What is alcohol dependence?
Many people enjoy the occasional drink without any harm. It becomes a problem when the drinking gets out of control or the drinker starts to damage themselves or others. The damage may be physical, psychological or social - or a mixture of these.
Heavy drinking is when alcohol consumption exceeds the safe recommended levels of 21 units per week for men and 14 units per week for women. But alcohol dependence - or addiction - occurs when the drinker is physically or psychologically unable to do without alcohol.
Blood alcohol levels - a few facts:-
- A unit is 10mg of pure alcohol or, for example, one single pub measure (25ml) of whisky - this is rapidly absorbed from an empty stomach, reaching peak levels in the blood in about ½ to 1 hour.
- 10ml of consumed alcohol can double into 15-20mgs/100ml in blood.
- Alcohol generally leaves the body at the rate of 15mgs per hour.
- The current legal limit for driving in the UK is 80mgs/100ml in blood.
How is dependence caused?
Alcohol dependence is thought to be caused by interaction between the following factors:-
- Individual characteristics - personality, genes and parental influence.
- Environment and lifestyle - the person's occupation, peer pressure, specific events and stress.
- The alcohol itself - the type of drink, the amount and the duration of drinking.
What are the symptoms?
There are a number of possible symptoms, both physical and psychological, or sometimes they take the form of disruption to life at home or in the workplace.
Major physical signs include:-
- Vomiting (especially blood), diarrhoea, abdominal pains
- "accidental" injuries
- Faints, fits, falls or blackouts
- Withdrawal symptoms such as tremors, night sweats, insomnia
- The smell of alcohol on the breath
Major psychological clues include:-
- Anxiety
- Depression
- Sexual problems
- Drug abuse
- Inappropriate behaviour
- Family members may also experience psychological problems or become the victims of violence or abuse
- Other indications include trouble at work, with finances or the law
- Personal honesty and healthy emotional openness is seriously compromised.
How common is it?
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27% of people who drink in England and Wales are thought to be problem drinkers
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The highest rates of problem drinking are among young, single, working men.
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Between 0.5% and 3% of the population are thought to be in need of treatment
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20% of general hospital beds and 10% of psychiatric hospital beds are occupied due to alcohol related diseases.
What are the effects?
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Besides physical illness, alcohol dependence can do a great deal of harm in other ways. For example, the drinker's healthy social life may be damaged. At work, likely to be less efficient and more prone to taking time off, possibly leading to reprimand and finances may be mismanaged. Risk of accidents, violence and criminal behaviour.
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Relationships and family life are put under strain. Children may copy their parent's drinking or develop behavioural problems while marriage are likely to suffer through stress and by the drinker not being fully involved in family life, forcing the other partner to carry more responsibility. Spouses may become depressed and the relationship itself may break down.
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Depression coexists with addictiveness and risk of self harm is very high.
How is it assessed?
There are various methods of assessing the level of alcohol dependence. These include examinations of both physical and mental health, blood and breath tests, questionnaires on drinking habits, assessment of social circumstances and risk of violence or suicide.
How is it treated?
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Depending on the severity of the problem, the drinker's GP may refer them to a specialist Consultant or alcohol treatment unit, either in the NHS or to the private sector. Treatment ranges from simple interventions to medically supervised detoxification with Addiction Treatment Programme, counselling, education and therapy.
- Specialist Addiction Treatment Programmes (such as the one run at Godden Green Clinic) have group work to achieve sobriety and recovery by promotion of honesty, acceptance and willingness to change. In such a treatment programme, individual therapy, cognitive behavioural therapy, anxiety management and family therapy is also available. Relatives groups are also very helpful. A number of self-help groups and voluntary agencies also offer basic advice and support.
But it's my problem too!
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If your partner suffers from alcoholic dependence, your own life may be in turmoil as you worry about their drinking and state of health but don't know what to do for the best.
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It could seem as though you are being pulled in different directions at the same time. For example, you might feel concern for your partner but contempt for their drinking, or want to help but are afraid of change.
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Your partner may try to blame you for their condition, or perhaps you blame yourself and feel guilty or depressed as a result. You may find yourself covering up for them or inadvertently enabling their addiction and believe that no-one understands your predicament.
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However, there are other people in the same situation and you need not cope alone. Even if your partner is not yet ready to accept treatment, you can begin by seeking help for yourself.
These questions will help you decide if you are affected by your partner's (or another family member) drinking:-
- Do you worry about how much your partner drinks?
- Do you have financial problems due to their drinking?
- Do you lie to cover for them?
- Have you felt that drinking is more important to your partner than you are?
- Have you blamed their companions for your partner's drinking?
- Have you threatened to leave your partner?
- When you kiss your partner, have you tried secretly to smell alcohol on their breath?
- Are you afraid to upset your partner for fear of setting off another bout of drinking?
- Have you been hurt or embarrassed by their behaviour when drinking?
- Are you holidays often ruined by their drinking?
- Have you ever considered calling the police because of your partner's behaviour?
- Do you search for hidden drinks in their house?
- Have you felt that your partner would stop drinking if only...?
- Have you ever refused social invitations out of fear of your partner's drinking?
- Have you felt guilty about the extent of your efforts to control their drinking?
- Do you feel that if your partner stopped drinking, many of your other problems would be solved?
- Have you ever threatened to harm yourself in order to scare them to their senses?
- Have you ever threatened your children or colleagues unjustly because you were angry about your partner's drinking?
- Have you felt that no-one understands your predicament?
Further reading:-
- The Courage to Change by D Wholey
- Families Under the Influence by M Elkin
- Alcohol Problems by K J B Rix & E L Rix
Additional Help
Adult Children of Alcoholics ( UK ), Tel: 07071 781899
Alcoholics Anonymous, Tel: 01904 644026 (see our Links page)
Al-Anon Family Group, Tel: 0207 403 0888 ( A 24 hour helpline for families and friends throughout the UK and Eire)
National Association of Children of Alcoholics, Tel: 0800 289061 (help-line 9.30am-5.00pm Mon-Fri)
SOS (Secular Organisation for Sobriety), Tel: 0700 078 1230 (A self help group also known as Save Our Selves)
Our practice has a leaflet which includes all of the above information and if you would like us to send you a copy, please get in touch and we will be happy to do so. |
