That blog post was about the importance of talking to your children about alcohol and I link to a great website developed by the U.S. Department of Health and Human Services. Now I want to take this discussion even further and dispense a little more information about alcohol abuse, alcohol dependence, and alcohol facts, in general. Why? Because there are millions of people affected by alcohol everyday, whether it’s due to their own alcohol problem or because someone they love has a problem. The U.S. has one of the highest rates of alcohol abuse and dependence in the world and most people know at least one person who has a problem with alcohol. People with alcohol problems need help. It is not something that can be cured on its own without treatment and support. It is something that needs to be recognized and addressed. Treatment for alcohol abuse and dependence is imperative, not only for the health of the person with the problem but for everyone else in their life as well.

What is Alcoholism?

I don’t use the term *alcoholic.* The term *alcoholic* is not a medical or legal term. Instead, I use the terms *alcohol abuse* and *alcohol dependence*.  Both can easily be lumped into the term *alcoholic,* but there is a difference:

Alcohol Abuse is the compulsive use of alcohol, using alcohol in excess and during substantial periods of time, planning and thinking about it often, and continuing to use it despite problems. Abusing alcohol impacts relationships and will often impair the ability to function day-to-day.

Alcohol Dependence is a physiological dependence where symptoms for withdrawal will occur after 12 hours of stopping use. Withdrawal symptoms include trembling, sweating, heart palpitations, vomiting, nausea, seizures, delirium, and possible death. Unlike withdrawal from narcotics, withdrawal from alcohol can result in death without in-patient care. You read that correctly: It is the only substance where there is a risk of death during the withdrawal process. Another important piece of information to note is that adolescents do not experience alcohol withdrawal, which is most likely due to the difference in their liver function.

Just because someone abuses alcohol does not mean they are necessarily dependent on alcohol. At least, not yet. Only someone who craves alcohol, needs a large quantity of alcohol to get *high*, cannot stop drinking, and experiences withdrawal symptoms can be defined as alcohol dependent. However, both categories of drinkers will require assistance to quit.

Long-Term Physical Effects of Excessive Alcohol Use in Men:

• Lowered amounts of testosterone.
• Reddening of face, nose, and eyes.
• A shelf-like appearance on the stomach or “beer belly”. This is actually due to the expansion of the liver.
• Breast development and widening of hips.

Long-Term Physical Effects of Excessive Alcohol Use in Women:

• Lowered amount of estrogen.
• Hips narrowed and figure becomes more boxy.
• Development of facial hair.
• Skin discoloration, including a reddening of skin.

Long-Term Medical Effects of Excessive Alcohol Use in Both Men and Women:

• Cardiomypathy, which is the enlargement of the heart. Alcohol weakens heart tissue and the heart will grow to compensate.
• Chronic medical conditions such as liver cirrhosis, various cancers, high blood pressure, psychological problems, and pancreatitis.
• Alcohol kills brain cells. Organic dementia can occur over time, which is caused by parts of the brain dying.
• Wernicke-Korsakoff Syndrome can happen over time. One major symptom is lying, which might actually be subconscious compensation for memory loss.
• Malnutrition. Not only does alcohol kill vitamins but people who are alcohol dependent do not eat properly or enough.

Biggest Misconceptions About Alcohol Use:

• Nothing can actually block or absorb alcohol. Eating before you drink can slow down the process of the alcohol entering the bloodstream, but only by mere seconds. It will not change the level of alcohol that will enter the bloodstream.
• Nothing can remove the alcohol from your bloodstream. Only time can do that. Cold showers, fresh air, or coffee will not sober a person up. They will simply turn a drunk person into a wide-awake drunk person.
• Alcohol is a depressant but it does not help you sleep more soundly. Alcohol can move a person into sleep more quickly but it inhibits the Delta phase of sleep, which is the deepest stage of the sleep cycle.
• Think that a shot of whiskey has more alcohol than a glass of wine or a bottle of beer? Wrong. The alcohol content in a 1.5 ounce shot of hard liquor is comparable to a 5 oz glass of wine or a 12 oz bottle of beer. The amount of ethanol is what affects people, not the type of drink.
• You will not always react the same way to alcohol. Your tolerance level fluctuates depending on weight, age,  sex, metabolism, and how often and how much you regularly drink.

Becoming Aware of Alcohol Use

Aside from the physical problems, there are a number of issues that are generated from problematic alcohol use. These are just some of the questions that help counselors identify an alcohol problem:

• How much do you drink every day or every week?
  
• Do you drink so much that you have to use a day (or several days) to recover?
  
• Have you lost relationships or jobs because of your drinking?
  
• Have you dropped classes or quit school because of drinking?
  
• Do you avoid friends and family because you are drinking?
  
• Do you cancel plans because of your drinking?
  
• Do you avoid certain people because they talk to you about your drinking habits?
  
• Have you had a DUI?
  
• Do you have health problems, like frequent headaches, weakness, or tremors?
  
• How much money do you spend on alcohol in one week?

If it’s determined that there is a problem, the next obvious step is treatment and support. Many people go to treatment willingly while others need to be coerced via interventions. It does not matter whether or not the person went to treatment willingly, the success rate remains about equal.

Treatment

Alcohol dependency requires in-patient care in order to properly monitor and treat the withdrawal process. Once a person has gone through alcohol withdrawal, it is still imperative to continue a life-long course of action to prevent a relapse. The addiction component is never cured and will need to be managed for the rest of their life.

There is no one right way to treat alcohol abuse and it can be a process to find the right course of treatment and recovery. It is also ideal that family and friends get support as well. For people that need help or for those who need help supporting someone they love, here is a list of a few support groups and treatment resources:

Alcoholics Anonymous World Services – A worldwide self-supporting fellowship of sober alcoholics whose recovery is based on 12-steps.

Al-Anon Family Group Headquarters – A free non-profit organization that supports family members and friends of alcoholics.

Alateen - A fellowship through Al-Anon, this organization helps young people who are affected by someone else’s drinking.

Families Anonymous, Inc. – A worldwide organization that offers 12-step, self-help programs for families and friends of alcoholics.

National Council on Alcoholism and Drug Dependence, Inc. – an organization that provides resources and referrals on how to overcome alcohol and drug addiction.

Toughlove International – A national self-help organization for parents, children, and communities.

Do not delay in getting help for yourself or for someone that needs it. Lives, families, and communities depend on it.

Please share any comments or questions.

Some startling facts about underage drinking:

• Children who first use alcohol before the age of 15 are six times more likely to have alcohol problems than those who start drinking after the age of 21.
• 40% of children have tried alcohol before 8th grade.
• 75% of high school seniors have tried alcohol.
• According to the National Institute on Alcohol Abuse and Alcoholism, approximately 5,000 people under the age of 21 die as a result of drinking alcohol.
• 11% of 8th graders, 22% of 10th graders, and 29% of 12th graders have engaged in heavy episodic  (binge) drinking.
• Children are starting to drink much earlier than ever before. The average age of first use in 2003 was 14. In 1965, the average age was 17.5.

The new website suggests short and frequent discussions rather than have “the talk” which can be long and intimidating for children. Many children will simply tune parents out, especially if they are being talked *at* and not *to.* When you start a dialogue with your child, make sure to ask them questions and make time for their questions, too. Another important factor is to establish your rules and thoughts on alcohol use early and consistently.

If you need some tips and guidelines about how to talk to your kids about alcohol, this website is a fantastic place to start. Parents will not only be able to gather a lot of useful information, but they can also create a personalized action plan for talking with their child. What you say to a 9 year old boy will obviously be different from what you say to a 19 year old girl. The personalized action plan is a wonderful guideline to help you have those discussions, whether your child is 9 or 19.

If you don’t talk to your kids about drinking, you’re actually saying something.  Start early and talk often. I urge all parents to check out this website:

www.underagedrinking.samhsa.gov

Have any comments? Please share!