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. Some individuals drink to cope with or "medicate" emotional problems. Social and environmental factors such as peer pressure and the easy availability of alcohol can play key roles. Poverty and physical or sexual abuse also increase the odds of developing alcohol dependence.

As with similar substances with a sedative-hypnotic mechanism, such as barbiturates and benzodiazepines, withdrawal from alcohol dependence can be fatal if it is not properly managed. Alcohol's primary effect is the increase in stimulation of the GABAA receptor, promoting central nervous system depression. With repeated heavy consumption of alcohol, these receptors are desensitized and reduced in number, resulting in tolerance and physical dependence. When alcohol consumption is stopped too abruptly, the person's nervous system experiences uncontrolled synapse firing.

Causes and Risk Factors

A man drinking from a bottle of liquor while sitting on a boardwalk, ca.

The Alcohol Use Disorders Identification Test , a screening questionnaire developed by the World Health Organization, is unique in that it has been validated in six countries and is used internationally. Like the CAGE questionnaire, it uses a simple set of questions – a high score earning a deeper investigation.

Treating Alcoholism

People who begin drinking — especially binge drinking — at an early age are at a higher risk of alcohol use disorder. Acamprosate may stabilise the brain chemistry that is altered due to alcohol dependence via antagonising the actions of glutamate, a neurotransmitter which is hyperactive in the post-withdrawal phase. By reducing excessive NMDA activity which occurs at the onset of alcohol withdrawal, acamprosate can reduce or prevent alcohol withdrawal related neurotoxicity.

Socially, alcoholism may be tied to family dysfunction or a culture of drinking. After the initial treatment program, the employee may be in follow-up counseling and treatment for an extended period of time, possibly up to a year. This will most likely consist of outpatient counseling, AA meetings, and follow-up sessions with the EAP counselor. Detoxification – Detoxification, also known as "detox," is a process whereby the alcoholic undergoes a supervised withdrawal. The body can begin to recover from the toxic effects of alcohol and the patient can become sober.

What does alcohol do to the brain?

Some people may drink alcohol to the point that it causes problems, but they’re not physically dependent on alcohol. Societal factors include level of economic development, culture, social norms, availability of alcohol, and implementation and enforcement of alcohol policies. Adverse health impacts and social harm from a given level and pattern of drinking are greater for poorer societies. Alcohol is a psychoactive substance with dependence-producing properties that has been widely used in many cultures for centuries.

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For such reasons, the sociological definition regards alcoholism as merely one symptom of social deviance and believes its diagnosis often lies in the eyes and value system of the beholder. For example, periodic intoxication can cause sickness necessitating days of absence from work. In a modern industrial community, this makes alcoholism similar to a disease. In a rural Andean society, however, the periodic drunkenness that occurs at appointed communal fiestas and results in sickness and suspension of work for several days is normal behaviour. It should be noted that this drunkenness at fiestas is a choice and does not produce regret. If the sociological model were entirely correct, alcoholism should often be expected to disappear with maturation as is the case with many other symptoms of social deviance. A third definition, behavioral in nature, defines alcoholism as a disorder in which alcohol assumes marked salience in the individual’s life and in which the individual experiences a loss of control over its desired use.

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