When Alcohol Becomes a Problem
Recognizing and Dealing with AUDs
How do you know when you or a loved one has developed a serious drinking problem? The actual amount of alcohol he or she drinks is not a good basis for answering this. Neither is the person's insistence that, "I can stop drinking anytime I want to." Most chronic alcoholics have stopped drinking for extended periods at one time or another, but that does not mean that they can control the problem without help: Almost always, the abstinent alcoholic will relapse unless he or she remains in some form of substance-abuse treatment. You should suspect an AUD when the person in question:
- Drinks larger amounts of alcohol than intended -- for example, the individual says, "I'm just going to have one for the road" and winds up downing five beers.
- Spends a great deal of time drinking or recovering from drinking.
- Has trouble meeting social, occupational or other important obligations.
- Continues to drink even though alcohol has repeatedly caused physical or psychological problems.
- Gradually needs more and more alcohol to get the same kick.
- Experiences withdrawal symptoms (shaking, sweating, "seeing things") upon discontinuing alcohol use.
- Constantly expresses annoyance when others express concern about his or her drinking, or has been told by a physician, employer or family member that he or she has a drinking problem.
The treatment of AUDs requires a thorough medical and psychological assessment. Concurrent physical disorders, vitamin deficiencies and potential psychiatric problems must be addressed. In some cases, a mood stabilizer or antidepressant may be part of the overall treatment plan. The medication naltrexone (ReVia) may help reduce the urge to drink and enhance abstinence in some patients but should be used in concert with psychotherapy or a twelve-step program, such as Alcoholics Anonymous.
A few studies support the use of disulfiram (Antabuse), a medication that induces nausea and other unpleasant reactions if the individual drinks. For families who must deal with a loved one's AUD, Al-Anon and similar support groups for families can be helpful. The key to success is helping the individual accept the need for help and insisting that he or she gets it.