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Beneficiile renunrii la fumat

Potrivit specialitilor, intervalul scurs de la ultima igar fumat aduce dependentului de tutun beneficii de
care acesta nu este ntotdeauna contient. Medicii spun c o parte dintre aceste beneficii sunt uor de
constatat chiar de ctre persoana care ia decizia s renune la acest viciu, la scurt timp dup ultima igar.

Mai jos putei regsi o serie de benefecii care apar odat cu stingerea ultimei igri.

La 20 de minute de la inhalarea ultimul fum de igar tensiunea arterial scade la valori normale.
Acest fapt se poate verifica prin simpla msurare a tensiunii arteriale imediat dup o tigara i, apoi, dup alte
20 de minute.

La 8 ore de la stingerea igrii nivelul de monoxid de carbon din snge se normalizeaz. n
consecin, nivelul de oxigen crete ajungnd la un nivel normal. Acest beneficiu este resimit de fiecare
fumtor n fiecare zi, dup cele 8 ore de somn.

La 24 de ore de la inhalarea ultimului fum de igar riscul de accident vascular i de moarte subit
scade. Dependena de tutun este recunoscut pentru predispoziia la afeciunile mai sus menionate.

La 48 de ore de la renunarea la fumat gustul i mirosul se mbuntesc. Astfel, mncarea va avea un
gust mai delicios i un miros mai apetisant. Mai mult, dup acest interval de timp, nivelul de nicotin dispare
din organism.

La 72 de ore de la stingerea ultimei igri respiraia devine mai uoar, iar capacitatea pulmonar
crete. De asemenea, dup acest interval de timp, proasptul nefumator va simi c are mai mult energie, iar
tuburile bronhiale se relaxeaz.

La 2-3 sptmni de la renunarea la dependena de tutun circulaia sanguin se mbuntete.
Mersul pe jos devine mai uor, iar funcia pulmonar crete cu pn la 30%. Dup zece sptmni de la
ultima igar circulaia sngelui se mbuntete continuu. Dispare senzaia de "picioare grele", gleznele
devin mai suple, anumite vene si capilare devin mai puin vizibile sub pielea de pe picioare.

La 9 luni de la renunarea de la fumat tusea tabagic, oboseala i respiraia grea se amelioreaz.
Organismul dispune de mai mult energie. n plus, la 9 luni de la renunarea la fumat crete rezistena
organismului la efort.

La 1 an de la stingerea ultimei igri riscul de boli cardiovasculare se reduce cu 50%, iar riscul unui
accident vascular cerebral este la fel de mic ca n cazul unui nefumtor.

La 5 ani de la fumarea ultimei igri riscul de cancer bucal, laringian sau de esofag se reduce cu
50%. n plus, funcia cardiovascular poate fi comparat cu cea a unei persoane care nu a fumat niciodat.

La 10 ani de la stingerea ultimei igri riscul de cancer pulmonar scade cu 30-50%.

La 15 ani de la renunarea la acest viciu fostul fumtor poate fi considerat nefumtor din toate
punctele de vedere, riscul unui atac de cord ajungnd i el la limita statistic normala pentru persoanele care
nu au fumat niciodat. Acelai lucru este valabil i n privina incidenei cancerului.

How to stop drinking alcohol
If you've made the decision to stop drinking alcohol completely, for health reasons or otherwise, read on for
practical tips and advice.
There are lots of reasons why you might want to stop drinking alcohol. Some people need to stop drinking as
a result of developing an alcohol related medical condition such as liver disease, or because they start taking
medication which reacts badly with alcohol. Others choose to do so for religious reasons, or simply as a
move towards a healthier lifestyle.

If youre thinking about removing alcohol from your life, you should know that youre not alone. 15% of
adults in Britain abstain from alcohol
1
, with 43% of those who abstain saying they used to drink alcohol but
have given up
2
.

Whatever your reasons, this page gives lots of tips on how to stop drinking alcohol, details of the potential
benefits of not drinking, as well as information on the potential withdrawal symptoms you could experience
if you move from drinking heavily, to drinking no alcohol at all.
Practical tips on giving up alcohol
Firstly, if you think you have a serious drinking problem and are experiencing any of the associated
symptoms, you should consult your doctor or another medical professional about it as soon as possible.
There are also a number of national alcohol support services who you can go to for advice.
Giving up completely isnt easy especially if youve been a heavy drinker in the past. The following tips
and techniques can make it that little bit easier.
Make your intentions known
Tell your family and friends that youre trying to stop drinking alcohol and explain why. This way, you can
share your successes with them, and theyll understand why youve started turning down drinks or trips to
the pub.
Frequently reminding yourself and the people close to you why you want to stop drinking can help keep you
on track, and may even encourage someone else to give up or cut down with you.
Avoid temptation
In the early stages, its a good idea to avoid situations where you may be tempted to drink. This could mean
opting out of the weekly pub quiz for a while, or if you tend to drink when eating out, try going to restaurants
that dont sell alcohol, or simply volunteering to drive. Similarly, try to identify the times when you would
usually drink and fill the gap with something else. So if you would usually head to the pub after work on a
Friday evening, you could organise to meet friends at the cinema, or if youre giving up alcohol in pursuit of
a new, healthier you, why not fill the gap with a weekly exercise class or a trip to the swimming pool to help
you wind down?
Identifying your triggers is all the more important if youve tried and struggled to stop drinking in the past.
Try to identify why you were unsuccessful - did you still go to the pub most evenings? Did you explain your
reasons for not drinking to your partner? Was alcohol still readily available at home?
Give up or gradually reduce your drinking?
If you want to stop drinking alcohol as part of a move towards a healthier lifestyle, cutting down on the
amount of alcohol you drink as opposed to giving up alcohol completely can help bring lots of health
benefits, and can be significantly easier to sustain. Reducing the amount you drink can also be a stepping
stone to giving up alcohol completely in the future.
Cutting down doesnt have to be complicated - if you currently drink every night, try designating a couple of
days a week as alcohol-free days. This can soon become habit, the personal challenge helping remove the
temptation and perhaps encouraging you to add more alcohol-free days.
Our MyDrinkaware tool can help you track the amount youre drinking in units, calories and hard cash, and
also lets you record days on which you drink nothing at all.
You can read more tips for cutting down at home, or tips for cutting down when out on our site.
Reward progress
Its important that you acknowledge the fact that making changes to your lifestyle can be difficult and that
you reward yourself with something if you are making progress, and that you are not too hard on yourself if
you slip up every once in a while.
An easy way to keep track of how youre doing and keep your motivation up is to give yourself short term
goals. Perhaps you could aim firstly for an alcohol-free week, then an alcohol-free month, for example.
If you tend to drink in front of the TV after work, try replacing that glass of wine with something else you
enjoy, or treat yourself to some new clothes or a day out with the money youre saving on alcohol.
Enjoy the benefits
Whether youre cutting alcohol out of your life completely or cutting down gradually, you may notice a
number of improvements to the way you look and feel. Among other things, you might find you have more
energy, that youre sleeping better, or that youve lost a bit of weight. In the long term you will also be
helping to reduce your risk of developing cancer, liver or heart disease and could lower your blood pressure.
Potential withdrawal symptoms
Going cold turkey or suddenly drinking no alcohol at all can cause serious withdrawal symptoms if you
were drinking heavily before the change.
Dr Sarah Jarvis of Drinkawares Medical Advisory Panel points out that "psychological symptoms are very
common, and not just if you're a really heavy drinker. You can have short term problems even with relatively
low levels of alcohol consumption if you've become used to drinking really regularly. Psychological
symptoms can include irritability, poor concentration, feeling shaky, feeling tired, difficulty sleeping or bad
dreams.
Physical symptoms including trembling hands, sweating, headache, nausea, vomiting, palpitations and lack
of appetite are less common, but are often a sign that the sufferer was drinking at worrying levels. Severe
physical side effects include convulsions, confusion, fever and even hallucinations. If you experience
physical withdrawal symptoms of any kind, you should see your doctor as soon as possible.
Your doctor may be able to prescribe medication that can help with the withdrawal symptoms, and will be
able to refer you to a specialist alcohol team for support. They can also offer counselling and psychological
support, and can put you in touch with local support groups to help you stay on track.
Take a break from alcohol
We explore the benefits of having alcohol-free days.
Building up tolerance
Depending on drink
See how you feel
Help to cut down
We all need a break every now and again. From our jobs. From our partners. From the miserable weather.
But if were used to having a drink to unwind every day, it can be difficult to take a break from alcohol.
We spoke to medical experts Dr Nick Sheron, a liver specialist from Southampton University, and Professor
Paul Wallace, Drinkawares Chief Medical Advisor, to explore the benefits of introducing some drink-free
time to your week.
Building up tolerance
If you drink regularly, your body starts to build up a tolerance to alcohol. This is one of the main reasons its
important to consider taking regular breaks from drinking.
Tolerance is a physiological response we have to any drug including alcohol, explains Professor
Wallace. The more you consume, the more your body gets used to it.
Regular drinking induces certain enzymes in your liver that metabolise alcohol. If you drink heavily, over
weeks or months, levels of these enzymes will go up and your tolerance builds, explains Dr Sheron. If you
stop drinking completely, the enzyme levels go back down.
As your tolerance builds up, you need to consume more alcohol to get the same effects. This can mean you
end up drinking to levels that are harmful to your short and long-term health, putting you at risk a range of
problems from heart disease to cancer. Taking a break from alcohol can have the effect of lowering or
resetting your tolerance, so that it becomes easier to cut back. As all of our bodies respond slightly
differently to alcohol, the amount of time it takes to develop tolerance, or to reset it, varies from person to
person.
The benefit of having drinking days off is that your body doesnt become so accustomed to alcohol, and
youre likely to reverse a tendency towards tolerance, says Professor Wallace.
Learn the signs of alcohol dependence
Depending on drink
Theres another issue to watch out for too: the potential to become dependent. The term alcohol
dependence might conjure up images of someone whos putting away whole bottles of whisky or stumbling
around drunk every day. But there are varying degrees of alcohol dependence. If you drink every day, you
dont have to be drinking to extreme levels to develop a dependence where you find it increasingly difficult
to do without alcohol.
It may not be a full blown physical dependence, where if you dont have alcohol you get the shakes, says
Professor Wallace. But you can become psychologically dependent.
You may have reached this level if you cant settle down to a night in front of the TV without a bottle of
wine chilling in the fridge. Or if you fear an evening with the in laws because theres no time to have a drink
first. If you find that a day without alcohol becomes problematic, you could be psychologically dependent,
says Professor Wallace.
Dr Sheron suggests that if youre continuously drinking without having days off, taking a break can be an
important way to test how dependent on alcohol you might be. What better sign do you have that your
drinking is out of control, than if you promised yourself youre going to cut it out for a few days and you
dont or cant? he says.
To tackle such dependency, Dr Sheron believes its important to interrupt your drinking cycle and take
regular breaks from alcohol. That way you lower your risk of becoming psychologically or physically
dependent on it.
See how you feel
Regular drinking, particularly when above the government's lower risk guidelines, can cause an upset
stomach, indigestion and headaches. You may well find these symptoms disappear on drinking days off.
Alcohol can disrupt your sleep too, so without it youre likely to wake up more refreshed. You may also feel
better in yourself, more alert and generally brighter without alcohol in your system. In the long term, cutting
back on alcohol will lower your risk of serious diseases such as cancer, liver disease and stroke.
Both Professor Wallace and Dr Sheron suggest giving alcohol-free days a go and seeing how you feel. If
you are drinking every day, test out having a break for yourself and see what positive results you notice,
says Professor Wallace.
Help to cut down
Our online tool MyDrinkaware, allows you to track the amount youre drinking and look at how it may be
affecting your health.
Tips for cutting down at home
If you're in the routine of drinking a lot at home, try out these five simple cutting down ideas.
1. Keep track of the alcohol units youre drinking
The government advises that people should not regularly drink more than the lower risk guidelines of 3-4
units of alcohol for men (equivalent to a pint and a half of 4% beer) and 2-3 units of alcohol for women
(equivalent to a 175 ml glass of wine). Regularly means drinking every day or most days of the week.
Using our unit calculator will make the calculations easier or you can sign up to MyDrinkaware to track your
drinking over time.
2. Know what youre buying
A really easy way of cutting down on alcohol if youre a wine drinker is to buy small (125ml) glasses for the
house rather than the large 250ml ones. Youre more likely to spread one 750ml bottle over a few days if
youre not unwittingly pouring a third of it into one cavernous 250ml glass.
3. Home measures
Its worth buying an alcohol measure for when you next pour yourself a spirits-based drink at home. There
will be no more guess work involved and youll be able to keep track of how much youre drinking. Getting
your measures spot on will also ensure your favourite drinks taste exactly as they do when you order them at
the bar. Try Drinkaware's unit measure cup
4. Dinner only drinking
Instead of opening your whole evening up to drinking, why not just allocate dinner as the time you enjoy a
drink? This gives you a leisurely period of time to have a glass of wine or beer, which can then be followed
up nicely with a healthy dessert or hot drink to accompany the evenings TV! Read more on dinner only
drinking
5. Get inventive with your wine!
You might not see any harm in polishing off the last part of the bottle of wine youve been drinking, but in
reality it could be what sends you over the daily unit guidelines. Its a myth that wine doesnt keep overnight,
you just need a good bottle stop. Its also surprising the amount of things you can do with leftover wine in
the kitchen from freezing it for cooking to using older wine for vinaigrette! Read more on cooking with wine
Tips for cutting down when out
Cutting down on alcohol doesn't mean you have to sacrifice your social life; try these out when you're next
out.
1. Beware of rounds
Drinking in rounds may be a British tradition, but they can be expensive, dangerous if it means keeping pace
with the fastest drinker in your group and a nightmare if youre trying to cut down on alcohol. Stay in control
(and save cash) by opting for smaller rounds with only a couple of friends within your group or giving
rounds a miss.
2. Eat up
After-the-pub grub is another drinking tradition, but why wait until the nights nearly over to load up on fast
food? A healthy meal before you go out, and snacks between drinks can help to slow down the absorption of
alcohol and so helps you stay in control. With less alcohol inside you that greasy pizza or kebab will look a
lot less appetising at chucking out time too.
3. Track your drinking on the go
If youre out and about use our free and simple MyDrinkaware tool on your smartphone to track the alcohol
youre drinking. It will help you stay within the government's lower risk guidelines and stay on top of your
night out.
4. Small is better
Make the lower risk guidelines go further by having bottles of beer or halves instead of pints and choosing a
smaller glass for your wine. Buying spritzers or shandies will also help keep that unit count down.
5. Make space
Sipping a soft drink between alcoholic drinks slows down the rate of your drinking and means youll drink
less over the course of the evening. If youre out clubbing, take a bottle of water out with you on the
dancefloor. Down the pub (or even at home)? Then go for a non-alcoholic mocktail, a premium soft drink, or
a glass of water.
Alcohol Addiction Treatment & Self-Help
How to Stop Drinking and Start Recovery


Overcoming an addiction to alcohol can be a long and bumpy road. At times, it may even feel impossible.
But its not. If youre ready to stop drinking and willing to get the support you need, you can recover from
alcoholism and alcohol abuseno matter how bad the addiction or how powerless you feel. You dont have
to wait until you hit rock bottom; you can make a change at any time. Read to get started on the road to
recovery today.
In This Article:
Commit to stop drinking
Set goals and prepare for change
Get sober safely
Find new meaning in life
Plan for triggers and cravings
Ask for help and support
Get started on treatment

Alcohol treatment and recovery 1: Commit to stop drinking
Most people with alcohol problems do not decide to make a big change out of the blue or transform their
drinking habits overnight. Recovery is usually a more gradual process. In the early stages of change, denial is
a huge obstacle. Even after admitting you have a drinking problem, you may make excuses and drag your
feet. Its important to acknowledge your ambivalence about stopping drinking. If youre not sure if youre
ready to change or youre struggling with the decision, it can help to think about the costs and benefits of
each choice.
Evaluating the costs and benefits of drinking
Make a table like the one below, weighing the costs and benefits of drinking to the costs and benefits of
quitting.
Is Drinking Worth The Cost?
Benefits of drinking: Benefits of not drinking:
It helps me forget about my problems.
I have fun when I drink.
Its my way of relaxing and unwinding after a
stressful day.
My relationships would probably improve.
Id feel better mentally and physically.
Id have more time and energy for the people and
activities I care about.
Costs of drinking: Costs of not drinking:
It has caused problems in my relationships.
I feel depressed, anxious, and ashamed of myself.
It gets in the way of my job performance and family
responsibilities.
Id have to find another way to deal with problems.
Id lose my drinking buddies.
I would have to face the responsibilities Ive been
ignoring.
Alcohol treatment and recovery 2: Set goals and prepare for change
Once youve made the decision to change, the next step is establishing clear drinking goals. The more
specific, realistic, and clear your goals, the better.
Do you want to stop drinking altogether or just cut back? If your goal is to reduce your drinking, decide
which days you will drink alcohol and how many drinks you will allow yourself per day. Try to commit to at
least two days each week when you wont drink at all.
When do you want to stop drinking or start drinking less? Tomorrow? In a week? Next month? Within
six months? If youre trying to stop drinking, set a specific quit date.
After youve set your goals to either stop or cut back your drinking, write down some ideas on how you can
help yourself accomplish these goals. For example:
Get rid of temptations. Remove all alcohol, barware, and other drinking reminders from your home and
office.
Example #1: My drinking goal
I will stop drinking alcohol.
My quit date is __________.
Example #2: My drinking goal
I will stop drinking on weekdays, starting as of __________.
I will limit my Saturday and Sunday drinking to no more than 3 drinks per day or 5 drinks per weekend.
After three months, I will cut back my weekend drinking even more to a maximum of 2 drinks per day and 3
drinks per weekend.
Announce your goal. Let friends, family members, and co-workers know that youre trying to stop drinking.
If they drink, ask them to support your recovery by not doing so in front of you.
Be upfront about your new limits. Make it clear that drinking will not be allowed in your home and that
you may not be able to attend events where alcohol is being served.
Avoid bad influences. Distance yourself from people who dont support your efforts to stop drinking or
respect the limits youve set. This may mean giving up certain friends and social connections.
Learn from the past. Reflect on previous attempts to stop drinking. What worked? What didnt? What can
you do differently this time to avoid pitfalls?
Can I cut back on my drinking or do I need to stop drinking completely?
Whether or not you can successfully cut back on your drinking depends on the severity of your drinking
problem.
If youre an alcoholicwhich, by definition, means you arent able to control your drinkingits best to try
to stop drinking entirely. But if youre not ready to take that step, or if you dont have an alcohol abuse
problem but want to cut back for personal or health reasons, the following tips adapted from the National
Institute on Alcohol Abuse and Alcoholism can help:
Set a drinking goal. Choose a limit for how much you will drink. Make sure your limit is not more than one
drink a day if youre a woman, or two drinks a day if youre a man. Now write your drinking goal on a piece
of paper. Put it where you can see it, such as on your refrigerator or bathroom mirror.
Keep a "diary" of your drinking. To help you reach your goal, keep a "diary" of your drinking. For
example, write down every time you have a drink for 1 week. Try to keep your diary for 3 or 4 weeks. This
will show you how much you drink and when. You may be surprised. How different is your goal from the
amount you drink now?
Watch it at home. Keep a small amount or no alcohol at home. Don't keep temptations around.
Drink slowly. When you drink, sip your drink slowly. Take a break of 1 hour between drinks. Drink soda,
water, or juice after a drink with alcohol. Do not drink on an empty stomach! Eat food when you are
drinking.
Take a break from alcohol. Pick a day or two each week when you will not drink at all. Then, try to stop
drinking for 1 week. Think about how you feel physically and emotionally on these days. When you succeed
and feel better, you may find it easier to cut down for good.
Alcohol treatment and recovery 3: Get sober safely
Some people can stop drinking on their own, while others need medical supervision in order to withdraw
from alcohol safely and comfortably. Which option is best for you depends on how much youve been
drinking, how long youve had a problem, and other health issues you may have.
Withdrawing from alcohol
When you drink heavily and frequently, your body becomes physically dependent on alcohol and goes
through withdrawal if you suddenly stop drinking. The symptoms of alcohol withdrawal range from mild to
severe, and include:
Headache
Shaking
Sweating
Nausea or vomiting
Anxiety and restlessness
Stomach cramps and diarrhea
Trouble sleeping or concentrating
Elevated heart rate and blood pressure


Alcohol withdrawal symptoms usually start within hours after you stop drinking, peak in a day or two, and
improve within five days. But in some alcoholics, withdrawal is not just unpleasantit can be life
threatening.
Call 911 or go to the emergency room if you experience any of the following withdrawal symptoms:
severe vomiting
confusion and disorientation
fever
hallucinations
extreme agitation
seizures or convulsions

The symptoms listed above may be a sign of a severe form of alcohol withdrawal called delirium tremens, or
DTs. This rare, emergency condition causes dangerous changes in the way your brain regulates your
circulation and breathing, so its important to get to the hospital right away.
Do I need to go to detox?
If youre a long-term, heavy drinker, you may need medically supervised detoxification. Detox can be done
on an outpatient basis or in a hospital or alcohol treatment facility, where you may be prescribed medication
to prevent medical complications and relieve withdrawal symptoms. Talk to your doctor or an addiction
specialist to learn more.
Alcohol treatment and recovery 4: Find new meaning in life
While getting sober is an important first step, it is only the beginning of alcohol recovery. Rehab or
professional treatment can get you started on the road to recovery, but to stay alcohol-free for the long term,
youll need to build a new, meaningful life where drinking no longer has a place.
5 steps to a sober lifestyle
Take care of yourself. To prevent mood swings and combat cravings, concentrate on eating right and
getting plenty of sleep. Exercise is also key: it releases endorphins, relieves stress, and promotes emotional
well-being.
Build your support network. Surround yourself with positive influences and people who make you feel
good about yourself. The more youre invested in other people and your community, the more you have to
losewhich will help you stay motivated and on the recovery track.
Develop new activities and interests. Find new hobbies, volunteer activities, or work that gives you a sense
of meaning and purpose. When youre doing things you find fulfilling, youll feel better about yourself and
drinking will hold less appeal.
Continue treatment. Your chances of staying sober improve if you are participating in a support group like
Alcoholics Anonymous, have a sponsor, or are involved in therapy or an outpatient treatment program.
Deal with stress in a healthy way. Alcohol abuse is often a misguided attempt to manage stress. Find
healthier ways to keep your stress level in check, such as exercising, meditating, or practicing breathing
exercises or other relaxation techniques.
Alcohol treatment and recovery 5: Handle triggers and cravings
Cravings for alcohol can be intense, particularly in the first six months after you quit drinking. Good alcohol
treatment prepares you for these challenges, helping you develop new coping skills to deal with stressful
situations, alcohol cravings, and social pressure to drink.
Avoiding drinking triggers
Avoid the things that trigger your urge to drink. If certain people, places, or activities trigger a craving
for alcohol, try to avoid them. This may mean making major changes to your social life, such as finding new
things to do with your old drinking buddiesor even giving up those friends.
Practice saying no to alcohol in social situations. No matter how much you try to avoid alcohol, there
will probably be times where youre offered a drink. Prepare ahead for how youll respond, with a firm, yet
polite, no thanks.
Managing alcohol cravings
When youre struggling with alcohol cravings, try these strategies:
Talk to someone you trust: your sponsor, a supportive family member or friend, or someone from your
faith community.
Distract yourself until the urge passes. Go for a walk, listen to music, do some housecleaning, run an
errand, or tackle a quick task.
Remind yourself of your reasons for not drinking. When youre craving alcohol, theres a tendency to
remember the positive effects of drinking and forget the negatives. Remind yourself that drinking wont
really make you feel better.
Accept the urge and ride it out, instead of trying to fight it. This is known as urge surfing. Think of
your craving as an ocean wave that will soon crest, break, and dissipate. When you ride out the craving,
without trying to battle, judge, or ignore it, youll see that it passes more quickly than youd think.
The 3 basic steps of urge surfing:
Take an inventory of how you experience the craving. Do this by sitting in a comfortable chair with your
feet flat on the floor and your hands in a comfortable position. Take a few deep breaths and focus your
attention inward. Allow your attention to wander through your body. Notice where in your body you
experience the craving and what the sensations are like. Notice each area where you experience the urge, and
tell yourself what you are experiencing. For example, My craving is in my mouth and nose and in my
stomach.
Focus on one area where you are experiencing the urge. Notice the exact sensations in that area. For
example, do you feel hot, cold, tingly, or numb? Are your muscles tense or relaxed? How large an area is
involved? Notice the sensations and describe them to yourself. Notice the changes that occur in the
sensation. My mouth feels dry and parched. There is tension in my lips and tongue. I keep swallowing. As I
exhale, I can imagine the smell and tingle of booze.
Repeat the focusing with each part of your body that experiences the craving. Describe to yourself the
changes that occur in the sensations. Notice how the urge comes and goes. Many people, when they urge
surf, notice that after a few minutes the craving has vanished. The purpose of this exercise, however, is not to
make the craving go away but to experience the craving in a new way. If you practice urge surfing, you will
become familiar with your cravings and learn how to ride them out until they go away naturally.
Source: National Institute on Alcohol Abuse and Alcoholism
Alcohol treatment and recovery 6: Get support
Whether you choose to go to rehab, rely on self-help programs, get therapy, or take a self-directed treatment
approach, support is essential. Dont try to go it alone. Recovering from alcohol addiction is much easier
when you have people you can lean on for encouragement, comfort, and guidance.
Support can come from family members, friends, counselors, other recovering alcoholics, your healthcare
providers, and people from your faith community.
Lean on close friends and family Having the support of friends and family members is an invaluable
asset in recovery. If youre reluctant to turn to your loved ones because youve let them down before,
consider going to couples counseling or family therapy.
Build a sober social network If your previous social life revolved around alcohol, you may need to make
some new connections. Its important to have sober friends who will support your recovery. Try taking a
class, joining a church or a civic group, volunteering, or attending events in your community.
Consider moving in to a sober living home Sober living homes provide a safe, supportive place to live
while youre recovering from alcohol addiction. They are a good option if you dont have a stable home or
an alcohol-free living environment to go to.
Make meetings a priority Join a recovery support group and attend meetings regularly. Spending time
with people who understand exactly what youre going through can be very healing. You can also benefit
from the shared experiences of the group members and learn what others have done to stay sober.
Alcohol treatment and recovery 7: Getting started on treatment
As well as joining a recovery support group, you may also decide to see a mental health professional and
take advantage of the latest addiction therapies and programs. As you consider the different options
available, keep the following in mind:
Theres no magic bullet or single treatment that works for everyone. Everyones needs are different, so
its important that you find a program that feels right to you. Any alcohol addiction treatment program
should be customized to your unique problems and situation.
Treatment should address more than just your alcohol abuse. Addiction affects your whole life,
including your relationships, career, health, and psychological well-being. Treatment success depends on
examining the way alcohol abuse has impacted you and developing a new way of living.
Seek treatment for any other medical or psychological issues youre experiencing. Alcohol abuse
frequently goes hand in hand with other mental health problems, including anxiety, depression, attention
deficit disorder, and bipolar disorder. In many cases, the drinking is an attempt to self-medicate. When these
problems co-occur, recovery depends on treating them both.
Commitment and follow-through are key. Recovering from alcohol addiction is not a quick and easy
process. In general, the longer and more intense the alcohol use, the longer and more intense the treatment
youll need. But regardless of the treatment programs length in weeks or months, long-term follow-up care
is crucial to recovery.
There are many places to turn for help. Not everybody requires medically supervised detox or an extended
stint in rehab. The level of care you need depends on your age, alcohol use history, and other medical or
psychiatric conditions. In addition to doctors and psychologists, many clergy members, social workers, and
counselors offer addiction treatment services.
Expect setbacks
Alcohol recovery is a processone that often involves setbacks. Dont give up if you relapse or slip. A
drinking relapse doesnt mean youre a failure or that youll never be able to reach your goal. Each drinking
relapse is an opportunity to learn and recommit to sobriety, so youll be less likely to relapse in the future.
What to do if you slip:
Get rid of the alcohol and get away from the setting where you lapsed
Remind yourself that one drink or a brief lapse doesnt have to turn into a full-blown relapse
Dont let feelings of guilt, blame, or shame keep you from getting back on track
Call your sponsor, counselor, or a supportive friend right away for help
Next steps...

Find an alcohol recovery support group. Support groups can be an invaluable source of guidance,
assistance, and encouragement. Many use sponsors (former addicts who have time and experience remaining
sober) to provide support when youre dealing with the urge to use. Read: Self-help Groups for Alcohol
Addiction.


Find the right alcohol treatment program. Many types of alcohol treatment programs are available.
Quality programs not only address the alcohol abuse but also any other life problems that contribute to your
addiction. Read: Choosing an Alcohol Treatment Program.


How to Cut Down on Your Drinking
NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM
NATIONAL INSTITUTES OF HEALTH

How to Cut Down on Your Drinking
If you are drinking too much, you can improve your life and health by cutting down. How do you know if
you drink too much? Read these questions and answer "yes" or "no":
Do you drink alone when you feel angry or sad?
Does your drinking ever make you late for work?
Does your drinking worry your family?
Do you ever drink after telling yourself you won't?
Do you ever forget what you did while you were drinking?
Do you get headaches or have a hang-over after you have been drinking?
If you answered "yes" to any of these questions, you may have a drinking problem. Check with your doctor
to be sure. Your doctor will be able to tell you whether you should cut down or abstain. If you are alcoholic
or have other medical problems, you should not just cut down on your drinking--you should stop
drinking completely. Your doctor will advise you about what is right for you.
If your doctor tells you to cut down on your drinking, these steps can help you:
1. Write your reasons for cutting down or stopping.
Why do you want to drink less? There are many reasons why you may want to cut down or stop drinking.
You may want to improve your health, sleep better, or get along better with your family or friends. Make a
list of the reasons you want to drink less.
2. Set a drinking goal.
Choose a limit for how much you will drink. You may choose to cut down or not to drink at all. If you are
cutting down, keep below these limits:
Women: No more than one drink a day
Men:No more than two drinks a day
A drink is:
a 12-ounce bottle of beer;
a 5-ounce glass of wine; or
a 1 1/2-ounce shot of liquor.
These limits may be too high for some people who have certain medical problems or who
are older. Talk with your doctor about the limit that is right for you.

Now--write your drinking goal on a piece of paper. Put it where you can see it, such as on your refrigerator
or bathroom mirror. Your paper might look like this:
My drinking goal
I will start on this day ____________.
I will not drink more than ______ drinks in 1 day.
I will not drink more than ______ drinks in 1 week.
or
I will stop drinking alcohol.
3. Keep a "diary" of your drinking.
To help you reach your goal, keep a "diary" of your drinking. For example, write down every time you have
a drink for 1 week. Try to keep your diary for 3 or 4 weeks. This will show you how much you drink and
when. You may be surprised. How different is your goal from the amount you drink now? Use the "drinking
diary" below to write down when you drink.
Week:

# of drinks type of drinks
place
consumed
Mon.
Tues.
Wed.
Thurs.
Fri.
Sat.
Sun.
Week:

# of drinks type of drinks
place
consumed
Mon.
Tues.
Wed.
Thurs.
Fri.
Sat.
Sun.
Week:

# of drinks type of drinks
place
consumed
Mon.
Tues.
Wed.
Thurs.
Fri.
Sat.
Sun.
Week:

# of drinks type of drinks
place
consumed
Mon.
Tues.
Wed.
Thurs.
Fri.
Sat.
Sun.

Now you know why you want to drink less and you have a goal. There are many ways you can help
yourself to cut down. Try these tips:
Watch it at home.
Keep a small amount or no alcohol at home. Don't keep temptations around.
Drink slowly.
When you drink, sip your drink slowly. Take a break of 1 hour between drinks. Drink soda, water, or juice
after a drink with alcohol. Do not drink on an empty stomach! Eat food when you are drinking.
Take a break from alcohol.
Pick a day or two each week when you will not drink at all. Then, try to stop drinking for 1 week. Think
about how you feel physically and emotionally on these days. When you succeed and feel
better, you may find it easier to cut down for good.
Learn how to say NO.
You do not have to drink when other people drink. You do not have to take a drink that is
given to you. Practice ways to say no politely. For example, you can tell people you feel
better when you drink less. Stay away from people who give you a hard time about not
drinking.
Stay active.
What would you like to do instead of drinking? Use the time and money spent on drinking to
do something fun with your family or friends. Go out to eat, see a movie, or play sports or a
game.
Get support.
Cutting down on your drinking may be difficult at times. Ask your family and friends for
support to help you reach your goal. Talk to your doctor if you are having trouble cutting down. Get the help
you need to reach your goal.
Watch out for temptations.
Watch out for people, places, or times that make you drink, even if you do not want to. Stay away from
people who drink a lot or bars where you used to go. Plan ahead of time what you will do to avoid drinking
when you are tempted.
Do not drink when you are angry or upset or have a bad day. These are habits you need to
break if you want to drink less.
DO NOT GIVE UP!
Most people do not cut down or give up drinking all at once. Just like a diet, it is not easy to
change. That is okay. If you do not reach your goal the first time, try again. Remember, get
support from people who care about you and want to help. Do not give up!
Alcohol: Toxic or Tonic?
For some people, drinking in moderation can be beneficial. But at higher levels, it's deadly.
The health effects of alcohol have been debated for hundreds of years. The consensus today is that alcohol,
like many things in life, can be either beneficial or damaging depending on how it's used.
After much investigation, researchers still share uncertainty about the benefits of alcohol, and whether
benefits from modest drinking can offset alcohols risks.
Many researchers feel convinced that heart health benefits can be gained from mild to moderate alcohol
drinking, defined as 1 drink per day for women and 2 drinks per day for men. (A "drink" equals 12 ounces of
beer or wine cooler, 5 ounces of wine, or an ounce and a half of distilled spirits.)
Some experts disagree, saying that alcohol has not been proven to improve heart health. These experts worry
that much-discussed surveys suggesting a heart benefit from alcohol have fooled us.
With heavier drinking, possible benefits are lost, and significant risks are present.
When it comes to alcohol, women are at a disadvantage that has very little to do with body size: A 250-
pound woman is more likely to be damaged by alcohol than is a 140-pound man. That's because women
absorb alcohol much more efficiently after it is consumed. Women also have higher levels of the liver
enzyme that breaks down alcohol in the body, which allows them to metabolize alcohol about 20% faster
than men. Although faster alcohol metabolism may seem to be an asset, it isn't a good thing. Much of the
damage done to the body is caused not by alcohol itself but by acetaldehyde, a highly reactive byproduct of
alcohol metabolism. When alcohol is broken down quickly, as it is in women, more of this toxic chemical is
produced in less time, causing more damage.
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Health benefits, still debated
The greatest potential health benefit of alcohol is its apparent ability to protect the arteries and the heart.
Studies that observed the drinking patterns and heart health of very large groups of people have linked mild
or moderate alcohol consumption to a lower risk of death from coronary heart disease. Similar research
indicates that moderate alcohol use is linked with a lower risk of stroke.
Scientists have identified several reasons that alcohol may have a beneficial effect. Four theories have been
suggested: First, alcohol increases blood levels of the "good" HDL (high-density lipoprotein) cholesterol,
which clears plaque from the arteries. Second, alcohol affects the body's clotting mechanisms, decreasing the
likelihood that a clot will block a blood vessel. Third, alcohol is linked to lower levels of C-reactive protein,
a substance that is linked to lower levels of inflammation in the bloodstream. Finally, some researchers feel
that alcohol may have anti-oxidant effects that may prevent injury in blood vessels.
Regardless of whether you drink beer, wine or spirits, the possible beneficial (and harmful) effects of alcohol
are the same. However, there is some controversy about whether red wine has additional heart benefits that
stem from something other than its alcohol content. Red wine and red grape juice, for that matter has
high levels of flavonoids, natural chemicals that act as antioxidants and may decrease the harmful effects of
"bad" LDL (low-density lipoprotein) cholesterol.
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Health hazards
Despite any social benefits and despite its potential heart health benefits, alcohol has dangers. Even at
moderate levels (just a drink or two per day), alcohol can cause serious problems:
Drug interactions. Many drugs, like alcohol, are metabolized by the liver. Because the liver has limited
processing capacity at any given time, these substances can compete with alcohol for prompt processing.
Additionally, alcohol can block the function of selected enzymes (proteins) that line the intestine. These
enzymes are part of a system well-known to doctors as the "cytochrome P450" system and are responsible
for breaking down many medications and toxins. Alcohol, when consumed, may block the effects of some
drugs and augment the effects of others.
Night blindness. Alcohol can decrease the retinas ability to adapt to low light.
Accidents. Alcohol affects judgment and slows reflexes, which can lead to falls or to accidents involving
vehicles or other machinery.
Breast cancer. Even consuming just one drink per day may increase the risk of breast cancer in women.
Women may be able to decrease their breast cancer risk by taking extra folic acid daily, because use of this
vitamin was linked to a lower breast cancer rate among drinkers in one large survey.
Heavy drinking can have additional health consequences. The quantity of alcohol that has been considered
heavy drinking has varied from one study to another. Most doctors currently consider "problem drinking" to
be regular consumption of more than 14 drinks per week (or more than 4 drinks in 1 day) if you are a man
and more than 7 drinks per week (or more than 3 drinks in 1 day) if you are a woman.
Liver disease. Alcoholic hepatitis and cirrhosis are the two most common liver problems that result as a
consequence of heavy drinking. Alcoholic hepatitis is inflammation of the liver, which ultimately can cause
permanent damage if drinking continues. Cirrhosis occurs when damage to the liver is so severe that scarring
interferes with blood flow and liver function.
Cancers. In addition to breast cancer (which can result from mild to moderate alcohol use), heavy alcohol
use can cause other cancers. Alcohol appears to be especially dangerous when it is combined with smoking,
significantly increasing the risk of cancer of the throat and esophagus. The risk of liver cancer increases in
alcoholics who have hepatitis or cirrhosis.
Hypertension and stroke. Heavy drinking leads to high blood pressure, which increases the risk of stroke.
Heart problems. Alcoholism can cause cardiomyopathy and heart failure. If this happens, the heart enlarges,
weakens and ultimately loses its ability to pump effectively. Consuming very large quantities of alcohol can
cause sudden death from heart arrhythmias.
Pancreatitis. Overuse of alcohol can result in recurrent attacks of severe pain caused by inflammation of the
pancreas, the organ that makes enzymes for digestion and the hormone insulin. Continued alcohol use can
permanently damage the pancreas, leading to malnutrition and diabetes.
Gastrointestinal symptoms. Alcohol can cause a wide range of common, uncomfortable but reversible
problems, including gastritis (inflammation of the lining of the stomach), diarrhea and weight loss. These
interrelated problems are all due to the effects that alcohol has on the lining of the stomach, as well as
impairment of intestinal enzymes and transport systems.
Anemia and low platelets. Alcohol limits the productivity of your bone marrow, so you can have a low
hematocrit (anemia) or a low platelet count. A low platelet count makes you more susceptible to bleeding or
bruising.
Insomnia. After a heavy alcohol exposure wears off, your brain may become overstimulated in recovery.
This is an early symptom of alcohol withdrawal.
Fractures and osteoporosis. In addition to causing thinned bones, alcohol can lead to falls. Both of these
events make a drinker more likely to get a fractured hip or other bone injury.
Dementia. Continued alcohol exposure causes steady injury to brain cells. It is a major cause of dementia.
Reproductive effects. People who drink heavily may become infertile. In men, alcohol lowers sperm count
and can cause impotence. In women, alcohol can cause hormonal changes that can result in irregular
menstruation and infertility.
Adults who choose to drink should remember that the health benefits come only from low to moderate
consumption. For those who don't drink, most experts don't recommend starting. The risk of alcoholism is
real, (see When Enough Is Enough ) and the only way to avoid developing that disease is never to start
drinking in the first place.
Alcohol: When Enough Is Enough

Learn how to recognize a drinking problem and where to turn for help.
Not all alcohol abusers look or act alike. Nor do they start on the road to alcoholism the same way or share
the same set of problems. What they have in common is that they are all, in some way, damaging their lives.
There are many ways to be diagnosed as being alcohol dependent. Alcohol abusers often show at least one of
these danger signs:
Tolerance The need to drink increasingly greater amounts to get the same effects of pleasure (the same
high or "buzz") or noticeable disability ("I can hold my liquor.").
Withdrawal Symptoms, ranging from mild hangovers with nausea and headache to severe shaking, that
develop soon after drinking stops and can continue for several days.
Loss of control Showing an inability to control drinking behavior or having obsessive thoughts about
drinking.
Concern by others Problems reported by coworkers or friends.
Health, family and legal problems Examples include repeated injuries, driving citations and chronic
lateness.
Someone who abuses alcohol is not necessarily disabled. Many alcoholics are high achievers who work
every day. It isn't always easy to detect an alcohol abuser by how much or how often the person drinks
among company or by how intoxicated he or she seems to be.
Risk Factors And Resources
According to the National Institute on Alcohol Abuse and Alcoholism, about 18 million Americans drink too
much alcohol. The likelihood of developing a drinking problem depends on several factors:
Psychiatric disorders. Anxiety or depression may make a person more vulnerable to addiction.
Family history. Alcoholism often has a genetic basis, causing people with parents or siblings who have
alcohol addiction to have a risk of alcoholism that is three or four times the usual risk. People who have a
family history of alcoholism but are adopted to other families still have high rates of alcoholism
Age. If a person gets intoxicated for the first time at a young age, this person will have a higher risk of later
developing alcoholism.
Despite the tremendous power of alcohol addiction, many people do achieve recovery and long-term
stability. If you or someone you know has a problem with alcohol, don't wait, seek help today. You may
want to start with a call to your family doctor. He or she can give you a medical evaluation and treatment
information and refer you to community services that can help. Or you can contact your state agency
responsible for overseeing alcohol and drug treatment programs. The recovery program with the most clear
history of success, Alcoholics Anonymous, meets in many towns and communities across the country.
Alcohol And Gastrointestinal Disease


Alcohol And Disease
Liver Disease
Cancers of the GI Tract
Gastritis and Heartburn
Pancreatitis
Nutritional Concerns
Health information on alcohol can be confusing. Studies have suggested that moderate drinking may prevent
heart disease. But this is balanced by the many potential health problems of over use.
The amount of alcohol consumed is the most important factor. All researchers agree that any health benefits
from alcohol are derived only from low to moderate use, usually defined as no more than one drink per day
for non-pregnant women and two drinks per day for men. (One drink is equal to 12 oz of beer, 4 to 5 oz of
wine, or 1 oz of hard liquor.) These are the maximum amounts considered generally safe, but since alcohol
affects individuals differently, your personal "safe" amount may be lower, depending on your genetics, sex,
weight and health problems, addiction tendencies and medications.
The negative effects of alcohol can be made worse if you use tobacco. For certain gastrointestinal-tract
cancers, the combination of tobacco use and alcohol appears to be particularly dangerous. The risk of getting
esophageal and laryngeal cancer for someone who uses tobacco and drinks alcohol is greater than you would
predict if you just added the two risk factors together. Instead, each of these two habits magnifies the harm
caused by the other.
As far as your GI tract is concerned, there are many potential hazards to drinking alcohol:
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Liver Disease
The liver acts as a filter and waste-treatment plant for many substances that pass through the body. It is a
place where drugs or alcohol are metabolized, or broken down. The liver has a high-risk job; in the process
of breaking down different substances it can sometimes create harmful chemicals and can be injured from
this exposure. When alcohol is consumed in small amounts by people with normal livers, it is easily
processed and metabolized. However, alcohol consumed in large amounts can generate toxic byproducts as it
is broken down. These toxins can accumulate and damage the liver.
Alcohol consumed in large amounts is one substance that can generate toxic byproducts as it is broken down,
and these toxins can accumulate and damage the liver. Alcohol consumption also interferes with the normal
breakdown of certain medications within your body, so usual doses of these medicines can become unsafe.
An important example of this is the use of acetaminophen (Tylenol). Acetaminophen must be adjusted to
modest doses in order to account for alcohol exposure; otherwise, a portion of the medicine can be converted
to a highly toxic chemical before it is cleared from the body. The more alcohol you consume, the greater the
likelihood that your liver will experience damage as it processes the alcohol.
Ongoing damage within the liver can cause alcoholic hepatitis inflammation of liver tissue with or
without symptoms of nausea and vomiting and yellowing of the skin and eyes. Harm from alcohol
alternatively may result in fatty liver, a deposit of fat tissue within the liver that usually causes no symptoms
but can progress to cause serious liver scarring (cirrhosis). Damage done by alcohol is reversible only if
drinking is stopped at an early stage. The liver has the ability to regenerate to some degree, but once the
damage causes scarring and cirrhosis of the liver, it is irreversible. Cirrhosis can ultimately lead to liver
failure, which is fatal unless a liver transplant can be performed.
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Cancers of the GI Tract
Alcohol has been called a co-carcinogen because it works in conjunction with tobacco use to multiply risks
for certain cancers. If a person who uses tobacco also drinks, the chances that mouth or esophageal cancer
will develop are increased. In fact, over 80% of squamous cell cancers of the mouth and esophagus (as well
as pharynx and larynx) can be accounted for by tobacco use and alcohol consumption. Liver damage from
heavy drinking also can increase the risk of liver cancer.
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Gastritis and Heartburn (GERD)
Alcohol can result in generalized, painful irritation of the stomach lining, called gastritis. When you drink,
some alcohol is absorbed almost immediately through the lining of the stomach which is why drinking on
an empty stomach will affect you more than drinking after a meal.
Alcohol weakens or relaxes the lower esophageal sphincter, the muscular ring at the entrance to the stomach
that is normally closed except during burps and swallows. Heartburn can develop when the loosened lower
esophageal sphincter allows acidic stomach contents to flow upwards into the esophagus, irritating and
damaging the lining.
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Pancreatitis
Alcohol can create inflammation within the pancreas, called pancreatitis. This organ manufactures digestive
juices. When it becomes inflamed, the pancreas can unleash a collection of enzymes that are capable of
digesting not just food but also human tissue, causing additional pain and inflammation. Because it is a
cascade of inflammation, pancreatitis always has the potential to become very severe and life threatening.
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Nutritional Concerns
Alcohol consumption can distract a person from regular meals, and it can take away an appetite for
nourishing foods. Irritation of the intestine from alcohol reduces the ability of your intestine to absorb
nutrients and vitamins. For all these reasons, heavy drinkers often lack adequate supplies of essential
vitamins and minerals, such as folate, thiamine, magnesium, and phosphate.
Cirrhosis
What Is It?
Symptoms
Diagnosis
Expected Duration
Prevention
Treatment
When to Call a Professional
Prognosis
Additional Info
What Is It?
No body organ performs a wider variety of essential jobs than the liver. It:
Produces essential proteins that help blood to clot
Removes or neutralizes poisons, drugs and alcohol
Manufactures bile that helps the body to absorb fats and cholesterol
Helps to maintain normal blood sugar levels
Regulates several hormones
Cirrhosis is a disease in which normal liver cells are replaced by scar tissue, which interferes with all of these
important functions. In extreme cases, the damage is so severe that the only solution is a liver transplant.
Cirrhosis has many causes. In the United States and Europe, the most common causes are excessive alcohol
use and chronic infection with the hepatitis C virus.
Alcohol has a toxic effect on liver cells. Alcoholic cirrhosis tends to develop after a decade or more of heavy
drinking, although it is possible for "social drinkers" to have cirrhosis. It is not known why some people are
more prone to adverse reactions than others, but women are at greater risk of cirrhosis, even when they drink
less alcohol than men.
Chronic hepatitis C causes inflammation of the liver that eventually can lead to cirrhosis. Without treatment,
about one out of every five people with chronic hepatitis C develops cirrhosis after 20 years.
Chronic hepatitis B, which causes damage in a similar way, is another common cause of cirrhosis in the
world. But it is less common in industrialized countries because of routine vaccination against hepatitis B.
More recently, non-alcoholic fatty liver disease has become a more common cause of cirrhosis. Doctors call
it nonalcoholic steatohepatitis (NASH). Fat deposition in the liver leads to inflammation, which can progress
to scarring.
Rarer causes of cirrhosis include:
Autoimmune diseases that attack the bile ducts or liver cells
Severe reactions to prescription drugs
Prolonged exposure to environmental toxins
Infections from bacteria and parasites usually found in the tropics or Asia
Repeated episodes of heart failure with liver congestion.
Certain inherited diseases, including:
Hemochromatosis, in which too much iron builds up in the liver and other organs
Wilson's disease, which produces abnormal concentrations of copper
Alpha-1-antitrypsin deficiency, which is the absence of a particular enzyme in the liver
Symptoms
In its early stages, cirrhosis often has no symptoms. But as liver cells die, the organ makes less of the
proteins that regulate fluid retention and blood clotting and loses its ability to metabolize the pigment
bilirubin. This causes symptoms and complications that include:
Fatigue
Loss of appetite
Nausea
Weakness
Weight loss
Fluid accumulation in the legs (edema) and abdomen (ascites)
Increased bleeding and bruising
Jaundice, a yellowing of the skin and eyes
Itching
Confusion
As damage increases, the liver fails to detoxify the blood and becomes less able to metabolize many
medications, which magnifies their effects. Eventually, toxins build up in the brain. These changes can
produce:
Increased sensitivity to drugs
Personality and behavioral changes, including confusion, neglect of appearance, forgetfulness, trouble
concentrating and changes in sleep habits
Loss of consciousness
Coma
Scarring also impedes blood flow and increases pressure in the portal vein, which moves blood from the
stomach to the liver. This condition is called portal hypertension. Blood vessels in the stomach and
esophagus swell, and the body creates new ones in an attempt to bypass the liver. These vessels, called
varices, have thin walls. If one bursts, the resulting hemorrhage (major bleeding) can cause death within
hours if not treated.
Diagnosis
Your doctor will ask about your medical history, family history of liver disease, diet, alcohol consumption,
medications you are taking, and risk factors for hepatitis B and C, such as intravenous drug use. During a
physical examination, the doctor determines whether the liver feels harder or larger than normal, looks for
skin changes such as bruising and jaundice, and looks for evidence of fluid swelling in the legs or abdomen.
Blood tests may be ordered to look for evidence of liver inflammation, an elevated bilirubin level, a buildup
of toxins (such as ammonia) and reduced levels of essential substances made by the liver.
Two of the blood tests that indicate a poor prognosis in people with cirrhosis are a low albumin level and a
high INR (adjusted Pro-Time). The high INR indicates the person's liver cannot make the normal amount of
clotting proteins.
The liver may be viewed using ultrasound or a computerized tomography (CT) scan, or other imaging
technique.
Cirrhosis can usually be diagnosed based on the history, physical exam, blood test results and imaging.
Sometimes a liver biopsy is needed. A tiny sample of liver tissue is removed through a needle and then
examined for scarring and damage to cells.
Expected Duration
Cirrhosis is usually a progressive disease. Although it usually cannot be reversed, the liver damage can be
halted or slowed down with treatment or changes in behavior in many cases.
Prevention
The most important step you can take to prevent cirrhosis is to avoid excessive drinking. It is best to
consume an average of no more than two alcoholic drinks a day for men or one drink a day for women. If
you have chronic hepatitis or other liver problems, avoid alcohol completely.
Some other causes of cirrhosis can be prevented. To avoid infection with hepatitis B and C, do not inject
illegal drugs, snort cocaine, or have unprotected sex, especially with multiple partners. If you are considering
body piercing or tattooing, make sure that the equipment is cleaned properly. Health care and emergency
workers should follow infection control precautions carefully whenever they are exposed to blood.
Hepatitis B also can be prevented with a vaccine, a series of three shots that is 90% effective.
By preventing nonalcoholic fatty liver disease, you prevent the small risk of developing cirrhosis. This
means maintaining a healthy weight and getting plenty of exercise.
Treatment
Treatment for cirrhosis varies depending on the cause and stage of the disease. Because liver damage usually
cannot be reversed, the aim of all treatment is to keep the disease from getting worse and to reduce
complications.
Regardless of the cause, anyone with cirrhosis should abstain from alcohol and use caution in taking
medications that can make liver disease worse, including over-the-counter acetaminophen (Tylenol and
generic types). You also will be treated for underlying diseases -- for example, antiviral medications for
chronic hepatitis B or C, corticosteroids or other immunosuppressant medications for autoimmune hepatitis,
and phlebotomy, which is the periodic removal of a pint of blood -- to reduce iron levels in
hemochromatosis.
Much of the treatment is directed at complications.
Your doctor may recommend a low-sodium diet and diuretics if you are retaining excess fluid in your body.
Lactulose or other medication will be prescribed if you have confusion caused by hepatic encephalopathy.
Lactulose is a laxative that decreases the absorption of certain substances toxic to the brain.
Medications can be prescribed for itching and infections.
Blood pressure medicines may help to lower pressure in the portal veins to decrease the risk of internal
bleeding.
Bleeding varices pose an immediate, life threatening hazard. To prevent them from bleeding, doctors called
gastroenterologists do endoscopy to find the varices and treat them. The varices can be injected with a
solution to shrink them or they can be sealed with bands. The same procedure is done when varices are
actively bleeding. Intravenous and oral drugs are also given to reduce bleeding.
The person may also need a procedure called transjugular intrahepatic portosystemic shunt (TIPS). This
involves creating a new blood channel in the liver that relieves some of the high portal pressure. With less
portal pressure, there is less bulging of the varices. And new varices are less likely to form.
If liver function becomes too impaired from cirrhosis, a transplant is the only treatment. Approximately 80%
to 90% of patients survive liver transplantation, and long-term survival rates have improved because of drugs
such as cyclosporine (Neoral, Sandimmune) that suppress the immune system to keep it from attacking the
new liver.
When to Call a Professional
If you have any risk factors for liver disease, make an appointment with your doctor. Cirrhosis can often be
prevented if action is taken early enough.
If you have cirrhosis, get immediate medical attention for:
Vomiting blood
Black, tarry stools
High fever
Abdominal pain
Confusion
Prognosis
Treatment leads to improvement in most cases when the disease is discovered in its earlier stages. Most
patients are able to live a normal life for many years. The outlook is less favorable if liver damage is
extensive or if someone with cirrhosis does not stop drinking. People with cirrhosis usually die of bleeding
that can't be stopped, serious infections or kidney failure. They often enter irreversible coma in their last
days.
Additional Info
National Institute of Diabetes & Digestive & Kidney Disorders
Office of Communications and Public Liaison
Building 31, Room 9A06
31 Center Drive, MSC 2560
Bethesda, MD 20892-2560
Phone: 301-496-3583
http://www.niddk.nih.gov/
American Liver Foundation
75 Maiden Lane
Suite 603
New York, NY 10038
Phone: 212-668-1000
Fax: 212-483-8179
http://www.liverfoundation.org/
Alcohol Dependence (Alcoholism)
What Is It?
Symptoms
Diagnosis
Expected Duration
Prevention
Treatment
When To Call a Professional
Prognosis
Additional Info
What Is It?
Alcoholism (alcohol dependence) is the most severe type of drinking problem. There is no absolute number
of drinks per day or quantity of alcohol that defines alcoholism, but experts have defined a limit above which
the risks of drinking increase significantly.
Here are some defining characteristics of alcohol dependence:
Tolerance -- The need to drink more and more alcohol to feel the same effects, or the ability to drink more
than other people without getting drunk.
Withdrawal symptoms -- After stopping or cutting back on drinking, symptoms are anxiety, sweating,
trembling, trouble sleeping, nausea or vomiting, and, in severe cases, physical seizures and hallucinations.
Desire to stop drinking, but inability to do so.
Loss of control over the amount of alcohol consumed.
Preoccupation with drinking.
Paying less attention to other life activities.
Ignoring problems, sometimes very obvious ones.
A person with alcohol dependence has come to rely on alcohol physically, psychologically and emotionally.
The brain adapts to the presence of alcohol and undergoes persistent changes. When alcohol use suddenly
stops, the body's accustomed internal environment changes drastically, causing symptoms of withdrawal.
Alcoholism can be linked to many psychological, interpersonal, social, economic and medical problems.
Alcoholism can increase the risk of depression and suicide and play a role in violent crimes, including
homicide and domestic violence (abuse of a spouse or child). It can lead to traffic accidents and even
accidents involving intoxicated pedestrians who decide to walk home after drinking. Alcoholism also can
lead to unsafe sexual behavior, resulting in accidental pregnancy or sexually transmitted diseases.
Alcohol dependence increases the risk of liver disease (hepatitis and cirrhosis), heart disease, stomach ulcers,
brain damage, stroke and other health problems. In pregnant women who drink alcohol, there is also the
danger that the child will develop fetal alcohol syndrome, a cluster of health problems including unusually
low birth weight, facial abnormalities, heart defects and learning difficulties.
The lifetime chance of developing alcoholism is very difficult to determine, but it is very common. In the
United States, about 1 in 16 adults have severe problems with drinking and millions more are engaged in
what experts consider risky drinking. In fact, a recent analysis revealed that 30% of a representative sample
of U.S. residents reported an alcohol use disorder at some time in their lives.
Alcohol problems come about from a combination of biological tendencies and environmental influences.
Biology. People with a family history of alcohol dependence are at greater risk for developing the illness
themselves. For example, if a parent has alcohol dependence, a child has a four-times greater risk of
becoming alcohol-dependent. This is partly due to inheriting genes that increase vulnerability, perhaps by
governing a person's physical responses to alcohol or the experience of intoxication. Sometimes alcohol is
used to blot out feelings arising from an underlying depression or anxiety disorder.
Environment. Alcohol may be a big part of a person's social group or may have been a part of family life
(sometimes quite destructively). A person may turn to alcohol to get relief from stress (which frequently
backfires, because the drinking causes problems of its own). Family support and healthy friendships can
reduce the risk.
Symptoms
Alcohol dependence can involve any of the following symptoms or behaviors:
Having long episodes of intoxication
Drinking alone
Having work problems or financial problems caused by drinking
Losing interest in food
Being careless about personal appearance
Having blackouts
Driving drunk
Hurting oneself or someone else while intoxicated
Hiding liquor bottles and glasses to hide the evidence of drinking
Experiencing mood or personality changes
Because large amounts of alcohol can be toxic to the body (for example, the cardiovascular, gastrointestinal
or nervous systems), alcoholism also may cause physical symptoms:
Morning nausea or shaking
Signs of malnutrition due to a poor diet
Abdominal pain or diarrhea
A flushed red color to the face and palms
Numbness, weakness or tingling in the arms or legs
Unusually frequent accidental injuries, especially falls
Diagnosis
Even though alcohol related disorders are very common, only a small minority of individuals recognize the
problem and get help. Therefore, screening is very important, whether it is done by primary care physicians
or friends and family.
The National Institute on Alcohol Abuse and Alcoholism (NIAAA) now recommends that primary care
physicians ask a very simple, but specific question -- How many times in the past year have you had:
(Men) 5 or more drinks in a day?
(Women) 4 or more drinks in a day?
The goal with this question is to get a quick idea whether or not the person is at increased risk for developing
alcohol-related problems. The limits are different for women and men because of known differences in how
alcohol is absorbed, distributed and eliminated from the body. Thus, the risk goes up for men who drink
more than 4 standard drinks in a day (or more than 14 in a week); while for women, the limit is lower -- 3
drinks in a day (and 7 drinks in a week).
Almost always, people feel nervous or defensive about their drinking, which is one reason this very common
problem so often goes undetected or unaddressed. The NIAAA therefore recommends that physicians make a
point of using their time with patients to educate them about drinking and its dangers.
As a screening test, the single question about drinking patterns is as good as slightly more detailed ones, such
as the CAGE test. CAGE questions may be easier for concerned family members and friends to ask, since
they may hesitate to ask direct questions about quantity.
The word "CAGE" is a device for remembering the questions (see the highlighted words):
Do you worry that you might need to CUT down on drinking?
Do you feel ANNOYED because other people have criticized your drinking?
Do you feel GUILTY about drinking?
Do you need a morning EYE OPENER drink to steady your nerves or to fight a hangover?
Another screening questionnaire used by physicians is the 10-question AUDIT (Alcohol Use Disorders
Identification Test) developed by the World Health Organization.
Doctors often also ask whether a person has alcohol-related problems at work, at home or with the law, such
as getting into fights or driving while intoxicated. The doctor may ask about physical symptoms of
alcoholism. As embarrassing as the answers may be, the doctor should view drinking problems as an
understandable human predicament and not a reason for their patients to feel ashamed.
A physical examination can reveal signs of poor nutrition and alcohol-related liver or nerve damage. Blood
tests can check for anemia, vitamin deficiencies and abnormal levels of liver chemicals.
The NIAAA has a very helpful set of resources for the general public and for clinicians. They are all easily
available online at www.niaaa.nih.gov.
Expected Duration
For most people who have alcohol dependence, the first alcohol-related life problems usually appear in the
mid-20s to early 40s. Left untreated, alcoholism often persists and gets worse over time. Up to 30% of
people with alcohol dependence do manage to abstain from alcohol or control their drinking without formal
treatment. On the other hand, the illness can be fatal -- there are approximately 100,000 alcohol-related
deaths per year in the United States.
Prevention
There is no absolute way to prevent alcoholism. Screening is important, because early detection and
treatment can prevent dangerous complications.
Treatment
Only a minority of people with drinking problems are able to cut down and drink "in moderation." More
often, once a person has lost control of his or her drinking, the safest approach is usually to stop drinking
alcohol completely.
The first step in this process is recognizing the problem. The well-known phenomenon of denial, which is a
common part of the illness, often turns the illness into a chronic one. Unfortunately, the longer the illness
persists, the harder it is to treat.
A doctor or substance abuse expert may be able to help a person look at the consequences of drinking. A
nonjudgmental approach to the discussion is essential. If an individual is beginning to think about alcohol as
a problem worth trying to solve, educational groups may provide support for weighing the pros and cons of
drinking.
It is never easy for family members and friends to identify the problem. A professional may have to help
loved ones -- kindly, but firmly -- talk to the drinker about the painful impact drinking has on them.
Once an individual commits to stopping drinking, the physician will look for and treat withdrawal symptoms.
Depending on the amount and duration of drinking and any symptoms, detoxification (often simply called
"detox") from alcohol can be done as an outpatient, or as an inpatient in a hospital or drug treatment facility.
During the withdrawal process, the doctor may prescribe a class of antianxiety drugs called benzodiazepines
for a short period in order to reduce withdrawal symptoms.
After weaning from alcohol, medication in some cases can help reduce cravings. Two medications that fit in
this category are naltrexone (ReVia) and acamprosate (Campral). As an alternative, sometimes the drug
disulfiram (Antabuse) may be prescribed. Disulfiram does not reduce craving, but it creates an incentive not
to drink, because drinking alcohol while taking it causes nausea and vomiting. A drug called topiramate
(Topamax), which is used to treat seizures and migraine headaches, may diminish the reinforcing effects of
alcohol, but it is not yet approved for this use by the Food and Drug Administration (FDA). Also not
approved by the FDA, there is limited evidence that baclofen (Lioresal), a drug used to treat muscle
spasticity, could help people quit alcohol use.
After detoxification, many people with alcohol disorders need some form of long-term support or counseling
to remain sober. Recovery programs focus on teaching a person with alcoholism about the disease, its risks,
and ways to cope with life's usual stresses without turning to alcohol. Psychotherapy may help a person
understand the influences that trigger drinking. Many patients benefit from self-help groups such as
Alcoholics Anonymous (AA), Rational Recovery or SMART (Self Management and Recovery Training).
It is very important to treat any other problems, such as depression or anxiety, which may contribute to the
risk of drinking.
If the doctor suspects that alcohol-related damage to the liver, stomach or other organs, additional tests may
be necessary. A healthy diet with vitamin supplements, especially B vitamins, is helpful.
When to Call a Professional
Call your doctor whenever you or someone you love has an alcohol-related problem. Remember, alcoholism
is not a sign of weakness or poor character. It is an illness that can be treated. The sooner treatment begins,
the easier alcoholism is to treat.
Prognosis
About 30% of alcoholics are able to abstain from alcohol permanently without the help of formal treatment
or a self-help program. For the rest, the course of the illness is very varied. Some people will go through
periods where they remain sober, but then relapse. Others have a hard time sustaining any period of sobriety.
It is clear, however, that the more sober days you have, the greater the chance that you will remain sober.
Another motivating fact -- remaining sober can increase life expectancy by 15 or more years.
Alcohol Withdrawal
What Is It?
Symptoms
Diagnosis
Expected Duration
Prevention
Treatment
When to Call a Professional
Prognosis
Additional Info
What Is It?
Alcohol withdrawal is the changes the body goes through when a person suddenly stops drinking after
prolonged and heavy alcohol use. Symptoms include trembling (shakes), insomnia, anxiety and other
physical and mental symptoms.
Alcohol has a slowing effect (also called a sedating effect or depressant effect) on the brain. In a heavy, long-
term drinker, the brain is almost continually exposed to the depressant effect of alcohol. Over time, the brain
adjusts its own chemistry to compensate for the effect of the alcohol. It does this by producing naturally
stimulating chemicals (such as serotonin or norepinephrine, which is a relative of adrenaline) in larger
quantities than normal. If the alcohol is withdrawn suddenly, the brain is like an accelerated vehicle that has
lost its brakes. Not surprisingly, most symptoms of withdrawal are symptoms that occur when the brain is
overstimulated.
The most dangerous form of alcohol withdrawal occurs in about 1 out of every 20 people who have
withdrawal symptoms. This condition is called delirium tremens (also called DTs). In delirium tremens, the
brain is not able to smoothly readjust its chemistry after alcohol is stopped. This creates a state of temporary
confusion and leads to dangerous changes in the way your brain regulates your circulation and breathing.
The body's vital signs such as your heart rate or blood pressure can change dramatically or unpredictably,
creating a risk of heart attack, stroke or death.
Symptoms
If your brain has adjusted to your heavy drinking habits, it takes time for your brain to adjust back. Alcohol
withdrawal symptoms occur in a predictable pattern after your last alcohol drink. Not all symptoms develop
in all patients:
Tremors (shakes). These usually begin within 5 to 10 hours after the last alcohol drink and typically peak at
24 to 48 hours. Along with tremors (trembling), you can have a rapid pulse, an increase in blood pressure,
rapid breathing, sweating, nausea and vomiting, anxiety or a hyper-alert state, irritability, nightmares or vivid
dreams, and insomnia.
Alcohol hallucinosis. This symptom usually begins within 12 to 24 hours after your last drink, and may last
as long as 2 days once it begins. If this happens, you hallucinate (see or feel things that are not real). It is
common for people who are withdrawing from alcohol to see multiple small, similar, moving objects.
Sometimes the vision is perceived to be crawling insects or falling coins. It is possible for an alcohol
withdrawal hallucination to be a very detailed and imaginative vision.
Alcohol withdrawal seizures. Seizures may occur 6 to 48 hours after the last drink, and it is common for
several seizures to occur over several hours. The risk peaks at 24 hours.
Delirium tremens. Delirium tremens commonly begins two to three days after the last alcohol drink, but it
may be delayed more than a week. Its peak intensity is usually four to five days after the last drink. This
condition causes dangerous shifts in your breathing, your circulation and your temperature control. It can
cause your heart to race dangerously or can cause your blood pressure to increase dramatically, and it can
cause dangerous dehydration. Delirium tremens also can temporarily reduce the amount of blood flow to
your brain. Symptoms can include confusion, disorientation, stupor or loss of consciousness, nervous or
angry behavior, irrational beliefs, soaking sweats, sleep disturbances and hallucinations.
Diagnosis
Alcohol withdrawal is easy to diagnose if you have typical symptoms that occur after you stop heavy,
habitual drinking. If you have a past experience of withdrawal symptoms, you are likely to have them return
if you start and stop heavy drinking again. There are no specific tests that can be used to diagnose alcohol
withdrawal.
If you have withdrawal symptoms from drinking, then you have consumed enough alcohol to damage other
organs. It is a good idea for your doctor to examine you carefully and do blood tests, checking for alcohol-
related damage to your liver, heart, the nerves in your feet, blood cell counts, and gastrointestinal tract. Your
doctor will evaluate your usual diet and check for vitamin deficiencies because poor nutrition is common
when someone is dependent on alcohol.
It is usually difficult for people who drink to be completely honest about how much they've been drinking.
You should report your drinking history straightforwardly to your doctor so you can be treated safely for
withdrawal symptoms.
Expected Duration
Symptoms of alcohol withdrawal typically improve within five days, though a small number of patients may
have prolonged symptoms, lasting weeks.
Prevention
Alcoholism is caused by many factors. If you have a sibling or parent with alcoholism, then you are three or
four times more likely than average to develop alcoholism. Some people with family histories of alcoholism
choose to abstain from drinking since this is a guaranteed way to avoid developing alcohol dependence.
Many people without a family history also develop alcoholism. If you are concerned about your drinking,
speak with your doctor.
Treatment
If you have severe vomiting, seizures or delirium tremens, the safest place for you to be treated is in a
hospital. For delirium tremens, treatment in an intensive care unit (ICU) is often required. In an ICU, your
heart rate, blood pressure, and breathing can be monitored closely in case emergency life-support (such as
artificial breathing by a machine) is needed.
Medicines called benzodiazepines can lessen alcohol withdrawal symptoms. Commonly used medicines in
this group include chlordiazepoxide (Librium) and lorazepam (Ativan).
Most alcohol abusers who are having withdrawal symptoms have a shortage of several vitamins and minerals
and can benefit from nutritional supplements. In particular, alcohol abuse can create a shortage of folate,
thiamine, magnesium, zinc and phosphate. It also can cause low blood sugar.
When to Call a Professional
Get help if you or someone you love has an alcohol-related problem. Alcoholism is an illness that can be
treated.
If you have an alcohol dependency problem and have decided to stop drinking, call your doctor for help.
Your doctor can advise you and can prescribe medicines to make withdrawal symptoms more tolerable if
they occur. Your doctor can also put you in touch with local resources that will help you to stay alcohol free.
Prognosis
Alcohol withdrawal is common, but delirium tremens only occurs in 5% of people who have alcohol
withdrawal. Delirium tremens is dangerous, killing as many as 1 out of every 20 people who develop its
symptoms.
After withdrawal is complete, it is essential that you not begin drinking again. Alcohol treatment programs
are important because they improve your chances of successfully staying off of alcohol. Only about 20% of
alcoholics are able to abstain from alcohol permanently without the help of formal treatment or self-help
programs such as Alcoholics Anonymous (AA). Of people who attend AA, 44% of those who remain free of
alcohol for 1 year probably will remain abstinent for another year. This figure increases to 91% for those
who have remained abstinent and have attended AA for 5 years or more.
On average, an alcoholic who doesn't stop drinking can expect to decrease his or her life expectancy by at
least 15 years.
Additional Info
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
5635 Fishers Lane
MSC 9304
Bethesda, MD 20892-9304
Phone: 301-443-3860
http://www.niaaa.nih.gov/
National Clearinghouse for Alcohol and Drug Information
P.O. Box 2345
Rockville, MD 20847-2345
Phone: 301-770-5800
Toll-Free: 1-800-729-6686
Fax: 301-468-7394
TDD: 1-800-487-4889
http://ncadi.samhsa.gov/
Alcoholics Anonymous World Services
P.O. Box 459
New York, NY 10163
Phone: 212-870-3400
http://www.alcoholicsanonymous.net/
Al-Anon/Alateen
Al-Anon Family Group Headquarters, Inc.
1600 Corporate Landing Parkway
Virginia Beach, VA 23454-5617
Phone: 757-563-1600
Fax: 757-563-1655
http://www.al-anon.alateen.org/
10 Tips to Stop Drinking Alcohol
Its not easy to quit drinking alcohol, and for many people it will be a
lifelong struggle. However, there are several common-sense things you can do immediately that will make it
a bit easier to quit than you might have suspected. The following 10 tips to Stop Drinking Alcohol will go a
long ways toward helping you overcome alcoholism and get your life back under control.
Tip #1: Do NOT keep alcohol at home or work. Instead, choose HEALTHY alternatives for those moments
you desire to drink an alcoholic beverage. This might be very hard at first for some people, but after a couple
of weeks it will seem MORE natural to have healthy food and drink choices around your living environment,
instead of things that lead to sickness and poverty. Simply put, you need to make it EASY to resist drinking
by removing the temptation. Dont underestimate the power of out of sight, out of mind.
Tip #2: Do NOT skip meals. Perhaps the most important tip to quit drinking is to NEVER skip a meal, as
that simply opens the door to alcohol abuse. Not only does eating 3 or 4 healthy meals a day give your body
all the necessary nutrients to help you look and feel your best, but you will actually have LESS of a desire to
drink alcohol when your stomach is full of food. Please read Get Sober by Avoiding These 2 Mistakes.
Tip #3: Do NOT talk, think or act as if you are powerless before your addiction. Alcohol is powerless before
you, and not vice-versa as 12 Step programs would lead you to believe. Remember, NO drink or drug can
ever enter your body without your approving of it, so dont allow yourself to fall into the victim mentality of
being powerless before alcohol because thats simply a ready-made excuse to keep drinking.
Tip #4: Do NOT let one mistake ruin your resolve. The things in life that are truly worth having are things
that take a little effort. Even if you have tried and failed a hundred times, its imperative that you try yet
again. And keep trying. No matter how small of a step you need to take, there will be SOMETHING that you
can do to reduce your addiction to alcohol. FIND that one, small something you can do and then DO it.
Please read Take a Baby Step Towards Sobriety.
Tip #5: DO maintain a healthy diet. Many of us will only put in the highest grade of gasoline and oil into our
cars, and yet put the worst kind of crap into our bodies for nourishment. Then we wonder why we dont feel
happy or healthy, or why we cant think clearly, or suddenly look so old. Isnt it far past time to treat your
body as the temple it is? Start eating plenty of fruit and vegetables (preferably organic), and stay away from
fast food, processed foods and the normal junk that most people eat. The healthier your diet is the LESS you
feel the need to put alcohol into your body.
Tip #6: DO start exercising again. A moderate exercise program can and will make a dramatic difference in
how you look and feel. Strive for 3 or more aerobic workouts per week to start out, lasting at least 20
minutes each. You can break that up into 2 ten-minute sessions if youd like. Add 2 (but no more than 3)
weight resistance workouts per week when you feel capable. Its really quite amazing that when you feel
healthy and strong you ALSO start to feel genuinely happy with your life. Ironically enough, the MORE you
exercise the LESS desire you have for alcohol.
Tip #7: DO remember the heartache that alcohol abuse has caused in your life. Im not saying to dwell on
your mistakes, or to let what happened in your past ruin your present. But I cant stress enough the
importance of remembering the bad times caused by alcohol, because this will help you to develop the
resolve to never go down that road again. Learn from your own mistakes, and vow to yourself to never let
alcoholism ruin your life. Please read The Secret to Sobriety.
Tip #8: DO recognize that a sugar addiction often leads into an alcohol addiction. If you have an addiction to
sugar your body is getting it from a variety of sources, including alcohol. So, what you THINK is a
temptation to drink alcohol is OFTEN just your body craving sugar. When you cut sugar and sweets from
your diet you will soon find that your cravings for alcohol have also been dramatically reduced.
Tip #9: DO recognize the wonderful miracle of pure, drinking water. Get in the habit of drinking at least 5
glasses of clean water each day as your body desperately needs water for almost every action it takes. You
can survive for weeks without food, but only a couple of days without water. Remember, only WATER is
water. Coffee, tea, soda, juice, etc, does NOT count. Plus, what many people think is desire to drink alcohol
is instead simply their bodies craving water. Drinking plenty of water will REDUCE your desire for alcohol.
Tip #10: DO be thankful for the many blessings that you already have. Your Creator has already given you
so many blessings in your life, and also has so many good things left for you to enjoy. It was only the
alcohol-induced stupor that prevented you from clearly seeing your blessings before. The more you recover
from your past alcohol abuse, the more your mind will begin to clear and you will start to appreciate all
that you have been given, and all that you can still do with your life. When you become truly thankful for
what you already have you then open the door to receive even more blessings in the future.
Bonus Tip: Inside of you is a BETTER you that just cant wait to come out! Remove the alcohol from your
life, let your better self shine, and youll soon be able to show the world all the love, talent, humor, and
compassion that was hidden inside.
If you regularly drink more than the recommended limits, try these simple tips to help you cut down.
The NHS recommends:
Men should not regularly drink more than 3-4 units of alcohol a day
Women should not regularly drink more than 2-3 units a day
If you've had a heavy drinking session, avoid alcohol for 48 hours
"Regularly" means drinking this amount every day or most days of the week.
Make a plan
Before you start drinking, set a limit on how much youre going to drink.
Set a budget
Only take a fixed amount of money to spend on alcohol.
Let them know
If you let your friends and family know youre cutting down and that its important to you, you could get
support from them.
Take it a day at a time
Cut back a little each day. That way, every day you do is a success.
Make it a smaller one
You can still enjoy a drink but go for smaller sizes. Try bottled beer instead of pints, or a small glass of wine
instead of a large one.
Have a lower-strength drink
Cut down the alcohol by swapping strong beers or wines for ones with a lower strength (ABV in %). You'll
find this information on the bottle.
Stay hydrated
Drink a pint of water before you start drinking, and don't use alcohol to quench your thirst. Have a soft drink
instead.
Take a break
Have the odd day each week when you dont have an alcoholic drink.
Drinks diary
You may be surprised to find out how much you actually drink. Download a drinks diary (PDF, 697kb) to
track your drinking over a week
Benefits of cutting down
The immediate effects of cutting down include:
feeling better in the mornings
being less tired during the day
your skin may start to look better
youll start to feel fitter
you may stop gaining weight
Long-term benefits include:
Mood
Theres a strong link between heavy drinking and depression, and hangovers often make you feel anxious
and low. If you already feel anxious or sad, drinking can make this worse, so cutting down may put you in a
better mood generally.
Sleep
Drinking can affect your sleep. Although it can help some people fall asleep quickly, it can disrupt your
sleep patterns and stop you from sleeping deeply. So cutting down on alcohol should help you feel more
rested when you wake up.
Behaviour
Drinking can affect your judgement and behaviour. You may behave irrationally or aggressively when
youre drunk. Memory loss can be a problem during drinking and in the long term for regular heavy drinkers.
Heart
Long-term heavy drinking can lead to your heart becoming enlarged. This is a serious condition that cant be
completely reversed, but stopping drinking can stop it getting worse.
Immune system
Regular drinking can affect your immune system. Heavy drinkers tend to catch more infectious diseases.
Social support to stop drinking
One potential challenge when people stop drinking is rebuilding a life without alcohol. It may be important
to
educate family and friends
develop new interests and social groups
find rewarding ways to spend your time that don't involve alcohol
ask for help from others
When asking for support from friends or significant others, be specific. This could include
not offering you alcohol
not using alcohol around you
giving words of support and withholding criticism
not asking you to take on new demands right now
going to a group like Al-Anon
Consider joining Alcoholics Anonymous or another mutual support group (see resources). Recovering
people who attend groups regularly do better than those who do not. Groups can vary widely, so shop around
for one that's comfortable. You'll get more out of it if you become actively involved by having a sponsor and
reaching out to other members for assistance.
Cei 12 Pasi ai Alcoolicilor Anonimi
1. Am admis ca eram neputinciosi in fata alcoolului, ca nu mai eram stapani pe viata noastra.
2. Am ajuns la credinta ca o Putere Superioara noua insine ne-ar putea reda sanatatea mintala.
3. Am hotarat sa ne lasam vointa si viata in grija unui Dumnezeu asa cum si-L inchipuia fiecare dintre noi.
4. Am facut fara teama un inventar moral amanuntit al propriei persoane.
5. Am marturisit lui Dumnezeu, noua insine si altei fiinte umane natura exacta a greselilor noastre.
6. Am consimtit fara rezerve ca Dumnezeu sa ne scape de toate aceste defecte de caracter.
7. Cu umilinta, I-am cerut sa ne indeparteze defectele.
8. Am intocmit o lista cu toate persoanele carora le-am facut necazuri si am consimtit sa reparam aceste rele.
9. Ne-am reparat greselile direct fata de acele persoane, acolo unde a fost cu putinta, dar nu si atunci cand le-
am fi putut face vreun rau lor sau altora.
10. Ne-am continuat inventarul personal si ne-am recunoscut greselile, de indata ce ne-am dat seama de ele.
11. Am cautat, prin rugaciune si meditatie, sa ne intarim contactul constient cu Dumnezeu asa cum si-L
inchipuia fiecare dintre noi, cerandu-i doar sa ne arate voia Lui in ce ne priveste si sa ne dea puterea s-o
implinim.
12. Dupa ce am trait o trezire spirituala ca rezultat al acestor pasi, am incercat sa transmitem acest mesaj
altor alcoolici si sa punem in aplicare aceste principii in toate domeniile vietii noastre.
Programul celor 12 pai ofer 12 promisiuni: 1. Vom cunoate o libertate i o fericire de o factur cu totul
nou. 2. Nu vom mai regreta i nu vom mai ncerca s ngropm trecutul. 3. Vom nelege ce nseamn
senintatea. 4. Vom cunoate pacea. 5. Nu conteaz ct de mult am deczut, vom vedea cum alii beneficiaz
de experiena noastr. 6. Sentimentele de inutilitate i de auto-comptimire vor disprea. 7. Ne vom pierde
interesul pentru propria persoan i ne va psa mai mult de soarta semenilor. 8. Ne vom cunoate pe noi
nine. 9. Atitudinea noastr, perspectiva asupra vieii, se vor schimba n bine. 10. Teama de oameni i
insecuritatea financiar ne vor prsi. 11. Vom rezolva situaii care odinioar ne derutau. 12. Deodat, ne
vom da seama c Dumnezeu poate svri lucruri pe care nu le pute realiza noi nine. (MARY THERESA
WEBB, COPACUL VIEII RENNOITE)