What Is Alcohol Abuse?

Alcohol abuse differs from alcoholism in that it does not include an extremely strong craving for alcohol, loss of control over drinking, or physical dependence. Alcohol abuse is defined as a pattern of drinking that results in one or more of the following situations within a 12-month period:

• Failure to fulfill major work, school, or home responsibilities
• Drinking in situations that are physically dangerous, such as while driving a car or operating machinery
• Having recurring alcohol-related legal problems, such as being arrested for driving under the influence of alcohol or for physically hurting someone while drunk
• Continued drinking despite having ongoing relationship problems that are caused or worsened by the drinking

Although alcohol abuse is basically different from alcoholism, many effects of alcohol abuse are also experienced by alcoholics.

What Are the Signs of a Problem?

How can you tell whether you may have a drinking problem? Answering the following four questions can help you find out:

• Have you ever felt you should cut down on your drinking?
• Have people annoyed you by criticizing your drinking?
• Have you ever felt bad or guilty about your drinking?
• Have you ever had a drink first thing in the morning (as an "eye opener") to steady your nerves or get rid of a hangover?

One "yes" answer suggests a possible alcohol problem. If you answered "yes" to more than one question, it is highly likely that a problem exists. In either case, it is important that you see your doctor or other health care provider right away to discuss your answers to these questions. He or she can help you determine whether you have a drinking problem and, if so, recommend the best course of action.

Even if you answered "no" to all of the above questions, if you encounter drinking-related problems with your job, relationships, health, or the law, you should seek professional help. The effects of alcohol abuse can be extremely serious—even fatal—both to you and to others.

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Ten Drug and Alcohol Policies That Save Lives

In every community, local leaders are grappling with problems caused by drug and alcohol use. Everyone wants to know: What really works? Which public policies are most effective in preventing and treating these problems? How can we save lives?

These questions are especially important for elected officials. But many politicians call for policies that won't work, while few even know that proven strategies exist. Every candidate for public office ought to know that there are better ways to prevent alcohol and drug problems than punishing people who have a disease.

Join Together has created a new publication that identifies proven strategies that every policymaker should know about. Ten Drug and Alcohol Policies That Will Save Lives draws on strong scientific research to make a concise and persuasive case for policy measures that are proven to have a positive effect. These includeincreasing alcohol taxes; requiring insurance coverage for the treatment of drug and alcohol problems on par with other diseases; supporting the use of effective addiction medications; screening routinely for alcohol and drug problems in every primary care and emergency room visit; requiring effective treatment and supervised aftercare instead of incarceration for nonviolent offenders. The policy proposals in this document are backed by research and supported by the public, which has shown great common sense on issues like restricting beer and other alcohol advertising targeted at children, and favoring treatment over jail for non-violent alcohol and other drug users.

The document is being distributed to all state and federal candidates running for Congress, governor, state legislator and other statewide elected offices. Individuals and organizations across the country have contributed to help print and mail 15,000 copies to reach every candidate, regardless of political affiliation. All candidates will receive the mailing before Election Day.

In addition, organizations and community leaders in Missouri, New Hampshire, Texas and other locations are downloading the document to distribute locally at candidate forums and events. "Together, we will educate the candidates about sensible measures that really make a difference," said David Rosenbloom, director of Join Together.

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I Do Not Need Rehab

Your family, friends, or coworkers are trying to make you go to rehab, but you don’t need it. You’re just having a little fun, going through a tough phase, or handling things the best way you can.

You may honestly believe that. But when everyone knows you have a problem but you, you’re probably in denial. Your drug or alcohol use has had a negative impact on your relationships, your job, your health, your finances, or some other area of your life but you can’t or won’t see it because that might mean having to give up your habit and face some difficult issues.

Addicts are often the last ones to recognize their disease and will blame everything but the addiction as their lives fall apart. Going through denial does not make an addict a liar, manipulator, or a bad person. Denial is an automatic psychological response to stress, conflict, and pain – a defense mechanism that helps people handle stress in the only way they currently know how. Their thoughts are so jumbled and their heads so fogged by substance abuse, they cannot distinguish the truth from a lie.

The Stages of Denial

Many addicts go through a number of stages of denial before finally admitting they have a problem with drugs or alcohol.

Stage 1: The addict minimizes his substance abuse problem by saying he is using less than he is or underestimating the seriousness of the problem. In some cases, the addict may lack accurate information about the disease of addiction and truly believes his use does not rise to level of addiction.

Stage 2: As it gets more difficult to minimize the problem, the addict begins making up excuses or elaborate stories to justify his drinking or drug use. An addict in this stage of denial will often argue, “If you had my problems, you’d use drugs, too.”

Stage 3: As the addict’s loved ones and friends become less tolerant of the excuses, the addict becomes angry or defensive, blaming others for her problems rather than accepting personal responsibility. For example, an alcoholic’s marriage is falling apart because of her drinking, but she blames her spouse for all of the couple’s problems.

In some cases, individuals already in recovery may revisit the stages of denial, believing they can use drugs or alcohol moderately without relapsing or believing they can safely use a drug other than the one they were addicted to before. Many recovering addicts will need to revisit a substance abuse treatment program or 12-Step program to internalize lasting change.

Throughout each of these stages, there are common patterns denial can take. Do you recognize any of these?

• Let’s talk about anything but the problem (avoidance)

• I don’t have a problem (absolute denial)

• My drinking/drug use is not that bad (minimizing)

• I have a good reason to drink or use drugs (rationalizing)

• It’s not my fault – it’s yours (blaming)

• Other people drink or use drugs more than me, so I don’t have a problem (comparing)

• I’ll accept help if you do what I want (manipulating)

• I’ll say whatever you want to hear as long as you leave me alone (compliance)

• I feel fine so I couldn’t have a problem (flight into health)

• Nothing can make it better so I may as well not try (strategic hopelessness)

• I’m not hurting anyone else and I have the right to drink or use drugs if I want (democratic disease state)

Overcoming Denial

Denial of an addiction is unhealthy and destructive and keeps the addict from living in reality. Denial can last for months, years, or even a lifetime. Ironically, as the 12 Steps of AA make clear, an addict must acknowledge his powerlessness over his addiction in order to reclaim the ability to lead a healthy, drug-free life.

Overcoming denial often requires a number of steps and efforts by loved ones:

• Be willing to admit that there is a problem and avoid enabling or co-dependent behaviors. These will only prolong the addiction and draw you further into your loved one’s disease.

• Talk to the addict by gently and honestly expressing your emotions and your pain and asking him to share his perception of the situation.

• If your efforts aren’t working, arrange an intervention, either with a group of loved ones and friends or by using a professional interventionist. By expressing your concerns and factually and non-judgmentally pointing out troubling behaviors, you may be able to convince the addict to get help.

• Call an addiction treatment center for more information or tips on getting a loved one into treatment.

• If the addict refuses to accept treatment, move on, seek support for yourself, and try reaching out to the addict again at a later date.

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Teens Lack Addiction Treatment Options

According to a new report from the University of Kentucky, 90 percent of the 1.4 million adolescents struggling with substance abuse do not get treatment, partly because not enough treatment programs are devoted to teens. The report was compiled by Hannah Knudsen, an assistant professor in the University of Kentucky Department of Behavioral Science and a researcher in the university's Center on Drug and Alcohol Research.

The report contained a random sampling of 154 programs. Knudsen looked at nine domains of quality. Overall, the cohort of programs received an average score. Addiction treatment services for teens in the Lexington, Kentucky area appear especially lacking. Of the 38 programs in the area, only six offer services for teens.

Knudsen commented, "One barrier has to do with the limited amount of funding that exists for substance abuse treatment. ... In addition, treating adolescents means that treatment programs need to find counselors with experience and training that helps them to work well with teenagers; that can also be a challenge." (Source: kykernel.com)

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Study Blames Alcohol, Other Drug Users for Crimes

A new study concludes that people who misuse alcohol and other drugs are responsible for about 25 percent of all violent crimes, Reuters reported May 21.
Seena Fazel of the University of Oxford in England and Martin Grann of the Karolinska Institute in Stockholm, Sweden, compared Sweden's national crime register for the years 1988-2000 with hospital discharges of individuals diagnosed with alcohol and other drug misuse and psychoses.

The researchers found that 16 percent of violent crimes, including murder, robbery, assault, and rape, were committed by individuals who had been discharged from the hospital after treatment for alcohol misuse, while 10 percent were linked to those who misused drugs such as amphetamines and opiates.

"It is likely you will find the same sort of figures in Western Europe and North America," said Fazel. "There needs to be more integration between the criminal-justice system and mental-health services because of this close association between crime and people who leave hospital with drug and alcohol problems."

The researchers concluded that, "Using resources to treat people with these problems could be cost-effective in terms of crime reduction." In particular, Fazel said that treatment should be considered if a person has been convicted of a violent crime. "Probation officers and mental health professionals should continue to work more closely," he said.

The study's findings are published in the May 22, 2004 issue of the British Medical Journal.

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