Alcoholism is a chronic, often progressive disease that can be fatal. The condition involves a preoccupation with alcohol and impaired control over alcohol intake. You may continue to abuse alcohol despite serious adverse health, personal, work-related and financial consequences. Alcoholism usually involves physical dependence on the drug--alcohol, but genetic, psychological, and social factors contribute to this addiction.

It's possible to have a problem with alcohol but not display all the characteristics of alcoholism. This is known as "alcohol abuse," which means you engage in excessive drinking that results in health or social problems, but you aren't dependent on alcohol and haven't fully lost control over the use of alcohol.

According to the National Council on Alcoholism and Drug Dependence, about 18 million Americans abuse alcohol.  Each year, more than 100,000 Americans die of alcohol-related causes.  Alcohol is a factor in nearly half of all traffic deaths.

Alcoholism and alcohol abuse cause major social, economic, and public health problems in the United States.  The annual cost of lost productivity and health expenses related to alcoholism may be as high as $185 billion.

Statistics

Alcoholism statistic in the United States remain staggering.  There are approximately 14 millions people in the country addicted to alcohol and millions more display symptoms of abuse, including binge drinking.  Sadly, a reported 2.6 million binge drinkers in 2002 were between the ages of 12 & 17.

Due to the more than 2 million people per year who drive under the influence, the National Highway Traffic Safety Administration claims that alcoholism statistics indicate 17,000 alcohol-related traffic fatalities in each of the last three years.

Since perceptions and behaviors become distorted under the influence of drugs and alcohol in any situation, annual alcoholism statistics also show that, in addition to traffic accidents, alcohol abuse causes:

• 1,400 deaths
• 500,000 injuries
• 600,000 assaults
• 70,000 sexual assaults

(Source:  National Institute on Alcoholism and Alcohol Abuse)

"Alcohol is the number one drug of choice among our nation's youth.  Yet the seriousness of this issue does not register with the general public or policymakers." --Enoch Gordis, M.D., Director, National Institute on Alcohol Abuse and Alcoholism

Underage alcohol abuse has led to these sad facts:

• Alcohol is the fourth leading cause of death among people ages 10 to 24.
• Underage drinking costs Americans nearly $58 billion annually.
• In the United States, on average, kids begin to drink at the age of 12.
• Alcoholism statistics show that, compared to those who start drinking at the legal age of 21, people who start using alcohol before the age of 15 are four times more likely to develop an alcohol addiction at some point in their lives.

Facts

Society

Approximately 14 million Americans — about 7.4 percent of the adult population — meet the diagnostic criteria for alcohol abuse or alcoholism.

More than one-half of American adults have a close family member who has or has had alcoholism.

Research was conducted in 1998 to determine the total cost attributable to the consequences of underage drinking. The cost was more than $58 billion per year, based on year 2000 dollars.

In 1992, the estimated productivity loss for employees with past or current alcoholism was $66.7 billion. Productivity losses were greatest for male employees who initiated drinking before age 15.

In a survey of 18- to 24-year-old current drinkers who failed to complete high school, nearly 60 percent had taken their first drink of alcohol before age 16.

In 1999, the average American drank 32 gallons of beer compared to 51 gallons of soft drinks, 24 gallons of milk, and 26 gallons of coffee.

Men who consume more than two alcoholic drinks per day are at increased risk for cancer, cerebrovascular disease, accidents, and violence.

Long-term, heavy alcohol use is the leading cause of illness and death from liver disease in the U.S.
Alcohol is implicated in more than 100,000 deaths annually.

In 1996, about 2 million (38%) of the estimated 5.3 million convicted offenders under the jurisdiction of corrections’ agencies were drinking at the time of the offense.

Doctors are conducting studies to find out the extent alcohol contributes to getting &/or worsening cancer, Alzheimer's Disease, heart disease/failure, stroke, ulcers, high blood pressure, and other diseases.

The Family

Approximately one in four children are exposed to family alcoholism, addiction, or alcohol abuse some time before the age of 18.

Current research suggests children are less likely to drink when their parents spend time and interact in a positive way with them, and when they and their parents report feeling close to each other.

Adolescents drink less and have fewer alcohol-related problems when their parents discipline them consistently and set clear expectations.

Children of alcoholics are significantly more likely to engage in underage alcohol use and to develop addiction and other alcohol-use disorders.

Parents' drinking behaviors and attitudes of acceptance about drinking have been associated with adolescents' initiating and continuing drinking.

Any drinking during pregnancy, even "social drinking," can put offspring at risk for learning and behavioral problems during adolescence.  Many are born with Fetal Alcohol Syndrome.

The Child

Sixty-seven percent of eighth graders and 83 percent of tenth graders believe that alcohol is readily available to them for consumption.

Forty percent of ninth-grade students reported having consumed alcohol before they were age 13.  In contrast, only 26.2 percent of ninth graders reported having smoked cigarettes, and 11.6 percent reported having used marijuana before they were age 13.

Forty-one percent of ninth-grade students reported drinking in the past month, while only 24 percent reported smoking in the past month.

One-fifth of eighth graders and 42 percent of tenth graders have been drunk at least once.

Almost one-fourth of ninth graders reported binge drinking (having had five or more drinks on one occasion) in the past month.

Rates of drinking differ among racial and ethnic minority groups.  Among students in grades 9 through 12, binge drinking was reported by 34 percent non-Hispanic white students, 11 percent of African American students, and 30 percent of Hispanic students.

The gap between alcohol use by boys and girls has closed.  Among ninth graders, girls consume alcohol and binge drink at rates almost equal to boys.

More than 40 percent of individuals who start drinking before the age of 13 will develop alcohol abuse or alcohol dependence at some point in their lives.

If drinking is delayed until age 21, a child's risk of serious alcohol problems is decreased by 70 percent.

The School

Evidence suggests that alcohol use by peers is a strong predictor of adolescent use of alcohol.

According to a 1995 national survey of fourth through sixth graders who read the Weekly Reader, 30 percent of students reported that they received "a lot" of pressure from their classmates to drink beer.

According to this same 1995 Weekly Reader survey, more than half (54%) of fourth through sixth graders reported learning about the dangers of illicit drugs at school, but fewer than a third (30%) learned about the dangers of drinking and smoking at school.

Among eighth graders, students with higher grade point averages reported less alcohol use in the past month.

Research indicates that adolescents who use alcohol may remember 10 percent less of what they have learned than those who don’t drink.

Among eighth graders, higher truancy rates were associated with greater rates of alcohol use in the past month.

One national study found that students are less likely to use alcohol if they are socially accepted by people at school and feel that teachers treat students fairly.

In a survey of seventh- through twelfth-grade teachers, 76 percent felt that underage student drinking was a serious or somewhat serious problem.

The Community

An overwhelming number of Americans (96%) are concerned about underage drinking, and a majority support measures that would help reduce teen drinking, such as stricter controls on alcohol sales, advertising, and promotion.

Recent advertising expenditures in the United States for beer, wine, and liquor combined ($1.4 billion) totaled about 20 times the amount spent on milk ads ($70.5 million).  A total of $910.4 million was spent on beer ads, $135.2 million on wine ads, and $377 million on liquor ads.

A study of fifth- and sixth-grade students found that those who demonstrated an awareness of beer ads also held more favorable beliefs about drinking and intended to drink more frequently when they grew up.

One study of Midwestern States found that 46 percent of ninth graders who reported drinking alcohol in the previous month said they obtained the alcohol from a person aged 21 or older.

In a study conducted in 38 States and the District of Columbia, areas with greater numbers of drinking establishments had higher rates of alcoholism.

The National Highway Traffic Safety Administration estimates that the 21-year-old minimum drinking age laws have saved 21,887 lives since the mid-1970s.

Among drivers aged 15-20, fatal crashes involving a single vehicle at night are three times more likely to be alcohol-related than other fatal crashes.  You booze, you cruise, you lose.

Frequently Asked Questions

What is alcoholism?

Alcoholism, also known as "alcohol dependence," is a disease that includes alcohol craving and continued drinking despite repeated alcohol-related problems, such as losing a job or getting into trouble with the law.  It includes four symptoms:

Craving -- A strong need, or compulsion, to drink.

Impaired Control -- The inability to limit one's drinking on any given occasion.

Physical Dependence -- Withdrawal symptoms, such as nausea, sweating, shakiness, and anxiety, when alcohol use is stopped after a period of heavy drinking.

Tolerance -- The ability to drink more & more, and the need for increasing amounts of alcohol in order to feel its effects.

For clinical and research purposes, formal diagnostic criteria for alcoholism have been developed.  Such criteria are included in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, published by the American Psychiatric Association, as well as in the International Classification Diseases, published by the World Health Organization.

Is alcoholism a disease?

Yes, alcoholism is a chronic, often progressive disease with symptoms that include a strong need to drink despite negative consequences, such as serious job or health problems.  Like many other diseases, it has a generally predictable course, has recognized symptoms, and is influenced by both genetic and environmental factors that are being increasingly well-defined.

Is alcoholism inherited?

Alcoholism tends to run in families, and genetic factors partially explain this pattern.  Currently, researchers are on the way to finding the genes that influence vulnerability to alcoholism.  A person's environment, such as the influence of friends, stress levels, and the ease of obtaining alcohol, also may influence drinking and the development of alcoholism.  Still other factors, such as social support, may help to protect even high-risk people from alcohol problems.

Risk, however, is not destiny.  A child of an alcoholic parent will not automatically develop alcoholism.  Conversely, a person with no family history of alcoholism can become alcohol dependent.

What are the signs and symptoms of alcoholism?

Most alcoholics deny that they have a drinking problem.  Other signs of alcoholism and alcohol abuse include:

• Drinking alone or in secret
• Not remembering conversations or commitments — sometimes referred to as "blacking out"
• Making a ritual of having drinks before, with, or after dinner, and becoming annoyed when this ritual is disturbed or questioned
• Losing interest in activities and hobbies that used to bring pleasure
• Feeling a need to drink
• Irritability as usual drinking time nears, especially if alcohol isn't available
• Keeping alcohol in unlikely places at home, at work, or in the car
• Gulping drinks, ordering doubles, becoming intoxicated intentionally to feel good or drinking to feel "normal" or as the only way to "have fun & loosen up"
• Having legal problems or problems with relationships, employment, or finances
• Building up a tolerance to alcohol so that you need an increasing number of drinks to feel alcohol's effects
• Experiencing physical withdrawal symptoms, such as nausea, sweating and shaking, if you don't drink

People who abuse alcohol may experience many of the same signs and symptoms as people who are dependent on alcohol.  However, alcohol abusers don't feel the same compulsion to drink and usually don't experience physical withdrawal symptoms when they don't drink.  A dependence on alcohol also creates a tolerance to alcohol and the inability to control your drinking.

If you've ever wondered if your own alcohol consumption crosses the line of abuse or dependence, ask yourself these questions:

• Do you need a drink as soon as you get up?
• Do you feel guilty about your drinking?
• Do you think you need to cut back on your alcohol consumption?
• Are you annoyed when other people comment on or criticize your drinking habits?

If you answered yes to two or more questions, it's likely that you have a problem with alcohol.  Even one "yes" answer may indicate a problem.

Take this test.

Can alcoholism be cured?

Not yet.  Alcoholism is a treatable disease, and medication has also become available to help prevent relapse, but a cure has not yet been found.  This means that even if an alcoholic has been sober for a long time and has regained health, he or she may relapse and must continue to avoid all alcoholic beverages.

Are there any medications for alcoholism?

Yes, two different types of medications are commonly used to treat alcoholism.  The first are tranquilizers called benzodiazepines (e.g., Valium, Librium), which are used only during the first few days of treatment to help patients safely withdraw from alcohol.

A second type of medication is used to help people remain sober.  A recently approved medicine for this purpose is naltrexone (ReVia).  When used together with counseling, this medication lessens the craving for alcohol in many people and helps prevent a return to heavy drinking.

Another older medication is disulfiram (Antabuse), which discourages drinking by causing nausea, vomiting, and other unpleasant physical reactions when alcohol is used.

Medications do not necessarily need to be used.  Many alcoholics quit drinking when they set their mind to it, attend counseling and/or AA meetings, and make a lifestyle change.

Does alcoholism treatment work?

Treatment outcomes for alcoholism compare favorably with outcomes for many other chronic medical conditions.  The longer one abstains from alcohol, the more likely one is to remain sober.

It is important to remember that many people relapse once or several times before achieving long-term sobriety.  Relapses are common and do not mean that a person has failed or cannot eventually recover from alcoholism.  If a relapse occurs, it is important to try to stop drinking again and to get whatever help is needed to abstain from alcohol.

Does a person have to be alcoholic to experience problems from alcohol?

No, even if you are not alcoholic, abusing alcohol can have negative results, such as failure to meet major work, school, or family responsibilities because of drinking; alcohol-related legal trouble; automobile crashes due to drinking; and a variety of alcohol-related medical problems.

Under some circumstances, problems can result from even moderate drinking -- for example, when driving, during pregnancy, or when taking certain medicines.

Are some groups more likely to develop alcohol problems?

Yes, nearly 14 million people in the United States -- 1 in every 13 adults -- abuse alcohol or are alcoholic. However, more men than women are alcohol dependent or experience alcohol-related problems, though this gap is closing.  In addition, rates of alcohol problems are highest among young adults ages 18-29 and lowest among adults 65 years and older.  Among major U.S. ethnic groups, rates of alcoholism and alcohol-related problems vary.

How do you tell whether your or someone you know has an alcohol problem?

Have you ever felt you should Cut down on your drinking?

Have people Annoyed you by criticizing your drinking?

Have you ever felt bad or Guilty about your drinking?

Have you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover (Eye opener)?

One "yes" answer suggests a possible alcohol problem.  More than one "yes" answer means it is highly likely that a problem exists. If you think that you or someone you know might have an alcohol problem, it is important to see a doctor or other health provider right away.  He or she can determine whether a drinking problem exists and, if so, suggest the best course of action.

Take this test.

If I have a problem with drinking, can I just cut down instead of quitting all together?

That depends.  If you are diagnosed as an alcoholic, the answer is "no."  Studies show that nearly all alcoholics who try to merely cut down on drinking are unable to do so indefinitely.  Instead, cutting out alcohol (that is, abstaining) is nearly always necessary for successful recovery.

However, if you are not alcoholic but have had alcohol-related problems, you may be able to limit the amount you drink.  If you cannot always stay within your limit, you will need to stop drinking altogether.

How can a person get help for an alcohol problem?

Many people also benefit from support groups.  For information on local support meetings run by Alcoholics Anonymous (AA), call your local AA chapter (check your local phone directory under "Alcoholism") or call 212-870-3400.  Check this page for on-line meeting schedules.

For meetings of Al-Anon (for friends and family members in an alcoholic person's life) and Alateen (for children of alcoholics), call your local Al-Anon chapter or call the following toll-free number: 1-888-4AL-ANON.

What ways can the family cope with an alcoholic?

Many recovering alcoholics and their family members find that participating in support groups is an essential part of coping with the disease, preventing or dealing with relapses, and staying sober.

The Fellowship of Alcoholics Anonymous (AA) was formed in 1935.  As a self-help group of recovering alcoholics, AA offers a sober peer group as an effective model of how you can achieve total abstinence.  Jerry, for whom this site was created, was a firm believer in the AA program, and even though he was a 33-year member, he knew that his continued sobriety was contingent upon many factors, one being the AA meeting.  He also attended meetings in order to help new members become & remain sober.

The AA program is built around 12 steps, which are straightforward suggestions for men and women who choose to lead sober lives.  Following the 12 steps aren't required for membership but rather are guides for people who choose to live their lives sober.  As guides to recovery, the 12 steps help alcoholics accept their powerlessness over alcohol.  They stress the necessity for honesty about the past and present.

Recovery in AA is based on accepting the unique experience of each alcoholic.  Through listening and sharing stories, alcoholics learn they aren't alone.  There are no fees for membership, only a willingness to try to remain sober.

Eventually family members of recovering alcoholics formed a complementary self-help group called Al-Anon.  Al-Anon is designed for people who are affected by someone else's alcoholism.  In sharing their stories, they gain a greater understanding of how the disease affects the entire family, not just the alcoholic.  Al-Anon also accepts the 12 steps of AA as the principles by which participants are to conduct their lives.  It also emphasizes how members need to learn detachment and forgiveness, if they too are to be free of the disease.

In many communities, Alateen groups are also available & geared to teenage children of alcoholics.

Your doctor or counselor can refer you to an AA group.  These groups are also commonly listed in the phone book, in the local newspaper, and on the Internet.  There may also be other support groups for alcoholics in your area.

If an alcoholic is unwilling to seek help, is there any way to get them treatment?

This can be a challenging situation.  An alcoholic cannot be forced to get help except under certain circumstances, such as when a violent incident results in police being called or following a medical emergency.

This doesn't mean, however, that you have to wait for a crisis to make an impact.  Based on clinical experience, many alcoholism treatment specialists recommend the following steps to help an alcoholic accept treatment:

Stop all "rescue missions."  Family members often try to protect an alcoholic from the results of his or her behavior by making excuses to others about his or her drinking and by getting him or her out of alcohol-related jams.  It is important to stop all such rescue attempts immediately so that the alcoholic will fully experience the harmful effects of his or her drinking -- and thereby become more motivated to stop.

Time your intervention.  Plan to talk with the drinker shortly after an alcohol-related problem has occurred--for example, a serious family argument in which drinking played a part or an alcohol-related accident.  Also choose a time when he or she is sober, when both of you are in a calm frame of mind, and when you can speak privately.

Be specific.  Tell the family member that you are concerned about his or her drinking and want to be supportive in getting help.  Back up your concern with examples of the ways in which his or her drinking has caused problems for both of you, including the most recent incident.

State the consequences. Tell the family member that until he or she gets help, you will carry out consequences--not to punish the drinker, but to protect yourself from the harmful effects of the drinking.  These may range from refusing to go with the person to any alcohol-related social activities to moving out of the house.  Do not make any threats you are not prepared to carry out.

Be ready to help.  Gather information in advance about local treatment options.  If the person is willing to seek help, call immediately for an appointment with a treatment program counselor.  Offer to go with the family member on the first visit to a treatment program and/or AA meeting.

Call on a friend.  If the family member still refuses to get help, ask a friend to talk with him or her, using the steps described above.  A friend who is a recovering alcoholic may be particularly persuasive, but any caring, nonjudgmental friend may be able to make a difference.  The intervention of more than one person, more than one time, is often necessary to persuade an alcoholic person to seek help.

Find strength in numbers. With the help of a professional therapist, some families join with other relatives and friends to confront an alcoholic as a group.  While this approach may be effective, it should only be attempted under the guidance of a therapist who is experienced in this kind of group intervention.

Get support.  Whether or not the alcoholic family member seeks help, you may benefit from the encouragement and support of other people in your situation.  Support groups offered in most communities include Al-Anon, which holds regular meetings for spouses and other significant adults in an alcoholic's life, and Alateen, for children of alcoholics.  These groups help family members understand that they are not responsible for an alcoholic's drinking and that they need to take steps to take care of themselves, regardless of whether the alcoholic family member chooses to get help.

What is a safe level of drinking?

However, certain people should not drink at all.  They include women who are pregnant or trying to become pregnant; people who plan to drive or engage in other activities requiring alertness and skill; people taking certain medications, including certain over-the-counter medicines; people with medical conditions that can be worsened by drinking; recovering alcoholics; and people under the age of 21.

Is it safe to drink during pregnancy?

No, drinking during pregnancy can have a number of harmful effects on the newborn, ranging from mental retardation, organ abnormalities, and hyperactivity to learning and behavioral problems.  Moreover, many of these disorders last into adulthood and often forever.

While we don't yet know exactly how much alcohol is required to cause these problems, we do know that they are 100-percent preventable if a woman does not drink at all during pregnancy.  Therefore, for women who are pregnant or are trying to become pregnant, the safest course is to abstain from alcohol.

As a person ages, does alcohol affect their bodies differently?

In addition, older people tend to take more medicines than younger people, and mixing alcohol with many over-the-counter and prescription drugs can be dangerous & even fatal.

Further, many medical conditions common to older people, including high blood pressure and ulcers, can be worsened by drinking.  Even if there is no medical reason to avoid alcohol, older men and women should limit their intake to one drink per day.

Does alcohol affect a woman's body differently than a man's body?

In addition, chronic alcohol abuse takes a heavier physical toll on women than on men.  Alcohol dependence and related medical problems, such as brain and liver damage, progress more rapidly in women than in men.

Is alcohol good for your heart?

If you are a nondrinker, you should not start drinking only to benefit your heart.  Protection against coronary heart disease may be obtained through regular physical activity and a low-fat diet.  And if you are pregnant, planning to become pregnant, have been diagnosed as alcoholic, or have any medical condition that could make alcohol use harmful, you should not drink.

Even for those who can drink safely and choose to do so, moderation is the key.  Heavy drinking can actually increase the risk of heart failure, stroke, and high blood pressure, as well as cause many other medical problems, such as liver cirrhosis.

If I am taking over-the-counter medications, do I need to stop drinking?

Excerpts from National Institute on Alcohol Abuse and Alcoholism