Abuse of alcohol is a major cause of preventable deaths associated with violence and motor vehicle crashes. Excessive alcohol intake strains personal relationships and may affect one's ability to hold a job. In addition, excessive alcohol intake may result in serious health problems, including damage to the liver and brain. The May 3, 2006, issue of JAMA includes an article about treatments for alcohol dependence. This Patient Page is based on one previously published in the April 6, 2005, issue of JAMA.
Alcohol abuse is a pattern of drinking that is accompanied by 1 or more of the following problems:
(1) failure to fulfill major work, school, or home responsibilities because of drinking;
(2) drinking in situations that are physically dangerous, such as while driving a car or operating machinery;
(3) recurring alcohol-related legal problems, such as being arrested for driving under the influence of alcohol or for physically hurting someone while drunk; and
(4) having social or relationship problems that are caused by or worsened by the effects of alcohol.
Alcoholism (alcohol dependence) is a more severe pattern of drinking that includes the problems of alcohol abuse plus persistent drinking in spite of obvious physical, mental, and social problems caused by alcohol. Also typical are
(1) loss of control—inability to stop drinking once begun;
(2) withdrawal symptoms (symptoms associated with stopping drinking such as nausea, sweating, shakiness, and anxiety); and
(3) tolerance (needing increased amounts of alcohol in order to feel drunk).
POSSIBLE TREATMENTS
There is no cure for alcoholism, but effective treatments are available. The type of treatment your doctor may recommend depends on the extent of alcohol use, whether there are associated medical problems, and your personal preferences.
Acute withdrawal and detoxification is used for individuals who use alcohol heavily and is designed to prevent and treat withdrawal symptoms, which can otherwise be severe and even life-threatening. This treatment may require a stay in a specialized facility in addition to close medical supervision.
Medications may be used to prevent relapse.
Individual or family counseling is also an important part of treatment. Because alcoholism may coexist with mental illness, including depression, it is important to undergo full evaluation for these illnesses. Counseling may also include families and partners who often need help coping with the stress of living with a family member with alcohol problems.
Mutual help groups include support groups such as Alcoholics Anonymous and Al-Anon. Individuals in these groups support each other by sharing personal experiences and advice.
FOR MORE INFORMATION
Substance Abuse and Mental Health Services Administration
The National Clearinghouse for Alcohol and Drug Information
800/729-6686
http://www.health.org
National Institute on Alcohol Abuse and Alcoholism
http://www.niaaa.nih.gov
Alcoholics Anonymous
http://www.alcoholics-anonymous.org
888/425-2666
http://www.al-anon.alateen.org
Alcohol Abuse and Alcoholism. 
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