Alcohol Abuse - DSM-IV

[neuro equipoise]

"Alcohol abuse, which is a separate diagnosis from alcohol dependence,
is defined by the DSM-IV as a maladaptive pattern of use with one or
more of the following criteria over a one-year period:


Repeated alcohol consumption that results in an inability to fulfill
obligations at home, school or work

Repeated alcohol consumption when it could be physically dangerous (such
as driving a car)

Repeated alcohol-related legal problems
such as arrests.

Continued drinking despite interpersonal or social problems that are
caused or made worse by drinking


Alcohol abuse is extremely amenable to brief intervention. Brief
intervention usually includes giving patients information about problems
associated with excessive drinking and advising them to cut down on
their drinking or abstain. Without intervention, 10% will likely
progress to dependence and 50% to 60% will continue to experience
problems over the next five years [132; 135]."

[Kirk S.]

Neuro,

Thanks for the definitions.

Even though there is a difference, when does abuse turn to dependence?
Also, where does this fit into the definition of alcoholism? Even though I
developed no real physical dependence, I was mentally dependent upon alcohol
and the effects it had on me. I also know that if I drink, I will again
become dependent upon it to avoid painful, uncomfortable or fearful
situations.

I had no physical withdrawal symptoms when I quit drinking. I did develop a
tolerance for alcohol however never got to the stage where more did less.

If someone has a problem, how do they get past the denial of it? At least
IMHO, admission of the problem or even the possibility of there being a
problem is essential to doing anything about it.

Kirk S.
"neuro equipoise" <NeuroEquipoise@webtv.net> wrote in message
news:19028-41052229-352@storefull-3277.bay.webtv.net...
>
> "Alcohol abuse, which is a separate diagnosis from alcohol dependence,
> is defined by the DSM-IV as a maladaptive pattern of use with one or
> more of the following criteria over a one-year period:
>
>
> Repeated alcohol consumption that results in an inability to fulfill
> obligations at home, school or work
>
> Repeated alcohol consumption when it could be physically dangerous (such
> as driving a car)
>
> Repeated alcohol-related legal problems
> such as arrests.
>
> Continued drinking despite interpersonal or social problems that are
> caused or made worse by drinking
>
>
> Alcohol abuse is extremely amenable to brief intervention. Brief
> intervention usually includes giving patients information about problems
> associated with excessive drinking and advising them to cut down on
> their drinking or abstain. Without intervention, 10% will likely
> progress to dependence and 50% to 60% will continue to experience
> problems over the next five years [132; 135]."
>

[neuro equipoise]

On - Tue, Jul 27, 2004, 5:58pm (EDT+4) crayzkirk@yahoo.com (Kirk*S.)
wrote:

> Even though there is a difference, when does
> abuse turn to dependence?

According to the DSM-IV criteria, a person is diagnosed as dependent
when three of the signs/symptoms below are evident:

"1.Development of tolerance to the effects of alcohol (the individual
requires more alcohol to achieve the desired effects)
2.Experience of withdrawal symptoms (e.g., tremors, rapid heartbeat,
delirium) when alcohol is not available or when intake is reduced.
3.Impaired control over drinking
4.Preoccupation with obtaining or consuming alcohol
5.Continued use of alcohol despite adverse consequences
6.Distortions in thinking, most notably denial"

> Also, where does this fit into the definition of
> alcoholism?

Alcohol dependence is 'alcoholism'.


> Even though I developed no real physical
> dependence, I was mentally dependent upon
> alcohol and the effects it had on me.

It's the impaired ability to deal with stress. Alcohol is used as a
substitute for certain inhibitory chemistry which should be in place,
but isn't.

> I also know that if I drink, I will again become
> dependent upon it to avoid painful, uncomfortable
> or fearful situations.

Yes, because the part of the brain which acts as a brake to stopping
stress, is not a powerful network in an alcohol dependent person. A
healthy, non-alcoholic person can withstand great pain, great stress.
This network can be strengthened though when alcohol is stopped.

> I had no physical withdrawal symptoms when I
> quit drinking. I did develop a tolerance for alcohol
> however never got to the stage where more did
> less.

Here's a withdrawal quote from the dependence link...
"Some alcoholics have symptoms of irritability, emotional liability,
insomnia, and anxiety that persist for weeks to months after alcohol
withdrawal."

> If someone has a problem, how do they get past
> the denial of it? At least IMHO, admission of the
> problem or even the possibility of there being a
> problem is essential to doing anything about it.

There has to be desire and some positive awareness for change to occur.
This link below is a 10 hour course on Alcohol Abuse/Dependence - the
info on getting past the denial, getting motivated, treatment, tests,
etc., is towards the end of the site. It's all an interesting read if
you have the time, Kirk.

Stay well...


"Physicians must understand the criteria and warning signs of alcohol
dependence. This enables the physician to confront and intervene earlier
in the course of the illness rather than relying on toxic liver markers.
Verifying the facts that show a person is at risk for alcohol dependence
and confronting the impaired individual with those facts is the
definition of an office or brief intervention. Brief intervention is
most effective before dependence is reached. Once diagnosable, the
patient needs more comprehensive intervention."

http://www.netce.com/course.asp?Course=651