When Alcohol Becomes a Problem
By Ronald Pies
Alcohol-use disorders (AUDs) are probably the most common mental disorders in the United States: Nearly one person in seven suffers from an AUD at some time in his or her life. The prevalence of AUDs among men is about three-to-five times greater than among women. Nevertheless, alcohol can have serious consequences in women, since they are more sensitive to alcohol's damaging effects on the liver, heart and brain. Women also end up with higher blood levels of alcohol than men given the same amount consumed -- probably due to sex differences in how alcohol is broken down and distributed in body tissues.
The Scourge of AlcoholAlcohol abuse and dependence does incalculable harm in the United States, accounting for about 5 percent of all deaths. The main health hazard associated with AUDs is cirrhosis of the liver, which was the ninth-leading cause of death in the U.S. in 1988. AUDs are also associated with driving accidents, violence and suicide. Very often, AUDs are accompanied by another psychiatric disorder such as a depression, anxiety or personality disorder. In some cases, AUDs can arise from attempts to "self-medicate" one of these other disorders with alcohol -- but in many cases the AUD is the primary, underlying disorder. Nevertheless, when an individual has both an AUD and a major mood or anxiety disorder, both problems must be addressed in treatment.