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Binge Drinking and Alcoholism

Binge Drinking and Alcoholism

Binge drinking seems to have become a bit of a British disease. With the price of wine so low in relative terms, the occasional glass of wine in the evening can easily turn into half a bottle, then into a bottle.

A bottle of red wine contains 10.5 units of alcohol.

The maximum safe levels of alcohol intake per week are 21 units for men and 14 units for women.

3 bottles of red wine a week puts a woman at double the safe weekly alcohol intake and a man also over the safe limit.

A recent study of people reporting depression to GP found that the majority of people recovered fully within 6 weeks of alcohol abstinence.

Risk Factors for Alcohol Dependence

‘Alcohol dependence is often characterised by the vicious circle of short-term psychological benefits from drinking, at the expense of long-term deterioration and increasing depression and sense of hopelessness.’ Alcohol and Mental Health, Institute of Alcohol Studies

The following have been demonstrated to be significant risks factors in the development of alcohol dependency (as differentiated from ‘alcohol abuse’).

  1. Lack of facial flushing
  2. Low responsitivity to alcohol
  3. Background ‘trait’ anxiety – i.e. social anxiety
  4. A family history of alcohol dependency

High levels of alcohol use can be predicted by such personality characteristics such as rebelliousness, impulsivity, and sensation seeking.

Alcohol dependence is significantly less common when there is a high level of facial flushing in response to alcohol, there is high social support and the person is highly affected by alcohol intoxication.

There is no association between alcohol dependence and left-handedness.

The correlation between mental health disorders and alcohol dependency is high.  In some, the mental health disorder leads to alcohol dependency.  In others, the alcohol dependency leads to the mental health disorder.

People with mental health disorders, which may be unrecognised and undiagnosed, may use alcohol to self-medicate unaware that medical treatment for their underlying symptoms is available and is safer and probably more effective.

  • Anti-Social Personality Disorder (ASPD) carries a risk factor for alcohol dependency 21 times higher than the average person.
  • Depression doubles the risk from normal.
  • Schizophrenia triples the risk from normal.
  • Anxiety raises the risk by about one and a half times.

In case you are worried that you are unusual in some way, it is worth knowing that in the USA over 700,000 people per day are receiving treatment for alcohol dependence.  I do not currently have any figures for the UK.

Approximately 20% of people with alcohol dependence achieve long-term sobriety without treatment.

Alcohol dependence can be suspected to be a problem in men drinking more than 50 units per week and in women drinking more than 35 units per week.

Diagnosis of alcohol dependence can be made using criteria from the ICD10.

According to these criteria, dependence is diagnosed if three or more of the following have been present together during the previous year:

  • A strong desire or compulsion to drink alcohol.
  • Difficulty in controlling drinking in terms of its onset, when to stop, or actual level of alcohol intake.
  • A physiological withdrawal state (e.g. tremor, sweating, rapid heart rate, anxiety, insomnia, or, less commonly, seizures, disorientation, hallucinations) when drinking has ceased or is reduced; or drinking alcohol occurs to relieve or avoid such a withdrawal state.
  • Evidence of tolerance, such that increased doses of alcohol are required in order to achieve effects originally produced by lower doses.
  • Progressive neglect of alternative pleasures or interests because of drinking; and increased amounts of time necessary to obtain or take alcohol, or to recover from its effects.
  • Persisting with alcohol use despite awareness of overtly harmful consequences.

The New Alcoholics 
I am increasingly seeing clients with alcohol problems who clearly do not fit the stereotypical alcoholic image.

They are intelligent, successful, high achievers with good family and social networks but find abstinence very difficult. Wine is usually the preferred drug of choice.

Commonly I hear:

“I drink to relax”
“It helps me sleep”
“I don’t feel the weekend is complete unless I’ve got drunk.”
“It makes me feel more social.”
“It is my reward at the end of the day.”

The most common symptoms are a loss of energy, minor depression (the classic “self-loathing” the morning after), loss of motivation, anxiety and social withdrawal.

It is interesting how so few regular drinkers make the connection between their alcohol intake and problems in their lives.

I had one client who had consumed one and a half bottles of wine per night who came to me for help with impotence. He utterly denied that there could be a causal relationship between his wine intake and his impotence. Like many drinkers, he expressed a marked level of anger at the suggestion that it might be the alcohol that was causing the other problems in his life. Anxiety and depression also go hand in hand with alcohol and the drinker gets caught in a vicious circle whereby they drink to feel better, thus worsening the problem.

The New Alcoholics have a problem in that they are not suited to the therapies where they 1. are required to hit rock bottom and 2. have to stand up in groups and say, “Hi, my name is…and I am an alcoholic” and attend regular meetings.

In order to get help with a problem in drinking, is it necessary to take on the identity of an “alcoholic”?

Of course not.

However, if what you seek is to “control your drinking” rather than abstain from drinking, you might need to reconsider your outcome. If the thought of not having a drink at all bothers you, then possibly you have a bigger problem than you imagine.

“Controlled drinking” is probably about as realistic as “controlled heroin use.” We would hardly expect someone addicted to heroin to be able to carry on using the drug in a controlled, non-addicted manner, and the same is pretty much true for alcohol users too.

Further Information

New Brain Cells Develop During Alcohol Abstinence, UNC Study Shows
“When used in excess, alcohol damages brain structure and function. Alcoholics have impairments in the ability to reason, plan or remember,” said Crews, also professor of pharmacology and psychiatry in UNC’s School of Medicine. “A variety of psychological tests show alcoholics have a difficulty in ability to understand negative consequences.”

Alcohol Dependency 
New research says that 3.8 million people in England and Wales are dependent on alcohol, and that a shortfall in funding for alcohol services means many people have to wait for help that they badly need.

Alcohol Concern
Alcohol Concern is the national agency on alcohol misuse. They work to reduce the incidence and costs of alcohol-related harm and to increase the range and quality of services available to people with alcohol-related problems.

A number of people have contacted me to let me know about “glutamine” and alcohol cravings. There seems to be a growing body of anecdotal evidence suggesting that largish doses of the protein Glutamine – which is commonly found in health food shops and sold in bulk as a bodybuilding food supplement – actively reduces alcohol cravings. Search google.groups with keywords, “alcohol cravings glutamine” for further information on this.

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