1. Craving – a strong need, or urge, to drink.
2. Loss of Control – difficulty stopping once drinking has begun.
3. Physical dependence – withdrawal symptoms (such as nausea, sweating, shakiness, and anxiety) after stopping drinking.
4. Tolerance – need to drink greater amounts of alcohol to get high.

   A person can still be affected by alcohol after it’s “out of the system.” In one study, participants were asked to drink between 10 pm and 2 am and were then tested performing various tasks at 9 am the next morning. Subjects showed significant impairment in their ability to recall information, retrieve information, and other cognitive tasks. This impairment was present even though blood alcohol levels were at or very near .00.

   The alcohol cravings an alcoholic feels can be as strong as the need for food or water. An alcoholic will continue to drink despite serious family, health, or legal problems. The risk for developing alcoholism is influenced both by a person’s genes and by their lifestyle.

   There is no cure for alcoholism. However, like other chronic diseases, alcoholism is treatable — and entirely preventable.

   Risk is not destiny. Just because alcoholism tends to run in families doesn’t mean that a child of an alcoholic parent will automatically become an alcoholic too. Some people develop alcoholism even though no one in their family has a drinking problem. By the same token, not all children of alcoholic families get into trouble with alcohol. Knowing you are at risk is important, though, because then you can take steps to protect yourself from developing problems with alcohol.

   When a person has a drink, the alcohol passes through the mouth and esophagus before entering the stomach and then the small intestine. Although alcohol can be absorbed anywhere along this route, it’s the stomach and small intestine that are the most important. About 25% of the alcohol is absorbed in the stomach and the rest in the small intestine.

   Many factors can alter the rate of alcohol absorption. If you have eaten a heavy meal, the release of the stomach contents to the small intestine slows down, delaying alcohol absorption. Stronger alcoholic drinks tend to be absorbed more quickly, though very strong drinks may slow the process. Fizzy drinks, like champagne, can get you drunk quicker, since the carbon dioxide they contain may speed up the drink’s passage from the stomach to the small intestine.

   Other medications, such as naltrexone (Revia), help people remain sober. When combined with counseling, naltrexone can reduce the craving for alcohol and help prevent a person from returning to drinking (known as relapsing). Another medication, disulfiram (Antabuse), discourages drinking by making the person feel very sick if they drink alcohol.

   Though several medications help treat alcoholism, there are no “magic bullets.” No single medication is available that works in every case and / or in every person. Developing new and more effective medications to treat alcoholism remains a high priority for researchers.

   There are certain warning signs that may indicate that a person is having problems with alcohol or other drug use. Exhibiting one or more of the following signs can be an indication:

• getting high or drunk on a regular basis • lying about things, or the amount of drugs or alcohol being using • avoiding you and others in order to get high or drunk • giving up activities they used to do (such as sports, homework) • no longer hanging out with friends who don’t use drugs or drink • frequent talking about using alcohol or other drugs • risk taking • pressuring others to drink or use other drugs • getting into trouble with the law • feeling run-down, hopeless, depressed, or even suicidal • missing work / poor work performance • belief that in order to have fun, they must drink or use other drugs • suspension from school for an alcohol or other drug-related incident

   Many of the signs, such as sudden changes in mood, difficulty in getting along with others, poor job or school performance, irritability, and depression, might be explained by other causes. Unless you observe drug use or excessive drinking, it can be hard to determine the cause of these problems.

   Your first step is to contact a qualified professional in your area who can give you further advice. Contact the Council’s Information & Referral Line for assistance with this and other related matters. (214) 522-8600

Stop all cover-ups.
Family members often make excuses to others or try to protect the alcoholic from the results of their drinking. It’s important to stop covering for the alcoholic so that they experience the full consequences of drinking.

Time your intervention.
The best time to talk to the drinker is shortly after an alcohol-related problem has occurred — like a serious family argument or an accident. Choose a time when they are sober, both of you are fairly calm, and you have a chance to talk in private.

Be specific.
Tell the family member that you are worried about their drinking. Use examples of the ways in which the drinking has caused problems, including the most recent incident.

State the results.
Explain what you will do if they don’t go for help — not to punish the drinker, but to protect yourself from their problems. What you say may range from refusing to go with the person to any social activity where alcohol will be served, to moving out of the house. Don’t make any threats you’re not prepared to carry out.

Get help.
Gather information in advance about treatment options in your community. If the person is willing to get help, call immediately for an appointment with a treatment counselor. Offer to go with the family member on the first visit to a treatment program and/or an Alcoholics Anonymous meeting.

Call on a friend.
If the family member still refuses to get help, ask a friend to talk with them using the steps described above. A friend who is a recovering alcoholic may be particularly persuasive, but any person who is caring and non-judgmental may help. The intervention of more than one person, more than one time, is often necessary to “coax” an alcoholic to seek help.

Find strength in numbers.
With the help of a health care professional, some families join with other relatives and friends to confront the alcoholic as a group. This approach should only be tried under the guidance of a health care professional who is experienced in this kind of group intervention.

Get support.
It’s important to remember that you are not alone. Support groups offered in most communities include Al-Anon, which holds regular meetings for spouses and other significant adults in an alcoholic’s life; and Alateen, which is geared to children of alcoholics. These groups help persons understand that they are not responsible for an alcoholic’s drinking and that they need to take steps to take care of themselves, regardless of whether the alcoholic chooses to get help.

   Certain people should not drink at all, however:
        • individuals younger than age 21
        • recovering alcoholics
        • women who are pregnant or trying to become pregnant
        • those taking certain medications (RX or OTC)
        • those planning to drive an auto / operate machinery
        • those engaging in activities requiring alertness / skill
        • those with medical conditions made worse by drinking

   Older adults also tend to take more medicines. Mixing alcohol with over-the-counter or prescription medications can be very dangerous, even fatal. More than 150 medications interact harmfully with alcohol. In addition, alcohol can make many of the medical conditions common in older people, including high blood pressure and ulcers, more serious. Physical changes associated with aging can make an individual feel “high” even after drinking a small amount. So even if there is no medical reason to avoid alcohol, older men and women should limit themselves to one drink per day.

   The female body has a lower water content than the male. Because alcohol mixes with this body water, a given amount of alcohol becomes more highly concentrated in a woman’s body than in a man’s. In other words, it would be like dropping the same amount of alcohol into a much smaller pail of water. This is why the recommended drinking limit for women is lower than for men. (one vs. two drinks a day)

   Chronic alcohol abuse also takes a heavier physical toll on women. Alcohol dependence and related medical problems, such as brain, heart, and liver damage, progress more rapidly in women than in men.

   Studies have shown that moderate drinkers — men who have two or less drinks per day and women who have one or less drinks per day — are less likely to die from one form of heart disease than are people who do not drink any alcohol or who drink more. It’s believed that these smaller amounts of alcohol help protect against heart disease by changing the blood’s chemistry, thus reducing the risk of blood clots in the heart’s arteries.

   If you are a nondrinker, however, you should not start drinking solely to benefit your heart. You can guard against heart disease by exercising and eating foods that are low in fat. You should not drink alcohol if you are pregnant, planning to become pregnant, have been diagnosed as alcoholic, or have another medical condition that could make alcohol use harmful.

   If you can safely drink alcohol and you choose to drink, do so in moderation. Heavy drinking increases the risk of heart failure, stroke, and high blood pressure, as well as cause many other medical problems, such as liver cirrhosis.