Alcohol screening can spot addiction

Apr 7 2004

Have you ever felt like you needed a drink? If an occasional cocktail changes into a need, it could mean an alcohol problem. National Alcohol Screening Day is April 8. In cities and towns throughout the United States, screening programs will be offered to help people determine whether they exhibit drinking behaviors that could be signs of alcohol addiction.

Almost half of Americans over 12 (yes, that includes adolescents) are current drinkers -- that is, who have had at least one drink in the past 30 days. About one-fifth of the same group had a binge drinking episode in the past 30 days. According to the National Institute on Alcohol Abuse and Alcoholism, about one in 14 Americans are alcoholics and more than one-half of Americans have a close family member who is an alcoholic. Despite a burgeoning literature on the science of alcoholism and addiction, alcoholism continues to be misunderstood by the general public.

Most people can drink alcohol and stay within limits. Moderate drinking is defined as two standard drinks (a standard drink is one 12 oz. beer or wine cooler, 5 oz. of wine or 1.5 oz. of 80 proof liquor) per day for men and one per day for women. This is not gender discrimination. Alcohol mixes in body water and women have less water filled tissue (muscle) for their weight than men so similar amounts cause higher blood levels in women.

Alcoholics are unable to limit alcohol consumption. It's not simply a matter of strength of will. Alcohol causes a different sensation in the alcoholic than in everyone else. A non-alcoholic who drinks too much may experience some type of euphoria, but tends to find the sensation unpleasant. The alcoholic's euphoria is much more pleasurable and sustained. It is a feeling not easily understood by the non-alcoholic, and it drives the alcoholic to achieve it repeatedly. Each attempt falls farther from the euphoria they have come to expect, until continued drinking is necessary to maintain a sense of being normal.

This chemical process is so powerful that the alcoholic will drink in risky situations, such as, driving or will drink when it is inappropriate, such as, at work. Alcoholics will drink when their family expresses concern or asks them to cut back. Even alcoholics who think they should cut down will continue to overindulge because of the intense need to feel the euphoria of alcohol.

Eventually, family and friends will be negatively impacted by the alcoholic. For example, spouses may cover up for an alcoholic who is too hung over or incapacitated to come to work. An alcoholic may try to manipulate a spouse or child in order to continue to drink because of the overwhelming compulsion alcohol causes them.

On the other hand, people who are not alcoholics drink and may never have a problem. How can you tell who is at risk? Unfortunately, there is no way currently to determine that. Having a sibling or parent with an alcohol or drug addiction puts you at high risk. Avoiding excess drinking at any time can help reduce the risk, but typically a person can not be certain of his or her chance of alcoholism until it occurs. Children should never consume alcohol in any amount -- no exceptions. Children who are at risk for alcoholism can become addicted much more easily than adults and there is no way to tell to whom it will happen until they become alcoholics.

Even though no specific test is available to look for alcoholism, alcohol screening can help identify behaviors that could be due to alcoholism. A commonly used test is referred to as the CAGE questions:

Have you ever tried to Cut down on your drinking?
Have people Annoyed you by criticizing your drinking?
Have you felt bad or Guilty about your drinking?
Have you ever had an Eye-opener?

A "yes" to even one of these questions could mean an alcohol problem; more than one "yes" means it is highly likely that alcoholism exists.

Other dangerous signs: regularly drinking more than two drinks a day (one per day for women) and having had more than five drinks at one setting more than once; drinking in dangerous situations, e.g, driving or if your doctor has told you that you have physical damage from drinking, such as liver disease; arguments with or estrangements from your spouse or family or strained relations with coworkers due to drinking; lateness or absences from work or firing due to alcohol; being a victim of violence related to drinking.

Although moderate alcohol consumption can have benefits on cholesterol and the heart, excess alcohol can injure the liver, pancreas, brain and nerves and the heart and it can increase the risk of certain cancers. Pregnant women risk causing birth defects and fetal alcohol syndrome in their babies if they drink.

If you think you or someone you know may have a drinking problem based on the screening questions, help is available. Alcoholics Anonymous is a good place to start. Information on this organization can be found at http://www.aa.org/ or through your doctor, who can also refer you to a professional alcohol counselor. Because alcoholism is an illness that affects those around them, families of alcoholics also need help. Al-anon is for spouses and Alateen for children of alcoholics. Information on these organizations can be found at http://www.al-anon.alateen.org/ The phone book often has numbers for local chapters under "alcoholism" and the Web site has links to local meetings.

Drinking alcohol has been part of the social fabric of human behavior since it was first discovered, but for some of us, its effects are slowly erosive. This is a good time to review the screening questions for yourself or go to http://www.nationalalcoholscreeningday.org/alcohol.asp to find a screening site near you.