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Alcoholic can be defined as an individual whose continued or excessive drinking
results in impairment of personal health, disruption of family and social relationships,
and loss of economic security. Alcohol abuse is a leading cause of morbidity
and mortality throughout the world. It is estimated in the United States that
as many as 10 % of men and 3 % of women may suffer from persistent problems
related to the use of alcohol.
There are many physical effects that an alcoholic experiences. Alcohol affects
many organ systems of the body, but perhaps most notably affected are the central
nervous system and the liver. Almost all ingested alcohol is metabolized in
the liver and excessive alcohol use can lead to acute and chronic liver disease.
Liver cirrhosis resulting from alcohol abuse is one of the ten leading causes
of death in the United States. From data obtained in autopsy studies, it appears
that between 10 % and 15 % of alcoholic individuals had cirrhosis at the time
of death. It is unknown why some alcoholic people develop liver disease while
others do not. One possibility is that there are genetic factors that predispose
some alcoholic individuals to liver disease. Some data also suggest that co-factors
such as chronic infection with hepatitis C virus may increase the risk of the
development of cirrhosis in an alcoholic. In general, women who drink an equal
amount of alcohol are at higher risk than men for the development of liver
disease. This is probably because of decreased metabolism of alcohol in the
stomach prior to absorption.
If an alcoholic is unwilling to seek help, is there any way to get him or
her into treatment? This can be a challenging situation. An alcoholic cannot
be forced to get help except under certain circumstances, such as when a violent
incident results in police being called or following a medical emergency. However,
this doesn't mean that you have to wait for a crisis to make an impact. Based
on clinical experience, many alcoholism treatment specialists recommend the
following steps to help an alcoholic accept treatment:
Stop all "rescue missions." Family members often try to protect
an alcoholic from the results of his or her behavior by making excuses to others
about his or her drinking and by getting him or her out of alcohol-related
jams. It is important to stop all such rescue attempts immediately so that
the alcoholic will fully experience the harmful effects of his or her drinking.
This can be a big motivation for the alcoholic to stop.
Be specific. Tell the family member that you are concerned about his or her
drinking and want to be supportive in getting help. Back up your concern with
examples of the ways in which his or her drinking has caused problems for both
of you, including the most recent incident.
State the consequences. Tell the family member that until he or she gets help,
you will carry out consequences. This is not to punish the drinker, but to
protect yourself from the harmful effects of the drinking. These may include
refusing to go with the person to any alcohol-related social activities or
even moving out of the house. Do not make any threats you are not prepared
to carry out.
Be ready to help. Gather information in advance about local treatment options.
If the person is willing to seek help, call immediately for an appointment
with a treatment program counselor.
Call on a friend. If the family member still refuses to get help, ask a friend
to talk with him or her, using the steps described above. A friend who is a
recovering alcoholic may be particularly persuasive, but any caring, nonjudgmental
friend may be able to make a difference. The intervention of more than one
person is often necessary to persuade an alcoholic person to seek help. Multiple
interventions may also be necessary.
Find strength in numbers. With the help of a professional therapist, some
families join with other relatives and friends to confront an alcoholic as
a group. While this approach may be effective, it should only be attempted
under the guidance of a therapist who is experienced in this kind of group
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