2. Julia Escamilla – Grade 12 What Is Alcoholism ? Dealing with denial Social Drinker Early Stage Middle Stage Late Stage Treat ment Relapse Prevention Additional Resources Citations

3. What Is Alcoholism ? What is alcoholism? According to the American Medical Association, “alcoholism is an illness characterized by significant impairment that is directly associated with persistent and excessive use of alcohol. Impairment may involve physiological, psychological or social dysfunction.” Psychologically speaking, alcoholism has less to do with “how much” someone is drinking, and more to do with what happens when they drink. If you have problems when you drink, you have a drinking problem. The reality is that alcohol is often abused because it initially offers a very tempting promise. With mild intoxication, many people become more relaxed. They feel more carefree. Any preexisting problems tend to fade into the background. Alcohol can be used to enhance a good mood or change a bad mood. At first, alcohol allows the drinker to feel quite pleasant, with no emotional costs. As an individual’s drinking progresses, however, it takes more and more alcohol to achieve the same high. Eventually the high is hardly present.

4. Dealing With Denial Denial is a characteristic distortion in thinking experienced by people with alcoholism. For decades, people who treat alcoholics, and recovering alcoholics themselves, have puzzled over why alcoholics continue to drink when the link between alcohol and the losses they suffer is so clear. Denial is an integral part of the disease of alcoholism and a major obstacle to recovery. Although the term “denial” is not specifically used in the wording of the diagnostic criteria, it underlies the primary symptom described as drinking despite adverse consequences. Treatment professionals are beginning to recognize that not all individuals with alcoholism have the same level of denial. In fact, people have various levels of awareness of their alcohol use problems, which means they are in different stages of readiness to change their behavior. Professionals have taken advantage of this insight about alcoholism to develop treatment approaches that are matched to a person’s readiness to change and that motivate people to enter the change process even when they are frightened of what’s in store. However, despite these advances in treatment, many individuals with alcoholism persist in denying their problem, and typically, the more severe the addiction, the stronger the denial.

5. The Social Drinker Social drinkers have few problems with alcohol. A social drinker can basically take or leave it. There is no preoccupation with drinking. A social drinker is able to control the amount of alcohol consumed and rarely drinks to the point of intoxication. For these individuals, drinking is a secondary activity. It is the party, the meal, the wedding that interests the social drinker, not the opportunity to drink. Social drinkers are those individuals who drink in low-risk patterns. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), "low-risk" drinking for females consists of no more than 7 drinks per week and no more than 3 drinks per sitting. For males, it consists of no more than 14 drinks per week and no more than 4 drinks per day.

6. Early Stage An individual who is experiencing the early stages of alcoholism will begin to have an assortment of problems associated with drinking. In early stage alcoholism, a person may start to sneak drinks, begin to feel guilty about his or her drinking, and become preoccupied with alcohol. Blackouts, drinking to the point of drunkenness, and increased tolerance (needing more alcohol to achieve the same effect) are all signs of early alcoholism. An individual who is entering the early stage of alcoholism will seek out companions who are heavy drinkers and lose interest in activities not associated with drinking. Family and friends may begin to express concern about the person’s consumption of alcohol. Work problems, such as missing work or tardiness, may also take place.

7. Middle Stage By the time someone has entered the middle stages of alcoholism, his or her life has become quite unmanageable, although the alcoholic still denies that he or she has a problem. At this point, the alcoholic will often drink more than intended. He or she will drink in an attempt to erase feelings such as anger, depression and social discomfort. Drinking in the morning to relieve a bad hangover may also take place. The alcoholic’s health care provider may begin to suggest that the alcoholic stop drinking. The individual may try to stop drinking, but without success. Job loss, medical problems, and serious family conflicts occur during this phase.

8. Late Stage At this stage, the alcoholic’s life has become completely unmanageable. Medical complications are numerous and include liver diseases such as cirrhosis or hepatitis. Acute pancreatitis (inflammation of the pancreas), high blood pressure, and bleeding of the esophageal lining can result from prolonged use. The heart and brain are compromised so that an alcoholic is at a higher risk for a heart attack or stroke. Depression and insomnia and even suicide are more prevalent at this stage. A condition known as Wernicke-Korsakoff Syndrome, which involves memory loss, indicates that the individual has sustained brain damage from drinking. A child born to a woman who drinks during her pregnancy may have a condition called fetal alcohol syndrome, causing a number of birth defects. An alcoholic at this stage has become physically addicted to alcohol and will experience seizures or delirium tremens (DTs) if he or she stops drinking. It is extremely important to seek out medical care at this point in the disease process

9. Treatment If an individual is dependent on alcohol, he or she should be supervised medically during a detoxification process. Further treatment may include individual or group counseling. Mental health professionals have been trained to treat substance abuse problems. You can seek out treatment with an individual counselor or by entering an inpatient or outpatient substance abuse treatment program. Support groups such as Alcoholics Anonymous, Smart Recovery, and Rational Recovery have helped many alcoholics to stay sober, allowing them to live productive lives.

10. Relapse Prevention Preventing relapse requires that the person develop a plan tailored to maintaining new behavior. The plan involves integrating into their behavior diversion activities, coping skills, and emotional support. The person’s decision to cope with cravings is aided by knowing: (1) there is a difference between a lapse and a relapse; and (2) continued coping with the craving while maintaining the new behavior will eventually reduce the craving. Coping Skills: Ask for help from an experienced peer and use relaxation skills to reduce the intensity of the anxiety associated with cravings. Develop alternative activities, recognize “red flags,” avoid situations of known danger to maintaining new behavior, find alternative ways of dealing with negative emotional states, rehearse responses to predictably difficult events, and use stress management techniques to create options when the pressure is intense. Reward yourself in a way that does not undermine your self-caring efforts. Pay attention to diet and exercise to improve mood, reduce mood swings, and provide added strength to deal with stressful circumstances and secondary stress symptoms, including loss of sleep, eating or elimination problems, sexual difficulties, and breathing irregularities.

11. Additional Resources Alcoholics Anonymous: AA World Services, Inc., Box 459, New York, NY 10163, Phone:(212) 870-3400 www.aa.org. Rational Recovery Systems, Inc.: www.rational.org Smart Recovery: 24000 Mercantile Road, Suite 11, Beachwood, OH 44122, Phone:(216) 292-0220 www.smartrecovery.org

12. Citations Pictures from slide 2: http://www.breakingthecycles.com/blog/2012/06/25/trying-to- decide-is-it-alcoholism-or-____/ http://www.breakingthecycles.com/blog/2012/06/25/trying-to- decide-is-it-alcoholism-or-____/ http://www.scienceclarified.com/A-Al/Alcoholism.html Pictures from slide 3: http://licensedmentalhealthcounselor.org/2012/05/page/2/ http://www.griefhealingblog.com/2013/06/tips-for-coping-with- disbelief-and.html Pictures from slide 4: http://www.recoveryconnection.org/what-type-of-drinker-are-you/ https://www.live-well.org.uk/richmond/health/am-i-drinking- sensibly.aspx Pictures from slide 5: http://www.oncolink.org/experts/article.cfm?c=72&id=2591 http://mcc4h.com/category/that-alcoholism-comes/ Pictures from slide 6: http://justwannabehealthy.com/3-stages-of-alcoholism-you-should- know.html http://life.nationalpost.com/2013/01/23/alcohol-and-sleep-booze- before-bed-leads-to-disrupted-nighttime-patterns-u-k-researchers/ Pictures from slide 7: http://thechart.blogs.cnn.com/2011/05/06/where-alcoholics-can-drink- themselves-to-death/ http://addiction.lovetoknow.com/final-stage-alcoholism Pictures from slide 8: http://www.alcoholic.org/research/affordable-alcohol-treatment/ http://www.alcoholic.org/research/alcoholism-and-chemical- dependency-treatment/ Pictures from slide 9: http://www.ascendrecovery.com/blog/relapse-prevention/

13. Citations Mascott, C. (2006). An Introduction to Alcoholism. Psych Central Bronson, Mary H. Glencoe Health. Student Ed. [S.l.]: McGraw Hill/Glencoe, 2009. Print. "Alcoholics Anonymous :." Alcoholics Anonymous :. N.p., n.d. Web. 27 Sept. 2013.