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About Alcohol use and misuse

Drinking is often a casual part of social life. Moderate drinking is no more than two drinks a day for most healthy men. It is no more than one drink a day for most healthy nonpregnant women and men older than 65. A standard drink is one 12-ounce bottle or can of beer or wine cooler, one 5-ounce glass of wine or 1-1/2 ounces of distilled spirits.

Alcohol dependence is a disease that causes a powerful craving for alcohol. But not all problems with alcohol are caused by alcohol dependence. Misusing alcohol can lead to serious or life-threatening results. Drinking too much over a long period of time can raise the risk for certain cancers. These include cancers of the liver, esophagus, throat, and larynx. Chronic harmful drinking can cause liver disease, problems with the immune system, and brain damage.

Heavy drinking means having more than 1 drink a day for most women who aren't pregnant, or more than 7 drinks in a week. For most men, heavy drinking is more than 2 drinks a day, or more than 14 drinks in a week.

Binge drinking is another kind of harmful drinking. It means having 5 or more drinks on an occasion for men, and 4 or more drinks on an occasion for women. A person who binge drinks may not have alcohol dependence.

Drinking raises the risk for death from car crashes. People who drink may be injured during leisure time or on the job. A pregnant woman who drinks can harm her fetus. Homicides and suicides are more likely among people who have been drinking.

What Is Alcohol misuse disorder?

Alcohol misuse is a pattern of drinking too much alcohol too often, and it causes problems in your daily life.

Alcohol use disorder can start as alcohol misuse. You may be misusing alcohol if you do one or more of these:

• You can't finish a major project at work, school, or home because of drinking.
• You drink while driving or running a machine.
• You have legal problems because of your drinking. An example is getting arrested for driving while drunk. Another example is hurting someone while you are drunk.
• You choose to drink even though you have personal problems made worse by your drinking.

What is alcohol use disorder?

Alcohol use disorder is a medical condition. It is characterized by an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences. It is sometimes called alcohol abuse, alcohol dependence, alcohol addiction and alcoholism. If you have at least 3 of these symptoms, you may have alcohol use disorder:

• You have a strong craving, hunger, or need for alcohol.
• You cannot limit or control your drinking, or are unable to stop drinking any time you choose.
• You often make excuses or blame problems with your behavior or relationships on other things when they are really because of your alcohol use.
• When you stop drinking after a period of heavy use, you have nausea, sweating, shakiness, and anxiety. These are called withdrawal symptoms.
• You need to drink more and more alcohol to feel the same "high."

Deciding to get help

Many people with problems caused by alcohol find it difficult to admit they need help. The sooner you get help, the better your chances of recovery. Any recovery program includes giving up alcohol entirely. Cutting back on your drinking doesn't work. You must quit. Recovery from alcoholism means a life-long commitment to avoid alcohol. This has many rewards, including regaining your health, your relationships, and your self-esteem.

Your healthcare provider can help you. Your provider will ask you questions about your drinking. Try to answer these questions as fully and honestly as you can. Your provider will also give you a physical exam. If your provider concludes that you may be dependent on alcohol, he or she may recommend that you see a specialist in treating alcoholism. Ask questions about any treatment choices and make sure you understand them.

Getting Well

Help for alcohol use disorder

Your healthcare provider may decide that even though you are not dependent on alcohol, you may still have a problem with alcohol abuse. Your provider can help you:

• Think about why you should stop abusing alcohol.
• Set a drinking goal. You may decide to quit drinking. You may decide to limit how much you drink.
• Think about why you abuse alcohol. You can find new ways to handle situations that make you want to drink.

Alcohol use disorder treatment

Your treatment depends on how severe your alcohol problem is. It also depends on what treatments are available where you live. You may need detoxification. This is a safe way of getting the alcohol out of your body. Your healthcare provider may give you a prescription for medicine that will help reduce symptoms from withdrawing from alcohol and keep you from taking up drinking again. You may also need to see a counselor or spend time in a rehab center. These types of treatments can help you deal with the issues that lead you to misuse alcohol. They can teach you how to manage your urge to drink and figure out things to do that don't remind you of drinking.

Your spouse or family also may need to see a counselor to help you recover. Your treatment program may help you find a lawyer, a job training program, child care, or a parenting class if you need it.

About CAGE: The CAGE questionnaire was developed by Dr. John Ewing, founding director of the Bowles Center for Alcohol Studies, University of North Carolina at Chapel Hill. CAGE is an internationally used assessment instrument for identifying problems with alcohol.