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Alcoholism

The stereotypical picture of an alcoholic - an old man living rough who drinks cheap sherry or methylated spirits - is, in fact, very rare. Most alcoholics are young men and (increasingly) women with responsible jobs who are supporting a family. It is more common in people with alcoholic parents, in those who make or sell alcohol, and in those such as the self-employed who have little or no supervision at work, and no one can see that they are drinking. Alcohol is one of the major health hazards of modern society.

Signs and symptoms

People who become alcoholics usually begin drinking heavily in response to stress. The temporary relief from stress that drinking brings gradually leads to a habit, where any feeling of tension can only be dissipated by alcohol. Eventually the person finds that he or she needs a drink just to feel normal, even on waking. Often the change from social drinking to alcoholism is imperceptible, occurring over several years, although it can occur very quickly. Early signs and symptoms are frequently unnoticed, even by friends and family. The following signs are indications of alcohol dependence:

1 Repeated withdrawal symptoms

These include feeling unwell with a headache (hangover) on most days; feeling sick or retching when, for instance, cleaning teeth; tremors (the DTs) in the morning so that it is difficult to hold a cup without shaking.

2 Drinking to relieve withdrawal symptoms

This includes drinking in the morning, and waiting outside pubs before they open.

3 Craving for alcohol

If a few days have passed without a drink, the alcoholic has an urgent desire to drink, and perhaps goes on a 'binge' of drinking over two or three days, Drinking may become secretive.

4 Increasing tolerance of alcohol

More drinks or longer and stronger drinks are needed for the same effect.

5 Uncharacteristic behaviour

The alcoholic may' become aggressive and irritable, and have bouts of depression or jealousy. Loss of memory, even blackouts, may occur, and an increasing lack of ability to concentrate will mean that the demands of a job become more difficult to meet.

Health risks

Heavy drinking eventually damages the body, and leads 10 many serious physical diseases, including cirrhosis of the liver gastric ulcers and other problems of the digestive tract causing internal bleeding, and brain damage, A pregnant woman who drinks excessively, that is, more than six measures of spirits or large glasses of wine a day, has a one in three chance of having a physically or mentally handicapped baby. Since alcoholics rarely eat adequately, vitamin deficiencies often occur.

Treatment

For treatment to be effective, the alcoholic must recognize that he or she has a problem and be highly motivated 10 overcome it. It may be possible for some people to control their drinking successfully, but most alcoholics have 10 abstain for the rest of their lives. They usually' need help to overcome the problem, and a counselling service such as Alcoholics Anonymous may be invaluable. Treatment is based on a combination of psychological and psychiatric counseling, detoxification programmers in hospital with tranquillizers used to suppress withdrawal symptoms, and eventual social reintegration into family' and work environment, The exact form of treatment will be varied to suit the individual. and its success largely depends on the alcoholic's determination to be cured.

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