Alcoholism is a chronic, often progressive disease in which a person continues to crave alcohol and drink despite repeated alcohol-related problems, such as losing a job or getting into trouble with the law. Alcoholism affects 10 to 20 percent of men and 3 to 10 percent of women. Nearly 14 million people in the United States—1 in every 13 adults—abuse alcohol or are alcoholic. This disease contributes to over 50 percent of car and industrial fatalities, drownings, and child or domestic abuse.

Alcoholism is often accompanied by the following signs and symptoms. Symptoms vary with the amount of alcohol taken and how long it has been abused.

• Craving for alcohol
• Inability to control drinking habits
• Withdrawal symptoms, such as nausea, sweating, shakiness, and anxiety, when alcohol use is stopped after a period of heavy drinking
• Tolerance (the need for increasing amounts of alcohol in order to feel its effects)
• Psychological, social, occupational dysfunction
• Malnutrition, anorexia
• Cardiovascular symptoms (leading cause of death)
• Increased levels of cancer (second leading cause of death)
• Repeated infections—for example, tuberculosis, urinary tract infections
• Lung conditions—complicated by smoking; for example, respiratory failure, pneumonia
• Central nervous system disorders—unsteady gait or stance; cognitive impairment; psychiatric manifestations (for example, mood, anxiety, psychotic disorders); blackouts; coma; sleep disruptions
• Diarrhea, vomiting
• Gastrointestinal bleeding
• Men—increased sexual drive with decreased ability to maintain an erection
• Women—miscarriage, stopping of menstrual periods
• Inflammation of the pancreas
• Hepatitis (a disease of the liver)
• Poor wound healing
• Buildup of fluid in the body
• Swollen, painful muscles, paralysis, lack of reflexes
• Increased bone fractures
• Hypoglycemia (low blood sugar)
• Hypothermia (reduction of body temperature)

Alcoholism is caused by chronic over-consumption of alcohol.

People with the following conditions or characteristics are at a higher-than-average risk for developing alcoholism.

• Genetically predisposed
• Preexisting psychiatric disorder
• Began consuming alcohol at an early age
• Stress

If you or someone you care for is experiencing symptoms associated with alcoholism, you should see your health care provider. He or she can help make a diagnosis and guide you in determining which treatment or combination of therapies will work best.

Your provider will take a history and do a physical exam to look for specific organ damage or trauma and to evaluate if your muscles are tender or weak. Laboratory tests will reveal any indicators of alcoholism, such as high blood alcohol. Imaging techniques may be used to diagnose alcohol-related disorders or to screen for repeated bone fractures.

The best prevention is to stop drinking alcohol completely. Medications are sometimes prescribed to curb alcohol cravings.

Treatment must address both medical issues and rehabilitation, such as motivational techniques for abstaining from drinking, psychotherapy, and Alcoholics Anonymous (or other support groups).

Your provider may prescribe the following medications.

• Tranquilizers called benzodiazepines which are used during the first few days of treatment to help patients safely withdraw from alcohol
• Antipsychotic medications for people who do not respond to benzodiazepines
• Naltrexone, a recently approved medication to help people remain sober. When used in combination with counseling, this medication may lessen the craving for alcohol and help prevent a return to heavy drinking.
• Disulfiram, an older medication, which discourages drinking by causing nausea, vomiting, and other unpleasant physical reactions when alcohol is used
• Medications for specific organ damage or for symptoms associated with alcohol withdrawal

A comprehensive treatment plan for alcoholism may include a range of complementary and alternative therapies.

A well-balanced, nutritionally adequate diet helps to stabilize alcohol-induced blood-sugar fluctuations and decrease cravings. Following these tips can help reduce symptoms.

• Eliminate simple sugars.
• Increase complex carbohydrates.
• Consume adequate protein.
• Increase essential fatty acids.
• Decrease saturated fats and fried foods.
• Avoid caffeine.

Potentially beneficial nutrient supplements include the following.

• Vitamin A (25,000 IU a day)
• Vitamins B₁ (50 to 100 mg a day), B₂ (50 mg a day), B₃ (25 mg a day), B₅ (100 mg a day), B₆ (50 to 100 mg a day), B₁₂ (100 to 1,000 mcg a day)
• Vitamin C (250 to 500 mg two times a day)
• Vitamin E (400 IU a day) to protect the heart
• Magnesium (250 mg bid) to decrease withdrawal symptoms
• Selenium (200 mcg a day) to protect the liver
• Zinc (15 mg a day) to aid metabolism
• Amino acids: carnitine (500 mg two times a day) to protect the liver, glutamine (1 g a day) to decrease cravings, glutathione (300 mg a day) to protect liver and heart
• Chromium (250 to 500 mcg twice a day) helps reduce sugar cravings and reduces low blood sugar related to alcohol cravings.

The use of certain herbal remedies may offer relief from symptoms.

• Milk thistle (Silybum marianum): 80 to 200 mg three times a day, to support the liver
• Dandelion (Taraxacum officinale): 2 to 8 g of root three times a day in tea, or 5 ml three times a day of leaf tincture helps detoxify the liver. Works well with milk thistle.
• Kudzu (Pueraria lobata) reduces cravings
• Skullcap (Scutellaria lateriflora): historic use for hysteria, tension, and nervous disorders, especially anxiety; a cup of tea before bed can help insomnia.
• Dessicated liver capsules (500 mg three times a day) help heal liver tissue.

Herbs are generally available as dried extracts (pills, capsules, or tablets), teas, or tinctures (alcohol extraction, unless otherwise noted). Dose for teas is 1 heaping tsp../cup water steeped for 10 minutes (roots need 20 minutes). Herbal extracts made with alcohol should be avoided in alcoholics.

An experienced homeopath can prescribe a regimen for treating alcoholism that is designed especially for you. Some of the most common acute remedies are listed below.

• Arsenicum album for anxiety and compulsiveness, with nausea, vomiting, and diarrhea
• Nux vomica for irritability and compulsiveness with constipation, nausea, and vomiting
• Lachesis for cravings for alcohol, headaches, and difficulty swallowing
• Lycopodium for low self-esteem, heartburn, impotence

Acute dose is three to five pellets of 12X to 30C every one to four hours until symptoms are relieved.

Acupuncture has shown potential as an effective treatment for addiction, according to a 1997 Consensus Statement by the National Institutes of Health. While at least two studies have found that acupuncture may reduce the desire to drink alcohol and the lower the number of admissions to alcohol detoxification centers, other studies have failed to duplicate these findings. Interestingly however, many addiction programs that currently offer acupuncture report that people appear to "like acupuncture" and, in many cases, want to continue with their detox program for longer periods of time when acupuncture is provided as a treatment option. This is very important since attendance is essential for the success of treatment.

Acupuncturists treat people with alcoholism based on an individualized assessment of the excesses and deficiencies of qi located in various meridians. In the case of alcoholism, a qi deficiency is usually detected in the liver meridian, while the gallbladder meridian tends to contain excess qi. In addition to performing needling treatment, acupuncturists may employ other methods such as moxibustion (a technique in which the herb mugwort is burned over specific acupuncture points).

Possible complications associated with alcoholism include mental confusion or delirium, severe amnesia, an unsteady gait, and loss of sperm cells, as well as ailments resulting from repeated, violent vomiting. Typically, there are periods of remission followed by periods of abuse. Life expectancy is decreased by about 15 years. About a fifth of alcoholics permanently abstain. During pregnancy, abstinence from alcohol is the only completely safe measure.

After initial care, medical follow-up should continue for 6 to 12 months.

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association; 1994.

Bartram T. Encyclopedia of Herbal Medicine. Dorset, England: Grace Publishers;1995:13.

Carr AC, Frei B. Toward a new recommended dietary allowance for vitamin C based on antioxidant and health effects in humans. Am J Clin Nutr. 1999;69(6):1086-1107.

Bullock ML, Umen MS, Culliton PD, Olander RT. Acupuncture treatment of alcoholic recidivism: a pilot study. Alcohol Clin Exper Res. 1987;11(3):292-295.

Bullock ML, Culliton PD, Olander RT. Controlled trial of acupuncture for severe recidivist alcoholism. Lancet. 1989;1:1435-1439.

Dambro MR. Griffith's 5-Minute Clinical Consult. 1999 ed. Baltimore, Md: Lippincott Williams & Wilkins, Inc.: 1999.

Fauci AS, Braunwald E, Isselbacher KJ, et al, eds. Harrison's Principles of Internal Medicine. 14th ed. New York, NY: McGraw-Hill; 1998.

Gruenwald J, Brendler T, Jaenicke C, et al, eds. PDR for Herbal Medicines. Montvale, NJ: Medical Economics Company; 1998:1128-1129.

Goroll A, ed. Primary Care Medicine. 3rd ed. Philadelphia, Pa: Lippincott-Raven Publishers; 1995.

JAMA Patient Page. How much vitamin C do you need? JAMA. 1999;281(15):1460.

Johnston CS. Recommendations for vitamin C intake. JAMA. 1999;282(22):2118-2119.

Johnson JL, Leff M. Children of substance abusers: overview of research findings. Pediatrics. 1999;103(5).

Kaplan HW, ed Comprehensive Textbook of Psychiatry. 6th ed. Baltimore, Md: Williams & Wilkins; 1995.

Levine M, Rumsey SC, Daruwala R, Park JB, Wang Y. Criteria and recommendations for vitamin C intake. JAMA. 1999;281(15):1415-1453.

Morrison R. Desktop Guide to Keynotes and Confirmatory Symptoms. Albany, Calif: Hahnemann Clinic Publishing; 1993:39-44, 272-276, 215-218.

Murray MT, Pizzorno JE. Encyclopedia of Natural Medicine. 2nd ed. Rocklin, Calif: Prima Publishing; 1998:122-127.

NIH Consensus Statement: Acupuncture. National Institutes of Health. 1997;15(5):1-34. Accessed at http://odp.od.nih.gov/consensus/cons/107/107_statement.htm on September 24, 2001.

Rosen P, ed. Emergency Medicine: Concepts and Clinical Management. 4th ed. St. Louis, Mo: Mosby-Year Book; 1998.

Sapir-Weise R, Berglund M, Frank A, Kristenson H. Acupuncture in alcoholism treatment: a randomized out-patient study. Alcohol Alcohol. 1999;34(4):629-635.

Werbach M. Nutritional Influences on Illness. New Canaan, Conn: Keats Publishing Inc; 1987:11-22.

Worner TM, Zeller B, Schwarz H, Zwas F, Lyon D. Acupuncture fails to improve treatment outcome in alcoholics. Drug Alcohol Depend. 1992;30:169-173.