1) What is alcoholism?
alcoholism is seen as a disease that has four symptoms:
* Cravings or strong urges to drink
* Impaired control over the amounts and frequency of drinking
* Physical dependence on alcohol so that if the alcoholic stops drinking he/she experiences withdrawal effects such as nausea, shaking, sweating, and anxiety
* Tolerance, which means that increased amounts of alcohol are required in order to get drunk

The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, published by the American Psychiatric Association (DSM-IV TR) has formal criteria for the diagnosis of alcoholism that are used for clinical and academic purposes. You can find out more about the diagnosis of alcoholism by clicking this link.

2. Is alcoholism a disease?
It is generally agreed in mainstream science that alcoholism is a disease. It has defineable symptoms, a predictable course, and can be treated in standard ways. alcoholism is understood to be a chronic disease which means that it lasts for a long time. This means that if an alcoholic starts drinking (even after being sober for many years) there is a very high risk that his/her alcoholism will return in full force. The causes of alcoholism have been linked to a combination of genetic and environmental factors.

3. Is alcoholism inherited?
Some research suggests that alcoholism does run in families. This could be either because of a genetic inheritance or something to do with the family environment that predisposes a person to drink. If there is a gene that makes you susceptible to alcoholism it has not yet been identified. There must be at least some element of environmental risk associated with alcoholism. Some people develop alcoholism even if nobody else in their family is alcoholic. Other people grow up in alcoholic families and don't become alcoholic. Having a genetic risk to alcoholism does not make alcoholism your unavoidable destiny. By making responsible choices you will be able to avoid developing a drinking problem.

5. Can alcoholism be treated?
Absolutely. There are many alcohol rehab facilities in South Africa that offer effective treatment for alcoholism. There are exciting new developments being made in the field of medicine (like this one) that suggest more effective treatments are on the horizon. Currently alcohol treatment relies on a mix of psychotherapeutic interventions in either residential or outpatient rehab facilities.

6. Which medications treat alcoholism?
There are oral medications that have been shown to help people avoid relapsing on alcohol. Three that are currently commonly used are disulfiram (Antabuse®), naltrexone (Depade®, ReVia®), and acamprosate (Campral®). These drugs work in different ways. Disulfiram will make the person feel sick after drinking alcohol; Naltrexone reduces cravings; and Acamprosate
reduces the psychological withdrawal symptoms.

Certain other medications (such as benzodiazepine) might be used in an alcohol detox center to help the alcoholic manage the withdrawal symptoms.

At the moment medications are not able to completely treat alcoholism. alcoholism has behavioural consequences that for the moment lie beyond the reach of medication.

7. Does alcoholism treatment work?
alcoholism treatment can work but with varying levels of success. The severity of the drinking problem, the clients willingness, the presence of co-occurring mental disorders, and other factors all influence the treatment outcome. A person might need several episodes of alcoholism treatment before managing to attain long term sobriety.

8. Do you have to be an alcoholic to experience problems?
Not at all. Alcohol is a harmful and toxic substance. Heavy drinking can be just as harmful as alcholism. Car crashes while drunk are a leading cause of death. Drinking even moderate amounts of alcohol while pregnant can be detrimental to the health of the fetus. Heavy drinking and alcohol abuse can lead to family problems and difficulties at work.

9. How can you tell if someone has a problem?
1) Have you ever felt that you need to cut back on drinking?
2) Have you ever had a drink first thing in the morning to take away a hangover?
3) Has anybody ever criticized your drinking?
4) Have you ever felt guilty about how much you drank?

If you answered yes to any of these questions you might have a drinking problem. You should read this article for more self-assessment questions.

alcoholism is a disease that gets worse if it is left untreated. If you suspect that you have a drinking problem then you should see your doctor as a matter of urgency.

10. Can a problem drinker simply cut down?
This depends on what sort of problem it is. Alcoholics are generally unable to simply cut down and eventually end up returning to excessive drinking. Complete abstinence is safer for alcoholics and offers the best chance for recovery. People who are heavy drinkers but have not developed physical tolerance might be able to learn how to limit their drinking. If they find that they cannot learn to stay within what is safe they should consider complete abstinence from alcohol. An alcohol rehab center normally encourages patients to stop drinking altogether.

11. If an alcoholic is unwilling to get help, what can you do about it?
This isn't an easy question to answer as each case is different. There are legal routes in South Africa to force an alcoholic into treatment. We can put you touch with social workers who specialize in this work if you contact us. It is possible for a foreign citizen to be ordered into treatment by a South African court. You can also consider staging an intervention.

12. What is a safe level of drinking?
This really depends on individual factors as well as the context in which alcohol is consumed. Staying within the legal limits to drive is essential for people planning to drive a car or engage in other activities that require mental alertness. Most healthy adults over the age of 21 and of average weight can handle up to 2 units of alcohol a day without suffering many problems. Pregnant women should abstain from alcohol entirely. Certain medications can make drinking alcohol very dangerous. Recovering alcholics should never drink alcohol as the risk of alcholism reoccurring is staggeringly high.

13. Is it safe to drink during pregnancy?
Absolutely not. Heavy drinking can result in birth defects, but there is no clear level of alcohol consumption that is considered safe. The U.S. Surgeon General suggests total abstinance from alcohol for pregnant women. The damage that drinking while pregnant causes to the baby results in permanent problems. Babies can be born with severe learning disabilities and show behavioural problems as they grow older.

14. Does alcohol affect older people differently?
Yes. Older people have a lower tolerance for alcohol and so are worse affected by it. Older people are already at risk because of their slower reaction times and problems with hearing and seeing. This make old people very vulnerable to accidents when drinking alcohol. Older people are also more likely to be using medications than younger people. This increases the risk of adverse reactions between alcohol and medicine. Some of these reactions can be fatal. Older people often have other medical conditions that can be aggravated by drinking alcohol. It is generally recommended that older people drink no more than one unit of alchol per day.

15. Does alcohol affect women differently?
Yes, women have a lower tolerance to alcohol than men. This holds true even after adjustments for body weight are taken into account. Women's bodies have a lower water content compared to men. This means that alcohol is more highly concentrated in a woman's body than in a man's. Prolonged alcohol abuse has also been shown to be more physically dangerous to women than men. Problems such as alcohol dependence and organ failure progress quicker in women than in men.

16. Is alcohol good for your heart?
People who drink moderately are thought to be less likely to die from heart disease than those or abstain or drink excessively. Rather than starting drinking, however, there are better health gains to be had from exercising regularly and eating foods low in cholesterol. Heavy drinking leads to a number of health problems such as organ failure, hyper tension, and stroke.

17. When taking medications, must you stop drinking?
Quite possibly yes. Consult with your prescribing doctor or pharmacist. There are many medications that interact with alcohol to produce negative side effects. Some medications will heighten the effect of alcohol and could lead to coma or death. Benzodiazepines and barbiturates are two examples of such medications.

19. How can a person get help for an alcohol problem?
There are many resources available for alcoholics. You can contact We Do Recover if you would like expert advice in finding an alcohol rehab facility in South Africa.