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Alcohol dependencePublished by BUPA's health information team, healthinfo@bupa.com, February 2008. This factsheet is for people who are alcohol dependent, or who would like more information about it. If you are dependent on alcohol you experience an overpowering urge to drink. Around one in 13 people in the UK are alcohol dependent. It's most common in people with anxiety, depression or job stress.
About alcohol dependenceAlcohol is an addictive drug on which you can become psychologically and physically dependent. Alcohol dependence syndrome (formerly known as alcoholism) is a pattern of routinely drinking excessive amounts of alcohol over a long period of time, resulting in addiction. It can be associated with psychological and physical health problems and can seriously affect your relationships with family and friends, and your job. Alcohol dependence is usually characterised by an overpowering urge to drink alcohol and the inability to limit or stop drinking once you have started. Some people who are dependent on alcohol report being preoccupied with it and that the need to drink alcohol takes over their lives. If you drink regularly, your body gets used to lots of alcohol and you may find that you need to drink increasingly more to feel its effects. This is known as alcohol tolerance and has a role in becoming addicted to alcohol. SymptomsThe signs and symptoms that you are dependent on alcohol include:
Another sign that you are dependent on alcohol is if you suffer from physical withdrawal symptoms when you stop drinking. You may feel the need to drink to avoid or relieve such symptoms. Withdrawal symptoms include:
ComplicationsThere are a number of physical and psychological complications which can result from alcohol dependence. Physical complicationsIf you drink large amounts of alcohol, you are at greater risk of getting:
Psychological complicationsThese can include:
Social complicationsHeavy drinking can sometimes cause:
CausesPeople drink alcohol for many different reasons. Many people who become alcohol dependent use alcohol as a way of dealing with anxiety and depression. However, although it may help you dismiss your problems in the short term, alcohol actually makes anxiety and depression worse. It does this by reducing chemicals called neurotransmitters in your brain which naturally help you fight depression and anxiety. Social factors, such as the affordability and availability of alcohol, are also thought to have a role in causing alcohol dependency. DiagnosisAcknowledging that alcohol is having a negative impact on your life is an important first step in your diagnosis and successful treatment. If you feel that you may be alcohol dependent, you should see your GP who will be able to help. Your GP will ask about your drinking, how you feel about it and its effect on your life and wellbeing. For example, he or she may ask you four specific questions, known as the CAGE questionnaire.
Your GP may also be able to diagnose alcohol dependence if you have a psychological or physical illness that indicates you are drinking too much (see Complications). Your GP may treat you or refer you to a doctor who specialises in treating addiction. TreatmentThe aim of treatment for alcohol dependence is for you to either stop drinking completely (abstinence) or to cut down to a controlled lower level. Your treatment will be tailored to suit you as an individual and depends on how much you are drinking, and any associated physical or mental health problems that you may have. There are many professional services and support groups that can give you the help and support you need to stop drinking. Self-helpAcknowledging that you are dependent on alcohol, and finding the determination to change and the will-power to do so, is important for successful treatment. There are a number of self-help tools such as information leaflets and websites which can help you to stop drinking. Other treatmentsDetoxificationIf you are a heavy drinker, physical withdrawal symptoms associated with stopping drinking can carry risks and you may need medical supervision while you give up. Detoxification or "detox" is the planned withdrawal from drinking alcohol and may involve taking a short course of medicine to help prevent withdrawal symptoms. Benzodiazepine medicines, such as diazepam or chlordiazepoxide hydrochloride, are most commonly used during detoxification. Your GP may prescribe these for you to take at home or you may stay in a specialist treatment centre during detoxification. CounsellingMany people find that talking to someone about their problem is a useful and important part of treatment. You may wish to speak to your GP or a trained counsellor who can help you understand the reasons for your drinking, and give you skills to control or stop the urge to drink. Counselling may also include your partner or family who may also benefit from involvement in the treatment. Mutual-help support groupsThere are many people in the UK who are alcohol dependent and who support each other by sharing personal experiences and advice. Mutual support groups can help you both while you are giving up and help prevent you becoming dependent again. Support groups such as Alcoholics Anonymous, SMART Recovery and Al-Anon (a support group for family and friends of those who are alcohol dependent) can be found nationwide (see Further information). Dietary supplementsSome people who are alcohol dependent are deficient in vitamins and minerals; vitamin B1 (thiamine) deficiency is the most common. Your doctor may prescribe thiamine tablets for you. Special considerationsIf you are pregnantDrinking alcohol during pregnancy can affect the development of your unborn baby and may cause your baby to have a condition called foetal alcohol syndrome. Drinking during pregnancy can also increase the chance of having a miscarriage (see Related topics). Preventing a relapseAfter you have successfully given up drinking, starting again (or relapsing) is common. There are a number of ways that you can plan ahead and minimise the risks of this happening to you. It's important to remember that treatment for alcohol dependence is an ongoing process. You are more likely to successfully give up drinking if you receive help and support from family and friends, mutual support groups, your GP or from a counsellor. There are medicines which your doctor may prescribe you which can help prevent your cravings for alcohol (such as acamprosate calcium) or other medicines (such as disulfiram) which help deter you from drinking by giving you unpleasant symptoms such as vomiting and a headache if you drink alcohol. Further information
Sources
Related topics
This information was published by BUPA's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Dr Adrian Winbow, Consultant Psychiatrist, Cygnet Hospital, Godden Green, Kent, and by BUPA doctors. It has been patient reviewed by Alcohol Concern. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional. Publication date: February 2008. Review date: February 2010
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