alcoholism alcoholism alcoholism is, broadly, any drinking of alcohol that results in significant mental or physical health problems. because there is disagreement on the definition of the word alcoholism, it is not a recognized diagnostic entity, and the use of alcoholism terminology is discouraged due to its heavily stigmatized connotations. predominant diagnostic classifications are alcohol use disorder (dsm-5) or alcohol dependence (icd-11); these are defined in their respective sources. this article is about chronic alcohol abuse that results in significant health problems. for alcohol abuse in general, see alcohol abuse. "alcoholic" redirects here. for alcoholic beverages, see alcoholic drink. for alcohol consumption by people in general, see alcohol (drug). for the chemical compound in general, see alcohol (chemistry). alcoholismother namesalcohol addiction, alcohol dependence syndrome, alcohol use disorder (aud)a french temperance organisation poster depicting the effects of alcoholism in a family, c. 1915: "ah! when will we be rid of alcohol?"specialtypsychiatry, clinical psychology, toxicology, addiction medicinesymptomsdrinking large amounts of alcohol over a long period, difficulty cutting down, acquiring and drinking alcohol taking up a lot of time, usage resulting in problems, withdrawal occurring when stoppingcomplicationsmental illness, delirium, wernicke–korsakoff syndrome, irregular heartbeat, cirrhosis of the liver, cancer, fetal alcohol spectrum disorder, suicidedurationlong termcausesenvironmental and genetic factorsrisk factorsstress, anxiety, easy accessdiagnostic methodquestionnaires, blood teststreatmentalcohol cessation typically with benzodiazepines, counselling, acamprosate, disulfiram, naltrexone alcoholics anonymous and other twelve step programs, twelve step facilitationfrequency380 million / 5.1% adults (2016)deaths3.3 million / 5.9% heavy alcohol use can damage all organ systems, but it particularly affects the brain, heart, liver, pancreas and immune system. alcoholism can result in mental illness, delirium tremens, wernicke–korsakoff syndrome, irregular heartbeat, an impaired immune response, liver cirrhosis and increased cancer risk. drinking during pregnancy can result in fetal alcohol spectrum disorders. women are generally more sensitive than men to the harmful effects of alcohol, primarily due to their smaller body weight, lower capacity to metabolize alcohol, and higher proportion of body fat. in a small number of individuals, prolonged, severe alcohol misuse ultimately leads to cognitive impairment and frank dementia. environment and genetics are two factors in the risk of development of alcoholism, with about half the risk attributed to each. stress and associated disorders, including anxiety, are key factors in the development of alcoholism as alcohol consumption can temporarily reduce dysphoria. someone with a parent or sibling with an alcohol use disorder is three to four times more likely to develop an alcohol use disorder themselves, but only a minority of them do. environmental factors include social, cultural and behavioral influences. high stress levels and anxiety, as well as alcohol's inexpensive cost and easy accessibility, increase the risk. people may continue to drink partly to prevent or improve symptoms of withdrawal. after a person stops drinking alcohol, they may experience a low level of withdrawal lasting for months. medically, alcoholism is considered both a physical and mental illness. questionnaires are usually used to detect possible alcoholism. further information is then collected to confirm the diagnosis. prevention of alcoholism may be attempted by reducing the experience of stress and anxiety in individuals. it can be attempted by regulating and limiting the sale of alcohol (particularly to minors), taxing alcohol to increase its cost, and providing education and treatment. treatment of alcoholism may take several forms. due to medical problems that can occur during withdrawal, alcohol cessation should be controlled carefully. one common method involves the use of benzodiazepine medications, such as diazepam. these can be taken while admitted to a health care institution or individually. the medications acamprosate or disulfiram may also be used to help prevent further drinking. mental illness or other addictions may complicate treatment. various forms of individual or group therapy or support groups are used to attempt to keep a person from returning to alcoholism. among them is the mutual aid support group alcoholics anonymous (aa). a 2020 scientific review found that clinical interventions encouraging increased participation in aa––twelve step facilitation (tsf)—resulted in higher abstinence rates over other clinical interventions, and most studies in the review found that tsf led to lower health costs. the world health organization has estimated that as of 2016, there were 380 million people with alcoholism worldwide (5.1% of the population over 15 years of age). as of 2015 in the united states, about 17 million (7%) of adults and 0.7 million (2.8%) of those age 12 to 17 years of age are affected. alcoholism is most common among males and young adults. geographically, it is least common in africa (1.1% of the population) and has the highest rates in eastern europe (11%). alcoholism directly resulted in 139,000 deaths in 2013, up from 112,000 deaths in 1990. a total of 3.3 million deaths (5.9% of all deaths) are believed to be due to alcohol. alcoholism reduces a person's life expectancy by approximately ten years. many terms, some slurs and others informal, have been used to refer to people affected by alcoholism; the expressions include tippler, drunkard, dipsomaniac and souse. in 1979, the world health organization discouraged the use of alcoholism due to its inexact meaning, preferring alcohol dependence syndrome. signs and symptoms the risk of alcohol dependence begins at low levels of drinking and increases directly with both the volume of alcohol consumed and a pattern of drinking larger amounts on an occasion, to the point of intoxication, which is sometimes called binge drinking. long-term misuse some of the possible long-term effects of ethanol an individual may develop. additionally, in pregnant women, alcohol can cause fetal alcohol syndrome. alcoholism is characterised by an increased tolerance to alcohol – which means that an individual can consume more alcohol – and physical dependence on alcohol, which makes it hard for an individual to control their consumption. the physical dependency caused by alcohol can lead to an affected individual having a very strong urge to drink alcohol. these characteristics play a role in decreasing the ability to stop drinking of an individual with an alcohol use disorder. alcoholism can have adverse effects on mental health, contributing to psychiatric disorders and increasing the risk of suicide. a depressed mood is a common symptom of heavy alcohol drinkers. warning signs warning signs of alcoholism include the consumption of increasing amounts of alcohol and frequent intoxication, preoccupation with drinking to the exclusion of other activities, promises to quit drinking and failure to keep those promises, the inability to remember what was said or done while drinking (colloquially known as "blackouts"), personality changes associated with drinking, denial or the making of excuses for drinking, the refusal to admit excessive drinking, dysfunction or other problems at work or school, the loss of interest in personal appearance or hygiene, marital and economic problems, and the complaint of poor health, with loss of appetite, respiratory infections, or increased anxiety. short-term effects main article: short-term effects of alcohol consumption drinking enough to cause a blood alcohol concentration (bac) of 0.03–0.12% typically causes an overall improvement in mood and possible euphoria (intense feelings of well-being and happiness), increased self-confidence and sociability, decreased anxiety, a flushed, red appearance in the face and impaired judgment and fine muscle coordination. a bac of 0.09% to 0.25% causes lethargy, sedation, balance problems and blurred vision. a bac of 0.18% to 0.30% causes profound confusion, impaired speech (e.g. slurred speech), staggering, dizziness and vomiting. a bac from 0.25% to 0.40% causes stupor, unconsciousness, anterograde amnesia, vomiting (death may occur due to inhalation of vomit while unconscious) and respiratory depression (potentially life-threatening). a bac from 0.35% to 0.80% causes a coma (unconsciousness), life-threatening respiratory depression and possibly fatal alcohol poisoning. with all alcoholic beverages, drinking while driving, operating an aircraft or heavy machinery increases the risk of an accident; many countries have penalties for drunk driving. long-term effects