For many people, drinking alcohol is nothing more than a pleasant way to relax.

People
with alcohol use disorders, however, drink to excess, endangering both themselves and
others. This question-and-answer fact sheet explains alcohol problems and how
psychologists can help people recover.
When does drinking become a problem?
For most adults, moderate alcohol use no more than two drinks a day for men and
one for women and older people is relatively harmless. (A "drink" means 1.5 ounces
of spirits, 5 ounces of wine, or 12 ounces of beer, all of which contain 0.5 ounces of
alcohol.
Moderate use, however, lies at one end of a range that moves through alcohol abuse to
alcohol dependence:

Alcohol abuse is a drinking pattern that results in significant and recurrent

adverse consequences. Alcohol abusers may fail to fulfill major school, work, or family
obligations. They may have drinking-related legal problems, such as repeated arrests
for driving while intoxicated. They may have relationship problems related to their
drinking.

People with alcoholism technically known as alcohol dependence have

lost reliable control of their alcohol use. It doesn't matter what kind of alcohol someone
drinks or even how much: Alcohol-dependent people are often unable to stop drinking
once they start. Alcohol dependence is characterized by tolerance (the need to drink
more to achieve the same "high") and withdrawal symptoms if drinking is suddenly
stopped. Withdrawal symptoms may include nausea, sweating, restlessness, irritability,
tremors, hallucinations and convulsions.
Although severe alcohol problems get the most public attention, even mild to moderate
problems cause substantial damage to individuals, their families and the community.
According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), 1 in 12
American adults is an alcohol abuser or alcoholic. 1 And, says NIAAA, young adults aged
18 to 29 are the most likely to have alcohol problems. For example, a government
survey revealed that almost 8 percent of young people aged 12 to 17 and almost 41
percent of young adults aged 18 to 25 indulge in binge drinking downing five or more
drinks on the same occasion at least once during the past month. 2
What causes alcohol-related disorders?
Problem drinking has multiple causes, with genetic, physiological, psychological,and
social factors all playing a role. Not every individual is equally affected by each cause.
For some alcohol abusers, psychological traits such as impulsiveness, low self-esteem
and a need for approval prompt inappropriate drinking. Some individuals drink to cope
with or "medicate" emotional problems. Social and environmental factors such as peer
pressure and the easy availability of alcohol can play key roles. Poverty and physical or
sexual abuse also increase the odds of developing alcohol dependence.
Genetic factors make some people especially vulnerable to alcohol dependence.
Contrary to myth, being able to "hold your liquor" means you're probably more at risk

not less for alcohol problems. Yet a family history of alcohol problems doesn't mean
that children will automatically grow up to have the same problems. Nor does the
absence of family drinking problems necessarily protect children from developing these
problems.
Once people begin drinking excessively, the problem can perpetuate itself. Heavy
drinking can cause physiological changes that make more drinking the only way to
avoid discomfort. Individuals with alcohol dependence may drink partly to reduce or
avoid withdrawal symptoms.
How do alcohol use disorders affect people?
While some research suggests that small amounts of alcohol may have beneficial
cardiovascular effects, there is widespread agreement that heavier drinking can lead to
health problems.
Short-term effects include memory loss, hangovers, and blackouts. Long-term problems
associated with heavy drinking include stomach ailments, heart problems, cancer, brain
damage, serious memory loss and liver cirrhosis. Heavy drinkers also markedly
increase their chances of dying from automobile accidents, homicide, and suicide.
Although men are much more likely than women to develop alcoholism, women's health
suffers more, even at lower levels of consumption.
Drinking problems also have a very negative impact on mental health. Alcohol abuse
and alcoholism can worsen existing conditions such as depression or induce new
problems such as serious memory loss, depression or anxiety.
Alcohol problems don't just hurt the drinker. Spouses and children of heavy drinkers
may face family violence; children may suffer physical and sexual abuse and neglect
and develop psychological problems. Women who drink during pregnancy run a serious
risk of damaging their fetuses. Relatives, friends and strangers can be injured or killed
in alcohol-related accidents and assaults.
When should someone seek help?
Individuals often hide their drinking or deny they have a problem. How can you tell if you
or someone you know is in trouble? Signs of a possible problem include having friends
or relatives express concern, being annoyed when people criticize your drinking, feeling
guilty about your drinking and thinking that you should cut down but finding yourself
unable to do so, or needing a morning drink to steady your nerves or relieve a
hangover.
Some people with drinking problems work hard to resolve them. With the support of
family members or friends, these individuals are often able to recover on their own.
However, those with alcohol dependence usually can't stop drinking through willpower
alone. Many need outside help. They may need medically supervised detoxification to
avoid potentially life-threatening withdrawal symptoms, such as seizures. Once people

are stabilized, they may need help resolving psychological issues associated with
problem drinking.
There are several approaches available for treating alcohol problems. No one approach
is best for all individuals.
How can a psychologist help?
Psychologists who are trained and experienced in treating alcohol problems can be
helpful in many ways. Before the drinker seeks assistance, a psychologist can guide the
family or others in helping to increase the drinker's motivation to change.
A psychologist can begin with the drinker by assessing the types and degrees of
problems the drinker has experienced. The results of the assessment can offer initial
guidance to the drinker about what treatment to seek and help motivate the problem
drinker to get treatment. Individuals with drinking problems improve their chances of
recovery by seeking help early.
Using one or more of several types of psychological therapies, psychologists can help
people address psychological issues involved in their problem drinking. A number of
these therapies, including cognitive-behavioral coping skills treatment and motivational
enhancement therapy, were developed by psychologists. Additional therapies include
12-Step facilitation approaches that assist those with drinking problems in using selfhelp programs such as Alcoholics Anonymous (AA).
These therapies can help people boost their motivation to stop drinking, identify
circumstances that trigger drinking, learn new methods to cope with high-risk drinking
situations, and develop social support systems within their own communities.
All three of these therapies have demonstrated their effectiveness. One analysis of
cognitive-behavioral approaches, for instance, found that 58 percent of patients
receiving cognitive-behavioral treatment fared better than those in comparison
groups.3 In another study, motivational interventions reduced how often and how much
adolescents drank following alcohol-related emergency room treatment. 4 And an
intervention called Making Alcoholics Anonymous Easier significantly increased
participants' odds of abstaining from alcohol. 5 Many individuals with alcohol problems
suffer from other mental health conditions, such as severe anxiety and depression, at
the same time. Psychologists can also diagnose and treat these "co-occurring"
psychological conditions. Further, a psychologist may play an important role in
coordinating the services a drinker in treatment receives from various health
professionals.
Psychologists can also provide marital, family, and group therapies, which often are
helpful for repairing interpersonal relationships and for resolving problem drinking over
the long term. Family relationships influence drinking behavior, and these relationships
often change during an individual's recovery. The psychologist can help the drinker and
significant others navigate these complex transitions, help families understand problem

drinking and learn how to support family members in recovery, and refer family
members to self-help groups such as Al-Anon and Alateen.
Because a person may experience one or more relapses and return to problem
drinking, it can be crucial to have a trusted psychologist or other health professional with
whom that person can discuss and learn from these events. If the drinker is unable to
resolve alcohol problems fully, a psychologist can help with reducing alcohol use and
minimizing problems.
Psychologists can also provide referrals to self-help groups. Even after formal treatment
ends, many people seek additional support through continued involvement in such
groups.
Alcohol-related disorders severely impair functioning and health. But the prospects for
successful long-term problem resolution are good for people who seek help from
appropriate sources.
The American Psychological Association gratefully acknowledge the assistance of Peter
E. Nathan, PhD, John Wallace, PhD, Joan Zweben, PhD, and A. Thomas Horvath, PhD,
in developing this fact sheet.
References
1

National Institute on Alcohol Abuse and Alcoholism. (2007). "FAQs for the general
public."
2
Substance Abuse and Mental Health Services Administration. (2011). "Results from
the 2010 National Survey on Drug Use and Health: Summary of national findings."
NSDUH Series H-41, HHS Publication No. (SMA) 11-4658.
3
Magill, M., & Ray, L.A. (2009). "Cognitive-behavioral treatment with adult alcohol and
illicit drug users: A meta-analysis of randomized controlled trials." Journal of Studies on
Alcohol and Drugs, 70 (4): 516-527.
4
Spirito, A., Sindelar-Manning, H., Colby, S.M., Barnett, N.P., Lewander, W., Rohsenow,
D.J., & et al. (2011). "Individual and family motivational interventions for alcohol-positive
adolescents treated in an emergency department." Archives of Pediatrics and
Adolescent Medicine, 165 (3): 269-274.
5
Kaskutas, L.A., Subbaraman, M.S., Witbrodt, J., & Zemore, S.E. (2009). "Effectiveness
of Making Alcoholics Anonymous Easier: A group format 12-step facilitation
approach." Journal of Substance Abuse Treatment, 37 (3): 228-239.
Updated March 2012

Part 2 of 8: Causes

What Causes Alcoholism?

The cause of alcoholism is still unknown. However, dependency on alcohol
develops when you drink so much alcohol that chemical changes in the brain
occur. These changes emphasize the pleasurable feelings that result when
you drink alcohol. These feelings cause an increased desire to drink, even if
it causes harm. Alcoholism typically develops gradually over time.
Part 3 of 8: Risk Factors

What Are the Risk Factors for Alcoholism?

Although the exact cause of alcoholism is unknown, there are certain factors
that may place you at higher risk for developing this disease.
Known risk factors for alcoholism include having:

more than 15 drinks a week if you are male

more than 12 drinks a week if you are female

more than five drinks per occasion at least once a week (binge
drinking)

a parent with alcoholism

a mental health problem, such as depression, anxiety, or schizophrenia

You may also be at a greater risk for alcoholism if you:

are a young adult experiencing peer pressure

have low self-esteem

experience a high level of stress

live in a family or culture where alcohol use is common and accepted

Part 4 of 8: Symptoms

What Are the Symptoms of Alcoholism?

Symptoms can be classified based on behaviors and physical outcomes that
occur as a result of alcohol addiction.
Alcoholics may engage in the following behaviors:

drinking alone

drinking more to feel the effects of alcohol (having a high tolerance)

becoming violent or hostile when asked about drinking

neglecting to eat or eating poorly

neglecting personal hygiene

missing work or school because of drinking

being unable to control alcohol intake

making excuses to drink

continuing to drink even when legal, social, or economic problems

develop
People

with

alcoholism

may

also

experience

the

following

physical

symptoms:

alcohol cravings

withdrawal symptoms if drinking is stopped, including shaking, nausea,

and vomiting

tremors in the morning after drinking

lapses in memory (blacking out) after a night of drinking

illnesses, such as alcoholic ketoacidosis (includes dehydration-type

symptoms) or cirrhosis (scarring) of the liver
Part 5 of 8: Definition

Definition of Alcoholism and of Being an Alcoholic

Self-Testing: Am I an Alcoholic?
Sometimes it can be hard to draw the line between safe alcohol use and
alcohol abuse or dependence. The Mayo Clinic suggests that if you answer
yes to any of the following questions, you may have a problem with alcohol:

If you are male, do you ever have five or more drinks in a day? If you
are a woman, do you ever have four or more drinks in a day? (A drink is
considered to be 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of 80
proof liquor.)

Do you need a drink as soon as you wake up?

Do you feel guilty about drinking?

Does it irritate you if others comment on your drinking?

Do you think it might be better if you cut back on your drinking?

Both the National Council on Alcoholism and Drug Dependence and the
Partnership at Drugfree.org both offer more complex tests that can help you
assess

whether

you

have

an

alcohol

problem: http://www.ncadd.org/index.php/learn-about-alcohol/alcohol-abuseself-test and http://www.alcoholscreening.org/

Professional Diagnosis
Alcoholism can be diagnosed by your doctor. If you are exhibiting signs of
alcoholism, your doctor will complete a physical exam and ask you questions
about your drinking habits.
Your doctor may ask if you:

drive when you are drunk

have missed work or have lost a job as a result of your drinking

need more alcohol to feel drunk when you drink

have experienced blackouts as a result of your drinking

have tried to cut back on your drinking but could not

Your doctor may also ask to speak with family members about your drinking.
Questionnaires to assess alcoholism may also be used by your doctor to
diagnose your condition.
Typically, the diagnosis of alcoholism does not require any other type of
diagnostic tests. However, your doctor may order blood work to check your
liver function if you have signs or symptoms of liver disease. Alcohol abuse
can cause serious and lasting damage to your liver as it attempts to filter the
alcohol from your bloodstream.
Part 6 of 8: Treatment

How Is Alcoholism Treated?

Treatment for alcoholism involves a number of supports that are aimed at
helping you refrain from drinking altogether (abstinence). Treatment may
occur in stages and can include the following:

detoxification or withdrawal to rid your body of alcohol

rehabilitation to learn new coping skills and behaviors

counseling to address emotional problems that may prompt you to

drink

support, including 12-step programs such as Alcoholics Anonymous

medical treatment for health problems associated with alcoholism

medications to help control addiction

There are a couple of different medications that may help with alcohol
addiction.

Naltrexone (ReVia, Vivitrol) is used only after an individual has detoxed

from alcohol. This type of drug works by blocking certain receptors in the
brain that are associated with the alcoholic high. This drug, in combination
with counseling, may help to decrease an individuals craving for alcohol.

Acamprosate (Campral) is a medication that can help to re-establish

the brains original chemical state before alcohol dependence. This drug
should also be used in conjunction with therapy.

Disulfiram (Antabuse) is a drug that causes physical discomfort

(nausea, vomiting, headaches) any time the individual consumes alcohol.
If your addiction to alcohol is severe, you may need to seek treatment at an
inpatient facility. These facilities will provide you with 24-hour care as you
withdraw from alcohol and recover from your addiction. Once you are well
enough to leave, you will need to continue to receive treatment on an
outpatient basis.
Part 7 of 8: Outlook

What Is the Outlook for a Patient with Alcoholism?

Recovery from alcoholism is difficult. Your prognosis will depend on your
ability to abstain from alcohol use. Many people who seek treatment for
alcoholism will be able to overcome addiction. A strong support system is
helpful for making a complete recovery.
Your prognosis will also depend on the health complications that have
developed as a result of your drinking. Alcoholism can severely damage your
liver. It can also lead to other health complications, including:

bleeding in the gastrointestinal (GI) tract

damage to brain cells

cancer in the GI tract

dementia (memory loss)

depression

high blood pressure

inflammation of the pancreas (pancreatitis)

nerve damage

changes in mental status, including Wernicke-Korsakoff syndrome; this

is a degenerative brain disease that causes symptoms such as mental
confusion, vision impairment, amnesia, or even coma
Part 8 of 8: Prevention

How Can You Prevent Alcoholism?

You can prevent alcoholism by limiting your alcohol intake. Women should
not drink more than one drink per day, and men should not drink more than
two drinks per day. If you begin to engage in behaviors that are typical for
alcoholics, or if you think that you may have a problem with alcohol, seek the
help of your doctor. Also, consider attending a local meeting of Alcoholics
Anonymous (AA).

References:

Alcoholics Anonymous. (2012). Alcoholics Anonymous. Retrieved July 13, 2012,

fromhttp://www.aa.org/?Media=PlayFlash http://www.aa.org/?Media=PlayFlash

Alcoholism. (2010, May 6). Mayo Clinic. Retrieved July 11, 2012,
fromhttp://www.mayoclinic.com/health/alcoholism/DS00340

Alcoholism. (2011). University of Maryland Medical Center. Retrieved July 11, 2012,
fromhttp://www.umm.edu/altmed/articles/alcoholism-000002.htm

Heller, J. L. (2011, April 1). Alcoholic ketoacidosis. National Library of Medicine

National Health Institutes. Retrieved July 13, 2012,
fromhttp://www.nlm.nih.gov/medlineplus/ency/article/000323.htm

NINDS: Wernicke-Korsakoff syndrome information page. (2007, February 14). National

Institute of Neurological Disorders and Stroke. Retrieved July 13, 2012,
fromhttp://www.ninds.nih.gov/disorders/wernicke_korsakoff/wernicke-korsakoff

Zieve, D. & Dugdale III, D. C. (2011, March 20). Alcoholism and alcohol
abuse. A.D.A.M. Medical Encyclopedia. Retrieved July 11, 2012,
fromhttp://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001940/

Young Adult Drinking

Too often todays headlines bring news of yet another alcohol-related tragedy involving
a young persona case of fatal alcohol poisoning on a college campus or a late-night
drinkingdriving crash. People ages 18 to 25 often are in the news, but are they really at
higher risk than anyone else for problems involving alcohol?

Some of the most important new data to emerge on young adult drinking were collected
through a recent nationwide survey, the National Epidemiologic Survey on Alcohol and
Related Conditions (NESARC). According to these data, in 20012002 about 70 percent
of young adults in the United States, or about 19 million people, consumed alcohol in
the year preceding the survey.

Its not only that young people are drinking but the way they drink that puts them at such
high risk for alcohol-related problems. Research consistently shows that people tend to
drink the heaviest in their late teens and early to mid-twenties (1,2). Young adults are
especially likely to binge drink and to drink heavily1 (3). (1 In this study, binge drinking
was defined as consuming five or more drinks in a row at least once in the past month.
Drinking heavily was defined as consuming five or more drinks in a row on at least five
occasions in the past month [3].) According to NESARC data, about 46 percent of
young adults (12.4 million) engaged in drinking that exceeded the recommended daily
limits2 at least once in the past year, and 14.5 percent (3.9 million) had an average
consumption that exceeded the recommended weekly limits. 3 (2 The recommended
daily limits for moderate alcohol consumption are no more than two drinks for men or
one drink for women per day [4].) ( 3 According to the National Institute on Alcohol Abuse
and Alcoholism [NIAAA], men may be at risk for alcohol-related problems if their alcohol
consumption exceeds 14 standard drinks per week or 4 drinks per day, and women may
be at risk if they have more than 7 standard drinks per week or 3 drinks per day. A
standard drink is defined as one 12-ounce bottle of beer, one 5-ounce glass of wine, or
1.5 ounces of distilled spirits.)

Such risky drinking often leads to tragic consequences (5)most notably alcoholrelated traffic fatalities (6). Thirty-two percent of drivers ages 1620 who died in traffic

crashes in 2003 had measurable alcohol in their blood, and 51 percent of drivers ages
2124 who died tested positive for alcohol (7). Clearly, then, young adult drinkers pose
a serious public health threat, putting themselves and others at risk.

AN AGE OF EXPLORATION

Young adulthood is a stage of life marked by change and exploration. People move out
of their parents homes and into dormitories or houses with peers. They go to college,
begin to work full-time, and form serious relationships. They explore their own identities
and how they fit in the world. The roles of parents weaken and the influences of peers
gain greater strength. Young adults are on their own for the first time, free to make their
own decisions, including the decision to drink alcohol.

Young adulthood also is the time during which young people obtain the education and
training they need for future careers. Mastery of these endeavors is vital to future
success; problems with school and work can produce frustration and stress, which can
lead to a variety of unhealthy behaviors, including increased drinking. Conversely,
alcohol use during this important time of transition can impede the successful mastery
of these developmental tasks (8), also increasing stress.
ALCOHOL AND THE MATURING BRAIN

Research shows that the brain continues to develop throughout adolescence and well
into young adulthood. Many scientists are concerned that drinking during this critical
developmental period may lead to lifelong impairments in brain function, particularly as
it relates to memory, motor skills, and coordination (9). Young adults are particularly
likely to binge drink4 and to suffer repeated bouts of withdrawal from alcohol. ( 4 NIAAA
defines binge drinking as consuming about four drinks for men or three drinks for
women in about 2 hours.) This repeated withdrawal may be a key reason for alcohols
harmful effects on the brain (10).

Even though research shows that drinking early in life can lead to impairment of brain
function in adulthood, findings also show that not all young people who drink heavily or
become alcohol dependent will experience the same level of impairment, and some
may not show any damage at all (11). This is because factors such as genetics, drinking
patterns, and the use of other drugs also influence risk.

FACTORS THAT INFLUENCE USE

Outside influences as well as individual characteristics help determine whether a person

will begin drinking and how much he or she will consume. Some of these factors
increase a persons risk for problems with alcohol, whereas others serve to protect him
or her from harm, as outlined below.

GenderMen are much more likely than women to drink in ways that are harmful. As
shown in a recent national survey of 19- to 30-year-olds, 45 percent of men and 26.7
percent of women reported heavy drinking (defined in that study as five or more drinks
on one occasion) in the past 2 weeks, and 7.4 percent of men and 3 percent of women
reported daily drinking (12).

Race/Ethnicity
Racial, ethnic, and cultural differences in drinking and alcohol-related problems also
have been documented. In general, White and Native American young adults drink
more than African Americans and Asians, and drinking rates for Hispanics fall in the
middle. In addition, while drinking among Whites tends to peak around ages 1922,
heavy drinking among African Americans and Hispanics peaks later and persists longer
into adulthood (13). Researchers suggest that these ethnic differences result, in part,
from the fact that Whites see heavy drinking as part of a youthful lifestyle, whereas
Hispanics tend to see heavy drinking as a right they earn when they reach maturity.

College vs. Noncollege Status

Many people think that the college campus environment itself encourages heavy
drinking (14). Alcohol use is present at most college social functions, and many students
view college as a place to drink excessively. Yet several studies have found that heavy
drinking and related problems are pervasive among people in their early twenties,
regardless of whether they attend college or not (15,16). In fact, a recent survey shows
that college students drink less frequently than their noncollege peers (that is, 3.7

percent of students report daily drinking vs. 4.5 percent of nonstudents). However, when
students do drink, such as at parties on the weekends, they tend to drink in greater
quantities than nonstudents5 (17). (5 In this study, 41.7 percent of college students vs.
37.1 percent of young adults reported drinking five or more drinks during the last 2
weeks [17].)

On the other hand, students tend to stop these drinking practices more quickly than
nonstudentsperhaps maturing out of harmful alcohol use before it becomes a longterm problem (16). Rates of alcohol dependence diagnosis appear lower for college
students than for 18- to 24-year-olds in the general population (15). And people in their
thirties who did not go to college reported a higher prevalence of heavy drinking than
people who did go to college (18).

Employment
Being employed full-time after high school was associated with a slight increase in
current drinking and a slight decrease in heavy drinking. Unemployed men, but not
women, especially tended to reduce their drinking. Homemakers reduced both their
current and heavy drinking, but this may have been because of increasing
responsibilities stemming from marital and parental roles rather than the result of being
a homemaker (19).

Military Service
Young adults in the military are more likely to drink heavily (i.e., consume five or more
drinks per typical drinking occasion at least once a week) than older enlistees. In 2002,
27 percent of adults ages 18 to 25 in the military reported heavy drinking, compared
with only 8.9 percent of those ages 26 to 55 (20). The reasons for heavy drinking rates
in the military include a workplace culture that supports alcohol use and the increased
availability of alcohol both in and around military bases (21).

Peer Influences
People entering college or the workforce may be especially vulnerable to the influence
of peers because of their need to make new friendships. And they may increase their

drinking in order to gain acceptance by peers. Borsari and Carey (22) contend that peer
influence is exerted directly (in the form of drink offers or urges to drink) and indirectly
(by modeling perceived social norms).

The phenomenon of perceived social normsor the belief that everyone is drinking
and drinking is acceptableis one of the strongest correlates of drinking among young
adults, and the subject of considerable research (15). Many college students think
campus attitudes are much more permissive toward drinking than they really are and
believe other students drink much more than they actually do (2224). Recent research
has shown that addressing these misperceptions can help reduce drinking (24). Then
again, the relationship between drinking practices and peer groups may not be so clear.
That is, a young person may opt to join a peer group based on that groups drinking
practices rather than change his or her drinking behavior to fit in with a particular peer
group (25).

Marriage and Parenthood

Just as the move to adulthood leads to greater exploration of the world and
experimentation with alcohol, assuming adult roles and responsibilities consistently
curbs alcohol use. This reduction in drinking may be a result of limitations that adult
roles place on social activities in general or may reflect a change in these young adults
attitudes toward drinking.

Young married women have the greatest decreases in drinking behavior, and married
men, compared with men in all other categories of living arrangements (i.e., living with
parents, in a dormitory, alone, or in other arrangements) have the fewest increases. The
data also indicate that becoming engaged (i.e., making a commitment to a relationship)
has a similar but less powerful effect on drinking compared with marriage, whereas
becoming divorced leads to increased drinking behavior (19).

Being a parent also is related to lower alcohol use for both men and women, although a
large part of this effect may simply be a result of getting married. Most women who
became pregnant eliminate their alcohol use, although most of their husbands do not
(19).

Young adults with serious alcohol problemsthat is, who fit the diagnostic criteria for
alcohol dependencemay not be as likely to choose stable roles such as marriage and
parenthood, or these milestones may not affect their drinking behavior to the same
extent that they affect people with less problematic drinking practices (26).

Personality Characteristics
A number of personality traits have been associated with drinking greater amounts of
alcohol and drinking more often, including impulsivity, risk-taking, and sensation-seeking
or the tendency to seek out new and exciting experiences (27). Sensation-seeking
and impulsivity also have been linked to deviant behavior and nonconformity, both of
which are predictors of heavy drinking and related problems among youth (28).

Then there are other personality traits, such as a feeling of invincibility, that are common
among young adults (27) and which can influence drinking. Many young people simply
do not see themselves as vulnerable to any negative consequences that might occur
because of drinking, such as having an accident or becoming dependent on alcohol.
This optimistic bias makes young adults more likely to take risks and perhaps to drink
excessively, although risk-taking may not be a direct cause of drinking. That is, research
shows that the decision to drink is influenced more by the perceived benefits of drinking
than by the perceived risks (29).

Negative moods, feelings of depression, and anxiety disorders also may influence
alcohol use (15). Research has suggested that some people drink to relieve feelings of
stress. In support of this, Cooper and colleagues (30) found that drinking to cope with
negative feelings was a good predictor of heavy drinking as well as drinking problems in
19- to 25-year-olds. Again, though, research also shows that young adults are more
likely to drink for positive or celebratory reasons than to drink to cope with negative
feelings (31).

Alcohol Expectancies

Positive alcohol expectancies, or the belief that drinking will lead to positive, pleasurable
experiences, play a key role in the drinking behavior of young adults. What a person
expects from drinking not only predicts when he or she will begin drinking but also how
much he or she will drink throughout young adulthood. As people age through
adolescence and into young adulthood, they increasingly expect benefits from drinking
and become less convinced of the risks (32,33).

Family Influences
During young adulthood parents may have less direct influence on their childrens
drinking behavior, but they still play a major protective role (32). The example set by
parents with their own drinking has been shown to affect their childrens drinking
throughout their lifetime (34). Young people model their behavior after their parents
patterns of consumption (including quantity and frequency), situations and contexts of
use, attitudes regarding use, and expectancies. The familys structure and aspects of
the parentchild relationship (e.g., parenting style, attachment and bonding, nurturance,
abuse or neglect, conflict, discipline, and monitoring) also have been linked to young
peoples alcohol use (34).

Genetics
Alcohol problems seem to run in some families (34). This family connection to
alcoholism may be the result of a genetic link and/or may reflect the childs modeling of
drinking behavior. Siblings also can influence drinking through modeling and by
providing access to alcohol (32). Its unclear whether children of alcoholics have
different drinking patterns and problems in young adulthood than those who do not have
a family history of alcoholism (15). Research does show, however, that people with a
family history of alcoholism are less likely than those with no family history to mature out
of heavy drinking as they approach young adulthood (35).

To better understand the role of genetics in alcohol abuse and alcoholism, scientists are
looking at differences (or variants) in particular genes to see if they can be linked to
drinking behavior. One study examined how gene variants linked to the regulation of
serotonina key brain chemical involved in mood, appetite, emotion, and addiction,
among other processesinfluenced drinking behavior in college students. This study
found that White students with a particular version of this gene engaged in binge

drinking more often, drank to intoxication more often, and consumed more alcoholic
drinks per drinking occasion than did students with other variants of the gene (36).

Another study focused on the gene that helps to form an enzyme (aldehyde
dehydrogenase or ALDH) that is important for breaking down alcohol in the body. This
study reported that Asian American college students who carried a particular version of
the ALDH gene which results in less efficient alcohol breakdown were less likely to be
regular drinkers and engage in binge-drinking episodes; they also reported a lower
number of maximum drinks consumed in a 24-hour period than Asian students with
other ALDH variants (37).

These studies are being complemented by large-scale efforts to identify genes that
contribute to alcoholism. One of these projects, funded by the National Institute on
Alcohol Abuse and Alcoholism, is the Collaborative Study on the Genetics of Alcoholism
(COGA). COGA researchers recently published reports of several genes associated
with alcohol dependence in adults (3840), and some of these findings already have
been replicated by other investigators (4143). The next step will be to determine
whether these same genes are relevant to drinking behavior in adolescents and young
adults.

By identifying specific genes influencing alcohol abuse and alcoholism, scientists can
begin to tease apart the complex interplay that exists between genetic and
environmental influences.
Reference: http://pubs.niaaa.nih.gov/publications/aa68/aa68.htm

The
Psychological
Alcoholism

Causes

Of

A. Tom Horvath, Ph.D., ABPP, Kaushik Misra, Ph.D., Amy K. Epner, Ph.D., and Galen Morgan
Cooper, Ph.D. , edited by C. E. Zupanick, Psy.D.
Even if alcoholism originates because of some biological process, recovery from alcoholism requires
people to become motivated to make significant changes. Addictions like alcoholism are
fundamentally a behavior. Psychology is a science that studies human behavior.
Most human behavior is a learned behavior. This is true of addictive behavior as well.
Psychological research has helped us to understand how people learn to engage in an unhealthy
behavior. More importantly, this research enables us to understand how people can unlearn a
behavior.
Another psychological cause of addiction is people's thoughts and beliefs. This is because much of
our behavior originates from our thoughts and beliefs. This includes addictive behaviors. For
instance, if someone believes that recovery is not possible, it is highly unlikely they will put forth any
effort to quit. Psychologists have developed techniques to help people change their thoughts and
beliefs. Their feelings and behavior subsequently change as well.
A third psychological cause of addiction is a person's developmental maturity. The capacity to align
our actions with our beliefs and values is what separates mature human beings, from immature
ones. This capacity ultimately distinguishes human beings from other species. If we routinely act
without thinking, and instead act according to every craving, whim, or impulse, we are operating at
the developmental level of a two year-old child. Addictions like alcoholism can occur because
someone lacks this developmental maturity. They may be very self-focused and intent on pursuing
impulsive desires without regard to the consequences. Psychotherapy can be considered a form of
accelerated development. Therefore, it can be very helpful for people who are attempting to recover
from alcoholism or other addictions.
Psychology has also helped us to understand while people find it so difficult to discontinue an
unhealthy behavior like alcoholism. People may find recovery difficult because they lack good
problem-solving skills and sufficient motivation. Alcoholism can also occur as a means of coping
with uncomfortable feelings or stress. Psychotherapy can help to strengthen people's motivation
and to improve their problem-solving skills, stress reduction skills, and coping skills.
In our topic center on Addiction, we review the various psychological reasons that people can
become addicted to alcoholin greater detail.

Alcohol Addiction Signs, Symptoms and Effects

What Are the Signs and Symptoms of Alcohol Abuse and Addiction?
Alcoholism is a serious medical disease with signs and symptoms that vary depending on the
amount and frequency of consumption. Progressing alcoholism will significantly disrupt the lives of
users and their families.
Physical signs of alcohol overconsumption and intoxication are recognizable by most adults:

Slurred or incoherent speech

Poor balance and clumsiness

Delayed reflexes

Stomach pains, vomiting or nausea

Loss of consciousness or blacking-out

Redness of the face during or after periods of consumption

It is possible for a person to reach a level of intoxication that becomes life-threatening (alcohol
poisoning). The respiratory system becomes depressed, and the person will stop breathing.

Signs of Alcohol Abuse

Progressive increases in the frequency and quantity of alcohol consumption can begin to produce
more serious medical symptoms of alcoholism. Someone abusing alcohol makes drinking a central
activity of her life, displacing healthy activity and relationships, and resulting in negative
consequences. Alcohol abusers often maintain some capacity to recognize situations that lead to
over-consumption, and to regulate their alcohol intake. Signs of alcohol abuse include:

Loss of control over amount consumed once they begin drinking

Regular inattention to family and professional obligations

Dangerous behaviors that carry risk of legal, financial and/or health consequences for
themselves and others

Increase in expressions of anger or other emotions, especially in inappropriate settings

Insomnia, which may be followed by oversleeping

Signs of Alcohol Dependence (Alcoholism)

Untreated alcohol abuse can progress to an addiction to alcohol characterized by physical
dependency and/or inability to stop despite serious consequences. Once they begin drinking,
alcoholics have little to no control over the amount they consume. Alcohol dependence indicates that
the user has made obtaining and consuming alcohol a predominant focus of her life. Signs and
symptoms of alcohol dependence represent a serious medical illness:

Significant hangovers, and increase in time needed to recover from after-effects of alcohol
use

Increased amount of alcohol consumed because of increased tolerance; or, decrease in the
effects of alcohol use without substantial increases in the amount consumed

Reduced attention to personal and professional responsibilities

Acknowledgement of side effects of medical complications from alcoholism

Repeated unsuccessful efforts to reduce alcohol consumption

Withdrawal symptoms when unable to consume alcohol

Withdrawal Symptoms of Alcoholism

Long-term alcohol abuse and addiction put the user at risk for serious medical consequences if they
attempt to stop alcohol consumption without proper medical advice and supervision. Alcoholism
withdrawal symptoms indicate advanced addictive disease, and should not be dismissed:

Tremors, convulsions, or uncontrolled shaking of the hands (or even the entire body)

Profuse sweating, even in cold conditions

Extreme agitation or anxiety

Persistent insomnia

Nausea or vomiting

Seizures

Hallucinations
Alcohol detoxification is poses greater health risks than other drugs. A sudden discontinuation of
alcohol consumption can often induce a condition known as delirium tremens. A person can die as a
direct result of alcohol withdrawal. Generally, medical detoxification is needed to safely discontinue
heavy drinking.

What Are the Effects of Alcohol Abuse and Alcohol Addiction?

Long-term alcohol abuse poses great dangers to an alcoholic's physical, mental, emotional, social
and spiritual health. In addition to serious ramifications for the user's career, family and friends,
alcoholism can cause irreversible damage to critical organs and body systems:

Liver

Nervous system

Heart

Stomach (intestines)

Brain

Alcohol abuse and addiction also produce other medical side effects. Alcoholics frequently attribute
these complications to other health conditions, as they attempt to avoid ownership of the
consequences of their drinking. Common medical side effects include:

High blood pressure

Sexual problems

Cancer

Stomach problems

Osteoporosis, especially in women

Alcoholism often causes severe social consequences on a person's life as well. Being drunk or hung
over at work frequently results in termination from a job, leaving a person and her dependents in
severe financial trouble. Domestic violence, marital conflict, legal problems and isolation from friends
and family are also common results of alcohol abuse, which may be worsened by the presence of
cooccurring anorexia or bulimia.

How Does Alcohol Affect the Body?

Alcohol acts as a depressant on the central nervous system. It has a complex mode of action and
affects multiple systems in the brain. Most notably alcohol works by binding to GABA receptors in the
brain and i activating the release of the chief inhibitory neurotransmitter in the central nervous
system. This aspect of alcohol's physiological effects is one reason alcohol detoxification can be
dangerous (see below). Alcohol is metabolized by the liver. Long term consumption of alcohol in
excessive amounts can cause irreversible damage to the liver.
Alcohol addiction, or alcoholism, is medically diagnosed as a disease which manifests itself in the
frequent use of alcohol, despite the negative consequences it has on a person's life. Alcohol abuse
causes over 100,000 deaths every year in the United States and Canada. It is the leading cause of
death in teenagers due to alcohol related motor vehicle accidents.
It is often apparent that a person suffers from alcoholism when both their mental and physical health
suffers as a direct result of their drinking. Drinking patterns are not the same for every alcoholic.
While some people get drunk every day, others binge drink at specific times depending on their
emotional state.

What Causes Alcoholism?

Although scientists cannot pinpoint specific reasons why alcoholism develops, they have identified
several contributing factors. Genetic predisposition, environment, and mental health are the leading
risk factors for developing this disease. These factors explain why members of a family with similar
life experiences may respond to alcohol consumption in different ways. Even in families where
alcohol abuse and addiction are prevalent, different members may respond very differently to
treatment and face unique challenges in recovery.

Reference: http://www.timberlineknolls.com/alcohol-addiction/signs-effects

Alcohol's Effects on the Body

Drinking too much on a single occasion or over time can take a serious toll on your
health. Heres how alcohol can affect your body:
Brain:
Alcohol interferes with the brains communication pathways, and can affect the way the
brain looks and works. These disruptions can change mood and behavior, and make it harder
to think clearly and move with coordination.
Heart:
Drinking a lot over a long time or too much on a single occasion can damage the heart,
causing problems including:

Cardiomyopathy Stretching and drooping of heart muscle

Arrhythmias Irregular heart beat
Stroke
High blood pressure

Research also shows that drinking moderate amounts of alcohol may protect healthy adults
from developing coronary heart disease.
Liver:
Heavy drinking takes a toll on the liver, and can lead to a variety of problems and liver
inflammations including:

Steatosis, or fatty liver

Alcoholic hepatitis
Fibrosis
Cirrhosis

Pancreas:
Alcohol causes the pancreas to produce toxic substances that can eventually lead to
pancreatitis, a dangerous inflammation and swelling of the blood vessels in the pancreas
that prevents proper digestion.
Cancer:
Drinking too much alcohol can increase your risk of developing certain cancers, including
cancers of the:

Mouth
Esophagus
Throat
Liver
Breast

Immune System:
Drinking too much can weaken your immune system, making your body a much easier
target for disease. Chronic drinkers are more liable to contract diseases like pneumonia and
tuberculosis than people who do not drink too much. Drinking a lot on a single occasion
slows your bodys ability to ward off infections even up to 24 hours after getting drunk.

Reference: http://www.niaaa.nih.gov/alcohol-health/alcohols-effects-body