Alcoholism - “Alcohol Dependence Syndrome”

Alcoholism or alcohol dependence, is a disease that includes 4 symptoms:

• Craving: A strong need or urge to drink.
• Loss of control: Not being able to stop drinking once drinking has begun.
• Physical dependence: Withdrawal symptoms, such as upset stomach, sweating, shakiness, and anxiety after stopping drinking.
• Tolerance: The need to drink greater amounts of alcohol to get “high”.

Alcoholism is the most severe stage of a group of drinking problems which begins with binge drinking and alcohol abuse. Alcohol problems occur at different levels of severity, from mild and annoying to life-threatening. Although alcohol dependence (alcoholism) is the most severe stage, less severe drinking problems can also be dangerous.

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The term "alcoholism" refers to a disease known as alcohol dependence syndrome, the most severe stage of a group of drinking problems which begins with binge drinking and alcohol abuse. Alcohol problems occur at different levels of severity, from mild and annoying to life-threatening. Although alcohol dependence (alcoholism) is the most severe stage, less severe drinking problems can also be dangerous.

Officially, binge drinking means having five or more drinks in one session for men and four or more for women. Another definition for binge drinking is simply drinking to get drunk. It is the most common drinking problem for young people, under age 21.

It's not chronic heavy drinkers who have the highest risk of alcohol-related injuries, it is the moderate drinkers who sometimes drink heavily who are more like to suffer injuries, especially while they are drinking.

"It's not only the amount of alcohol consumed that shapes the risk for injury, but also the usual consumption pattern," said lead researcher Gerhard Gmel, of the Alcohol Treatment Center at the Lausanne University Hospital and the Swiss Institute for the Prevention of Alcohol and Drug Problems. "At highest risk are those who usually consume moderately but sometimes binge drink. This is true for both sexes."

Gmel and colleagues screened 8,736 emergency department patients who had been admitted to the hospital's surgical ward during an 18-month period. Their study examined how the interaction among three aspects of drinking behavior -- average weekly consumption, binge-drinking episodes and the amount of alcohol consumed before hospital admission -- affects risk of injury.

The risk of injury increased for all types of drinkers with higher alcohol consumption in the 24 hours before hospital admission, but the greatest risk was among moderate drinkers who occasionally drank heavily and who had drank heavily in the previous 24 hours.

According to Gmel, during bouts of heavy drinking, moderate-drinking women were more than seven times as likely to be injured than women who never drank. Among moderate-drinking men who sometimes binged, the risk of injury were more than six times greater compared to male non-drinkers.

"This study confirms what a lot of us think happens with risky drinking behavior," said Linda Degutis, associate professor of surgery and public health at Yale University.

About 20 percent of adults in the United States are considered hazardous and harmful drinkers. "These are people who are not physically dependent on alcohol, but they binge drink or have health or social consequences because of their drinking," Degutis said.

Interventions that target chronic high-volume drinkers will not be effective in reducing injuries, according to Gmel, because the majority of injuries occur in the much larger population of moderate drinkers.

"There are many effective preventive measures, including strict enforcement of drinking driving policies and responsible beverage serving," he said. "The most effective strategy would be a combined effort at the individual and societal levels. This would include targeting happy hours and other environments that encourage rapid consumption of large quantities of alcohol and changing social norms of what is acceptable drinking behavior."

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