• Failing to fulfill work, school, or home duties
• Getting arrested for drunk driving, disorderly conduct, etc.
• Having relationship problems such as arguments or physical fights

• Cravings for alcohol
• The need for more and more alcohol to get the desired effect
• Withdrawal symptoms when blood alcohol levels decline

Alcohol abuse and/or dependence can develop in several ways:

• Drinking in excess on an almost daily basis
• Drinking a lot at certain times, such as every weekend
• Drinking a lot in binges, with or without long periods of not drinking
• Drinking infrequently, but with loss of control over drinking and/or behavior problems while drinking

Physical Effects of Alcohol

• Can impair mental/physical reflexes. The chart below describes the typical effects as blood alcohol content (BAC) increases.
  • For most states, blood alcohol content (BAC) of 0.10 is the indicator for driving while intoxicated.
• Can increase the risk of diseases such as cancer of the brain, tongue, mouth, esophagus, larynx, liver, and bladder; cirrhosis of the liver and hepatitis; gastritis and brain damage when used heavily. It can also cause heart and blood pressure problems.
• Can lead to malnutrition
• Is known to cause birth defects

• May cause someone to do things they might not do otherwise, such as driving at dangerous speeds or other daredevil acts
• May result in anger, violent behavior, or depression which can intensify as more alcohol is consumed. Can result in suicide.
• May result in memory loss, the inability to concentrate, and problems in other intellectual functions
• Can make family life chaotic. The divorce rate is 7 times higher among alcoholics. Also, children of alcoholics often have emotional problems lasting into adulthood.
• Often results in decreased work attendance and performance as well as problems in dealing with employees and coworkers

• Self-help groups such as:
  • Alcoholics Anonymous (AA)
  • Rational Recovery (RR)
  • Women for Sobriety (WFS)
  • Men for Sobriety (MFS)
    (See "Places to Get Information & Help" under "Alcohol/Drug Abuse" on pages 374 and 375.)
• Alcohol treatment programs. Many types exist:
  • Outpatient treatment is held in hospitals, clinics, or other alcohol rehabilitation centers. It focuses on education and is often set up in a group format. Substance abuse counselors, psychologists, social workers, etc., staff this type of treatment, which generally lasts from 610 weeks.
  • Day treatment programs in which the person checks into a facility all day, but goes home at night. Individual and group therapy as well as education are provided. This type of treatment is suitable for persons with more severe prob- lems than can be helped by outpatient pro- grams. It is less costly than inpatient treatment.
  • Inpatient treatment is usually a 1428-day stay in a hospital or other residential treat- ment facility. The alcoholic may need to go through detoxification. The focus of treat- ment is to rehabilitate the person to not use alcohol. This is done through education and individual and group therapy.
  • "Aftercare" eases the person back into the world" through individual counseling, group therapy, and support group meetings such as AA, after inpatient or outpatient treatment is finished. This can last one year. The person continues with individual and group therapy and support group meetings such as AA.
  • Psychotherapy, which can be individual, family, and/or group therapy
• Medications. One called Naltrexone, blocks the craving for alcohol and the pleasure of getting high. Another one, called Antabuse, causes physical reactions such as vomiting when drinking alcohol. Antabuse is rarely used.

Have you had memory lapses or blackouts due to drinking?	Or
Do you continue to drink even though you have health problems caused by alcohol?	Or
Do you get withdrawal symptoms such as headaches, chills, shakes, and a strong craving for alcohol, and, as a result, drink more to get rid of these symptoms?	Or
Do you take part in high-risk behaviors such as: unsafe sex in a nonmonogamous relationship or driving a boat or car or working with hazardous machinery when under the influence of alcohol?	Or
Has drinking caused trouble at home, at work, and/or with relationships with others?	Or
Do you have to drink alcohol for any of the following reasons? To get through the day or unwind at the end of the day To cope with stressful life events To escape from ongoing problems	Or
Do you answer yes to 2 or more of the following questions? Have you ever tried to cut down on your drinking? Have you ever been annoyed by anybody criticizing your drinking? Have you ever felt guilty about your drinking? Have you ever had an eye-opener (drink) in the morning?	Or

Self-Care Tips
Tips to Reduce the Risks Associated with Drinking:

• Know your limit and stick to it or don't drink any alcohol.
• Drink slowly. You are apt to drink less.
• Pour less alcohol and more mixer in each drink.
• Alternate an alcoholic beverage with one without alcohol.
• Eat when you drink. Food helps to slow alcohol absorption.
• Talk to persons who will listen to your feelings and concerns without putting you down. You will be less likely to turn to alcohol to "drown your sorrows."
• Find ways to calm yourself other than with alcohol. Examples include hobbies, relaxation exercises, physical activities, music, movies, etc.
• Realize that you are a role model for your children. They learn what they see. When you drink, do so responsibly.
• Don't mix drinking with driving, drugs, or operating machines. Doing so can be fatal.
• Don't rely on coffee or fresh air to make you sober. Even though you see these things done on TV, they won't make a person sober.
• Don't have any alcohol if you are pregnant.
• Contact your Employee Assistance Program (EAP) at work for information and other suggestions.