According to the U.S. National Institute of Alcohol Abuse and Alcoholism, about 70% of American adults always drink at low-risk levels or do not drink at all. (Thirty-five percent of Americans do not consume alcohol.) About 28% of American adults drink at levels that put them at risk for alcohol dependence and alcohol-related problems. - Risk factors for alcohol dependence include: - Age Drinking in Adolescence. About half of under-age Americans have used alcohol. About 2 million people ages 12 - 20 are considered heavy drinkers, and 4.4 million are binge drinkers. Anyone who begins drinking in adolescence is at risk for developing alcoholism. The earlier a person begins drinking, the greater the risk. A survey of over 40,000 adults indicated that among those who began drinking before age 14, nearly half had become alcoholic dependent by the age of 21. In contrast, only 9% of people who began drinking after the age of 21 developed alcoholism. Young people at highest risk for early drinking are those with a history of abuse, family violence, depression, and stressful life events. People with a family history of alcoholism are also more likely to begin drinking before the age of 20 and to become alcoholic. Such adolescent drinkers are also more apt to underestimate the effects of drinking and to make judgment errors, such as going on binges or driving after drinking, than young drinkers without a family history of alcoholism. Drinking in the Elderly Population. Although alcoholism usually develops in early adulthood, the elderly are not exempt. In fact, doctors may overlook alcoholism when evaluating elderly patients, mistakenly attributing the signs of alcohol abuse to the normal effects of the aging process. Alcohol also affects the older body differently. People who maintain the same drinking patterns as they age can easily develop alcohol dependency without realizing it. It takes fewer drinks to become intoxicated, and older organs can be damaged by smaller amounts of alcohol than those of younger people. Also, many of the medications prescribed for older people interact adversely with alcohol. Medications used for arthritis or pain pose a particular danger for interaction with alcohol. - Gender Most alcoholics are men, but the incidence of alcoholism in women has been increasing over the past 30 years. According to the U.S. Centers for Disease Control, about 17% of men and 8% of women meet criteria for alcohol dependence at some point in their lives. Studies suggest that women are more vulnerable than men to many of the long-term consequences of alcoholism. For example, women are more likely than men to develop alcoholic hepatitis and to die from cirrhosis, and women are more vulnerable to the brain cell damage caused by alcohol. - History of abuse Individuals who were abused as children have a higher risk for substance abuse later in life. In one study, 72% of women and 27% of men with substance abuse disorders reported physical or sexual abuse or both. They also had worse response to treatment than those without such a history. - Race and ethnicity Overall, there is no difference in alcoholic prevalence among African-Americans, Caucasians, and Hispanic-Americans. Some population groups, however, such as Native Americans, have an increased incidence of alcoholism while others, such as Jewish and Asian Americans, have a lower risk. Although the biological or cultural causes of such different risks are not known, certain people in these population groups may have a genetic susceptibility or invulnerability to alcoholism because of the way they metabolize alcohol. - Psychiatric and behavioral disorders - Psychiatric Disorders: Severely depressed or anxious people are at high risk for alcoholism, smoking, and other forms of addiction. Likewise, a large proportion of alcohol-dependent people suffer from an accompanying psychiatric or substance abuse disorder. Either anxiety or depression may increase the risk for self-medication with alcohol. Depression is the most common psychiatric problem in people with alcoholism or substance abuse. Alcohol abuse is very common in patients with bipolar disorder and schizophrenia. Specific anxiety disorders, such as panic disorders and social phobia, may pose particular risks for alcohol and substance abuse. Social phobia causes an intense fear of being publicly scrutinized and humiliated. Panic disorders cause intense anxiety and panic attacks. People with these disorders may use alcohol as a way to become less inhibited in public situations or to calm feelings of panic. People who have anxiety disorders are more likely to resume drinking after treatment for alcohol dependence. Long-term alcoholism itself may cause chemical changes that produce anxiety and depression. It is not always clear, then, whether people with emotional disorders are self-medicating with alcohol, or whether alcohol itself is producing mood swings. - Behavioral Disorders and Lack of Impulse Control: Studies indicate that alcoholism is strongly related to impulsive, excitable, and novelty-seeking behavior, and such patterns are established early on. Specifically, children with attention deficit hyperactivity disorder (ADHD), a condition that shares these behaviors, have a higher risk for alcoholism in adulthood. The risk is especially high in children with ADHD and conduct disorder. - Background Alcohol use disorders are generally categorized as: Alcohol Abuse : Alcohol abuse is a pattern of drinking that results in adverse outcomes such as: - Failure to fulfill work or personal obligations - Recurrent use of alcohol in potentially dangerous situations - Problems with the law - Continued use in spite of harm being done to social or personal relationships - Alcohol use can lead to alcohol dependence (alcoholism). Alcohol Dependence (Alcoholism): Alcohol dependence is the medical term for alcoholism. Alcohol dependence is characterized by: - Increased amounts of alcohol are needed to produce an effect (tolerance) - Withdrawal symptoms (nausea, sweating, irritability, tremors, hallucinations, and seizures) develop when drinking is stopped or reduced - Constant craving for alcohol and inability to limit drinking - Continuing to drink in spite of the knowledge of its physical or psychological harm to oneself or others Alcoholism (alcohol dependence) is a chronic illness marked by dependence on alcohol consumption. It interferes with physical or mental health, and social, family, or job responsibilities. This addiction can lead to liver, circulatory, and neurological problems. Pregnant women who drink alcohol in any amount may harm the fetus. - Genetic Factors Genetic factors appear to play a significant role in alcoholism and may account for about half of the total risk for alcoholism. The role that genetics plays in alcoholism is complex, however, and it is likely that many different genes are involved. Research suggests that alcohol dependence, and other substance addictions, may be associated with genetic variations in 51 different chromosomal regions. Even if genetic factors can be identified, however, they are unlikely to explain all cases of alcoholism. It is important to understand that whether they inherit the disorder or not, people with alcoholism are still legally responsible for their actions. Inheriting genetic traits does not doom a child to an alcoholic future. Environment, personality, and emotional factors also play a strong role. - Brain chemical imbalances after long-term alcohol use Alcohol has widespread effects on the brain and can affect neurons (nerve cells), brain chemistry, and blood flow within the frontal lobes of the brain. Neurotransmitters (chemical messengers in the brain) are affected by long-term use of alcohol. When a person who is dependent on alcohol stops drinking, chemical responses create an overexcited nervous system and agitation by changing the level of chemicals that inhibit impulsivity or stress and excitation. High norepinephrine levels, a chemical the brain produces more of when drinking is stopped, may trigger withdrawal symptoms, such as increasing blood pressure and heart rate. This hyperactivity in the brain produces an intense need to calm down and to use more alcohol. Drinking alcohol also stimulates the release of other neurotransmitters (serotonin, dopamine, and opioid peptides) that produce pleasurable feelings such as euphoria, a sensation of being rewarded, and a sense of well-being. Over time, however, alcohol use appears to deplete the stores of dopamine and serotonin. Persistent drinking, therefore, eventually fails to restore mood, but by then the drinker has been conditioned to believe that alcohol will improve spirits (even though it does not). - Social and emotional causes of alcoholic relapse Between 80 - 90% of people treated for alcoholism relapse, even after years of abstinence. Patients and their caregivers should understand that relapses of alcoholism are analogous to recurrent flare-ups of chronic physical diseases. Factors that place a person at high risk for relapse include: - Frustration and anger - Social pressure - Internal temptation - Mental and Emotional Stress: Alcohol blocks out emotional pain and is often perceived as a loyal friend when human relationships fail. It is also associated with freedom and with a loss of inhibition that offsets the tedium of daily routines. When the alcoholic tries to quit drinking, the brain seeks to restore what it perceives to be its equilibrium. - Treatment for alcoholism There are many options for treatment for alcohol use disorders. Treatment options include: * Behavioral therapy, which may include individual sessions with a health professional and support groups * Medications - Possible complications Alcoholism reduces life expectancy by about 10 - 12 years. - Alcoholism and early death Alcohol can affect the body in so many ways that researchers have a hard time determining exactly what the consequences are from drinking. However, it is not just from a higher risk of the more common serious health problems, such as heart attack, heart failure, diabetes, lung disease, or stroke. Alcohol consumption can lead to many problems that can increase the risk for death: - Higher rate of death from injury or violence. - Alcohol drinking can lead to death. This is a particular danger for adolescents who may want to impress their friends with their ability to drink alcohol but cannot yet gauge its effects. - Severe withdrawal and delirium tremens: Delirium tremens occurs in about 5% of alcoholics. It includes progressively severe withdrawal symptoms and altered mental states. In some cases, it can be fatal. - Dangerous health conditions (liver damage, pancreatitis, anemia, upper gastrointestinal bleeding, nerve damage, and erectile dysfunction). - Alcohol abusers who need surgery have an increased risk of postoperative complications, including infections, bleeding, insufficient heart and lung functions, and problems with wound healing. - Alcohol withdrawal symptoms after surgery may impose further stress on the patient and hinder recuperation. Expert says according to Islamic laws and regulations any level of alcohol is prohibited because of spiritual, mental and behavioral changes in those who dare drink it and also to follow the Mighty Creator’s orders regarding bondage rules and , one must not take alcohol at all, except small amounts present in medicines for the treatment of various diseases. Allah, the Mighty creator of human being has determined healthy and unhealthy foods in Quran. Alcohol has been said in the Holy Book to contain limited benefits (such as calories), but its harms are much more than its minimal benefits. Therefore it is not wise to drink it at all.