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People who abuse alcohol, on the other hand, do not crave alcohol or have withdrawal symptoms when they stop drinking, but they have problems similar to those of people who are dependent on alcohol. They often develop a pattern of drinking that gets them into trouble at work, with their families, or while driving. They may fail to fulfill responsibilities at work, school, or home. They may drive or operate dangerous machinery while intoxicated and may be arrested for driving or assaulting someone while under the influence of alcohol. Problem drinkers also may have blackouts, periods in which they have no memory of what happened during a drinking episode.

Diagnosis

How do you know if you are drinking too much? Your answers to the following four questions can help you find out:

• Have you ever felt you should cut down on your drinking?

• Has anyone ever annoyed you by criticizing your drinking?

• Do you ever feel bad or guilty about your drinking?

• Have you ever had a drink the first thing in the morning to steady your nerves or to get rid of a hangover?

One “yes” answer may indicate that you have a drinking problem. More than one positive response suggests that it is highly likely that you have a problem. If you think that you may have an alcohol abuse or addiction problem, see your doctor right away. He or she will ask you to describe how often and how much you drink and will perform a physical examination to determine the extent to which your drinking has caused any health problems. If necessary, he or she will refer you to an alcohol treatment program.

Q & A

Alcohol and Heart Disease

Q. Is it true that drinking alcohol helps protect against heart disease?

A. Moderate alcohol consumption (two drinks a day for men; one drink a day for women) has been found to lower the risk of heart disease by decreasing the buildup of fatty deposits in the arteries that supply blood to the heart. This buildup of fat in the arteries is a major risk factor for heart disease and stroke (major killers of both men and women). However, in spite of this potentially beneficial effect, you should not start drinking alcohol to prevent heart disease. Alcohol is an addictive substance, and long-term, heavy drinking can contribute to the development of serious health problems, including liver cirrhosis. Overall, the health risks of alcohol consumption outweigh its beneficial effects. You are better off keeping your heart healthy by exercising regularly; eating a nutritious low-fat, high-fiber diet; losing weight if you need to; and quitting smoking if you smoke.

Treatment

Alcoholism cannot be cured, but it can be treated. The type of treatment you receive depends on how serious your alcohol problem is and what treatment programs are available in your community. You may be treated as an outpatient or in a hospital, or a combination of both. You will probably undergo some form of individual or group counseling to help you identify the situations and emotions that trigger your desire to drink so you can learn to avoid them and find other ways of handling stress. Family therapy enlists the support of your family members to encourage you in your recovery.

If you are motivated to stop drinking and are unable to, or if you keep having relapses, your doctor may prescribe a medication, such as disulfiram, that makes you feel ill when you drink alcohol. Some doctors may prescribe a drug called naltrexone to reduce the risk of relapse in some people. If you experience withdrawal symptoms, you will have to undergo detoxification (the process of desensitizing your nervous system to the effects of alcohol). Detoxification is usually done over a period of a week to 10 days in a hospital or treatment center, where your condition can be carefully monitored.

The cornerstone of any treatment regimen is long-term involvement in an alcohol recovery program such as Alcoholics Anonymous. This type of program brings people who are struggling with a drinking problem together where they can give support to and encourage each