|
|
http://pubs.niaaa.nih.gov/publicati..._HTML/facts.htm
What Is Alcoholism?
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’s 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’t 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’s environment
influence whether a person with a genetic risk for alcoholism ever
develops the disease. A person’s risk for developing alcoholism can
increase based on the person’s environment, including where and how he
or she lives; family, friends, and culture; peer pressure; and even
how easy it is to get alcohol.
Genetics: Alcoholism is a complex disease. Therefore, there are likely
to be many genes involved in increasing a person’s risk for
alcoholism. Scientists are searching for these genes, and have found
areas on chromosomes where they are probably located. Powerful new
techniques may permit researchers to identify and measure the specific
contribution of each gene to the complex behaviors associated with
heavy drinking. This research will provide the basis for new
medications to treat alcohol-related problems.
Treatment: NIAAA-supported researchers have made considerable progress
in evaluating commonly used therapies and in developing new types of
therapies to treat alcohol-related problems. One large-scale study
sponsored by NIAAA found that each of three commonly used behavioral
treatments for alcohol abuse and alcoholism—motivation enhancement
therapy, cognitive-behavioral therapy, and 12-step facilitation
therapy—significantly reduced drinking in the year following
treatment. This study also found that approximately one-third of the
study participants who were followed up either were still abstinent or
were drinking without serious problems 3 years after the study ended.
Other therapies that have been evaluated and found effective in
reducing alcohol problems include brief intervention for alcohol
abusers (individuals who are not dependent on alcohol) and behavioral
marital therapy for married alcohol-dependent individuals.
Medications development: NIAAA has made developing medications to
treat alcoholism a high priority. We believe that a range of new
medications will be developed based on the results of genetic and
neuroscience research. In fact, neuroscience research has already led
to studies of one medication—naltrexone (ReVia™)—as an anticraving
medication. NIAAA-supported researchers found that this drug, in
combination with behavioral therapy, was effective in treating
alcoholism. Naltrexone, which targets the brain’s reward circuits, is
the first medication approved to help maintain sobriety after
detoxification from alcohol since the approval of disulfiram
(Antabuse®) in 1949. Acamprosate, an anticraving medication, has been
widely used in Europe and just recently was approved for use in the
United States. Researchers believe that acamprosate works on different
brain circuits to ease the physical discomfort that occurs when an
alcoholic stops drinking. All of these new medications have their
roots in neuroscience research, as do other drugs that are currently
under investigation for the treatment of alcoholism.
Combined medications/behavioral therapies: NIAAA-supported researchers
have found that available medications work best with behavioral
therapy. Thus, NIAAA has initiated a large-scale clinical trial to
determine which of the currently available medications and which
behavioral therapies work best together. Naltrexone and acamprosate
will each be tested separately with different behavioral therapies.
These medications will also be used together to determine if there is
some interaction between the two that makes the combination more
effective than the use of either one alone.
In addition to these efforts, NIAAA is sponsoring promising research
in other vital areas, such as fetal alcohol syndrome, alcohol’s
effects on the brain and other organs, aspects of drinkers’
environments that may contribute to alcohol abuse and alcoholism,
strategies to reduce alcohol-related problems, and new treatment
techniques. Together, these investigations will help prevent alcohol
problems; identify alcohol abuse and alcoholism at earlier stages; and
make available new, more effective treatment approaches for
individuals and families.
|
|