CONTENTS

About This Course

Table of Contents

1. Introduction to the Issues
2. Understanding Alcohol Abuse
3. Understanding Violence Against Women
4. Alcohol and Domestic Violence
5. Alcohol, Sexual Assault, and Rape
6. Prevention and Early Intervention
7. Screening and Assessment
8. Diagnosis and Treatment
9. Legal and Ethical Issues

Supplements
Fact Sheets
Videos
Resources

Silence Hurts
Alcohol Abuse and Violence Against Women

Module Content Objectives Introduction What Is a Drink? Alcoholism and Alcohol Problems -- Alcohol Abuse vs. Alcohol Dependence -- DSM-IV Criteria for Dependence -- Addiction and Craving Theories of Addiction Signs of Alcohol Abuse Risk Factors for Alcohol Abuse Roles in Families Where Alcohol is a Problem -- Defense Mechanisms The Effects of Alcohol and Violence on Teens and Young Adults Adult Children of Alcoholics (ACOA)-Teenagers and Older Myths and Facts About Alcohol Abuse Summary of Module References Module 2 Quiz

Alcoholism and Alcohol Problems

According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), alcoholism includes four major symptoms:

• Craving (a strong need to drink),
• Impaired control (the inability to limit one's drinking on any given occasion),
• Physical dependence (having withdrawal symptoms such as nausea, sweating, or shakiness when alcohol use is stopped after a period of heavy drinking), and
• Tolerance (the need for increasing amounts of alcohol to feel its effects).⁴

These symptoms are also characteristic of individuals who abuse cocaine, heroin, and amphetamines.

The diagnosis of alcoholism is determined primarily by a person's uncontrollable need for alcohol. It has little to do with the kind of alcohol that is ingested, how long an individual has been drinking, or even how much is consumed. Many alcoholics cannot simply use willpower to stop drinking. Frequently, they feel a powerful craving for alcohol, a need that can be as compelling as the need for food or water.

Alcohol problems often follow a pattern, progressing through four phases:⁵

1. Prealcoholic: Drinking regularly for relaxation or relief, with increased alcohol tolerance.
2. Prodromal: Problems, such as blackouts or memory loss during or after drinking, preoccupation with drinking, and guilty feelings regarding drinking, begin to surface.
3. Crucial: Physiological dependence, loss of control over drinking, family, marital, job, or legal problems are all characteristic of a life that is centered around alcohol.
4. Chronic: Drinking beginning during morning hours, physical deterioration, tremors and fears are indicative during the chronic phase.

Some individuals can drink without experiencing any problems, while others cannot. Some are also able to recover without help, but most people who abuse alcohol need outside assistance and counseling. NIAAA has found that vulnerability to alcoholism can be inherited. However, it is important to recognize that specific aspects of a person's environment are also important influences.

Environmental effects on alcohol use include peer pressure and availability of alcohol. In some cases, alcoholism runs in families. However, this does not mean that the child of a parent who abuses alcohol will automatically develop alcoholism. That child just has a higher propensity for abusing alcohol-especially if he or she grew up in an environment where alcohol was abused.

Drinking problems reveal themselves in many forms. Some people start drinking heavily early in life and develop a longstanding dependence. Others start when they experience a setback or crisis, such as job loss or death of a family member. Others may binge drink with weeks or months in between spurts of drinking.

Alcohol affects men and women differently, even when differences in body weight are taken into account. (for more information about how alcohol affects women, see the National Institute on Alcohol Abuse and Alcoholism Alcohol Alert No, 46.

Women who drink alcohol when they are pregnant risk causing sever damage to the fetus, including brain damage, physical problems, such as heart, lung, and kidney defects. Alcohol causes more damage to the fetus than any other substance. (For more information about fetal alcohol spectrum disorders (FASD) go to the SAMHSA's Fetal Alcohol Spectrum Disorders Center for Excellence Web site.