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Alcohol misuse during the Christmas period

 

Nicola Doran of Osborne Clarke begins a series of articles on dealing with alcohol misuse during the Christmas period with an overview. Employers need to be aware of the potential consequences for their business of alcohol misuse by employees, which may increase over the Christmas period. Reinforcing a clear alcohol policy may help to reduce the incidence of alcohol misuse. 

Introduction

The misuse of alcohol by employees creates a number of problems for employers. During the run-up to Christmas, employees' alcohol consumption may increase due to long lunches, and work and other social events. Employees sometimes assume that their employer's normal rules and policies relating to alcohol use will be relaxed during the festive season. As a result, problems relating to alcohol consumption and the workplace may come under the spotlight during the pre-Christmas period.

Working under the influence of alcohol - implications

As well as managing absence levels that may result from employees' alcohol misuse, employers need to be aware of the risks to their business of allowing employees to attend work under the influence of alcohol, either as a result of consumption during lunch breaks or over-indulgence at a social event the night before. Employees who are under the influence of alcohol may:

  • suffer from poor performance and impaired productivity;
  • fall asleep on the job;
  • have poor judgment and reduced ability to make sound decisions;
  • create health and safety risks;
  • act in a way that damages the reputation of the employer (for example by giving poor service or behaving inappropriately towards clients and other staff);
  • act in a manner that is offensive, which could result in allegations of harassment; and/or
  • become violent or aggressive.

The potential for health and safety risks to arise as a result of an employee being under the influence of alcohol depends on the nature of the workplace. The risk is greater in, for example, workplaces involving moving machinery or dangerous substances, than in an office environment. In certain environments the risk of immediate and serious danger to employees is increased by alcohol consumption due to the consequent lack of concentration and impairment to judgment. Employers have a general duty under health and safety legislation to ensure the health, safety and welfare at work of employees. Knowingly allowing an employee to continue working where his or her behaviour places the individual or others at risk could result in the employer being in breach of its duty of care.

Over and above the damage to business and client relationships that may result from an employee's alcohol misuse, it is important for employers to bear in mind that they may be vicariously liable for the actions of their employees. Although vicarious liability applies to acts by employees done "during the course of their employment", this has been interpreted widely and can include acts carried out during work social events. Therefore, employers could be liable for claims arising from employees' discriminatory behaviour towards others at work events, or employees' involvement in drink-driving-related accidents on the way home.

Employers' approach to alcohol use

Employers should decide on an appropriate and consistent approach to dealing with employees who attend work under the influence of alcohol, or who drink alcohol before or during working hours. Employers with workplaces in which there are health and safety risks associated with working under the influence of alcohol are likely to adopt a zero tolerance policy to drinking during working hours. Employers that regularly entertain clients may take a more relaxed approach to alcohol consumption in the workplace, within certain limits.

Employers should have a clear policy that sets out what is, and is not, acceptable in relation to alcohol consumption before and during working hours and the consequences of non-compliance with the policy. Prior to periods such as Christmas, it is sensible for employers to remind employees (possibly via an email to all) that a policy on alcohol use is in place, the requirements of the policy, and that it will continue to apply during the festive season.

Dealing with drunkenness at work

If an employee is intoxicated at work, the employer should deal with the situation immediately and consistently, and in accordance with any existing policy or normal practice. The employer should initially:

  • hold a brief meeting with the employee to assess the seriousness of the situation;
  • remind the employee of its policy on alcohol consumption (ie that it is not tolerated, or that employees are permitted to drink responsibly only to the extent that their work is not affected), and that a breach of the policy may lead to disciplinary action;
  • inform the employee if he or she is alleged to have breached disciplinary rules (for example he or she has fallen asleep, or displayed aggressive behaviour) or failed to follow required procedures or work practices;
  • decide whether or not the employee poses a health and safety risk;
  • decide whether or not the employee is fit to carry out his or her duties;
  • send the employee home if necessary, until he or she is fit to return to work; and
  • prevent the employee from driving if he or she came to work by car, and arrange alternative transport home.

Is disciplinary action appropriate?

Having dealt with the immediate problem of the presence at work of an employee who is under the influence of alcohol, and removed him or her from the workplace if necessary, the employer should decide whether or not to pursue the matter further through the disciplinary procedure. To avoid allegations of unfair treatment, employers should act consistently and in accordance with their alcohol policy if they have one, and normal disciplinary rules and procedures. However, in the event of one-off, minor incidents, consideration should be given to whether or not disciplinary action is an appropriate and proportionate response, particularly in the context of the Christmas period.

Where employees display more than a little "festive cheer" and their alcohol consumption impacts on their ability to carry out their role, compromises health and safety, or leads to rude or aggressive conduct, disciplinary action is likely to be a proportionate response. It may be necessary to suspend an employee in these circumstances, pending a full investigation. Depending on the outcome of the investigation, disciplinary action may follow. There are a number of factors that employers should consider when deciding if formal disciplinary action is appropriate, and what level of action to take, namely whether or not:

  • the employee's actions have impacted on the employer's business, and to what degree;
  • the employee's behaviour was an isolated occurrence;
  • the employer's rules on alcohol use are clear and consistent;
  • the employee breached a workplace policy or disciplinary rule due to being under the influence of alcohol (for example, he or she was rude to a customer or took unauthorised absence), and the extent of that breach;
  • the employee already has a current formal disciplinary warning for similar conduct on his or her file; and
  • there are mitigating circumstances that explain the employee's conduct (for example personal or work pressures have caused him or her to behave in a way that is out of character).

In some cases an informal warning may be a suitable course of action, with a caution that a repeat occurrence may result in formal disciplinary action.

 

Helen Dallimore of Osborne Clarke continues a series of articles on dealing with alcohol misuse during the Christmas period with a checklist that sets out some practical steps that employers can take to reduce, and deal with, alcohol misuse in the workplace, which may increase in the run-up to Christmas.  By ensuring that the rules on alcohol use during working hours are clear, applying an alcohol policy consistently and dealing with incidents of drunkenness at work quickly, employers can help to reduce the risks associated with alcohol misuse by employees. 

1. Identify the potential risk to the business of alcohol misuse by employees and the correct approach to adopt. 

The level of risk associated with employees being under the influence of alcohol at work varies across employers and the nature of the work performed. In some workplaces, for example those involving the operation of moving machinery, employees who attend work under the influence of alcohol may present an immediate and serious danger to themselves and others. In other workplaces (such as office environments) the risks may not be quite so apparent and some drinking at social events may be commonplace. However, all employers should be concerned about the potential effects of alcohol at work. Alcohol consumption can:

  • interfere with work performance, attendance and productivity;
  • impair judgment and decision-making;
  • lead to irresponsible behaviour, damaging the employer's reputation; and
  • increase the potential for problems between staff due to aggressive, violent or harassing behaviour that may result.

Therefore, employers should review their business and the roles within it to determine whether or not a zero tolerance policy on the consumption of alcohol should be adopted, or if a policy that permits sensible drinking only is more appropriate.

2. Ensure that disciplinary rules include alcohol misuse.

Employers should ensure that their disciplinary rules prohibit employees from being under the influence of alcohol in the workplace and that the wording in the disciplinary policy reflects their approach to alcohol misuse. Disciplinary procedures should include, as an example of gross misconduct, wording to the effect of "serious incapability at work brought on by alcohol or illegal drugs" (in accordance with the Discipline and grievances at work: Acas guide (PDF format, 898K) (on the Acas website)). Employers that adopt a zero tolerance approach to alcohol use by employees should also make clear that being under the influence of alcohol during working hours will be treated as gross misconduct and could result in summary dismissal.

Employers should also ensure that disciplinary rules forbid the type of behaviour that may occur as a consequence of employees being under the influence of alcohol, for example:

  • obscene language or other offensive behaviour;
  • negligence in the performance of duties;
  • physical violence, bullying or threatening behaviour;
  • bringing the organisation into serious disrepute;
  • causing loss, damage or injury through serious negligence; and
  • breaching health and safety rules.

The disciplinary policy should refer to the requirement to comply with drink-driving legislation and explain that an employee who commits a drink-driving offence is likely to damage the employer's reputation, particularly if the offence is committed while the employee is driving in the course of his or her duties or in one of the employer's vehicles. Employers should make clear that employees risk disciplinary action in these circumstances.

Some employers may wish to include as a disciplinary offence a failure to comply with a reasonable request to see the company doctor or be referred to occupational health where the employer considers that the employee may have an alcohol-dependency problem. Failure to submit to appropriate alcohol and drug screening tests may also be listed as a disciplinary offence in some cases. However, the non-statutory guidance on the Data Protection Act 1998 in the Employment practices data protection code (PDF format, 12MB) (on the Information Commissioner's Office website) makes clear that testing is appropriate only if there are serious health and safety concerns in relation to drugs and alcohol misuse (for example, where staff drive or operate machinery) and that testing should be carried out only with the explicit and informed consent of the individual.

3. Adopt an alcohol policy.

By adopting a policy on alcohol misuse (which may be combined with the employer's policy on drug misuse) employers can set the required standard, specify their expectations and help to ensure that employees who attend work under the influence of alcohol are treated consistently.

An alcohol policy should include:

  • an explanation of what kind of behaviour is, and is not, tolerated;
  • an explanation of what action the employer will take if an employee is under the influence of alcohol at work; and
  • if appropriate, provision for testing for alcohol.

The policy should also address how the employer will support employees who have an underlying alcohol addiction problem.

4. Consider reminding employees about their obligations in relation to alcohol use.

During the festive period some employees' alcohol consumption may increase due to social events and long lunches. Employers should consider reminding employees of their alcohol use policy and the consequences for employees if they fail to comply with required standards. Employers could make a general announcement to all employees via email or other means. By doing so, employers may reduce the number of alcohol-related incidents and be in a better position to defend claims of vicarious liability for employees' actions. Suggested wordings are set out below.

Workplaces in which there are serious health and safety consequences of employees attending work under the influence of alcohol

"In the run-up to Christmas there are inevitably social events and parties. While the Company wishes everyone to enjoy the festive period, you are reminded that the nature of the Company's business means that there are serious health and safety risks connected with employees being under the influence of alcohol or drugs in the workplace. Consequently, in the interests of your own safety and the safety of those around you [and in accordance with the Company's disciplinary rules and the alcohol [and drug] use policy] you must not drink or be under the influence of alcohol during the working day or during lunchtime or breaks, or at work-based meetings or events.

"Drinking alcohol while at work without authorisation or working under the influence of alcohol may be considered gross misconduct and could result in disciplinary action being taken against you, including summary dismissal."

Workplaces in which there is less risk associated with alcohol consumption

"In the run-up to Christmas there are inevitably social events and parties. While the Company wishes everyone to enjoy the festive period, you are reminded that you are expected to demonstrate responsible behaviour at work, work-related functions and social events. Should you consume alcohol before or during working hours, or at work social events, you are expected to do so responsibly and not in a way that will impair your work performance or lead to behaviour that may damage the reputation of the Company. Employees who attend work under the influence of alcohol may be subject to disciplinary action [in accordance with the Company's disciplinary rules and the alcohol [and drug] use policy]."

For all workplaces

"The Company reserves the right to suspend you from your duties [with pay] pending an investigation if it reasonably considers you to be under the influence of alcohol in the workplace.

"The Company expects all employees to comply with drink-driving legislation at all times. The Company's reputation will be damaged if you are convicted of a drink-driving offence, particularly where the offence is committed in the course of your duties or while you are driving one of the Company's vehicles. Such conduct could result in disciplinary action, including summary dismissal, being taken against you. If your job requires you to drive and you lose your licence (as a result of an offence committed in the course of your work or otherwise), you may be unable to continue to perform your job, and the Company may be left with no alternative but to terminate your employment."

5. Be consistent when applying the rules and policy on alcohol use.

Employers should ensure that they apply rules relating to alcohol use fairly and consistently, to avoid allegations of unfair treatment. Although different types of working environment within an employer's undertaking may justify different rules to some degree, employers should ensure that the reason for any difference in treatment can be justified, and that differences are kept to a minimum. Further, the same approach should be adopted across levels of seniority and managers should be required to comply with the alcohol policy in the same way as junior employees.

6. Deal immediately with employees who are under the influence of alcohol in the workplace.

Employers that suspect that an employee is under the influence of alcohol should act immediately to reduce the risk of negative consequences and demonstrate that they are taking the matter seriously. An employer confronted with an employee who appears to be under the influence of alcohol should:

  • hold a brief meeting with the employee to assess the seriousness of the situation;
  • remind the employee of its policy on alcohol misuse (ie that there is a zero tolerance policy or that sensible drinking only is permitted);
  • remind the employee that a breach of the policy may lead to disciplinary action;
  • inform the employee if he or she is alleged to have breached other disciplinary rules, for example he or she has been aggressive towards others;
  • send the employee home if he or she poses a health and safety risk and/or is incapable of carrying out his or her role;
  • suspend the employee pending further disciplinary investigation if necessary;
  • arrange transport home for the employee if necessary; and
  • call the police if the employee is aggressive and/or refuses to go home.

7. Take disciplinary action if appropriate.

If an investigation into an employee's conduct reveals that there is a disciplinary case to answer, the employer should consider taking formal disciplinary action. Whether or not disciplinary action is appropriate, and if it is the level of action that the employer should take, depends on the circumstances (see Alcohol misuse during the Christmas period: overview in this series for more details). By taking formal action employers send a message to employees that they consider alcohol misuse to be a serious issue that will not be tolerated. Employers should apply the disciplinary process fairly and consistently to avoid allegations of unfair or discriminatory treatment.

 

action is strengthened if it has an alcohol policy that makes clear its stance on alcohol consumption during working hours and how it will deal with employees who attend work under the influence of alcohol. Its disciplinary procedure should make clear that attendance at work under the influence of alcohol is likely to result in disciplinary action.

Alcohol policies should also make clear what behaviour is, and is not, acceptable. This will vary between employers and working environments. Some employers specify in their policy that being under the influence of alcohol during working hours is gross misconduct.

If Trifficfoods' policy reflects a ban on alcohol use during working hours, and it applies its policy strictly, Sam will face dismissal. The employees who accompanied him to the pub and drank alcohol during their lunch break will also face dismissal. If they challenge their dismissal in an employment tribunal the tribunal will consider whether or not:

  • it was necessary for Trifficfoods to have a strict prohibition on alcohol use during working hours;
  • the policy was well-communicated and accessible to employees;
  • the policy was consistently applied in practice; and
  • the dismissals were reasonable in the circumstances.

If Jenny had known that the employees were heading to the pub and had said and done nothing to remind them of the policy beforehand, this would not work in Trifficfoods' favour. Matters would be even worse if she, or another manager or supervisor, had accompanied the group to the pub.

Many employers adopt an alcohol policy under which only serious incapability at work as a result of alcohol consumption will constitute gross misconduct. If Trifficfoods' policy follows this approach, or if there is no policy or guidance, it may need to take a more lenient approach to disciplinary action, despite the fact that Sam fell asleep. While an employee who fell asleep may be regarded by an employment tribunal as falling into the category of being seriously incapable of undertaking work, dismissal in these circumstances may be regarded as harsh and falling outside the range of reasonable responses, particularly in the context of the Christmas period. 

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Overview of Alcohol Abuse

 

Americans have a complicated history with alcohol. At the end of the 19th century, politicians, women's groups, and churches banded together to convince lawmakers to outlaw alcohol. In 1919, the U.S. Congress passed the 18th Amendment, making the sale and distribution of alcohol illegal. Alcohol consumption declined but did not stop. In 1933, Prohibition ended and since then, millions of Americans have made alcohol a part of their social life.

In the 1960s, E. M. Jellinek pioneered the idea that excessive and harmful use of alcohol was a disease. Within a decade, public campaigns were launched in the United States to educate people about alcoholism as an illness.

Alcohol Abuse Definitions

In 1980, the American Psychiatric Association's Diagnostic and Statistical Manual III refined the definition of alcoholism by differentiating between alcohol abuse and dependence. People continue to use the terms "alcoholism" when they mean any harmful use of alcohol and "problem drinking" when they mean abuse, when in fact alcoholism and abuse have specific clinical definitions.

Alcoholism, also known as alcohol dependence, is a chronic, progressive, and potentially fatal disease. Characteristics of alcoholism include the following:

  • Drinking excessive amounts frequently
  • Inability to curb drinking despite medical, psychological, or social complications
  • Increased tolerance to alcohol
  • Occurrence of withdrawal symptoms when the person stops drinking

Alcohol abuse is a chronic disease in which the person refuses to give up drinking even though it causes neglect of important family and work obligations. Abuse, left untreated, can lead to dependence. Characteristics of alcohol abuse include the following:

  • Drinking when it is dangerous (e.g., while driving)
  • Frequent, excessive drinking
  • Interpersonal difficulties with family, friends, or coworkers caused by alcohol
  • Legal problems related to drinking
Incidence & Prevalence of Alcohol Abuse

Alcohol use typically begins in the late teens and early twenties, although a substantial number of people start drinking even earlier. The National Institutes of Health (NIH) reports that the younger the age, the greater the chance the person will abuse or become dependent on alcohol.

According to a February 2011 report from the World Health Organization (WHO), alcohol contributes to approximately 2.5 million deaths each year worldwide (nearly 4 percent of all deaths). About 6 percent of all male deaths and 1 percent of all female deaths are related to harmful effects of alcohol. In young people ages 15–29, 320,000 (9 percent) of all deaths are alcohol related.

 

Common causes for alcohol-related deaths include injuries, cancer, heart disease and liver disease (e.g., cirrhosis of the liver).

In January 2013, the CDC issued a sobering report indicating that binge drinking—defined as consuming 4 or more drinks on one occasion for females—occurs about 1 in 8 women and 1 in 5 high school girls. According to the CDC, binge drinking increases the risk for several health problems in women, including breast cancer, STDs, heart disease, and unwanted pregnancy.

 

Risk Factors and Causes of Alcohol Abuse

Genetic, biological, environmental, psychological, and sociocultural factors play a part in alcoholism.

Genetic Risk Factors for Alcohol Abuse

Scientists suggest that genetics may play a role in the following:

  • Increased risk for alcoholism
  • Increased tolerance
  • Ongoing craving for alcohol

Genes that may be involved in alcoholism have not been identified. A number of studies of twins and adoptions support the idea that genetics may be involved in alcoholism. In one study, identical male twins, raised in separate environments, shared patterns of alcohol use, including dependence. Another study showed a continued likelihood of alcoholism in male siblings born into alcoholic families but adopted into nonalcoholic families.

Biology & Alcohol Abuse

Research notes that Chinese, Japanese, and Koreans with a deficiency or absence of alcohol dehydrogenase (a liver enzyme) tend to drink less and are at lower risk for alcoholism. Because their livers do not break down alcohol, these people experience vomiting, flushing, and increased heart rate and don't drink as often. Researchers hope to provide a biological account for the low incidence of alcoholism in Jews who consume a large amount of alcohol. Other groups are at an increased risk for alcoholism. Native Americans (a population with a high incidence of alcoholism) generally don't become intoxicated as quickly as other races and so may tend to drink more.

At least two studies have shown a possible correlation between certain brain wave patterns and an increased risk for alcoholism.

Environment, Psychology, & Culture and Alcohol Abuse

Gender, family history, and parenting influence drinking behavior. A substantially higher number of men than women abuse alcohol; some estimate the ratio to be as high as 5:1. However, the number of women who drink, abuse, and become dependent on alcohol is rising. Studies indicate that up to 25% of sons of alcoholic fathers will develop alcohol abuse or dependence.

Most children of alcoholics do not develop dependence. Children in families with multiple risk factors are at greater risk for alcohol abuse and/or dependence. Some of these risk factors include growing up with parents who:

  • are dependent on alcohol
  • have coexisting psychological disorder(s)
  • use alcohol to cope with stress

Family violence and having several close blood relatives who are alcohol dependent are also risk factors.

The expectations and beliefs about alcohol may influence alcohol use. Younger family members tend to mimic the alcohol use patterns of their parents, siblings, and other family members. Peers also influence drinking behavior.

 

Some studies show that regardless of a family history of alcoholism, a lack of parental monitoring, severe and recurrent family conflict, and poor parent-child relationships can contribute to alcohol abuse in adolescents. Children with conduct disorders, poor socialization, and ineffective coping skills as well as those with little connection to parents, other family members, or school may be at an increased risk for alcohol abuse and/or dependence.

Recently, the NIH reported that lower educational levels and unemployment do not cause higher rates of alcoholism. Results from a 1996 study show that the rates of alcoholism in adult welfare recipients were comparable to those of the general population. The study did show higher rates of death from alcoholism in welfare recipients.

 

 

Alcoholism Prognosis

Abstinence is necessary for successful alcoholism treatment. Alcoholics cannot resume social drinking without risking a return to dependence. Many feel they are the exception to the rule; however, for every 10 people who say they will stop drinking, only 4 do. Motivation and intervention by family or friends can help the alcoholic achieve abstinence.

Recovery from alcohol dependence is possible. DSM-IV reports one study in which 65% of patients who abused or were dependent on alcohol abstained for at least a year following treatment. Another study showed 40% to 60% of alcoholics abstaining for longer than 1 year.

 

 

 

Alcohol Abuse Courses

There is no one course for alcohol dependence. Some people begin drinking early in life; others begin later. Some abuse alcohol for a short period of time; others are dependent for life.

When a person begins to rely on alcohol to enhance all social interactions, he or she is at risk for dependence. Alcoholics believe that alcohol is necessary to get through everyday activities, alleviate stress, and cope with problems. The alcoholic denies the overpowering role alcohol plays. He or she may drink in secret to avoid confrontations with family or friends, and then feel guilty afterwards; drink more to alleviate the emotional stress, feel guilty; drink again; and so on, thereby creating a cycle of abuse.

Others use alcohol in isolation to ease the pain of loneliness and alienation. Depression may also be a factor, and alcohol use may serve as a form of self-medication. Alcohol produces sedative effects that relieve anxiety. However, these initial effects subside and more severe depressive symptoms follow. The alcoholic may drink to relieve these symptoms. Once again, alcohol creates a cycle of abuse.

Those who are dependent on alcohol show a variety of patterns of drinking, including:

  • Binge drinking: heavy drinking which lasts for days, weeks, or months followed by long periods of sobriety
  • Daily drinking: moderate to heavy drinking each day which may or may not occur at specific times of the day
  • Weekend drinking: heavy drinking to the point of intoxication, but only on weekends

Over the course of months of drinking, the central nervous system adapts to the alcohol and tolerance develops. The drinker requires increased amounts of alcohol to achieve the desired effect. Despite experiencing adverse effects, the person continues to drink and will likely increase the amount and frequency.

Over time, withdrawal symptoms, a sign of physical dependence, may develop. Symptoms include high blood pressure and accelerated pulse rate, and tremors which occur when not using alcohol.

Alcohol dependence has a variable course. Sometimes a crisis such as having a car accident while drunk will cause alcoholics to stop drinking for a short period of time (i.e., go into remission). After a while, they may relapse, or begin drinking again. Once the alcoholic begins drinking again, the amount and frequency likely escalate.

 

Two courses of alcohol dependence have been clinically defined:

  • Young males who typically begin drinking in the teens or early 20s, with abuse developing rapidly. Young men with a significant family history of alcoholism may become dependent within 1 or 2 years. Dependence often lasts through the 30s, and sometimes into the 50s and 60s. Of the two courses, this has the worse prognosis.
  • People of both genders who experience a late onset of abuse. There may or may not be a family history of alcoholism, and the progress from abuse to dependence is slower, taking from 5 to 15 years. The prognosis for recovery is better for this group.
Alcohol: Raise a Glass or Abstain?

It may seem like a good idea to indulge in a glass or two of wine every once in awhile. After all, alcohol’s benefits to the heart have been touted for years, so it can't hurt, can it? Growing scientific evidence suggests that moderate alcohol consumption may sometimes have a beneficial or protective effect on our health. Anything more than moderate, however, begins to have adverse effects.

The U.S. government's Dietary Guidelines for Americans, 2010, defines moderate consumption as no more than two alcoholic beverages a day for healthy adult men and no more than one drink a day for women. (One drink is 12 ounces of beer, 5 ounces of wine or 1 1/2 ounces of 80-proof liquor.) If you're over 65, you may want to heed the National Institutes of Health's advice for all older adults: No more than one drink a day.

Based on the latest research, here are some ways moderate alcohol use can affect your health, for better or worse:

  • Heart. Many researchers agree that alcohol plays a role in lowering risk of heart attack and stroke. What's more, a 2007 study showed a possible link between moderate drinking and less incidence of lower-extremity arterial disease in older adults. If you have high blood pressure, though, it's best not to drink—drinking long term can raise blood pressure further.
  • Brain. New research suggests that alcohol may help ward off dementia. Scientists analyzed 143 studies and determined that light to moderate drinkers may have a reduced risk of dementia and cognitive decline.
  • Metabolism. As we age, the rate at which alcohol is broken down in the body slows and lowers our alcohol tolerance. So the same drink that didn't bother you 20 years ago may now cause slurred speech or instability.
  • Meds. Mixing alcohol with prescription or over-the-counter drugs can lessen some medications' effectiveness—and it can be dangerous, too. Just one drink can cause serious side effects when taken with drugs such as aspirin, antihistamines, sleeping pills, antidepressants and painkillers.
  • Cancer risk. The American Cancer Society warns that even a few drinks a day may be associated with an increased breast cancer risk in women. Evidence suggests that your breast cancer risk increases as your alcohol consumption increases. This is especially true among women who drink and don't get enough folate. Folic acid supplements may help reduce your risk.
  • Behavior. Your reaction time can be slowed with moderate drinking. In a small study, older adults who had one to three drinks—and whose blood alcohol levels were still under the legal driving limit—were more likely to trip over obstacles than those who didn't drink.

 

If you drink moderately, you may be able to safely imbibe and gain some benefits as long as you don't have health conditions such as liver disease or heart failure or plan to drive. On the other hand, if you don't drink, don't start. The same benefits of alcohol can be achieved with less risk through a healthy lifestyle.

 

Alcohol and Drug Awareness Project (ADAP)

 

 

The use of alcohol and other drugs affects all of our lives—whether or not we choose to use them.

The Alcohol and Drug Awareness Project (ADAP) works to increase awareness and understanding in the campus community about these issues. The approach of the Alcohol and Drug Awareness Project centers on the belief that each individual is a person of worth and dignity and is capable of change. This attitude of realistic hope is foremost in the philosophy of the Project’s services. We work to provide individuals with the capability to identify factors associated with alcohol and other drug use, misuse, and dependence problems. We believe that supportive and therapeutic counseling services are effective methods of helping people resolve their problems. We work to develop an effective treatment system that provides for early intervention and prevention of the harmful effects of alcohol and other drugs. Assessment, counseling, education and support services are available. All services are free and confidential. The Alcohol and Drug Awareness Project respects the confidential nature of information shared in its programs and functions in compliance with Federal Regulation 42CFR, Part 2.

Alcohol and other drug counseling, both individual and group, is available for students who may be experiencing problems with alcohol or other drugs or are in recovery; those who have concerns about a significant other or who feel they have been affected by another's drinking or other drug use.

  • Students may self refer for an individual confidential counseling appointment.
  • Consultation is available for individuals and departments concerned about another's use of alcohol or other drugs.
  • Substance abuse prevention and education services include workshops and trainings for student and staff, campus wide events (speakers, panel presentations, theater performances), and media outreach.
  • Students are invited to attend recovery lunches.

If you have an alcohol or other drug emergency at night or on a weekend, or you are unable to reach the Alcohol and Drug Awareness therapist during regular hours, call the Mount Holyoke College Health Services at x2242 or from off-campus 413-538-2242.

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My Sober World came to an end....
 
I first met my now stxab 2 years ago....I did not realize at first that he had a drinking problem, but I do recall little red flags coming up all the time with his erratic behavior. I shrugged it all off and convinced myself it was just a passing phase or other....sometimes telling myself I was just imagining things.

We moved in together and within 2 weeks, I saw the monster he was as a drunk. He was jealous, possessive, overbearing, completely selfish, a pathological liar...and so much more! I did not even recognize the man I fell in love with and since I was not much of a drinker, more of a social drinker, I did not think anything of it until the abuse started.

By this time we were so dependent on each other, we did everything together, we worked together, made money together, spent 24 hours together, day in and out....I constantly complained about the drinking but never pushed the issue to the point of causing a fight. (Not yet anyways.)

I come from a very religious background and have learned early on that when someone is not in their right mind, do not provoke them. I became the classic enabler....being neutral, withdrawing when he tried to pull me into an argument....reminding him of his drinking problem but not lifting a finger to stop him.

I became pregnant with our first child and he seemed very happy about it, even going so far as to hide his drinking from me. He became overprotective and it lasted a few months that I thought he was sober. It was an act...he couldn't last more than 2 weeks! He hid his bottles, cans and whatever else he could hide from me.

The abuse continued where he would accuse me of everything under the sun....and at certain times he would actually have long hours of discussions with me about the future. He constantly told me that when he is not drinking he would hear voices in his head telling him all kinds of negative things, and he needed to keep himself busy at all times or he would go crazy.

I didn't understand but I supported him in everything he was trying to do....
I loved him and actually believed he would change for me and the baby. At least it seemed like he was trying....but the abuse escalated and his crazy behavior came back, he went right back to drinking and this time I was fed up. (Of the abuse) As for the alcohol, I was still learning about the disease.

I started to fight back to his abuse, and I left him several times. Only to have him come begging and pleading for me to come back, making all sorts of promises that he will change and we will have a great future together. I kept falling for it....I truly believed in my heart that he could change.

When he was sober, he was the perfect man for me....but as soon as he got drunk, he became a monster I did not recognize, nor did I like being around him. I immediately made friends with people we met and told every single one of them about his problem, which they already knew. Many of them tried to help me because I was very responsible and they knew about the baby.

I really had no where to run that far from him since my family was in another state thousands of miles away and he ruined every job I had independently from him by showing up and stalking me. We worked together but he somehow manipulated the situation to where I was completely dependent on him financially.....

After 9 months of living with him in a hellish existence, I finally made my plans of leaving the state a reality. With the help of my 19 yr old daughter and a few close friends, I made it to the airport and left him, while other friends distracted him.

I gave birth to our son in another state and had no contact with him for about 2 months. He started calling me up drunk and belligerent to cuss me out for leaving him, other times to beg for forgiveness, and so on and on...

He found his way to me and wanted to see our son. I told him I would bring him to see him but did not want to have anything to do with him...Big mistake!!! We ended up together again and this time he played the father role perfectly for about 5 months. He was very helpful with the baby and did things that showed me he changed.

He drank a little wine to help him sleep but nothing more....In time it started to escalate, subtly....He kept telling me that he had it under control and started making every excuse as to why he deserved a drink. Everything was falling into place, etc.

I forgot to mention he was a high functioning alcoholic, one that seemed really intelligent to the world but had the worst demons I have ever seen! He was a very hardworker and could do almost anything, from framing a house to electrical wiring, plumbing, roofing, concrete work, and he also fixed car engines....He was enrolled in a very prominent University for Mechanical Engineering, but the alcohol was ruining everything!

Soon enough he landed a big job, working at some woman's house, she had so many problems with her house, her yard, it was an endless list of things. Anyways, at this job, I was tied up with our baby so I was not able to go with him like I always do. I always work along side him, handing him his tools, cleaning up his work area, etc....We worked very well together, it's what kept us together.

The woman was giving him more and more work, and she was also buying him and his crew alcohol on the job. It started so slowly, I almost did not seeing it coming! He started coming home late every night, then showering, eating late dinner and making any and every excuse to leave again.

I talked to him about it and he got offensive, even started trying to bribe me with spending time with me the night before he went out all night! He was meeting up with this woman!

I finally decided it was time to draw the line! He chose to cheat on me and our little family for his alcohol and this woman? I decided right then and there that it was over and I was going to take my stand and deal out whatever punishment was coming to him.

He called me the next morning with some crappy excuse and I told him nicely to come get his things and get the hell out of my life. He didn't come home till later, and when he did he had this guilty look all over his face, but I was serious and knew it was going to be a fight!

He showered, and left again....he came home 2 hours later...woke up our little son and then he passed out on our bed. I picked his pocket because I noticed he was hiding his cell phone. I took the car keys and found the cell phone. I checked it and there it was, his text messages and his call log back and forth with this woman.

I walked into the house, handed our little son to my 22 yr old daughter. She was sleeping over. I went into the bedroom, slapped him so hard, he woke up in a panic asking what was wrong? I told him to get the f**** outta my house and called him every foul thing in the book!

He was embarrassed in front of my daughter, he kept trying to deny it as he dressed himself. I ran outside, hid the car keys under the house and also hid the cell phone.

He stormed out of the room, I already had his bag packed and I threw it out the door, and told him to get out! He ran around the diningroom table screaming at me to give him the car keys and I told him I don't have it, he probably lost it while he was drunk??? lol

He attacked me, pulling my hair and pushing me to the ground. I rolled over and tried to get away from him. My 22 yr old daughter came from behind and picked his feet off the ground, holding him in a head lock and telling him not to touch me because I am pregnant.

He stopped in shock that she was strong enough to control him. He sobered up and tried to explain to her that I am a liar, but I kept messing with his mind, telling him he is delusional....I told my daughter to call the police.

The police came and I told them he assaulted me and my daughter was witness to it. Right in front of our little baby he did this to me. The police handcuffed him and he turned to me begging me not to do this to him...

I spoke to him in our native language and told him in no uncertain terms that I no longer him, he is an alcoholic and the moment he cheated on me and abandoned us for someone else is the last straw...and I will never take him back ever!

Come to find out he had a prior arrest record so they kept him in longer than usual....his bail was $2k. (I had never called the police on him until now) As soon as he got out, he was ordered to stay away from me and my children until the court date which is set for June.....
I am rebuilding my life, and have no intention of every taking him back.

His words are all lies and I will never trust him again...ever! I gave him everything I had in me to tolerate his disease! I have been researching it for 2 years now, and although I made many mistakes in dealing with him, I rarely ever let him think it's okay to treat me badly! I was not going to stand for it nor am I going to accept it as normal behavior!

Right now he calls me from blocked numbers at least 2x a day, but does not say one word.
Frankly, I am glad he is out of my life and I do not have to worry if he got into an accident or where he is at! I am now 3 months pregnant with our second child, but it is no reason to hang onto to him.

I couldn't stop him from drinking and I never tried to...I wanted him to figure it out for himself, but unfortunately it won't be with me or our children. He is on his own and I can truly say, "Good riddance"...I warned him it was his last chance and I reminded him not to mess up our relationship, but he chose his alcohol over our relationship, so I chose my life with my son over him!

I just hope I have the strength to move on without falling for his sad sob stories.....I do have a soft spot for him, but after learning about alcoholism, I refuse to be with a man who may kill himself from his drinking. It's better to learn to live without him now than to end up suffering more later for something he chose to do!!!!!

What Is a Functional Alcoholic?

 

Many people think of alcoholics as disheveled, homeless winos who have lost everything, but there are people who meet the criteria for a medical diagnosis for alcohol dependence who are highly functional in society and still have their jobs, homes and families. This type of drinker is known as a functional alcoholic.

They rarely miss work and other obligations because of their drinking, although it does happen occasionally, and they usually excel at their jobs and careers. Typically, they are clever and witty individuals who are successful in many areas of their lives. To all but those who are closest to them, they give the outward appearance of being perfectly normal.

Denial Is a ProblemOne of the main reasons that alcoholics seek help for their drinking problems is the eventual negative consequences of their alcohol consumption. When the pain or embarrassment gets bad enough, they can no longer deny that their drinking needs to be addressed.

For the functional alcoholic, the denial runs deep, because they have yet to encounter outward negative consequences. They go to work every day. They haven't suffered financially. They have never been arrested. They don't have a problem!

But There Is a ProblemThe functional alcoholic consumes as much alcohol as any "full-blown" alcoholic, they just don't exhibit the outward symptoms of intoxication. This is because they have developed a tolerance for alcohol to the point that it takes more for them to feel the effects (including hangovers). Consequently, they must drink increasingly larger amounts to get the same "buzz" they want.

This slow build-up of alcohol tolerance means the functional alcoholic is drinking at dangerous levels that can result in alcohol-related organ damage, cognitive impairment and alcohol dependence. Chronic heavy drinkers can display a functional tolerance to the point they show few obvious signs of intoxication even at high blood alcohol concentrations, which in others would be incapacitating.

Are You a Functional Alcoholic?Could it be that you are an alcoholic even though you continue to function well in society? Could your drinking have slowly increased to the point that you have become alcohol dependent without even knowing it?

Below is a profile of typical functional alcoholic behavior. See if any of these actions seem familiar. This profile is of a female, but the same behaviors are typical for males, of course. It's also important to note that "functional alcoholic" is not a formal medical term or diagnosis.

    - When she was in college, she was the first to arrive and the last to leave the party. She could drink everyone else "under the table." Most of her friends graduated, grew up and stopped the partying. Now in her mid-30s, she still drinks like a freshman away from home the first time.

    She Can Hold Her Liquor - She can drink as much or more than anyone, but rarely appears intoxicated. She seldom staggers or slurs her speech. She is more than likely a "happy drunk," rarely getting unpleasant or belligerent when drinking.

    First One at the Bar - She's highly functional at work, but as soon as the work day is over, she's the first one at the bar or she makes a drink as soon as she walks into her home to "unwind." She probably drinks the first two or three drinks very quickly. If for some reason she has to unexpectedly stay late at work, she can become agitated or irritable.

    Drinking Is a Big Part of Her Life - She talks about drinking a lot and she is often the driving force behind office parties and drinking gatherings after work. She brags about her drinking bouts on her blog and most of the pictures in her photo albums were taken in barrooms. She tends to avoid events where no alcohol is available. She buys the economy sizes and always makes sure there is "enough" alcohol available.

    Jokes About Her Drinking - She laughs about her alcohol consumption and drinking episodes with jokes like, "I'm a drunk, alcoholics go to meetings." The humor is an attempt to validate that her drinking is a choice. After all, real alcoholics deny they have a problem, right? If confronted about the amount she drinks, however, she may get defensive, angry or belligerent.

    Friends Ignore the Symptoms - Because she is generally well liked and fun-loving, or perhaps because she's in a position of authority, those around her also laugh off her drunken escapades. But secretly, they know she has a problem. They talk behind her back. But rarely is she confronted directly about her drinking.

    She Begins to See the Effects - Although she continues to be functional, it begins to get more difficult to do. She begins to notice withdrawal symptoms when she's not drinking, such as the shakes or nervousness. She's having more frequent memory blanks. She needs more makeup to cover her flushed face, grayish pallor or dark circles. Her drinking antics are becoming more extreme, dangerous or embarrassing.

    A Dangerous StateUnfortunately, even when functional alcoholics begin to recognize that they have a drinking problem, they still resist reaching out for help. By the time they admit the problem, their withdrawal symptoms - which can begin within a few hours after their last drink - have become more and more severe.

    They may try to quit on their own, but the withdrawals are too unpleasant or severe. Therefore, they continue to drink to keep the withdrawals at bay and the cycle continues.

Usually, it is only when their continued drinking becomes more painful than the prospect of going through the pain of alcohol withdrawal, will they finally reach out for help. But it doesn't have to be that way. Medical detoxification provides medication, vitamins and diet to help ease the withdrawal process. Help is available.

Alcoholism and Problem Drinking

 

Alcoholism is a word which many people use to mean alcohol dependence (alcohol addiction). Some people are problem drinkers without being dependent on alcohol. If you are alcohol-dependent then detoxification ('detox') can help you to stop drinking.

Problems with drinking alcohol

There are roughly four levels of alcohol drinking - social, heavy, problem and dependent. As a rule, each level increases the risk to your health and safety.

Social drinking

Most people drink some alcohol. However, even a small amount of alcohol can be dangerous if you drive, operate machinery, or take some types of medication.

Related articles Heavy (hazardous) drinking

This is drinking above the recommended safe limits, which are:

  • Men should drink no more than 21 units of alcohol per week, no more than four units in any one day, and have at least two alcohol-free days a week.
  • Women should drink no more than 14 units of alcohol per week, no more than three units in any one day, and have at least two alcohol-free days a week.
  • Pregnant women. Advice from the Department of Health states that ... "pregnant women or women trying to conceive should not drink alcohol at all. If they do choose to drink, to minimize the risk to the baby, they should not drink more than 1-2 units of alcohol once or twice a week and should not get drunk".

Where do these recommendations come from?

  • The Department of Health recommends that men should not regularly drink more than 3-4 units of alcohol a day and women should not regularly drink more than 2-3 units a day. 'Regularly' means drinking every day or most days of the week. And if you do drink more heavily than this on any day, allow 48 alcohol-free hours afterwards to let your body recover.
  • The Royal College of Physicians (RCP) advises no more than 21 units per week for men and 14 units per week for women. But also, have 2-3 alcohol-free days a week to allow the liver time to recover after drinking anything but the smallest amount of alcohol. A quote from the RCP... "in addition to quantity, safe alcohol limits must also take into account frequency. There is an increased risk of liver disease for those who drink daily or near daily compared with those who drink periodically or intermittently."
  • The House of Commons Science and Technology Committee advise that people should have at least two alcohol-free days a week.
  • Some would argue that the upper limits of the recommendations are too high. For example, one study found that more than two units a day for men and more than one unit a day for women significantly increases the risk of developing certain cancers.

One unit of alcohol is in about half a pint of beer, or two thirds of a small glass of wine, or one small pub measure of spirits. See separate leaflet called Alcohol and sensible drinking for details.

Why these recommendations? Your liver processes alcohol. It can only cope with so much at a time. Drinking more alcohol than the liver can cope with can damage liver cells and produce toxic by-product chemicals. Drinking above the recommended safe limit is hazardous. That is, it increases your risk of developing diseases such as cirrhosis (liver damage), damage to the pancreas, certain cancers, heart problems, sexual problems, and other conditions. About 1 in 3 men and about 1 in 7 women drink more than the safe limit. In general, the more you drink, the greater the risk.

For example, if a man drinks five units each day (not greatly over the recommended limit) then, on average, he doubles his risk of developing liver disease, raised blood pressure, some cancers, and of having a violent death.

Problem (harmful) drinking

This is where you continue to drink heavily even though you have caused harm, or are causing harm or problems to yourself, family, or society. For example, you may:

  • Have cirrhosis or another alcohol-related condition.
  • Binge drink and get drunk quite often. This may cause you to lose time off work, or behave in an antisocial way when you drink. But note: not everybody with problem drinking binges or gets drunk. Many people with an alcohol-related condition such as cirrhosis drink small amounts frequently but do not get drunk.
  • Spend more money on alcohol than you can afford.
  • Have problems with your relationships or at work because of your drinking.

Many problem drinkers are not dependent on alcohol. They could stop drinking without withdrawal symptoms if they wanted to. But, for one reason or another, they continue to drink heavily.

Alcohol dependence (addiction)

This is a serious situation where drinking alcohol takes a high priority in your life. You drink every day, and often need to drink to prevent unpleasant withdrawal symptoms (see below). In the UK, about 2 in 100 women and about 6 in 100 men are alcohol-dependent.

What are the symptoms of alcohol dependence?

If you are alcohol-dependent you have a strong desire for alcohol. Sometimes the desire is overwhelming. You have great difficulty in controlling your drinking. In addition, your body becomes used to lots of alcohol. Therefore, you may start to develop withdrawal symptoms 3-8 hours after your last drink as the effect of the alcohol wears off. So, even if you want to stop drinking, it is often difficult because of the withdrawal symptoms. Withdrawal symptoms include: feeling sick, trembling, sweating, craving for alcohol, and just feeling awful. Convulsions occur in a small number of cases.

As a result, you drink alcohol regularly and depend on it to prevent withdrawal symptoms. If you do not have any more alcohol, withdrawal symptoms usually last 5-7 days but a craving for alcohol may persist longer. The severity of dependence can vary. It can develop gradually and become more severe. You may be developing alcohol dependence if you:

  • Often have a strong desire to drink alcohol and need a drink every day.
  • Drink alone often.
  • Need a drink to stop trembling (the shakes).
  • Drink early, or first thing in the morning (to avoid withdrawal symptoms).
  • Spend a lot of your time in activities where alcohol is available. For example, if you spend a lot of time at the social club or pub.
  • Neglect other interests or pleasures because of alcohol drinking.

If you are alcohol-dependent you are usually tolerant to the effect of alcohol. This means that you need more alcohol to notice any effects and to become drunk. This can make things worse, as it tends to make you drink even more.

If you are alcohol-dependent you may get drunk regularly. However, you may not get drunk. You may drink small amounts regularly to keep any withdrawal symptoms away. You may then be able to hide your problem from others. However, you are still at serious risk of developing conditions due to heavy drinking (liver damage, cancers, etc).

Delirium tremens (DTs)

This is a more severe withdrawal reaction after stopping alcohol. It occurs in about 1 in 20 people who have alcohol withdrawal symptoms about 2-3 days after their last drink. Symptoms include: marked tremor (the shakes) and delirium (agitation, confusion, and seeing and hearing things that are not there). Some people have convulsions. Complications can develop such as dehydration and other serious physical problems. It is fatal in some cases.

Related blogsShould I cut back, or should I stop alcohol completely?

If you are alcohol-dependent then it is best to cut back gradually and then stop alcohol completely. Do not stop alcohol suddenly if you are alcohol-dependent. Some withdrawal effects can be severe. This is why it is best to cut down gradually and then stop, or see your doctor about a detox - see later in this leaflet. Also, it is best to cut out alcohol completely if you have a condition due to alcohol, such as liver damage. Otherwise, reducing to a safe level of drinking is an option.

If you are trying to cut down, some tips which may help include the following:

  • Consider drinking low-alcohol beers, or at least do not drink strong beers or lagers.
  • Try pacing the rate of drinking. Perhaps alternate soft drinks with alcoholic drinks.
  • Consider cutting back on types of social activity which involve drinking. Perhaps try different social activities where drinking is not involved. Perhaps reduce the number of days in the week where you go out to drink.
  • Resist pressure from people who encourage you to drink more than you want to.
What can help me to reduce or stop drinking alcohol?

No one can make you stop or cut down drinking. You have to be committed and determined to do this yourself. However, it can be difficult, and one or more of the following may help.

Accepting the problem

Some people deny to themselves that they have a problem. The sort of thoughts that some people deceive themselves with include: "I can cope", "I'm only drinking what my mates drink", "I can stop at any time".

Accepting that you may have a problem, and seeking help where necessary, are often the biggest steps to cutting back on alcohol, or cutting it out completely.

Self-help

Some people are helped by books, websites, leaflets and their own determination. It is thought that about 1 in 3 people who have a problem with alcohol return to sensible drinking, or stop drinking, without any professional help. See the end of this leaflet for a list of resources.

Talking treatments

Some people are helped by counselling and advice from a practice nurse or doctor. Sometimes a referral to a specially trained counsellor may be advised. They can help you to talk through the issues in more detail and help you to plan how to manage your drinking. In some cases, more intensive talking treatments such as cognitive behavioural therapy (CBT), motivational interviewing, or motivational enhanced therapy may be appropriate. For example, CBT helps you to change certain ways that you think, feel and behave, and may help some people with alcohol problems.

Talking treatments are particularly useful for children with alcohol-related problems who are aged between 10 and 17. Children may also be offered family therapy in which other members of their family may be involved in a course of treatment.

Treating other illnesses

Alcohol may seem to be a quick answer to the relief of stress, anxiety, depression, or other mental health problems. However, the effect is short-lived and drinking a lot of alcohol often makes these conditions worse. If you feel that these conditions are the underlying problem then see your doctor. Medication and talking treatments such as CBT often work well for these conditions, and are a much better long-term option than heavy drinking.

Detoxification (detox)

This is an option if you are alcohol-dependent.

What is detoxification?

Detoxification, or detox, involves taking a short course of a medicine which helps to prevent withdrawal symptoms when you stop drinking alcohol. Benzodiazepine medicines such as chlordiazepoxide or diazepam are used for detox.

Many GPs are happy to prescribe for detox from alcohol. A common plan is to prescribe a high dose of medication for the first day that you stop drinking alcohol. You then gradually reduce the dose over the next 5-7 days. This usually prevents, or greatly reduces, the withdrawal symptoms. You must agree not to drink any alcohol when you are taking the detox medication. Your GP or practice nurse will usually see you regularly during the time of detox. Also, during this time, support from family or friends can be of great help.

Some people are referred to a specialist drug and alcohol unit for detox. This is usually better for those with little home or social support, those with a history of severe withdrawal symptoms, those with physical illness caused by alcohol, and those where previous attempts to stop alcohol have failed. The medicines used to detox in specialist units are much the same as GPs prescribe, apart from clomethiazole which should only be used in hospitals. Hospital units have more staff and expertise for giving support and counselling than GPs have. People with serious alcohol-related problems may be better off being admitted to hospital for detox.

The medication does not make you stop drinking. You need determination to stop. The medication simply helps you to feel better whilst your body readjusts to not having alcohol. Even after the period of detox you may still have some craving for alcohol. So you will still need willpower and coping strategies for when you feel tempted to drink.

Other medication sometimes used for alcohol problems
  • Vitamins, particularly vitamin B1 (thiamine), are often prescribed if you are alcohol-dependent - especially during detox. This is because many people who are dependent on alcohol do not eat properly and can lack certain vitamins. A lack of vitamin B1 is the most common. A lack of this vitamin can cause serious brain conditions called Wernicke's encephalopathy and Korsakoff's psychosis.
  • Acamprosate and naltrexone are medicines which can help to ease alcohol craving. Either of these may be prescribed to some people after a successful detox to help them stay off alcohol.
  • Disulfiram is another medicine which is sometimes used following a successful detox. When you take disulfiram you get very unpleasant symptoms if you drink any alcohol (such as flushing, vomiting, palpitations and headache). So, in effect, the medicine acts as a deterrent for when you are tempted to drink. It can help some people to stay off alcohol.
  • Lorazepam, olanzapine and haloperidol are all used in the treatment of delirium tremens.
  • Baclofen is a medicine that is reported in some medical studies to help some people to stay off alcohol or to reduce drinking quantity. It may also reduce craving and reduce anxiety in alcohol-dependent people. However, the evidence for the effect of baclofen is conflicting and other studies do not support these reports. More research is needed to clarify whether baclofen is helpful. Note: it is currently not licensed for the treatment of alcohol-related problems.
After detoxification and staying off alcohol

Many people who successfully detox go back to drinking heavily again at some point. There are various reasons why this may occur. It is thought that you are less likely to go back to drinking heavily if you have counselling, or other support to help you to stay off alcohol. Your doctor, practice nurse, or local drug and alcohol unit may provide ongoing support when you are trying to stay off alcohol. Self-help groups such as Alcoholics Anonymous have also helped many people to stay off alcohol.

If you do go back to heavy drinking, you can always try again to stop or cut down. Some people take several attempts before they stop drinking, or keep within the safe limits, for good.

Further resources and sources of helpDrinkline - National Alcohol Helpline

Helpline: 0800 917 8282
Offers help to callers worried about their own drinking, and support to the family and friends of people who are drinking. Advice to callers on where to go for help.

Alcohol abuse is a pattern of drinking that results in harm to one’s health, interpersonal relationships, or ability to work. According to Gelder, Mayou & Geddes (2005) alcohol abuse is linked with suicide. They state the risk of suicide is high in older men who have a history of drinking, as well as those suffering from depression. Certain manifestations of alcohol abuse include failure to fulfill responsibilities at work, school, or home; drinking in dangerous situations, including the operation of a motor vehicle; legal concerns associated with alcohol use; and continued drinking despite problems that are caused or worsened by drinking. Alcohol abuse can lead to alcohol dependence.[5] In the diagnosis manual DSM-5 alcohol abuse is combined with alcohol dependence to create one unified disorder, alcohol use disorder (AUD),[6] that includes a graded clinical severity from moderate to severe with at least 2 criteria to make diagnoses. For adolescents, the DSM-5 proposes that diagnoses meeting 2 or 3 criteria would be similar to alcohol abuse while meeting over 4 criteria would be equivalent to alcohol dependence when compared to the DSM-IV.

Alcohol abuse has both short-term and long-term risks. If a person drives while drunk or regularly consuming binge drinks (more than five standard drinks in one drinking session), they are considered to have been involved in alcohol abuse. Short-term abuses of alcohol include, but are not limited to, violence, injuries, unprotected sexual activities and, additionally, social and financial problems.[7]

The older adult population (over 65 years) is frequently overlooked when discussing alcohol abuse. A smaller volume of consumed alcohol has a greater impact on the older adult than it does on a younger individual. As a result the American Geriatrics Society recommends for an older adult with no known risk factors less than one drink a day or fewer than two drinks per occasion regardless of gender,[8][9][10] this is less than current recommendations of maximum alcohol consumption per week, for adults noted to be nine drinks for a male and seven for a female.[11]

Binge drinking[edit]
Main article: Binge drinking

In the USA, binge drinking is defined as consuming more than five units in men and four units in women. It increases chances for vandalism, fights, violent behaviours, injuries, drunk driving, trouble with police, negative health, social, economic, or legal consequences to occur.[12] Binge drinking is also associated with neurocognitive deficits of frontal lobe processing and impaired working memory as well as delayed auditory and verbal memory deficits.[12]

Binge drinking combined with the stress of returning to work is a contributing factor to Monday deaths from heart attacks.[13] The chances of becoming dependent are increased greatly in men who have 15 or more drinks each week or women who have 12 or more drinks each week. This is known as alcohol dependency.[14]

It is believed that one way to prevent binge drinking is to raise the legal drinking age.[1

 

 

Take the first step...

 

Do you have a dream deep in your heart that you want to pursue? If you do, have you taken the first step necessary to achieve it? Taking the first step is perhaps the most difficult thing to do in achieving a dream. There are a lot of mental obstacles that make it difficult to take that first step.

Here are some dont’s to help you solve the mental obstacles:

  1. Don’t wait until the situation is perfect.
    You should not wait until the situation is perfect because the situation will never be perfect. No matter how or when you see it, there will always be something that make you think again.
  2. Don’t wait until other people agree with you.
    Just like you shouldn’t wait for the situation to be perfect, you shouldn’t wait until everybody agrees with your idea. There will always be opposition, and that is perfectly normal. If you wait until there is a consensus, you will never start.
  3. Don’t wait until your skill is good.
    We might think that we need to have good skill before we start doing something. But the truth is, you will learn much more by doing than by waiting. Doing allows you to hone your skill much faster than just learning the theory.

As you can see, the three points above have “don’t wait” in them. So here is the bottom line: the best time to start is now.

I learned this in blogging. When I started my blog, I didn’t have the skill to create good content nor to market it properly. But I started blogging anyway. The first months were really tough. After blogging for four months, I got only ten subscribers. Thankfully, the experience taught me a lot. While there is still a lot of room for improvement, I’m now amazed to see what I’ve learned along the way.

Here are some more things you should do to successfully take the first step:

1. Believe in your dream.

Believing in your dream is essential to get the motivation you need to achieve it. You simply can’t fool your own heart. Deep down inside you know whether or not you can believe in your dream. Is the dream worth pursuing? Is it something that you want to pour your heart into?

2. Visualize your dream.

Can you imagine – in detail – how the world will look like when your dream comes true? Visualizing your dream will energize you because you can then see how the world changes for the better and how people live a happier life because of your dream. The energy and excitement is there for you to feel.

3. Expect a hard way ahead.

While it’s not impossible, achieving your dream is definitely not easy. Don’t expect an easy way; expect a hard one instead. Having the right expectations from the beginning will make the journey much easier for you. That way, you won’t be surprised and lose heart when you encounter obstacles along the way.

4. Take one bite at a time.

Your dream may be big (it should be!) and that might make it seem overwhelming. But, like the saying says, “When eating an elephant take one bite at a time.” So take a small portion of it that you can handle. Think about something that you can do within one week, and then think about what you can do today. It could be as simple as calling a more experienced friend to ask some questions.

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