Alcohol abuse means drinking too much alcohol on a regular basis. Defining too much is quite difficult – the safe long-term limits vary with body mass and sex and other factors, such as genetics and what the rest of our lifestyle is like. Current guidelines recommend limits of 3–4 units of alcohol per day for men and 2–3 units per day for women. But the overall maximum per week is 21 units for men and 14 units for women. Most experts regard true alcohol abuse as a higher intake of alcohol – more than 50 units per week for a man and over 35 units per week for a woman.

This article on alcohol abuse treatments is by Kathryn Senior, a freelance journalist who writes health, medical, biological, and pharmaceutical articles for national and international journals, newsletters and web sites.

One reason for drinking more than we should is not realising how many units drinks contain:

  • One pint of strong lager (alcohol 5% vol) = 3 units
  • One pint of standard strength lager (alcohol 3 - 3.5% vol) = 2 units
  • One standard (175ml) glass of wine (alcohol 12% vol) = 2 units
  • One 275ml bottle of an alcopop (alcohol 5.5% vol) = 1.5 units
  • One measure (25ml) of a spirit strength drink = 1 unit

How do I know if I need alcohol abuse treatment?

Drinking can be classified into four levels:

  • Social drinking is generally not considered dangerous. Research shows that 1–2 small alcoholic drinks per day can help reduce the risk of coronary heart disease. However, drinking any amount in some situations such as before driving or operating machinery can be extremely dangerous.
  • Heavy or hazardous drinking means drinking significantly more than the recommended limits.
  • Problem drinking means that you are not addicted but you still continue to drink even though drinking causes problems such as becoming ill, spending too much money, needing time off work, or becoming antisocial.
  • Alcohol dependence, true alcohol addiction, occurs when drinking alcohol takes a high priority in your life, you drink every day, and you can’t easily function without alcohol.

To find out if you need alcohol abuse treatment, your doctor may ask you how much and how often you drink, whether you have "blackouts", if you have tried cutting down, whether you feel guilty about your drinking, or whether you have a drink in the morning.

You may be dependent on alcohol if you have experienced three or more of the following symptoms during a year:

  • A strong urge to drink, difficulty stopping or controlling how much you drink.
  • Withdrawal symptoms, such as sweating, shaking, agitation and nausea, when you try to reduce drinking.
  • Increasing tolerance to alcohol (needing more to get the same effect).
  • You have still carried on drinking even though it has caused harm to you or others.
  • You have let people, work and other activities come second to drinking.

What happens if I don’t seek the treatment?

If you often drink more than the recommended safe limits your risk of developing diseases such as cirrhosis of the liver increases. You also risk doing damage to your pancreas, and the chances that you will develop certain cancers, heart problems, obesity, sexual/fertility problems, muscle diseases and skin disorders, are all greater. In general, all of these risks increase the more you drink.

Long-term alcohol abuse can also lead to anxiety, depression, sleeping problems, mood swings and violence. If you experience any of these alcohol-related conditions you may need to seek alcohol abuse treatment.

What types of treatments are available?

Alcohol abuse treatment can include self-help tactics to cut down the amount of alcohol you drink, such as going out less or switching to a drink with a lower alcohol content. You could also try finding new interests and different ways to relax. Work on having at least two alcohol-free days per week. Most people find it useful to get help to work on underlying issues such as stress, depression or anxiety.

If you have been heavily dependent on alcohol and you suddenly stop drinking, you go through a process of detoxification. You may need alcohol abuse treatments to reduce cravings at this stage. You might also need help with withdrawal symptoms such as headaches, nausea, sweating, and tremors, or even more serious symptoms like confusion, paranoia, fits or hallucinations.

Alcohol abuse treatments such as diazepam (e.g. Valium) or chlordiazepoxide can help reduce the withdrawal symptoms as soon as you stop taking alcohol. Other alcohol abuse treatments include medication to help curb your desire to drink alcohol:

  • Disulfiram is an alcohol abuse treatment that causes very unpleasant effects if you have a very small glass of wine or beer.
  • Naltrexone is an alcohol abuse treatment used to ease alcohol craving. This may be used after a successful detox to prevent you wanting to restart drinking.
  • Acamprosate is another alcohol abuse treatment that reduces alcohol cravings and is useful after detoxification. This can lead to some side-effects such as diarrhoea, headache and a rash.

What happens after the treatment?

Alcohol abuse treatments do include some drugs to help you over the worst. However, the majority of the treatment is about changing your thought patterns and attitudes to drinking and a stay in a detox center of a clinic that offers alcohol abuse treatments will include a lot of counselling and therapy.

Most people who have struggled with a drinking problem come through alcohol abuse treatment but then need to work every single day to stay sober. Alcohol abuse seems to be a problem for life – even if you don’t take a drink for years, just one mistake can undo the effects of the treatment and cause a serious relapse.

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