Virtual Medical Centre

Alcoholism (Alcohol Dependence)

• What is Alcoholism?
• Who gets Alcoholism?
• Predisposing Factors
• Progression
• Probable Outcomes
• How Will Alcoholism Affect Me?
• Clinical Examination
• How is Alcoholism Diagnosed?
• How is Alcoholism treated?
• Alcoholism References
• Drugs/Products Associated with Alcoholism

What is Alcoholism?

Alcohol dependence is also known as alcoholism; however, health professionals tend not to use this term because of its potential to increase stigma and discrimination of the condition. Alcohol dependency is the most common substance use disorder in Australia. Individuals who are alcohol dependent tend to prioritise drinking alcohol over other activities (including seeing friends and going to work). However, alcohol dependency is not an all or nothing condition. It occurs on a continuum ranging from mild to severe. Individuals with a mild dependence on alcohol may crave an alcoholic drink when it is not available and find it difficult to stop drinking after a couple of drinks. Individuals with severe alcohol dependence suffer physical and/or psychological withdrawal symptoms (e.g. vomiting, anxiety) when they do not consume alcohol.

Those with severe alcohol dependence regularly drink well above the limits recommended in the Australian National Health and Medical Research Council (NHMRC) Guidelines for healthy consumption of alcohol, while those with moderate alcohol dependence regularly drink slightly more than the recommended intake.

The guidelines recommend an average of not more than four standard drinks per day for men and two for women. The NHMRC recommends that not more than six and four standard drinks respectively should be drunk by men and women at one time.

One standard drink is equal to 10 grams of ethanol, which is the substance in alcohol that causes intoxication or drunkenness. Alcohol consumed in excess of these quantities poses a number of health risks, including the risk of becoming dependent on alcohol.

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In relation to its health effects, the NHMRC classifies alcohol consumption as:

1. Low risk: Alcohol consumption patterns which fall within the guideline recommendations and which have little or no associated increased risk and potential health benefits.
2. Risky: Alcohol consumption patterns which slightly exceed the guidelines for either average or daily consumption, where potential harm outweighs potential benefits.
3. High risk: Alcohol consumption patterns far above the guidelines where there is a considerably increased risk of associated health problems.

	What effect is alcohol having on you? Enter your weekly alcohol intake to find out how you rate.
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Who gets Alcoholism?

Alcohol consumption has always been common in Australia and many people are dependent on alcohol.

Alcohol intoxication disorder (more commonly known as binge drinking) is also common in Australia. Often, people who are dependent on alcohol also tend to binge drink.

At least two thirds of all alcohol consumed by Australians is consumed at levels which present either long or short term health risks. Some 10% of Australian men and women consume more than the average number of drinks recommended in the Australian guidelines. While a smaller proportion of Indigenous Australians drink than non-Indigenous Australians, a higher proportion of Indigenous Australians (20%) exceed the recommended average daily drinking limits than non-Indigenous Australians.

Over 6% of the Australian population meet the criteria for having alcohol consumption disorders, either alcohol dependence or intoxication disorder. Alcohol dependence is the most common disorder, occurring in about 4.1% of Australians. A greater proportion of men (6.1%) suffer from alcohol dependence than women (2.3%). 18–24 years olds (of whom 9.3% meet the criteria for alcohol dependence) are the age group most likely to be alcohol dependent in Australia. There is a higher rate of alcohol consumption disorders amongst Indigenous Australians, compared to non-Indigenous Australians.

Predisposing Factors

Some individuals have a higher risk of developing alcohol dependency than others. Individuals who drink frequently or in large quantities are more likely to become dependent on alcohol than those who don't drink as much. People also have a higher risk of developing alcohol dependence if they:

• Have a relative that suffers from alcohol dependency;
• Suffer from a mental health disorder (e.g. depression, stress and anxiety); or
• Where brought up in a house where consuming large amounts of alcohol was normal.
  

Progression

Alcohol dependency occurs on a continuum. Many Australians are only moderately or mildly dependent on alcohol (e.g. they may find it difficult to stop drinking once they start). They do not exhibit physical withdrawals like those with severe alcohol dependence, and do not consider their drinking patterns problematic. This may be because the major health and social consequences of alcohol dependence (with the exclusion of violence) do not begin when an individual first becomes alcohol dependent. For example, it may take years for an individual who is alcohol dependent to have financial or relationship problems as a result of drinking. In many cases chronic excessive drinking may have no immediate health and social consequences.

Even if a mild to moderate drinker is not feeling the effects right now, they may be dependent on alcohol if they:

• Consume alcohol in quantities greater than those recommended in the Australian guidelines for average or daily consumption;
• Need to drink every day or drink first thing in the morning to settle their nerves and recover from the effects of drinking the previous night;
• Experience physical and/or psychological withdrawal symptoms, including shaking in the morning, nausea and vomiting.
• Need to take days off work to recover from the effects of drinking too much;
• Miss going to social events or seeing friends so that they can drink alcohol; and/or
• Need to drink more alcohol to get drunk.

There is a tendency for some people with mild alcohol dependence to become more severely dependent.