An Addiction-Alcoholism Test/ Am I Addicted?

Here are three tests to help you decide if you have an addiction.The CAGE Test for Alcohol AddictionThis simple test is surprisingly accurate. Answer yes or no to each question.(1) 1. Have you ever thought you should Cut down your drinking?2. Have you ever felt Annoyed when people have commented on your drinking?3. Have you ever felt Guilty or badly about your drinking?4. Have you ever had an Eye opener first thing in the morning to steady your nerves or get rid of a hangover?Your score:Score one point for each yes answer.If you scored 1, there is an 80% chance you're addicted to alcohol.If you scored 2, there is an 89% chance you're addicted to alcohol.If you scored 3, there is a 99% chance you're addicted to alcohol.If you scored 4, there is a 100% chance you're addicted to alcohol.The Modified CAGE Test for All AddictionsMost self-test questionnaires apply to alcohol addiction, but can be easily adapted to any addiction.1. Have you ever thought you should Cut down your drug or alcohol use?2. Have you ever felt Annoyed when people have commented on your use?3. Have you ever felt Guilty or badly about your use?4. Have you ever used drugs to Ease withdrawal symptoms, or to avoid feeling low after using?

The AUDIT Test for Alcohol Addiction (Alcoholism) The AUDIT (Alcohol Use Disorders Identification Test) was developed by the World Health Organization (WHO). The test correctly classifies 95% of people into either alcoholics or non-alcoholics. It was tested on 2000 people before being published. (The pdf format version of the AUDIT is available through the WHO website. Copyright 1993 World Health Organization.)(2)To correctly answer some of these questions you need to know the definition of a drink. For this test one drink is:One can of beer (12 oz or approx 330 ml of 5% alcohol), orOne glass of wine (5 oz or approx 140 ml of 12% alcohol), orOne shot of liquor (1.5 oz or approx 40 ml of 40% alcohol). 1. How often do you have a drink containing alcohol?Never (score 0) Monthly or Less (score 1) 2-4 times a month (score 2) 2-3 times a week (score 3) 4 or more times a week (score 4)2. How many alcoholic drinks do you have on a typical day when you are drinking?1 or 2 (0) 3 or 4 (1) 5 or 6 (2) 7-9 (3) 10 or more (4)3. How often do you have 6 or more drinks on one occasion?Never (0) Less than monthly (1) Monthly (2) Weekly (3) Daily or almost daily (4)4. How often during the past year have you found that you drank more or for a longer time than you intended?Never (0) Less than monthly (1) Monthly (2) Weekly (3) Daily or almost daily (4)5. How often during the past year have you failed to do what was normally expected of you because of your drinking?Never (0) Less than monthly (1) Monthly (2) Weekly (3) Daily or almost daily (4)6. How often during the past year have you had a drink in the morning to get yourself going after a heavy drinking session?Never (0) Less than monthly (1) Monthly (2) Weekly (3) Daily or almost daily (4)7. How often during the past year have you felt guilty or remorseful after drinking?Never (0) Less than monthly (1) Monthly (2) Weekly (3) Daily or almost daily (4)8. How often during the past year have you been unable to remember what happened the night before because of your drinking?Never (0) Less than monthly (1) Monthly (2) Weekly (3) Daily or almost daily (4)9. Have you or anyone else been injured as a result of your drinking?No (0) Yes, but not in the past year (2) Yes, during the past year (4)10. Has a relative, friend, doctor, or health care worker been concerned about your drinking, or suggested that you cut down?No (0) Yes, but not in the past year (2) Yes, during the past year (4)Your score:If you scored 8-10 or more, you are probably addicted to alcohol. It may seem like the AUDIT questionnaire is an easy test to fail. If you applied this test to other aspects of your life you will almost certainly come up as being addicted to something. For example, most people watch too much television, or eat too much of their favorite food. But those are so-called "soft addictions", and the AUDIT questionnaire was not designed to assess them. It is extremely reliable when it comes to assessing alcohol addiction.References1) Ewing, J.A., Detecting alcoholism. The CAGE questionnaire. JAMA, 1984. 252(14): p. 1905-7. 2) Babor, T.F., et al., AUDIT: The Alcohol Use Disorders Identification Test. Guidelines for Use in Primary Care. World Health Organization, Department of Mental Health and Substance Dependence. http://whqlibdoc.who.int/hq/2001/WHO_MSD_MSB_01.6a.pdf. WHO.

What is Addiction?An addiction is a relationship with drugs or alcohol in which you use more than you would like to use, and you continue to use despite negative consequences.People use drugs or alcohol to escape, relax, or to reward themselves. But over time, drugs and alcohol make you believe that you cant cope without them, or that you cant enjoy life without using. The greatest damage is to your self-esteem.What is the Medical Definition of Addiction?An addiction must meet at least 3 of the following criteria. This is based on the criteria of the American Psychiatric Association (DSM-IV) and World Health Organization (ICD-10).(1) 1. Tolerance. Do you use more alcohol or drugs over time?2. Withdrawal. Have you experienced physical or emotional withdrawal when you have stopped using? Have you experienced anxiety, irritability, shakes, sweats, nausea, or vomiting? Emotional withdrawal is just as significant as physical withdrawal.3. Limited control. Do you sometimes drink or use drugs more than you would like? Do you sometimes drink to get drunk? Does one drink lead to more drinks sometimes? Do you ever regret how much you used the day before?4. Negative consequences. Have you continued to use even though there have been negative consequences to your mood, self-esteem, health, job, or family?5. Neglected or postponed activities. Have you ever put off or reduced social, recreational, work, or household activities because of your use?6. Significant time or energy spent. Have you spent a significant amount of time obtaining, using, concealing, planning, or recovering from your use? Have you spend a lot of time thinking about using? Have you ever concealed or minimized your use? Have you ever thought of schemes to avoid getting caught?7. Desire to cut down. Have you sometimes thought about cutting down or controlling your use? Have you ever made unsuccessful attempts to cut down or control your use?How Common is Drug or Alcohol Addiction?Approximately 10% of any population is addicted to drugs or alcohol. Addiction is more common than diabetes, which occurs in approximately 7% of the population.Addiction crosses all socio-economic boundaries. 10% of teachers, 10% of plumbers, and 10% of CEOs have an addiction. The terms alcohol addiction, alcoholism, and alcohol dependence are all equivalent. The same is true for the terms drug addiction and drug dependence. (Reference: www.AddictionsAndRecovery.org.)How Does Addiction Feel?An addictive substance feels good because it stimulates the pleasure center of the brain through neurotransmitters such as dopamine and GABA. If you have a genetic predisposition, addictive substances dont just feel good. They feel so good that you will want to chase after them.This is where addiction comes in. If you have a genetic predisposition, addictive substances feel so good that you are willing to suffer negative consequences in order to get more and to continue to feel the high.Addictive substances feel different inside an addicts brain than they do to a non-addict. This is why the two sides have difficulty understanding each other. In someone who is not addicted, drugs and alcohol only produce a mild high. Therefore a non-addict cannot understand why the addict would go to such lengths, when it is clearly destroying their life.Denial is a big part of addiction. Because addictive substances feel good, an addict will initially deny that they have a problem. In the long-run addiction isolates you from the people and activities and that mean the most to you.The Cost of AddictionThe dollars and cents cost of addiction is mind boggling. At least twice as many people die from alcoholism in the US every year as die from motor vehicle accidents.(2)Alcohol intoxication is associated with 40-50% of traffic fatalities, 25-35% of nonfatal motor vehicle injuries, and 64% of fires. Alcohol is present in nearly 50% of homicides, either in the victim or the perpetrator.(3)Alcohol intoxication is involved in 31% of fatal injuries, and 23% of completed suicides.(4)One study found that 86 % of homicide offenders, 37 % of assault offenders, and 57 % of men and 27 % of women involved in marital violence were drinking at the time of their offense.(5)The Consequences of AddictionPeople only stop using drugs and alcohol when they have suffered enough negative consequences. When you've suffered enough pain and enough regret you are ready to stop.You are ready to stop when the two sides of addiction collide. On the one hand, addiction feels so good that you want to use more. On the other hand, addiction leads to negative consequences. After a while, something has got to give. You don't have to hit rock bottom. The purpose of websites like this is to show you the potential negative consequences of addiction so that you will be ready to quit before you've lost everything. You can imagine what it would be like to hit rock bottom. And that can help motivate you. The most important consequences of addiction are social, emotional, and psychological. People usually think of the physical and economic consequences of addiction. "I don't have a serious addiction because my health is fine, and I haven't lost my job." But those are very late stage consequences.As far as work is concerned that's usually the last thing to suffer. You need your work in order to pay your bills, so that you can continue your addiction. When your work begins to suffer, you've slipped from being a functioning addict to a non-functioning addict. The damage addiction does to your relationships and self-esteem is far deeper and takes longer to repair. You've hurt friends and family. You've disappointed yourself. You've traded important things in your life so that you could make more time to use. You've lived a double life. You've seen the hurt in your family's eyes, and the disappointment in your children's faces. Those are the consequences that can motivate you to begin recovery.References1) DSM stands for The Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association. ICD stands for The International Classification of Disease, published by the World Health Organization. 2) Mokdad, A. H., Marks, J. S., Stroup, D. F., &Gerberding, J. L., Actual causes of death in the United States, 2000.JAMA, 2004. 291(10): p. 1238-45.3) Lowenfels, A. B., & Miller, T. T., Alcohol and trauma.Ann Emerg Med, 1984. 13(11): p. 1056-60. 4) Smith, G. S., Branas, C. C., & Miller, T. R., Fatal nontraffic injuries involving alcohol: A metaanalysis.Ann Emerg Med, 1999. 33(6): p. 659-68. 5) Roizen, J., Epidemiological issues in alcohol-related violence.Recent Dev Alcohol, 1997. 13: p. 7-40.The Genetics of AddictionThe Role of Family History Addiction is due 50 percent to genetic predisposition and 50 percent to poor coping skills. This has been confirmed by numerous studies. One study looked at 861 identical twin pairs and 653 fraternal (non-identical) twin pairs. When one identical twin was addicted to alcohol, the other twin had a high probability of being addicted. But when one non-identical twin was addicted to alcohol, the other twin did not necessarily have an addiction. Based on the differences between the identical and non-identical twins, the study showed 50-60% of addiction is due to genetic factors.(1) Those numbers have been confirmed by other studies.(2) The children of addicts are 8 times more likely to develop an addiction. One study looked at 231 people who were diagnosed with drug or alcohol addiction, and compared them to 61 people who did not have an addiction. Then it looked at the first-degree relatives (parents, siblings, or children) of those people. It discovered that if a parent has a drug or alcohol addiction, the child had an 8 times greater chance of developing an addiction.(3)Why are there genes for addiction? We all have the genetic predisposition for addiction because there is an evolutionary advantage to that. When an animal eats a certain food that it likes, there is an advantage to associating pleasure with that food so that the animal will look for that food in the future. In other words the potential for addiction is hardwired into our brain. Everyone has eaten too much of their favorite food even though they knew it wasn't good for them. Although everyone has the potential for addiction, some people are more predisposed to addiction than others. Some people drink alcoholically from the beginning. Other people start out as a moderate drinker and then become alcoholics later on. How does that happen? Repeatedly abusing drugs or alcohol permanently rewires your brain. If you start out with a low genetic predisposition for addiction, you can still end up with an addiction. If you repeatedly abuse drugs or alcohol because of poor coping skills, then you'll permanently rewire your brain. Every time you abuse alcohol, you'll strengthen the wiring associated with drinking, and you'll chase that buzz even more. The more you chase the effect of alcohol, the greater your chance of eventually developing an addiction.Your genes are not your destiny. The 50% of addiction that is caused by poor coping skills is where you can make a difference. Lots of people have come from addicted families but managed to overcome their family history and live happy lives. You can use this opportunity to change your life. (Reference: www.AddictionsAndRecovery.org)What Is Your Family History?Most people don't know their family history of addiction very well. Addiction is not the sort of thing that most families talk about. Not too long ago you could have a raging alcoholic in your family and nobody would talk about it. Or they would make some quaint remark like, "Oh he drinks a little too much." There was so little people could do about addiction before that there was no point in talking about it. But now that you can do something about addiction, a family history is worth talking about. Once you stop using and tell your family that you're in recovery, that's often when they will tell you about the family secrets. That's when family members will sometimes come out of the closet and tell you their stories.Let your coping skills be the legacy you pass on to your children. Don't let your genes be the only legacy you pass on to your children. Your children are more likely to have an addiction because of your addiction. But their genes don't have to be their destiny. You can help your children lead happy lives by teaching them healthy coping skills by being an example with your recovery.Is Addiction a Disease?Addiction is like most major diseases. Consider heart disease, the leading cause of death in the developed world. It's partly due to genes and partly due to poor life style choices such as bad diet, lack of exercise, and smoking. The same is true for other common diseases like adult-onset diabetes. Many forms of cancers are due to a combination of genes and life style. But if your doctor said that you had diabetes or heart disease, you wouldn't think you were bad person. You would think, "What can I do to overcome this disease?" That is how you should approach addiction. Addiction is not a weakness. The fact that addiction crosses all socio-economic boundaries confirms that addiction is a disease. People who don't know about addiction will tell you that you just need to be stronger to control your use. But if that was true then only unsuccessful people or unmotivated people would have an addiction, and yet 10% of high-functioning executives have an addiction. If you think of addiction as a weakness, you'll paint yourself into a corner that you can't get out of. You'll focus on being stronger and trying to control your use, instead of treating addiction like a disease and focusing on stopping your use. Cross AddictionYou can become addicted to any drug, if you have a family history of addiction. If at least one of your family members is addicted to alcohol, you have a greater chance of developing an addiction to any other drug. Cross addiction occurs because all addictions work in the same part of the brain. If your brain is wired so that you're predisposed to one addiction, then you're predisposed to all addictions. This is especially important for women who may come from alcoholic families, but who often develop addictions that go undetected, like addictions to tranquilizers, pain relievers, or eating disorders.One addiction can lead to other addictions, and one drug can make you relapse on another drug. That's one of the consequences of a brain that's wired for addiction. Suppose you're addicted to cocaine. If you want to stop using cocaine then you have to stop using all addictive drugs including alcohol and marijuana. You may never have had a problem with either of them, but if you continue to use alcohol or marijuana, even casually, they'll eventually lead you back to your drug of choice. Recovery requires total abstinence. How does cross addiction cause relapse:1. All addictions work in the same part of the brain. Addiction is addiction is addiction. Therefore one drug can lead you back to any other drug. 2. Even moderate drinking or smoking marijuana lowers your inhibitions, which makes it harder for you to make the right choices. 3. If you stop using your drug of choice but continue to use alcohol or marijuana, you're saying that you don't want to learn new coping skills and that you don't want to change your life. You're saying that you want to continue to rely on drugs or alcohol to escape, relax, and reward yourself. But if you don't learn those new skills, then you won't have changed, and your addiction will catch up with you all over again.(Reference: www.AddictionsAndRecovery.org)References1) Prescott, C. A., &Kendler, K. S., Genetic and environmental contributions to alcohol abuse and dependence in a population-based sample of male twins.Am J Psychiatry, 1999.156(1): p. 34-40. 2) Enoch, M. A., & Goldman, D., The genetics of alcoholism and alcohol abuse.Curr Psychiatry Rep, 2001. 3(2): p. 144-51. 3) Merikangas, K. R., Stolar, M., Stevens, D. E., Goulet, J., et al., Familial transmission of substance use disorders.Arch Gen Psychiatry, 1998. 55(11): p. 973-9.

Alcohol Abuse, Alcohol Addiction and AlcoholismA Simple Test: Signs of Alcoholism and Alcohol AbuseIf you answer yes to three of these four questions, you are probably an alcoholic. Do you have six or more drinks at least once a month? Do you have trouble saying no to alcohol sometimes? Do you drink more than you would like to drink sometimes? Do you sometimes feel guilt about how much you drank or what you did? Do you sometimes hide or minimize your drinking to others?Are you concerned about your drinking? Have you ever wondered if you are an alcoholic? You probably suspect the answer. But maybe youre afraid to admit it. This is your chance to do something about it. Click here for a more detailed alcohol dependence test. Is there a difference between alcoholism, alcohol dependence, and alcohol abuse? All these terms mean the same thing in the DSM 5 (The Diagnostic Manual of the American Psychiatric Association) and ICD-10 (International Classification of the World Health Organization). These names have fallen in and out of favor over the years, in an effort to avoid negative associations, but they are equivalent. Table of Contents Alcohol WithdrawalEffects of AlcoholBinge DrinkingAlcohol PoisoningTreatmentHelping Someone with AlcoholismStages of Alcoholism: The Functioning AlcoholicIn the early stage of alcoholism you regularly drink too much, but you havent suffered many consequences. This is when its easiest to make a change. The middle stage of alcoholism is the classic functioning alcoholic. You still have a job and your relationships are intact, but your life is beginning to suffer. This is the most common scenario. You don't have to suffer major losses to have an addiction. Late stage alcoholism is the non-functioning alcoholic. By then you have lost your job and probably have to drink every day. It's what people think alcoholism is like, but this stereotype is rare. Alcoholism is progressive. The consequences get worse over time. It's never easy to quit. But if you have already suffered some consequences and don't want them to get worse, there's never a better time to quit than now.What is Moderate Alcohol Use? Moderate drinking is no more than 1 drink per day for women and no more than 2 drinks per day for men according to the US Department of Health and Human Services The World Health Organization suggests no more than 2 drinks per day, and no more than 5 drinking days per week. They also suggest at least 2 non-drinking days per week. A standard drink is defined as 12 oz of beer, 5 oz of wine, or 1.5 oz of spirits. How Much Drinking is Too Much?Maximum limits for alcohol use set by the National Institute of Alcohol Abuse and Alcoholism.[1] For men, more than 4 drinks in a day, or more than 14 drinks per week. For women, more than 3 drinks in a day, or more than 7 drinks per week.People who drink more than the maximum limits are at high risk of becoming alcoholics. [2]How Common is Alcoholism or Alcohol Abuse? Approximately 60 percent of drinkers, drink less than 4 drinks on the days they drink. Only 10 percent of drinkers, have 5 or more drinks more than half the days they drink.[3]Alcohol WithdrawalAlcohol withdrawal occurs because your brain works much like a spring. Alcohol is a brain depressant that pushes down on the spring. When you suddenly stop drinking it is like taking the weight off the spring. Your brain is out of balance. The spring rebounds and your brain produces excess adrenaline which causes the withdrawal symptoms.What goes on at the level of brain neurotransmitters? GABA is the calming neurotransmitter of the brain. GABA and adrenaline are supposed to be in balance in the brain. Drinking regularly causes the brain to produce less GABA, because the brain begins to rely on alcohol for part of the calming effect. When you suddenly stop drinking, your brain chemistry is out of balance. You dont have enough GABA neurotransmitter, and you have a relative excess of adrenaline, which causes all the withdrawal symptoms. h2>Alcohol Withdrawal Symptoms These are some of the symptoms of alcohol withdrawal: Anxiety Irritability Insomnia Shaky hands Sweating Muscle tension/ Tightness in the chest Headache Nausea/ Vomiting PalpitationsSuddenly stopping alcohol can lead to seizures, strokes, or heart attacks in high risk patients. A medically supervised detox can minimize your withdrawal symptoms and reduce the risk of dangerous complications. Some of the dangerous symptoms of alcohol withdrawal are: Grand mal seizures Heart attacks Strokes Hallucinations Delirium tremens (DTs)Alcohol Detox (detoxification) to Prevent WithdrawalDetoxification, or detox, involves taking a short course of medication to help reduce or prevent withdrawal symptoms. Medications such as Valium (diazepam), Librium (chlordiazepoxide), or Ativan (lorazepam), the benzodiazepine family, are usually used for detox.Detox can be done as either an inpatient or outpatient depending on the persons health, their volume of drinking, and their past history of withdrawal. Detox is always done under close supervision. A common plan for outpatient detox is to prescribe a high dose of medication on the first day, and then gradually reduce the dose over the next 5-7 days. People with serious alcohol abuse may be admitted to hospital.This is general medical information, and not tailored to the needs of a specific individual.Effects of Alcohol - Alcohol FactsAlcoholic Hepatitis/ Alcoholic Liver DiseaseThe liver filters toxins from the blood, including alcohol. If you drink excessively, the liver cannot keep up, and becomes damaged. This is called alcoholic hepatitis. In the United States, alcoholic liver disease affects more than 2 million people (approximately 1% of the population). There are three stages of liver damage: 1) elevated liver enzymes, 2) alcoholic hepatitis or fatty liver, 3) cirrhosis.The most common form of liver damage is elevated liver enzymes. Your doctor can do a blood test to check if you have elevated liver enzymes. The three enzymes tested are AST, ALT, and GGT. Your liver is able to repair itself, and at this stage liver damage is potentially reversible. If you stop drinking the liver enzymes may go back to normal.How do liver enzyme tests work? The enzymes AST, ALT, and GGT normally occur inside liver cells. If your liver is damaged, the enzymes escape into your blood stream and show up in your blood test. Therefore the higher the enzyme count, the greater the liver damage. The most accurate of these tests for alcoholic liver damage is GGT.The second most common form of liver damage is fatty liver.Some fat in the liver is normal. The liver is the main organ of fat metabolism in the body. But when your liver is damaged by alcohol abuse fat begins to deposit in your liver. If fat makes up more than 5% - 10% of the liver, it is considered a fatty liver. Fatty liver can be identified by blood tests and a liver ultrasound. This stage of liver damage is also reversible with abstinence. However, fatty liver damage has a greater risk of turning into cirrhosis with continued alcohol abuse. Significant liver damage can cause jaundice. Jaundice means that your skin and/or the whites of your eyes have turned yellow. This occurs when your liver can't remove a toxin called bilirubin from your blood. Bilirubin is yellow, therefore when it builds up your skin and the whites of your eyes turn yellow. Jaundice can be reversible if you stop drinking.Alcoholic CirrhosisRepeated liver damage can cause cirrhosis. Your liver is a remarkable organ, but it can only repair itself so many times. After a while your liver won't be able to repair itself and it will turn into scar tissue. Cirrhosis is just the medical term that means part of your liver has turned into scar tissue. Signs of Cirrhosis or Severe Hepatitis Reduced appetite Weight loss Nausea and vomiting Pain especially in the left side of the abdomen Yellowing skin and whites of the eyes (jaundice) Swelling abdomen due to fluid accumulation (Your liver produces many of the proteins in your blood. When it is damaged, fluid in your blood vessels gradually seeps out and accumulates in your abdomen.) Hepatic encephalopathy. A damaged liver has trouble removing toxins from your body. The buildup of toxins can damage your brain, leading to changes in your mental state, behavior, personality, and in severe cases, coma.There is good news. Your liver is a big organ and you have more liver than you need. People can lose 30 percent of their liver in a car accident and still lead normal lives. So if you have less than 30 percent cirrhosis and you stop drinking, you can still lead a normal life. Your doctor can do an ultrasound to see if you have cirrhosis, and estimate what percent of cirrhosis you may have.

Alcoholic NeuropathyNerve damage due to alcohol abuse is called alcoholic neuropathy. Alcohol is toxic to nerves cells, which can cause brain damage and peripheral nerve damage. A significant part of alcoholic neuropathy is also caused by the poor nutrition associated with alcoholism.Alcoholic neuropathy usually has a reversible and irreversible component. The reversible components is caused by the poor nutrition, and can be treated by thiamine (vitamin B1), folic acid, and vitamin B12. The irreversible component is caused by the direct poisoning of nerve cells, and there is no known cure. Up to half of long-term, heavy alcohol abusers develop alcoholic neuropathy. Symptoms of Alcoholic Neuropathy Numbness or pins and needles (paresthesia) in the arms and legs. This usually occurs in the hands and feet in what is called a stocking-glove distribution. Pain in the arms and legs Muscle cramps and muscle weakness Impotence (in men) In severe cases, nerves that regulate internal body functions (autonomic nerves) may be affected. Alcohol and Hypertension: High Blood PressureMore than two drinks a day has been proven to cause high blood pressure.[4] Studies have also shown that reducing or eliminating alcohol use can reduce blood pressure.[5] Alcohol Abuse and Cancer RiskAlcohol abuse significantly increases the risk of most forms of cancer, including mouth, esophagus, breast, stomach, liver, prostate, and colon cancer.[6] How does alcohol increase cancer risk? It is likely that there are several ways this happens. Acetaldehyde, a byproduct of alcohol metabolism is thought to be one of the main causes of alcohol related cancers.[7]In the case of mouth, esophagus, and stomach cancer, alcohol appears to also act as a direct irritant that damages tissues. Alcohol may also allow harmful chemicals, such as tobacco smoke, to enter the digestive tract more easily. This explains why smoking and drinking combined are more deadly than either one alone.Alcohol Abuse and Breast CancerBreast cancer, the leading cause of death in women, is strongly correlated with alcohol abuse. Drinking more than two drinks a day increases the risk of breast cancer by 50%! [8] This result has been confirmed in studies of over one hundred thousand women.Depression and Alcohol AbuseDepression is one of the most common, serious consequences of alcohol abuse. You may wonder if alcohol abuse leads to depression or if its the other way around? Do people drink to deal with depression, which then leads to alcohol abuse and addiction? Research has shown that alcoholism and alcohol abuse usually lead to depression. [9]Alcohol abuse doubles the risk of depression. One study looked at 2,945 alcoholics. 15% were depressed before they began abusing alcohol. 26% were depressed while they were using alcohol, and 15% remained depressed once they had stopped drinking for an extended period.[10] Alcohol and Pregnancy: Fetal Alcohol SyndromeAll studies show that there is no safe amount of alcohol during pregnancy. Alcohol is toxic to the fetus and especially to the developing brain of the fetus. Drinking during pregnancy has a number of effects including low birth weight and increased risk of premature birth. The main serious side effect of drinking during pregnancy is fetal alcohol syndrome. Fetal alcohol syndrome (FAS) and alcohol-related developmental disorders combined occur in approximately one in 100 live births in the US and Great Britain. [11]Some of the consequences of fetal alcohol syndrome include: learning disabilities depression obsessive-compulsive disorder physical disabilities such as kidney and internal organ diseases skeletal abnormalities including facial deformities Binge Drinking Binge drinking is defined as five or more drinks per occasion for a man, or four or more drinks for a woman, at least one day a month. Heavy binge drinking is defined as that much alcohol at least 5 days a month.Why is binge drinking so risky? Drinking four or five drinks over a few hours will raise your blood alcohol concentration (BAC) quickly which makes you drunk quickly. Drinking the same amount over several hours, and accompanied by food, will not have the same effect on your blood alcohol concentration, and therefore will have less effect on your brain.Approximately 12 percent of woman report having been sexually assaulted when either they or their assailant had been drinking.[12] Binge drinking increases the risk of unprotected sex, sexual assault, and sexually transmitted diseases.Approximately one third of accidental deaths and one third of motor vehicle deaths are related to alcohol abuse.[13]Binge drinking increases the risk of academic problems, fights, motor vehicle accidents, physical and sexual assault, and changes in brain development that may have long-term effects.Binge drinking dramatically increases the risk of developing an addiction. College students who drink more than 5 drinks, more than twice in two weeks are 19 times more likely to develop alcoholism than non-binge drinkers.[14]Resources for Binge Drinking National Institute of Alcohol Abuse: Underage Drinking National Institute of Alcohol Abuse: College Drinking College Drinking Fact Sheet College Drinking PreventionHow Big is a Drink? The Definition of a Standard Alcoholic Drink.A standard drink is defined as 14 grams of pure alcohol according to the US Department of Health and Human Services. However in Europe the most commonly used standard is 10g of pure alcohol. 1 can of beer (12 oz or 330 ml) at 5% alcohol is one drink 1 glass of wine (5 oz or 140 ml) at 12% alcohol is one drink 1 shot of liquor (1.5 oz or 40 ml) at 40% alcohol is one drinkNote that a 750ml bottle of wine contains 5 drinks. Therefore 2 drinks a day is less than half a bottle of wine a day.The basic formula for calculating a drink is that each milliliter of pure alcohol weighs 0.79 grams. Therefore, for example, 12 oz of beer or 330 ml of beer x 5% alcohol x 0.79 = 13 grams of pure alcohol.Blood Alcohol Concentration (BAC) CalculatorThis information is provided as guideline only and should not be relied upon to determine if you can safely operate a vehicle. Many factors can affect BAC, including the amount of alcohol consumed, rate of consumption, food consumption, and factors such as gender, age, weight, height and metabolism. However these numbers apply over a broad range of body weights.It can take up to 30 minutes after the last drink to reach the maximum BAC level.To Keep BAC Less than 0.05 (g/dL or 50 mg/dL) For men, 2 drinks or less in the first hour, and 3 drinks or less over three hours. For women, 1 drink or less in the first hour, 2 drinks or less over three hours.BAC Greater than 0.05 (g/dL or 50 mg/dL) For men, more than 3 drinks over 4 hours. For women, more than 3 drinks over 4 hours.Alcohol PoisoningAlcohol poisoning is a serious and potentially deadly consequence of drinking large amounts of alcohol over a short period of time. If you suspect someone has alcohol poisoning, call for emergency medical help right away. There are many kinds of alcohol: Ethyl alcohol is drinking alcohol. It can also be found in mouthwash, cooking extracts, and medications in liquid form. Isopropyl alcohol is found in rubbing alcohol, lotions, and some cleaning products. It is more toxic than drinking alcohol. Methanol (methyl alcohol) is used as an industrial solvent. It is very toxic and as little as 10 mL of pure methanol can cause permanent blindness. Ethylene glycol is a common ingredient in antifreeze, air conditioning, paints, and solvents. It is toxic to the central nervous system, heart, and kidneys. Because it has a sweet taste, children are more inclined to consume large quantities of it. Alcohol Poisoning SymptomsThese symptoms can occur from poisoning by all forms of alcohol. Alcohol poisoning symptoms begin to occur when the blood alcohol concentration (BAC) is approximately 0.25. (Intoxication occurs at 0.05. Poisoning occurs at 5 times the blood alcohol level of intoxication.) Vomiting. This is the only symptom that can occur at lower blood alcohol levels. Alcohol depresses the gag reflex and increases the risk of the person choking on their own vomit (aspiration). Many famous and not-so-famous people have died this way. Breathing, slow or irregular. In severe cases this can progress to stopping breathing. Skin, pale, bluish, cold or clammy due to insufficient oxygen. Body temperature, low. Heartbeat, slow or irregular, which may progress to cardiac arrest. Seizures. Confusion. Unconsciousness. Coma. Death can occur at BAC 0.37 or higher. Alcohol Poisoning What to Do (Treatment) Seek immediate medical care if you suspect the person has alcohol poisoning, even if you don't see the classic symptoms. Try to keep the person awake and sitting up. Keep them warm. If the person is unconscious, make sure they stay on their side, not their back, and turn their head to the side to help prevent choking. What Not To Do Don't give the person food, drink, or medication of any kind. Don't try to make the person vomit. Their gag reflex wont be working properly which means they could choke on their vomit. Don't leave an unconscious person alone to sleep it off. Again they may choke on their own vomit.BAC and Growing ImpairmentBAC (0.05 0.08)Relaxation, euphoria, sociable, and talkative. Impaired judgment, attention, and fine motor control.BAC (0.08 0.1)Slurred speech.Poor muscle coordination.BAC (0.1 0.2)Vomiting.Drowsiness.Impaired balance. Staggering. Impaired vision, including ability to see detail and peripheral vision.BAC (0.2 0.3)Disoriented, confused. Impaired perception of color, form, motion, and dimensions.Increased pain threshold and lack of muscular coordination.Near total loss of motor functions, inertia, little response to stimuli, inability to stand or walk, vomiting, and incontinence. Possible loss of consciousness, stupor.BAC (0.3 0.5)Unconsciousness.Depressed or absent reflexes.Reduced body temperature.Impaired circulation and respiration.Coma, death.Treatment, Recovery and Relapse Prevention for AlcoholismIf you have decided you have an alcohol problem, youve taken an important step. The key to making change is to use the supports available. Self-help groups, online groups, your physician, therapist, rehab, websites like this are all potential supports. Using supports helps you feel like youre not alone. It gives you confidence that you can make changes. It helps you see techniques that have worked for others. It dramatically increases your chances of success.To learn more about recovery skills and relapse prevention methods please follow these links. You can change your life. Your continued recovery depends on learning healthier coping skills and making better decisions.Getting Help: Online Resources for Alcohol ProblemsThere are many online resources for dealing with alcohol problems. Here are a few select links: Alcoholics Anonymous (AA) (aa.org) Adult Children of Alcoholics (ACA) (adultchild.org) Women for Sobriety (WFS) (womenforsobriety.org) AA Intergroup (aa-intergroup.org) 12 Step Forums (12stepforums.net) Reddit.com/Alcoholism (reddit.com/r/alcoholism) Reddit.com/AlcoholicsAnonymous/ (reddit.com/r/alcoholicsanonymous)Finding Treatment Find an addiction specialist in your area: ASAM Addiction Medicine Treatment Finder Find a substance abuse treatment facility: Substance Abuse Treatment Facility Locator Please click here for a more detailed list of addiction and recovery resources.Helping Someone with Alcoholism or Alcohol AbuseIf someone you love has a drinking problem, you may be struggling between how to help the person and how to avoid being overwhelmed. You are probably feeling a combination of anger, fear, shame, and sometimes even guilt. I hope some of these suggestions will help you. Educate yourself on addiction and recovery. Say that it is hard for you to raise the topic of their drinking, but you are concerned. You care about them, and what their drinking is also doing to your family. Try not to accuse or judge. Avoid name calling. This is a difficult time for both of you. Provide a sober environment that reduces triggers for using. Allow the alcoholic time to go to meetings. Dont expect them stop drinking and stay sober without help. Understand that your lives will change. Do not wish for your old life back. You both need to create a new life where it is easier to not use alcohol or drugs. Make sure that you both have time for fun. People use alcohol to escape, relax, and reward themselves. The alcoholic needs to find alternative ways to escape, relax, and reward themselves otherwise they will turn back to their addiction. Set boundaries that you all agree on. The goal of boundaries is to improve the health of the whole family. Do not use boundaries to punish or shame. If you want to provide financial support, buy the goods and services the person needs instead of giving them money that they might use to buy alcohol. Recognize and acknowledge the potential the person has within them.What Not To Do Dont be surprised if the person is defensive. Don't punish, threaten, bribe, or preach to the person. It will only make them more defensive. Do not enable. Do not provide excuses or cover up for them. Do not shield them from the consequences of their drinking. People are more likely to change if they have suffered enough negative consequences. Do not argue or try to discuss things with the person when they are under the influence. It wont get you anywhere. Don't try to drink along with them.Things You Can Do For Yourself Practice loving detachment. What are your needs beyond the needs of the alcoholic? How can you take care of yourself even when the other person does not take care of themselves? How can you do that without feeling guilty and without being punitive? You also need time to recover. Living with an alcoholic is exhausting. Avoid self-blame. You cant control another persons decisions, and you cant force them to change. Do not work harder than the person youre trying to help. The best approach is to not do things for the alcoholic, but instead to be an example of balance and self-care. Being a caretaker is not good for you or for them. Understand that there is only so much you can do. Ask for help. Talk to a professional. Go to a support group such as Al-Anon. (More support groups are listed below.) If at all possible, try not to be negative when dealing with them. That may only increase their feelings of guilt and push them further into drinking.Helpful Links for Family and Friends of Alcoholics Al-Anon.org (al-anon.org) For family members of alcoholics. Coda.org (coda.org) For co-dependent individuals. Adultchildren.org (adultchildren.org) For adult children of alcoholics and addicts.

References1) National Institute of Alcohol Abuse and Alcoholism, Helping Patients Who Drink Too Much: A Clinicians Guide. 2005.2) Dawson, D.A., B.F. Grant, and T.K. Li, Quantifying the risks associated with exceeding recommended drinking limits. Alcohol ClinExp Res, 2005. 29(5): p. 902-8.3) Dawson, D.A. and L.D. Archer, Relative frequency of heavy drinking and the risk of alcohol dependence. Addiction, 1993. 88(11): p. 1509-18.4) MacMahon, S., Alcohol consumption and hypertension. Hypertension, 1987. 9(2): p. 111-21.5) Puddey, I.B., et al., Evidence for a direct effect of alcohol consumption on blood pressure in normotensive men. A randomized controlled trial. Hypertension, 1985. 7(5): p. 707-13.6) Bagnardi, V., et al., Alcohol consumption and the risk of cancer: a meta-analysis. Alcohol Res Health, 2001. 25(4): p. 263-70.7) Poschl, G. and H.K. Seitz, Alcohol and cancer. Alcohol Alcohol, 2004. 39(3): p. 155-65.8) Seitz, H.K., et al., Epidemiology and pathophysiology of alcohol and breast cancer: Update 2012. Alcohol Alcohol, 2012. 47(3): p. 204-12.9) Fergusson, D.M., J.M. Boden, and L.J. Horwood, Tests of causal links between alcohol abuse or dependence and major depression. Arch Gen Psychiatry, 2009. 66(3): p. 260-6.10) Schuckit, M.A., et al., Comparison of induced and independent major depressive disorders in 2,945 alcoholics. Am J Psychiatry, 1997.154(7): p. 948-57.11) Sampson, P.D., et al., Incidence of fetal alcohol syndrome and prevalence of alcohol-related neurodevelopmental disorder. Teratology, 1997. 56(5): p. 317-26.12) Abbey, A., et al., Alcohol and sexual assault. Alcohol Res Health, 2001. 25(1): p. 43-51.13) Hingson, R.W., et al., Age of drinking onset and unintentional injury involvement after drinking. JAMA, 2000. 284(12): p. 1527-33.14) Courtney, K.E. and J. Polich, Binge drinking in young adults: Data, definitions, and determinants.Psychol Bull, 2009. 135(1): p. 142-56.

Anti-Alcohol Drugs (Antabuse)

IMPORTANT: This is general medical information, and is not tailored to the needs of a specific individual. This material is NOT complete. It does not cover all possible precautions, side effects, or interactions. You should always consult your physician when making decisions about your health. And you should consult your physician before starting or stopping medication.I have no financial interest in Antabuse or any maker of Antabuse. I simply believe, based on the medical evidence, that Antabuse increases the chances of recovery.How Antabuse WorksAntabuse has been used since 1951 to help people stop drinking. (The generic name of Antabuse is Disulfiram.) Antabuse is not only effective for stopping drinking. If you have a drug problem, anything that helps you stop drinking will also help you stop using drugs, because alcohol usually leads to drugs. Antabuse works by making you sick to your stomach if you have a drink. It works because if you know you can't drink, then you won't think about drinking as much.Numerous studies have proven that Antabuse is effective. It has been shown to reduce cravings for alcohol (1), and to reduce the risk of relapse.(2, 3) It has also proven to reduce the risk of relapse in adolescent addicts.(4) People who use Antabuse feel liberated. That internal struggle that goes on every day, "Will I drink? Won't I drink?" is silenced when you're on Antabuse. Because drinking is not an option you don't waste your time thinking about drinking, and instead you focus more on your recovery.Antabuse is effective, because you have to wait for one to two weeks before you can have a drink after you stop Antabuse. You can't stop Antabuse one day and have a drink the next. It gives you plenty of time to reconsider, restart your Antabuse, and ask for help.Antabuse is a bridge between your two lives. On the one hand, you have the life that you know. It's not what's good for you, but it's what you know. On the other hand, you have the life that you want to get to. It's better for you, but you don't know how to live there. You don't know how to relax, reward yourself, and celebrate without using drugs or alcohol. Antabuse helps you live in that life long enough so that you can develop new habits and coping skills. (Reference: www.AddictionsAndRecovery.org)The Antabuse ReactionIt takes one drink to produce a reaction. It takes one bottle of beer, one glass of wine, or one shot of liquor to become sick. The normal sequence of the Antabuse reaction is: Flushing of the face Headache Low blood pressure Racing heart Dizziness Nausea and vomitingIf you have one drink, you will vomit about as much as if you had food poisoning.A few people are very sensitive to Antabuse and get a stronger reaction. A quick test of whether you're sensitive to Antabuse is to see if your skin flushes when you put alcohol on your skin. If you're sensitive you may still decide to use Antabuse, but you'll have to be a little more careful about avoiding alcohol. Most people just need to show some common sense when they're on Antabuse. The Do's and Don'ts of AntabuseWait at least 24 hrs after drinking before starting Antabuse. Consider the following arithmetic. If you had 10 drinks and weighed only 100 lbs (45kg), the alcohol would be completely eliminated from your system in 24 hrs. If you weighed more than 100 lbs (45kg) it would take less than 24 hrs. http://bloodalcoholcalculator.orgFor most people, it takes one drink to produce an Antabuse reaction, therefore it's hard to get by mistake. You can have foods that have been cooked in wine, as long as they've been cooked the alcohol evaporates quickly. You have to be careful of some deserts that have a lot of uncooked alcohol in them. You also have to be careful of some cough syrups and cold preparations that can contain as much as 40% alcohol. Most people prefer to use non-alcoholic mouthwashes to be on the safe side. Although the amount of alcohol you absorb from mouthwash doesn't equal one drink, assuming you don't drink your mouthwash. You can use perfumes, colognes, or aftershaves. The amount of alcohol you absorb through your skin is minimal. The standard patient information sheet on Antabuse says that you should avoid all of these things: mouthwash, perfumes, colognes, even vinegar. But I've treated thousands of patients, and I've never known any of them to get a reaction from anything other than drinking. Antabuse liberates you, if you use a little common sense.Side EffectsThe side effects of Antabuse are less common than the side effects of relapse. During the first week or two that you take Antabuse, you'll probably feel a little more tired. It usually lasts for a week or two and then it goes away.During the first two months that people take Antabuse, about 20% develop a funny taste in their mouth. It's usually described as a metallic taste. 80% of people don't get it, and if you do get that taste, it often goes away after a few weeks or months. That's it for the minor side effects of Antabuse. The major side effects of Antabuse are rare. The most common but still rare side effect of Antabuse is liver damage. Any drug that you take over a long-term has the potential to cause liver damage. With Antabuse, it happens in roughly one out of 30,000 people. Your doctor can do a simple blood test to check the state of your liver before you start. After you've been on Antabuse for a month you should have your liver tests repeated. Your doctor should periodically check your liver enzymes while you're on Antabuse.Any drug can have any possible side effect. You can never say never in medicine. Every year people die from taking Tylenol (acetaminophen). But that doesn't mean we should stop using Tylenol. The benefits far outweigh the risks. And the benefits of Antabuse outweigh the risks of drinking.Before taking Antabuse you should give your doctor your entire medical history. You may not be a able to take Antabuse if you have a significant medical history of heart or blood vessel disease, diabetes, an underactive thyroid, brain disorders (e.g., seizures, brain damage), kidney disease, liver disease, a history of severe depression, a history of psychosis, or a history of suicide attempts. Antabuse can alter the metabolism and blood levels of certain drugs, especially tricyclic antidepressants, Dilantin (phenytoin), coumadin, isoniazid, and theophylline. Do NOT take Antabuse if you're pregnant, or trying to become pregnant.Serious Warning SignsIf you notice any of the following rare but serious warning signs, stop using Antabuse and tell your doctor immediately: dark urine, severe abdominal pain, persistent nausea or vomiting, yellowing of the eyes or skin.Resistance to Trying AntabuseThere are three main reasons why you may be reluctant to try Antabuse.First, because you're worried about the side effects. Although the side effects of Antabuse can be serious, they are rare. The side effects of relapsing on alcohol are common and serious. The second reason is because you want to do your recovery on your own. You've always been self-reliant and you want to be self-reliant in your recovery. But recovery involves learning to ask for help. Doing it on your own is overrated. You need to ask for help from your doctor, treatment program, 12 step group, and sponsor. Antabuse is just one more thing you can use. It is not an alternative to your supports. It complements them. The third and final reason why you may be reluctant to try Antabuse is because you want to leave the door open to having a drink. Just in case you want to relapse there won't be anything in your way. Of course, if you leave that door open then it's guaranteed you'll relapse eventually. It's just a matter of time. If you've decided that you want to change your life. If you've decided that you have suffered enough negative consequences, then I encourage you to talk to your doctor about Antabuse. (Reference: www.AddictionsAndRecovery.org)Getting a PrescriptionSpeak to your doctor about Antabuse. Antabuse is available at most pharmacies. If you are a Canadian resident and your doctor cannot find a pharmacy that dispenses Antabuse, it can be ordered through www.pharmacy.ca, which is an internet pharmacy that delivers free of charge through Canada Post.If Your Drug Plan Does Not Cover AntabuseAntabuse is a simple drug that is can be made by a compounding pharmacist. Therefore if your drug plan does not cover the cost of Antabuse, you can sometimes have it made relatively cheaply as long as you have a prescription. The monthly cost is usually much less than the price of alcohol.

Anti-Alcohol DrugsThere are three anti-alcohol drugs available: Antabuse (disulfiram) Campral (acamprosate). ReVia (naltrexone)I have focused on Antabuse for a few reasons. It has a long track record, and is considered safe and effective. It's available in generic form, which means that it's quite inexpensive. The cost of Antabuse is a lot less than the price of alcohol.Studies have shown that Antabuse is at least as effective, and sometime more effective than the other two medications, which have only been around for a few years.(1, 5) References1) Petrakis, I., Ralevski, E., Nich, C., Levinson, C., et al., Naltrexone and disulfiram in patients with alcohol dependence and current depression.J ClinPsychopharmacol, 2007. 27(2): p. 160-5. 2) Krampe, H., Stawicki, S., Wagner, T., Bartels, C., et al., Follow-up of 180 alcoholic patients for up to 7 years after outpatient treatment: impact of alcohol deterrents on outcome.Alcohol ClinExp Res, 2006. 30(1): p. 86-95. 3) De Sousa, A., & De Sousa, A., A one-year pragmatic trial of naltrexone vs disulfiram in the treatment of alcohol dependence.Alcohol Alcohol, 2004. 39(6): p. 528-31.4) Niederhofer, H., &Staffen, W., Comparison of disulfiram and placebo in treatment of alcohol dependence of adolescents.Drug Alcohol Rev, 2003. 22(3): p. 295-7. 5) de Sousa, A., & de Sousa, A., An open randomized study comparing disulfiram and acamprosate in the treatment of alcohol dependence.Alcohol Alcohol, 2005. 40(6): p. 545-8.

A Moderate - Controlled Drinking PlanIf you're not sure if you're addicted to alcohol, try the following test. Keep an honest journal of how much you drink every day for 6 months, and see if you can stick to moderate drinking. It's important that you do this for at least 6 months, because it's easy to moderate your drinking for a short time.If there are days when you drink more than a moderate amount, make note of the circumstances and identify your triggers. Review your journal regularly. If you're happy with your use great. But if you're not happy, or if you can't stick to moderate drinking, then that should tell you something. Ultimately alcoholics decide to quit drinking, because they realize it's easier to not drink, than it is to control their drinking.A Moderate Drinking Plan Set a realistic goal for your alcohol use. Decide ahead of time how much and how often you would like to drink. Keep an honest journal of your drinking. This helps you become mindful of your drinking. Start with a non-alcoholic drink to quench your thirst. When youre at a social event make sure you have a non-alcoholic drink to start. Thirst can make you drink more alcohol than you need. This also helps you become more mindful of your drinking. Dont drink on an empty stomach. Make eating part of the experience. Hunger can also make you drink more alcohol than you need. Alternate alcoholic and non-alcoholic drinks. Don't have all your alcoholic drinks at once, or you may be tempted to drink more than you planned. Instead have at least one glass of water before each alcoholic drink. Avoid heavy drinking situations. Some situations are associated with heavy drinking, and it may be difficult to stick to your plan. Learn to recognize and avoid heavy drinking situations.What is Moderate Alcohol Use? Guidelines for moderate drinking have been set by the US Department of Health and Human Services and the World Health Organization. The US guidelines suggest no more than 1 drink per day for women and no more than 2 drinks per day for men. A drink is defined as 12 oz of beer, 5 oz of wine, or 1.5 oz of spirits. The WHO guidelines suggest no more than 2 drinks per day, and no more than 5 drinking days per week. They recommend 2 non-drinking days. Of course, you can't stockpile your drinks, and have them all at the end of the week.How Big is a Drink? The Definition of a Drink.A drink is 14g of pure alcohol according to the US Department of Health and Human Services. The World Health Organization defines a drink as 10g of pure alcohol.Each milliliter of pure alcohol weighs 0.79 grams. Therefore, you can calculate the alcohol content of a drink with the following formula: 1 can of beer (330 ml, 12 oz) at 5% (strength) x 0.79 (conversion factor) = 13 grams of alcohol 1 glass of wine (140 ml, 5 oz) at 12% x 0.79 = 13.3 grams of alcohol 1 shot of liquor (40 ml, 1.5 oz) at 40% x 0.79 = 12.6 grams of alcoholNote that a 750ml bottle of wine contains 5 drinks. Therefore 2 drinks a day is less than half a bottle of wine a day.Reference: www.AddictionsAndRecovery.org