Ensuring Solutions to Alcohol Problems (Ensuring Solutions) at the George Washington University Medical Center seeks to increase access to treatment for individuals with alcohol problems by educating policymakers, business leaders and the general public about the extent and costs of untreated alcohol problems and about ways to increase access to treatment. Ensuring Solutions uses several terms to describe alcohol-related problems:

Problem drinking (also known as alcohol abuse) and risky drinking describe types of drinking that lead to problems – life threatening situations at work and at home. While a person may not be dependent on alcohol, he or she may drink in ways that endanger his or her own health and well-being. A hangover after drinking heavily at home or at a sporting event may undermine productivity at work the next day, increasing the chances of injury or accidents. Problem drinking can impair judgment and physical coordination – common factors in car crashes, falls and drownings. Problem drinking is also associated with violent behavior. Alcohol use can make other illnesses such as depression, diabetes or hypertension more difficult to treat. Alcohol can interact with medications, a problem for many older Americans. Drinking during pregnancy increases the risks of a baby being born with fetal alcohol syndrome, the leading preventable cause of mental retardation.

Alcoholism and alcohol dependence describe a chronic illness, very similar to other illnesses such as diabetes, high blood pressure, and depression. A person who is dependent on alcohol and is physically addicted has the illness, alcoholism. He or she drinks frequently, often quite a lot, and gets sick without alcohol. The technical term for that particular aspect of alcoholism is withdrawal. Craving and a need to use more and more alcohol to get the same effect (tolerance) are common. Between 50 percent and 60 percent of the people who are alcohol dependent have a blood relative who was also dependent on alcohol. This pattern is particularly common among people who start drinking heavily in their teens. Although 40-60 percent of those who are dependent on alcohol are able to stop drinking (often with treatment and/or or the help of self-help groups like Alcoholics Anonymous), some people find it very difficult to stop drinking and to stay sober. Heavy drinking over a long period of time significantly increases risks for cirrhosis of the liver; stomach, esophageal, and breast cancer; and organic brain syndromes.

December 2002