In today’s society, addictive behavior is one of the most complex and pervasive mental health problems. Alcoholism is especially costly to the disordered individual as well as to society. It creates an enormous toll through alcohol caused accidents (E.g.: Automobile accidents), disruption of family life, facilitation of violence in certain individuals, and inefficiency and loss of businesses (and work/employment in general). Addictive behavior is behavior based on the pathological need for a substance or activity. It may involve the abuse of substances such as nicotine, alcohol, or cocaine. Addictive disorders can be seen all around us; in extremely high rates of alcohol abuse and dependence. Alcohol, a drug that affects mental functioning, is considered a psychoactive drug. It is not digested, but absorbed through the stomach and intestinal walls and metabolized in the liver in the process of oxidation (Meyer, Chapman, et al., 2009). A socially acceptable drug, alcohol may be purchased and consumed legally. It is easily accessible, and in comparison to other psychoactive drugs, considerably inexpensive. This combination may explain the high Prevalence of alcoholism, as the three Es: effect; expense; and ease of access, are the critical determinants of drug use patterns (Meyer, Chapman, et al., 2009). Alcohol abuse and dependence are major problems in the United States and Canada, and are among the most destructive of the psychiatric disorders (Volpicelli, 2001). In the recent National Comorbidity Survey-Replication study, the lifetime prevalence for alcohol abuse in the U.S is 13.4 percent, nearly one and a half per every ten people (Kessler, Chiu, et al., 2005). Interestingly, females are more vulnerable to intoxication than males (The sensation that occurs when the body cannot metabolize alcohol quickly enough, and the excess directly affects the brain).This is due to several reasons: Females have more body fat; less body water; and a slower rate of alcohol metabolism (Wang, Fowler, et al., 2003).
So what are the criteria that identify a person as an alcoholic? According to the DSM-IV-TR, substance-dependence disorder is a maladaptive pattern of substance use leading to clinically significant impairment, as manifested by at least three of the listed maladaptive behaviors, occurring at any time in the same 12 month period. The disorder usually involves a pathological use of a substance resulting in a marked physiological need for increasing amount of a substance to achieve desired effects, also known as tolerance (results from biochemical changes in the body that affect the rate of metabolism and elimination of the substance from the body). Dependence will cause symptoms of withdrawal when the substance is not available. These are physical symptoms such as sweating, tremors, and tension. Other maladaptive behaviors listed in the DSM-IV-TR include: Substance is often taken in larger amounts over a longer period than was intended; a persistent desire or unsuccessful effort to cut down or control substance use; the person spends a great deal of time engaging in activities necessary to obtain the substance, use the substance, or recover from its effects; the person has given up or reduced the amount of important social, occupational, or recreational activities because of substance use; and continued substance use despite persistent or recurrent physical or psychological problems caused or exacerbated by the substance. (DSM-IV-TR, 2000)
There is a common pattern of progression into alcohol dependence and it goes as follows (Meyer, Chapman, et al., 2009). :
1) Pre-alcoholic Phase
a. Social drinking and occasional weekend drinks are the main symptoms.
b. Both tolerance and frequency of drinking increase, usually slowly.
c. Alcohol use serves primarily as an escape from anxiety, mild depression, or boredom.
2) Initial Alcoholism
a. Tolerance, frequency, and abuse increase.