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Alcoholism, also known as alcohol use disorder (AUD), is a broad term for any drinking of alcohol that results in problems. It was previously divided into two types: alcohol abuse and alcohol dependence.In a medical context, alcoholism is said to exist when two or more of the following conditions is present: a person drinks large amounts over a long time period, has difficulty cutting down, acquiring and drinking alcohol takes up a great deal of time, alcohol is strongly desired, usage results in not fulfilling responsibilities, usage results in social problems, usage results in health problems, usage results in risky situations, withdrawal occurs when stopping, and alcohol tolerance has occurred with use. Risky situations include drinking and driving or having unsafe sex among others. Alcohol use can affect all parts of the body but particularly affects the brain, heart, liver, pancreas, and immune system. This can result in mental illness, Wernicke–Korsakoff syndrome, an irregular heart beat, liver failure, and an increase in the risk of cancer, among other diseases. Drinking during pregnancy can cause damage to the baby resulting in fetal alcohol spectrum disorders. Generally women are more sensitive to alcohol’s harmful physical and mental effects than men.
Both environmental factors and genetics are associated with alcoholism with about half the risk attributed to each. A person with a parent or sibling with alcoholism is three to four times more likely to be alcoholic themselves. Environmental factors include social, cultural, and behavioral influences. High stress levels, anxiety, as well as inexpensive easily accessible alcohol increases risk. People may continue to drink partly to prevent or improve symptoms of withdrawal. A low level of withdrawal may last for months following stopping. Medically, alcoholism is considered both a physical and mental illness. Both questionnaires and certain blood tests may detect people with possible alcoholism. Further information is then collected to confirm the diagnosis.
Prevention of alcoholism is possible by regulating and limiting the sale of alcohol, taxing alcohol to increase its cost, and providing inexpensive treatment. Treatment may take several steps. Because of the medical problems that can occur during withdrawal, alcohol detoxification should be carefully controlled. One common method involves the use of benzodiazepine medications, such as diazepam. This can be either given while admitted to a health care institution or occasionally while a person remains in the community with close supervision. Other addictions or mental illness may complicate treatment. After detoxification support such as group therapy or support groups are used to help keep a person from returning to drinking. One commonly used form of support is the group Alcoholics Anonymous. The medications acamprosate, disulfiram, or naltrexone may also be used to help prevent further drinking.
The World Health Organization estimates that as of 2010 there were 208 million people with alcoholism worldwide (4.1% of the population over 15 years of age). In the United States about 17 million (7%) of adults and 0.7 million (2.8%) of those age 12 to 17 years of age are affected. It is more common among males and young adults, becoming less common in middle and old age. It is the least common in Africa at 1.1% and has the highest rates in Eastern Europe at 11%. Alcoholism directly resulted in 139,000 deaths in 2013 up from 112,000 deaths in 1990. A total of 3.3 million deaths (5.9% of all deaths) are believed to be due to alcohol. It often reduces a person’s life expectancy by around ten years. In the United States it resulted in economic costs of $224 billion USD in 2006. Many terms, some insulting and others informal, have been used to refer to people affected by alcoholism including: tippler, drunkard, dipsomaniac, and souse. In 1979, the World Health Organization discouraged the use of “alcoholism” due to its inexact meaning, preferring “alcohol dependence syndrome”.
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