Medications Can Aid Recovery from Alcoholism

by Food and Drug Administration (FDA)

The number 13 represents bad luck for some people, but for Floyd McCrory of Rockville, Md., it's a sign of continuing good fortune.

This year, he celebrates 13 years of sobriety.

"Best thing I ever did," he said about quitting drinking. "It turned my whole life around."

McCrory, 63, realized he was an alcoholic in 1983. That was the year he got so sick from alcohol-induced pancreatitis, he swore he'd never drink again. He went into a 28-day treatment program and now attends as many as 12 Alcoholics Anonymous meetings a week, he said.

In addition, he serves as volunteer director of the Rockville (Md.) Metro Group. As director, he helps other people overcome their addiction to alcohol.

He's rarely short of work because, according to the most recent estimates from the federal government's National Institute on Alcohol Abuse and Alcoholism, in 1992, 6.3 percent of men and 2.6 percent of women were alcoholics. That translates to nearly 8 million alcoholics in the United States. As many as 1.5 million of them seek treatment each year.

Many follow McCrory's example: They enroll in inpatient and outpatient alcoholism treatment programs and supplement that with regular attendance at AA and other self-help group meetings.

Others find success with AA and other self-help groups alone. Some turn to psychotherapy. Some quit drinking completely on their own.

In some cases, recovering alcoholics are aided by two drugs specifically for treating alcoholism, one of which was approved by the Food and Drug Administration in December 1994.

Like McCrory, many alcoholics who seek treatment find success — they learn to abstain totally from alcohol. But the majority — as many as 90 percent, according to NIAAA — relapse at least once during the four years following treatment. Fifty percent relapse within the first few months. Subsequent treatment attempts may or may not prove successful.

What Is Alcoholism?

Alcoholism is a complex disease with physical, social and psychological consequences — not only for alcoholics but also for people closest to them.

In the past, alcoholism was often viewed as a moral weakness or character flaw; it was thought that the person could stop drinking if he or she really wanted to. It wasn't until 1970, with the establishment of NIAAA and a national public education effort, that people began to understand and accept that alcoholism is a life-threatening, chronic disease involving psychological and physical dependence on alcohol.

Based on the American Psychiatric Association's 4th edition of Diagnostic and Statistical Manual of Mental Disorders, NIAAA recognizes four signs of alcoholism:

• Loss of control over drinking. Alcoholics may intend to have two or three drinks, but before they know it, they are on their 10th.
• Continued use of alcohol despite social, medical, family, and work problems.
• Increased alcohol tolerance over time — that is, needing more alcohol to become intoxicated.
• Withdrawal symptoms when alcoholics stop drinking after a period of heavy drinking. The symptoms include anxiety, agitation, increased blood pressure, and, in extreme cases, seizures. These symptoms may persist for several days.

People do not need to have all four signs to be diagnosed as alcoholic. Those who have significant problems controlling their drinking and functioning in social situations because of alcohol may be considered alcoholics without the physical signs, tolerance and withdrawal.

The APA manual distinguishes between alcoholism and alcohol abuse. The latter is a less severe problem; unlike alcoholics, alcohol abusers do not develop physical withdrawal or compulsive alcohol use. However, like alcoholics, their drinking has negative health, economic and social effects. Both alcoholics and alcohol abusers need treatment, although the goals differ. In most cases of alcohol abuse, the goal is to limit drinking, while for alcoholism, it is to stop drinking altogether.

Why some people become alcoholics remains a mystery, although most scientists now agree that a combination of genetic and environmental factors increases a person's vulnerability.

Based on the results of Swedish adoption studies, some researchers divide alcoholism into two types. Type I, the most common, occurs in both men and women and is associated with adult-onset alcohol dependence. This form, also known as "milieu-limited" alcoholism, appears to be the result of "genetic predisposition and environmental provocation," according to NIAAA's 1991 publication Alcohol Research: Promise for the Decade — that is, the development of alcoholism in these cases is an interaction between inherited predisposition and the person's life situations.

Type II, or male-limited, alcoholism, on the other hand, is due mainly to genetics. It occurs only in men, usually with early onset in the teen years, and is more difficult to treat. Type II alcoholics tend to exhibit antisocial, aggressive behavior.

About the Author

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