secular]] Organizations for Sobriety (SOS)
* Women for Sobriety
* LifeRing Secular Recovery
* Celebrate Recovery (based on [[Christianity]] and the [[Bible]])
==Related pages==
* [[Addiction]]
* [[Drunkenness]]
* [[Fetal alcohol syndrome]]
* [[CIWA|CIWA scale]] (used to measure how bad alcohol withdrawal is)
* [[CAGE questionnaire]] (used to test adults for alcoholism)
* [[CRAFFT Screening Test]] (used to test teenagers for alcohol and drug problems)
==References==
==References==
{{reflist|2}}
{{reflist|2}}
==Other websites==
* [https://www.cdc.gov/alcohol/fact-sheets.htm Fact sheets about alcohol] (from the [[CDC|United States Centers for Disease Control]])
* [http://kidshealth.org/en/kids/alcohol.html?ref=search Information about alcohol for kids] (from KidsHealth.org)
* [http://www.girlshealth.gov/substance/index.html Information about alcohol for teenagers] (from GirlsHealth.gov)
===Help for alcoholism===
* [http://www.samhsa.gov/find-help/national-helpline National Substance Abuse Hotline] - find help for alcoholism, 24 hours a day, 7 days a week (run by SAMHSA.gov)
* [http://pubs.niaaa.nih.gov/publications/Treatment/treatment.htm Treatment for Alcohol Problems: Finding and Getting Help] (by the National Institute on Alcohol Abuse and Alcoholism)
* [https://www.alcohol.org/ Resources of Alcoholism Treatment]
'''Groups for alcoholics and their families'''
* [http://www.aa.org Alcoholics Anonymous]
* [http://www.al-anon.org Al-Anon] (support group for people who have an alcoholic family member)
* [http://al-anon.org/for-alateen Alateen] (support group for teenagers who have an alcoholic family member)
* [http://www.smartrecovery.org SMART Recovery]
* [http://www.sossobriety.org Secular Organizations for Sobriety] (SOS)
* [http://www.womenforsobriety.org Women for Sobriety]
* [http://www.lifering.org LifeRing Secular Recovery]
* [http://www.celebraterecovery.com Celebrate Recovery]
[[Category:Addiction]]
[[Category:Alcohol drinking habits]]
[[Category:Diseases]]
[[Category:Diseases]]