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The first step on the road to recovery is knowing when to get help. At Affordable Drug Treatment we provide referrals to
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 For many people, the facts about alcoholism are not
clear. What is alcoholism, exactly? How does it differ from alcohol abuse? When should a person seek help for a problem related to his or her drinking? Find out more about
both alcoholism and alcohol abuse, the symptoms of each, when and where to seek help, treatment choices, and additional helpful resources.
For most people who drink, alcohol is a pleasant accompaniment to social activities. Moderate alcohol use;up to two drinks per day for men and one drink per day for women and
older people;is not harmful for most adults. Nonetheless, a large number of people get into serious trouble because of their drinking. Currently, nearly 14 million Americans;1
in every 13 adults;abuse alcohol or are alcoholic. Several million more adults engage in risky drinking that could lead to alcohol problems. These patterns include binge
drinking and heavy drinking on a regular basis. In addition, 53 percent of men and women in the United States report that one or more of their close relatives have a drinking
problem.
The consequences of alcohol misuse are serious;in many cases, life threatening. Heavy drinking can increase the risk for certain cancers, especially those of the liver,
esophagus, throat, and larynx (voice box). Heavy drinking can also cause liver cirrhosis, immune system problems, brain damage, and harm to the fetus during pregnancy. In
addition, drinking increases the risk of death from automobile crashes as well as recreational and on-the-job injuries. Furthermore, both homicides and suicides are more
likely to be committed by persons who have been drinking. In purely economic terms, alcohol-related problems cost society approximately $185 billion per year. In human terms,
the costs cannot be calculated.
Alcoholism or Alcohol Dependence Alcoholism, also known as alcohol dependence, is a disease that includes four symptoms:
Craving: A strong need, or compulsion, to drink.
Loss of control: The inability to limit one drinking on any given occasion.
Physical dependence: Withdrawal symptoms, such as nausea, sweating, shakiness, and anxiety, occur when alcohol use is stopped after a period of heavy drinking.
Tolerance: The need to drink greater amounts of alcohol in order to get high.
People who are not alcoholic sometimes do not understand why an alcoholic can just use a little willpower to stop drinking. However, alcoholism has little to do with
willpower. Alcoholics are in the grip of a powerful craving, or uncontrollable need, for alcohol that overrides their ability to stop drinking. This need can be as strong as
the need for food or water.
Although some people are able to recover from alcoholism without help, the majority of alcoholics need assistance. With treatment and support, many individuals are able to
stop drinking and rebuild their lives.
Many people wonder why some individuals can use alcohol without problems but others cannot. One important reason has to do with genetics. Scientists have found that having an
alcoholic family member makes it more likely that if you choose to drink you too may develop alcoholism. Genes, however, are not the whole story. In fact, scientists now
believe that certain factors in a person environment influence whether a person with a genetic risk for alcoholism ever develops the disease. A person risk for developing
alcoholism can increase based on the person environment, including where and how he or she lives; family, friends, and culture; peer pressure; and even how easy it is to get
alcohol.
Alcohol Abuse
Alcohol abuse differs from alcoholism in that it does not include an extremely strong craving for alcohol, loss of control over drinking, or physical dependence. Alcohol
abuse is defined as a pattern of drinking that results in one or more of the following situations within a 12-month period:
Failure to fulfill major work, school, or home responsibilities; Drinking in situations that are physically dangerous, such as while driving a car or operating machinery;
Having recurring alcohol-related legal problems, such as being arrested for driving under the influence of alcohol or for physically hurting someone while drunk; and
Continued drinking despite having ongoing relationship problems that are caused or worsened by the drinking. Although alcohol abuse is basically different from alcoholism,
many effects of alcohol abuse are also experienced by alcoholics.
Signs of an Alcohol Problem
How can you tell whether you may have a drinking problem? Answering the following four questions can help you find out:
Have you ever felt you should cut down on your drinking?
Have people annoyed you by criticizing your drinking?
Have you ever felt bad or guilty about your drinking?
Have you ever had a drink first thing in the morning (as an eye opener) to steady your nerves or get rid of a hangover?
One answer suggests a possible alcohol problem. If you answered to more than one question, it is highly likely that a problem exists. In either case, it is important that you
see your doctor or other health care provider right away to discuss your answers to these questions. He or she can help you determine whether you have a drinking problem and,
if so, recommend the best course of action.
Even if you answered ; to all of the above questions, if you encounter drinking-related problems with your job, relationships, health, or the law, you should seek
professional help. The effects of alcohol abuse can be extremely serious;even fatal;both to you and to others.
Getting Treatment
Accepting the fact that help is needed for an alcohol problem may not be easy. But keep in mind that the sooner you get help, the better are your chances for a successful
recovery.
Any concerns you may have about discussing drinking-related problems with your health care provider may stem from common misconceptions about alcoholism and alcoholic people.
In our society, the myth prevails that an alcohol problem is a sign of moral weakness. As a result, you may feel that to seek help is to admit some type of shameful defect in
yourself. In fact, alcoholism is a disease that is no more a sign of weakness than is asthma. Moreover, taking steps to identify a possible drinking problem has an enormous
payoff;a chance for a healthier, more rewarding life.
When you visit your health care provider, he or she will ask you a number of questions about your alcohol use to determine whether you are having problems related to your
drinking. Try to answer these questions as fully and honestly as you can. You also will be given a physical examination. If your health care provider concludes that you may
be dependent on alcohol, he or she may recommend that you see a specialist in treating alcoholism. You should be involved in any referral decisions and have all treatment
choices explained to you.
Alcoholism Treatment
The type of treatment you receive depends on the severity of your alcoholism and the resources that are available in your community. Treatment may include detoxification (the
process of safely getting alcohol out of your system); taking doctor-prescribed medications, such as disulfiram (Antabuse®) or naltrexone (ReVia ), to help prevent a return
(or relapse) to drinking once drinking has stopped; and individual and/or group counseling. There are promising types of counseling that teach alcoholics to identify
situations and feelings that trigger the urge to drink and to find new ways to cope that do not include alcohol use. These treatments are often provided on an outpatient
basis.
Because the support of family members is important to the recovery process, many programs also offer brief marital counseling and family therapy as part of the treatment
process. Programs may also link individuals with vital community resources, such as legal assistance, job training, childcare, and parenting classes.
Alcoholics Anonymous
Virtually all alcoholism treatment programs also include Alcoholics Anonymous (AA) meetings. AA describes itself as a worldwide fellowship of men and women who help each
other to stay sober. Although AA is generally recognized as an effective mutual help program for recovering alcoholics, not everyone responds to AA style or message, and
other recovery approaches are available. Even people who are helped by AA usually find that AA works best in combination with other forms of treatment, including counseling
and medical care.
Can Alcoholism Be Cured?
Although alcoholism can be treated, a cure is not yet available. In other words, even if an alcoholic has been sober for a long time and has regained health, he or she
remains susceptible to relapse and must continue to avoid all alcoholic beverages. Cutting down on drinking doesn't work; cutting out alcohol is necessary for a successful
recovery.
However, even individuals who are determined to stay sober may suffer one or several slips, or relapses, before achieving long-term sobriety. Relapses are very common and
do not mean that a person has failed or cannot recover from alcoholism. Keep in mind, too, that every day that a recovering alcoholic has stayed sober prior to a relapse is
extremely valuable time, both to the individual and to his or her family. If a relapse occurs, it is very important to try to stop drinking once again and to get whatever
additional support you need to abstain from drinking.
Help for Alcohol Abuse
If your health care provider determines that you are not alcohol dependent but are nonetheless involved in a pattern of alcohol
abuse, he or she can help you to:
Examine the benefits of stopping an unhealthy drinking pattern. Set a drinking goal for yourself. Some people choose to abstain from alcohol. Others prefer to limit the
amount they drink. Examine the situations that trigger your unhealthy drinking patterns, and develop new ways of handling those situations so that you can maintain your
drinking goal. Some individuals who have stopped drinking after experiencing alcohol-related problems choose to attend AA meetings for information and support, even though
they have not been diagnosed as alcoholic. |
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 Cocaine is a powerfully addictive drug of abuse.
Once having tried cocaine, an individual cannot predict or control the extent to which he or she will continue to use the drug.
As cocaine abuse continues, tolerance often develops. This means that higher doses and more frequent use of cocaine are required for the brain to register the same level of
pleasure experienced during initial use. Choosing the right cocaine and crack treatment program is crucial to a successful recovery. The major routes of administration of
cocaine are sniffing or snorting, injecting, and smoking (including free-base and crack cocaine). Snorting is the process of inhaling cocaine powder through the nose where it
is absorbed into the bloodstream through the nasal tissues. Injecting is the act of using a needle to release the drug directly into the bloodstream. Smoking involves inhaling
cocaine vapor or smoke into the lungs where absorption into the bloodstream is as rapid as by injection.
Crack is the street name given to cocaine that has been processed from cocaine hydrochloride to a free base for smoking. Rather than requiring the more volatile method of
processing cocaine using ether, crack cocaine is processed with ammonia or sodium bicarbonate (baking soda) and water and heated to remove the hydrochloride, thus producing a
form of cocaine that can be smoked. The term crack refers to the crackling sound heard when the mixture is smoked (heated), presumably from the sodium bicarbonate.
There is great risk whether cocaine is ingested by inhalation (snorting), injection, or smoking. It appears that compulsive cocaine use may develop even more rapidly if the
substance is smoked rather than snorted. Smoking allows extremely high doses of cocaine to reach the brain very quickly and brings an intense and immediate high. The injecting
drug user is at risk for transmitting or acquiring HIV infection/AIDS if needles or other injection equipment are shared.
Danger of Cocaine to Your Health Cocaine is a strong central nervous system stimulant that interferes with the reabsorption process of dopamine, a chemical messenger
associated with pleasure and movement. Dopamine is released as part of the brain's reward system and is involved in the high that characterizes cocaine consumption.
Physical effects of cocaine use include constricted peripheral blood vessels, dilated pupils, and increased temperature, heart rate, and blood pressure. The duration of
cocaine's immediate euphoric effects, which include hyper-stimulation, reduced fatigue, and mental clarity, depends on the route of administration. The faster the absorption,
the more intense the high. On the other hand, the faster the absorption, the shorter the duration of action. The high from snorting may last 15 to 30 minutes, while that from
smoking may last 5 to 10 minutes. Increased use can reduce the period of stimulation.
Some users of cocaine report feelings of restlessness, irritability, and anxiety. An appreciable tolerance to the high may be developed, and many addicts report that they seek
but fail to achieve as much pleasure as they did from their first exposure. Scientific evidence suggests that the powerful neuropsychological reinforcing property of cocaine is
responsible for an individual's continued use, despite harmful physical and social consequences. In rare instances, sudden death can occur on the first use of cocaine or
unexpectedly thereafter. However, there is no way to determine who is prone to sudden death.
High doses of cocaine and/or prolonged use can trigger paranoia. Smoking crack cocaine can produce a particularly aggressive paranoid behavior in users. When addicted
individuals stop using cocaine, they often become depressed. This also may lead to further cocaine use to alleviate depression. Prolonged cocaine snorting can result in
ulceration of the mucous membrane of the nose and can damage the nasal septum enough to cause it to collapse. Cocaine-related deaths are often a result of cardiac arrest or
seizures followed by respiratory arrest.
Cocaethylene-Mixing Cocaine and Alcohol When people mix cocaine and alcohol consumption, they are compounding the danger each drug poses and unknowingly forming a complex
chemical experiment within their bodies. NIDA-funded researchers have found that the human liver combines cocaine and alcohol and manufactures a third substance, cocaethylene,
that intensifies cocaine's euphoric effects, while possibly increasing the risk of sudden death.
Treatment of Cocaine Abuse
The widespread abuse of cocaine has stimulated extensive efforts to develop treatment programs for this type of drug abuse.
NIDA's top research priority is to find a medication to block or greatly reduce the effects of cocaine, to be used as one part of a comprehensive treatment program.
NIDA-funded researchers are also looking at medications that help alleviate the severe craving that people in treatment for cocaine
addiction often experience. Several medications are currently being investigated to test their safety and efficacy in treating cocaine addiction.
In addition to treatment medications, behavioral interventions, particularly cognitive behavioral therapy, can be effective in decreasing drug use by patients in treatment
for cocaine abuse. Providing the optimal combination of treatment services for each individual is critical to successful treatment outcome. |
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