COL By any name, drinking a lot is a problem

By Dr. Allen Douma

Tribune Media Services

Q: A family member seems to be drinking a lot lately and I suspect she has a problem with it. I am confused by terms such as "alcohol abuse," "alcohol dependency" and "problem drinker." Are they all the same? -- C.M., Queens, N.Y.

A: Alcoholism and alcohol abuse are serious problems and the statistics are shocking. At least 15 million people in the North America are alcoholics or have significant problems because of alcohol use.

Alcoholism is a chronic disease that is rooted in the brain, but it can destroy most organs of the body. Although the direct cause is obvious -- chronic overuse of alcohol -- why one person becomes addicted and another does not is only partially understood.


Genetic and biochemical factors may predispose one to alcoholism, but social and environmental factors also play a role. We're still a long way from being able to predict who will become an alcoholic.

I use the following terms when thinking and talking about this subject: "Problem drinking" means any use of alcohol that significantly harms the drinker or others. "Alcohol abuse" means the repetitive use of alcohol to feel better, often to alleviate anxiety or solve other emotional problems.

Alcoholism is a true addiction evidenced by physiological dependence (withdrawal symptoms when intake is interrupted), tolerance (the need to increase the dose to obtain the desired effect) and progressive impairment in social and occupational functioning.

If you choose to get involved in helping your family member, please understand that it will not be easy and you must not get discouraged. The first step is to be reasonably sure in your own mind that she has an alcohol-related problem, based on your observations in terms of symptoms and behaviors.

One of the best ways to determine if someone is a problem drinker or is abusing alcohol is to ask her directly. You may want to also verify your observations with appropriate family members and discuss with them the options open to you for helping her.

Admitting the problem and availability of support are two critical elements in dealing with alcoholism. Your family member may be fortunate. Once she acknowledges her problem and wants to work on it, she obviously has at least one family member and probably many friends who want to help her.

If, on further exploration, you find that she does have a drinking problem or is abusing alcohol, your unconditional love is the most important thing you can bring to her. Remember, you are not a therapist but a loving family member

Many kinds of support programs are available and have been effective for many people.


The best known is Alcoholics Anonymous.

For more information, including techniques to help your family member acknowledge a problem and seek help, contact the National Council of Alcoholism and Drug Dependence at (800) 622-2255 or

Dr. Allen J. Douma writes a daily column on a variety of medical and health issues. Write to him in care of Tribune Media Services, 435 N. Michigan Ave., Suite 1500, Chicago, IL 60611; or contact him at

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