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By Lisa Garmezy
Problem drinking escalates. It won't go on indefinitely at the current
Level - the level where your spouse thinks "Oh no, here we go," when you open the bottle. In this season of partying and resolutions, alcohol abuse - a major problem in HPD - merits a second look.
Stereotypes of winos and sloshed businessmen don't reflect the reality that one in 13 Americans either abuses alcohol or is an alcoholic. One in five alcoholics is the "high-functioning" type, who caters to his problem after work. Cravings, loss of control, physical dependence and tolerance define alcoholism.
Before alcoholism but after moderate drinking comes abuse. The colleagues and family members who occupy this grey area may show the following signs:
- Repeatedly drinking more than self-set limits.
- Having a persistent desire to quit or cut down.
- Drinking and driving.
- Spending too much time drinking.
- Having hangovers or sleep disorders.
You are likely to be an abuser (or alcoholic) if you exceed the National Institute on Alcohol Abuse and Alcoholism guidelines. For men, that's more than four drinks in a day or more than 14 in a week. For women, or anyone over 65, it's more than three in a day or more than seven in a week.
Of course, your "one drink" may be three. A standard drink is 12 ounces of beer, eight or nine ounces of malt liquor, five ounces. of wine, or 1.5 ounces of 80-proof liquor.
Cross these boundaries and you risk your health, family and career. Osteoporosis, high blood pressure, diabetes and many other conditions are made worse by alcohol abuse.
For Women, A Different Challenge
Old stereotypes are male, but Diane Schuler put a female face on alcoholism. She's the New Yorker who drove the wrong way on the freeway, killing herself, four children in her vehicle and three men in the SUV she hit. Her blood showed THC and twice the legal limit of alcohol; the family insists she didn't have a problem. Excessive drinking in women, like in the elderly, is often overlooked, and it's often secretive.
Alcohol challenges men and women differently. First, size matters. People under 140 pounds are more likely to have an alcohol-related crash after just one drink. And alcohol abuse makes you more likely to be either a perpetrator or a victim of family violence.
Men progress from alcohol abuse to alcoholism more rapidly than women. But because women's bodies contain less water, drinking at the abuse level hurts women's health more quickly than men's. For example, women develop cirrhosis of the liver more quickly. While moderate, non-abusive drinking seems to promote heart health, it also appears to stimulate recurrences of breast cancer.
As you know, there is no safe level for drinking during pregnancy. Fetal Alcohol Syndrome causes incurable central nervous system problems that impact growth and can cause mental retardation.
Another outcome of FAS: the marriage dies faster than a shocked dad can register the diagnosis. Women tend to stay with alcoholic men; almost all alcoholic women end up divorced. Fair or not, recent research shows men think the "right" amount for a date or female friend to drink is about one and a half drinks less than the amount women expect them to say.
Drinking can be a satisfying way to defy expectations. If sending the message "you are not in control of me" spurs you on, find healthier ways to establish your independence.
The Pill Problem
Comedienne Stefanie Wilder-Taylor described her husband's "oh, no" reaction at babyonbored.blogspot.com, which began as a commentary on motherhood. Now she blogs about alcoholism and her struggle to stay sober.
As her daughter screamed one sleepless night, Stefanie wrote, "The main thing I thought about was how badly I wanted a Xanax. But to be honest, I wanted three. . .One Xanax would be like one cookie - pointless. One measly Xanax is not even medicinal. But three...three seemed like just the thing to unclench my jaw and make life seem workable."
Alcohol abuse makes a transition to prescription pill abuse more likely. The people we see abusing pills resemble Stefanie more than the folks you see on patrol grinding pills to inject or snort. Women, more than men, drift into abuse of prescribed narcotic pain killers and tranquilizers. We go the doctor more. We get more prescriptions.
Getting Help
When your efforts to quit aren't effective, get help. The Council on Alcohol and Drugs (713-942-4100) can make referrals, including to 12-step programs. Medical supervision is strongly recommended when withdrawing from pills or high amounts of alcohol. New medications that reduce cravings in the brain rather than inducing nausea may be prescribed.
Please visit the "Rethinking Drinking" website for practical tips and tools: www.rethinkingdrinking.niaaa.nih.gov. Google "Alcohol: A Women's Health Issue" for information from NIAAA. Stefanie's blog invites readers to write in with supportive messages for her, and for each other.
Last, many people in trouble know exactly what they need to do to get healthy and stronger. When someone in your life is cutting down, be encouraging and find things to do together that don't include alcohol. Never obstruct sobriety.
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