Alcoholism is a word which a lot of people use to mean ‘alcohol dependence’ (alcohol addiction). Some people are ‘problem drinkers’ but are not dependent on alcohol. If you are alcohol dependent then detoxification (’detox’) could help you to stop drinking.

Problems with drinking alcohol

There are roughly four ‘tiers’ of alcohol drinking - social, heavy, problem and dependent..Each tier increases the risk to your health and safety.

Social drinking

Most people drink alcohol. All the same, even a little amount of alcohol can be dangerous if you drive, work machinery, or are taking medication..

Heavy (hazardous) drinking

This is alcohol consumption above the suggested ’safe’ limits which are:

* Men should drink no more than 21 units of alcohol per week, and never more than four units a day.
* Women should drink no more than 14 units of alcohol per week, and never more than three units in any one day.
(Pregnant women ought not drink at all.)

One unit of alcohol is in approximately half a pint of beer, or two thirds of a small glass of wine, or a small pub measure of spirits.

Drinking more than the recommended safe limit is risky. That is, it increases the chance of developing diseases such as cirrhosis (liver damage), harm to the pancreas, cancer, heart problems, sexual problems, and other conditions. Approximately 1 in 3 men, and about 1 in 7 women, drink more than the safe limit. Simply stated, the more you drink, the greater the hazard.

For example, if a man drinks five units each day then, on average, the risk of developing liver disease, raised blood pressure, some cancers, and of having a violent death is doubled.

Problem (harmful) drinking

This is where you persist drinking heavily even though you have caused damage, or are causing harm or problems to yourself, family, or society. For example, you may:

* Have cirrhosis or another alcohol related condition.
* Binge drink and get drunk regularly. This may cause you to miss work, or behave in an antisocial manner when you drink. But, not every problem drinker binges or gets drunk. Numerous people with an alcohol related condition like cirrhosis drink small amounts often, but do not get intoxicated.
* Spend more money on alcohol than you can afford.
* Have troubles with your relationships or in the workplace because of your drinking.

Many problem drinkers are not alcohol dependent. They could cease drinking without withdrawal symptoms if they wanted to. But, for one reason or another, they continue drinking heavily.

Alcohol dependency (addiction)

This is a grave situation where drinking alcohol takes a high precedence in your life. You drink every day, and frequently need to drink to prevent awful withdrawal symptoms (see below). In the United Kingdom about 2 in 100 women and about 6 in 100 men are dependent on alcohol.
What are the symptoms of a dependence on alcohol?

If you are alcohol dependent you have a unassailable need for alcohol. Sometimes the desire is overpowering. You have great difficulty in controlling your drinking. and your body becomes used to large amounts of alcohol. Therefore, you might start to develop ‘withdrawal’ symptoms 3-8 hours after your last drink as the effect of the alcohol wears off. So, even if you want to quit drinking, it is often challenging because of the withdrawal symptoms.

Withdrawal symptoms include: nausea, shakiness, sweating, craving for alcohol, and jsimply feeling awful. Fits occur in a small number of cases.

As a consequence, you drink alcohol on a regular basis and ‘depend’ on it to prevent withdrawal symptoms. If you do not consume any more alcohol, withdrawal symptoms usually last 5-7 days, but the craving for alcohol may persist longer. The severity of dependence varies. It can grow gradually and until it becomes severe. You may be developing a dependence on alcohol if you:

* Frequently have a strong need to drink alcohol and want a drink every day.
* Drink alone frequently.
* Need a drink to stop shaking (the shakes).
* Drink early, or first thing in the morning (to avoid withdrawal symptoms).
* Spend a lot of you time doing activities where alcohol is available. For example, at the social club or pub.
* Disregard other interests or pleasures because of alcohol drinking.

If you are alcohol dependent you are usually ‘tolerant’ to the effect of alcohol. Meaning that you need more alcohol to experiencw any effects and to become inebriated. This can make things riskier as it tends to make you drink even more.

If you are alcohol dependent you may get intoxicated regularly. However, you may not get drunk. You may drink little amounts often to keep any withdrawal symptoms at bay. You might then be able to ‘hide’ your problem from other people. However, you are still at serious risk of developing dangerous conditions due to heavy drinking (liver damage, cancers, etc).

Delirium tremens (’DTs’)

This is a more dangerous withdrawal reaction after stopping alcohol and occurs in about 1 in 20 people who have alcohol withdrawal symptoms roughly 2-3 days after their last drink. Symptoms include: pronounced tremor (the shakes) and delirium (unrest, confusion, and halucinations). Some people have fits. Complications can develop like dehydration and other serious physiological problems. It is deadly in some cases.

Should I cut down, or stop drinking alcohol completely?

Stopping alcohol altogether is usually best if you are, or have been, alcohol dependent. Also, if you have a medical condition due to alcohol such as liver damage. Otherwise, cutting down to a safe level of drinking is an option. Never stop alcohol suddenly if you are alcohol dependent. Some withdrawal effects can be dangerous. It is best to cut down bit by bit and then stop, or see your doctor about a ‘detox’ - see later.)

If you are trying to cut down, some tips which may help are listed below

* Drink low alcohol beers, do not drink ’strong’ beers or lagers.
* Try pacing yourself. Maybe alternate soft drinks with alcoholic drinks.
* Look at cutting back on types of social activity which necessitate drinking. Maybe try different social activities where drinking is not called for. Maybe reduce the number of days in the week where you usually go out to drink.
* Ignore pressure from people who encourage you to drink more than you want to.

What can help me to reduce or stop my drinking?

Nobody can make you stop or cut down drinking. You have to be dedicated and prepared to do it on your own. However, it can be demanding, and one or more of the following may help.

Accepting the problem

Some people deny to themselves that they have a problem. The sort of thoughts that some people deceive themselves with include: “I can handle it”, “I’m only drinking what my friends drink”, “I can stop anytime”. Accepting the presence of a problem, and seeking help where necessary, is often the biggest step to take to cut down on your drinking or to stop completely.

Self help

I managed to quit by reading self help books and by finding websites offering advice and it wasn’t as hard as I’d imagined. It is thought that about 1 in 3 people who have a problem with alcohol return to sensible drinking, or stop drinking, without any professional help.

Talking treatments

Managing your addiction sometimes calls for more intensive talking treatments such as cognitive-behaviour therapy (CBT), motivational interviewing, or motivational enhanced therapy. CBT helps you to alter certain patterns of your thinking and behaviour and is being used with considerable success as a quitting strategy.

I was also helped by counselling and advice from my Doctor and an alcohol counsellor.

The treatment of other illnesses

Alcohol may appear to be a ‘quick’ fix for stress relief, anxiety, depression, or other mental health problems. Nevertheless, the effect is short-lived and drinking large amounts of alcohol often makes these ailments worse. If you feel these are the underlying problems then see your doctor. Medication and counselling or CBT may offer a good solution and are a much better in the long term than heavy drinking.

Detoxification (’detox’)

What is detoxification?

Detoxification or ‘detox’ requires taking a short course of a medicine which helps to stop withdrawal symptoms when you quit drinking alcohol. Benzodiazepine medicines such as chlordiazepoxide are used for detox.

Many Doctors are happy to prescribe for detox from alcohol. The usual method is to prescribe a high dose of medication for the first day that you stop drinking alcohol, then gradually reduce the dose over the week. This usually prevents, or greatly represses unpleasant withdrawal symptoms. You must not drink any alcohol when you are taking detox medication. Your Doctor or nurse will generally see you quite often during detox. Also during this time, support from family or friends can be helpful.

Sometimes people are referred to a specialist drug and alcohol unit for detox. This is generally better for those with little home or social back up, those with a history of terrible withdrawal symptoms, those with physiological illness caused by alcohol, and those where previous attempts to stop alcohol have been unsuccessful. The medicines used to detox in specialist units are often the same as Doctors prescribe. However, these units have more staff and expertise for providing support and counselling. Some people with serious alcohol related problems are also admitted to hospital for detox.

The medication only helps to make stopping drinking easier. You do however need determination to stop. The medication merely helps you to feel better whilst your body readapts to a life without alcohol. Even after detox it is likely that you will have a craving for alcohol. So willpower and coping strategies are required for when you feel enticed to drink.

Other medication occasionally used for alcohol problems

* Vitamins, particularly vitamin B1 (thiamine), is often prescribed if you are alcohol dependent. Particularly whilst in detox. This is because many people who are alcohol dependent do not eat properly and can lack certain vitamins. lack of vitamin B1 is the most common and the absense of this vitamin can cause serious brain conditions called Wernicke’s encephalopathy and Korsakoff’s psychosis.
* Acamprosate is a medicine which can help to reduce alcohol craving and may be prescribed to some people after a successful detox to help them stay off alcohol.
* Disulfiram is another medicine which is occasionally used following a successful detox. When you take disulfiram you get unpleasant symptoms if you drink any alcohol (such as flushing, being sick, heart palpitations and headache). So, in effect, the medicine acts as a deterrent when you are tempted to drink and can help some people to stay off alcohol.

After detoxification and staying off alcohol

Unfortunately many people who successfully quit go back to drinking heavily again at some point. There are various reasons why this happens. It has been suggested that you are less likely to go back to drinking heavily if you have counselling, or other support to help you to stay off alcohol. Your doctor, practice nurse, or local drug and alcohol unit may provide ongoing support when you are trying to stay off alcohol. Self-help groups can also help many people to stay off alcohol.

If you return to heavy drinking, you can always try to stop again, some people need several attempts before they can stop for good, or to keep within safe limits.
It simply is a matter of “having a go” I was a hardened drinker and was able to do it after years of addiction and you could do the same!