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Substance Abuse and Addiction Health Center

When Alcohol Becomes a Problem

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Alcohol-use disorders (AUDs) are probably the most common mental disorders in the United States: Nearly one person in seven suffers from an AUD at some time in his or her life. The prevalence of AUDs among men is about three-to-five times greater than among women. Nevertheless, alcohol can have serious consequences in women, since they are more sensitive to alcohol's damaging effects on the liver, heart and brain. Women also end up with higher blood levels of alcohol than men given the same amount consumed -- probably due to sex differences in how alcohol is broken down and distributed in body tissues.

The Scourge of Alcohol

Alcohol abuse and dependence does incalculable harm in the United States, accounting for about 5 percent of all deaths. The main health hazard associated with AUDs is cirrhosis of the liver, which was the ninth-leading cause of death in the U.S. in 1988. AUDs are also associated with driving accidents, violence and suicide. Very often, AUDs are accompanied by another psychiatric disorder such as a depression, anxiety or personality disorder. In some cases, AUDs can arise from attempts to "self-medicate" one of these other disorders with alcohol -- but in many cases the AUD is the primary, underlying disorder. Nevertheless, when an individual has both an AUD and a major mood or anxiety disorder, both problems must be addressed in treatment.

What causes "alcoholism" -- the common but poorly defined term usually applied to AUDs? This has been a source of controversy for decades, even among health-care professionals. The emerging consensus is that AUDs result from a complex interaction between biological and psychosocial factors. While the precise role of heredity in AUDs is not known, some types of AUDs appear to run in families, and are at least partly related to genetic factors. While blaming someone for having an AUD may be unjustified, holding the person responsible for getting help is critical. After all, diabetes is a biological disorder, but diabetics are still held accountable for taking their insulin.

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