| SOSTANZE D'ABUSO: ALCOL |
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ALCOL ED INVECCHIAMENTO (NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM)
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Understanding Alcohol-Related Disorders and Their
Treatment, Psychologists play a vital role
For many people, drinking alcohol is nothing more than a
pleasant way to relax. People with alcohol-related disorders drink to
excess, endangering both themselves and those around them. This
question-and-answer fact sheet explains these potentially life-threatening
disorders and how psychological therapies can help people recover.
When does drinking become a problem?
What causes alcohol-related disorders?
How do alcohol-related disorders affect people?
When should someone seek help?
How can a psychologist help?
Does treatment really work?
When does drinking become a problem?
For most adults, moderate alcohol use -- no more than two drinks a day
for men and one for women and older people -- is relatively harmless. (A
"drink" consists of 1.5 ounces of spirits, 5 ounces of wine or 12 ounces
of beer, which contain equal amounts of alcohol.) Moderate use, however,
lies at one end of a continuum that moves through alcohol abuse to alcohol
dependence:
- Alcohol abuse is a drinking pattern that results in adverse
consequences that are both significant and recurrent. Alcohol abusers
may fail to fulfill major school, work or family obligations. They may
have drinking-related legal problems, such as drunk driving arrests.
They may have relationship problems related to their drinking.
- People with alcoholism-technically known as alcohol dependence-have
become compulsive in their alcohol use. Although they can control their
drinking at times, they are often unable to stop once they start. As
their tolerance increases, they may need more and more alcohol to
achieve the same "high." Or they may become physically dependent on
alcohol, suffering withdrawal symptoms such as nausea, sweating,
restlessness, irritability, tremors and even hallucinations and
convulsions when they stop after a period of heavy drinking. It doesn't
matter what kind of alcohol someone drinks or even how much: alcohol
dependent people simply lack reliable control over their drinking.
According to the National Institute on Alcohol Abuse and
Alcoholism (NIAAA), one in 13 American adults is an alcohol abuser or
alcoholic at any given time. A 1997 government survey revealed that
drinking problems are also common among younger Americans -- despite the
fact that most states outlaw drinking under age 21. Almost five million
youths aged 12 to 20 engage in binge drinking, for example, with females
downing at least four drinks on a single occasion and males at least five.
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What causes alcohol-related disorders?
Problem drinking has multiple causes, with genetic,
physiological, psychological and social factors all playing a role. For
some alcohol abusers, psychological traits such as impulsiveness, low
self-esteem and a need for approval prompt inappropriate drinking. Others
drink as a way of coping with emotional pain. Still others use alcohol to
"medicate" psychological disorders. Once people begin drinking
excessively, the problem can perpetuate itself. Heavy drinking can cause
physiological changes that make more drinking the only way to avoid
discomfort.
Genetic factors render some people especially
vulnerable to alcohol dependence. (Contrary to myth, being able to "hold
your liquor" means you're probably more at risk -- not less.) Yet a family
history of alcoholism doesn't mean that children of alcoholics will
automatically grow up to become alcoholics themselves. Environmental
factors such as peer pressure and the easy availability of alcohol can
also play key roles. Although alcohol-related disorders can strike anyone,
poverty and physical or sexual abuse also increase the odds.
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How do alcohol-related disorders affect
people?
While some research suggests that small amounts of
alcohol may have beneficial cardiovascular effects, there is widespread
agreement that heavier drinking can lead to health problems. In fact,
100,000 Americans die from alcohol-related causes each year. Short-term
effects include distorted perceptions, memory loss, hangovers and
black-outs. Many problems aren't apparent until they become serious,
however. Over the long term, heavy drinking can cause impotence, stomach
ailments, cardiovascular problems, cancer, central nervous system damage,
serious memory loss and liver cirrhosis. It also increases the chances of
dying from automobile accidents, homicide and suicide. Although men are
much more likely than women to develop alcoholism, women's health suffers
more even at lower levels of consumption.
Although moderate
drinking may result in relaxation and euphoria, heavy drinking also has a
very negative impact on mental health. In fact, alcohol abuse and
alcoholism can worsen existing conditions, such as depression or
schizophrenia, or induce new problems, such as serious memory loss,
depression or anxiety.
People with alcohol-related disorders don't
just hurt themselves, however. According to NIAAA, more than half of
Americans have at least one close relative with a drinking problem. The
results can be devastating. Spouses are more likely to face domestic
violence. Children are more likely to develop psychological problems,
suffer physical and sexual abuse and neglect and -- because of the
combination of genetic vulnerability and social learning -- grow up to be
alcoholics. Women who drink during pregnancy run a serious risk of
damaging their fetuses. It's not just relatives who suffer. Heavy drinkers
often kill strangers through accidents or homicide.
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When should someone seek
help?
Because some in our society view alcohol-related
disorders as a sign of moral weakness, individuals often hide their
drinking or deny they have a problem. How can you tell if you or someone
you know is in trouble? Signs of a possible problem include having friends
or relatives express concern, being annoyed when people criticize your
drinking, feeling guilty about your drinking and thinking that you should
cut down but finding yourself unable to do so. Needing a morning drink to
steady your nerves or relieve a hangover is another warning sign.
Alcoholics usually can't stop drinking through willpower alone.
Most need outside help. They may need medically supervised detoxification
to avoid potentially life-threatening withdrawal symptoms such as
seizures, for instance. Depending on the problem's severity, treatment can
take place during office visits, hospital stays or residential treatment
programs. Once people are stabilized, they need help resolving
psychological issues that may be associated with problem drinking.
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How can a psychologist
help?
Psychologists play a vital role in the successful
treatment of alcohol-related disorders, serving as integral members of the
multidisciplinary team that may be required to provide care. Be sure to
choose a psychologist who is experienced in working with alcohol-related
disorders. To improve the chances of recovery, seek help early.
Using several types of psychological therapies, psychologists can
help people address psychological issues involved in their problem
drinking. These therapies include cognitive-behavioral coping skills
treatment, motivational enhancement therapy and 12-step facilitation
approaches. All have received support from well-designed, large-scale
treatment trials. These therapies can help people boost their motivation
to stop drinking, identify circumstances that trigger drinking, learn new
methods to cope with high-risk drinking situations and develop social
support systems within their own communities. In addition to psychological
therapies, psychologists can provide referrals to self-help groups such as
Alcoholics Anonymous.
The treatment process doesn't end once
drinking does, however. To help prevent relapses, psychologists typically
keep working with people as they begin new lives. Even after formal
treatment ends, many people seek additional support through continued
involvement in self-help groups.
Because families influence both
drinking and recovery, marital and family therapy may prove helpful.
Psychologists can help families repair relationships and navigate the
complex transitions that occur as recovery begins. They can help families
understand alcoholism and learn how to support family members in recovery.
And they can refer family members to self-help groups such as Al-Anon and
Alateen.
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Does treatment really
work? Yes. Evidence strongly suggests that many people --
especially those with jobs, families and other forms of social support --
can resolve their alcohol-related problems after their first attempt. Not
everyone is so fortunate, however. Some require a number of attempts to
solve their drinking-related problems.
Alcohol-related disorders
severely impair functioning and health. But the prospects for successful,
long-term problem resolution are good for people who seek help from
appropriate sources. Qualified psychologists with experience in this area
can help those who suffer from alcohol-related disorders address their
problems and resolve them in an appropriate manner.
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The American Psychological Association Practice Directorate
and the APA College of Professional Psychology gratefully acknowledge the
assistance of Peter E. Nathan, PhD, John Wallace, PhD, and Joan Zweben,
PhD, in developing this fact sheet.
January
2000
This document may be reproduced in its entirety without
modifications.
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| Primo Piano Dipartimento Politiche Antidroga
Presidenza del Consiglio dei Ministri |
- Principi generali della posizione italiana contro l’uso di droghe ( IT, EN)
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