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

Understanding Alcohol Abuse

Alcoholism is a complex, sometimes fatal, problem that is not commonly understood. The term alcoholism is used mainly to describe someone who has an uncontrollable need for alcohol. Most alcoholics cannot just will themselves to not drink. The craving for alcohol can be as strong as the need for food and water. Alcoholism has four major symptoms:

• Craving: A strong need to drink
• Impaired Control: The inability to limit the amount of alcohol consumed
• Physical Dependence: Experiencing withdrawal (e.g., nausea, sweating, shakiness) when alcohol use is stopped after heavy drinking
• Tolerance: The need for increasing amounts of alcohol to feel its effects¹

Family history may influence whether or not a person is vulnerable to the disease. A child with one or two alcoholic parents has a greater chance of becoming an alcoholic than a child with no family history of alcoholism.

Warning Signs

Some signs of alcohol abuse can be mistaken for other health problems. These signs include:

• Abrupt changes in work or school, such as a decline in grades or work quality and attendance
• Difficulty focusing or a glazed appearance in the eyes
• Odor on the breath
• Flushed skin, loss of memory, or blackouts
• Unexplained bruises and accidents
• Lack of attention to appearance and attitude
• Difficulty with relationships, or relationships that are strained
• Centering all social activities around alcohol²

The CAGE Quiz

Do you have or does someone you know have a drinking problem? These four questions can help to assess whether a problem exists or not:

• Have you ever felt you should Cut down on your drinking?
• Have people Annoyed you by criticizing your drinking?
• Have you ever felt bad or Guilty about your drinking?
• Have you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover (Eye opener)?³

One "yes" response to the "CAGE" quiz suggests a possible alcohol problem. More than one "yes" response suggests the person should see a health care provider as soon as possible. A person answering "no" to the questions in the quiz might still have a drinking problem. If the person has any drinking-related problems with a job, relationship, health, or the law, he or she should seek professional help.

Recognizing alcohol problems in young people isn't easy. Signs of abuse are sometimes dismissed as typical teenage problems. In fact, teens may do everything possible to hide the problems.

Risk Factors

People of all ages, income levels, and living conditions can have alcohol-related problems. Nearly 14 million Americans have a drinking problem. Risk factors that may lead some people to addiction include:

• Substance use by parents or other family members
• Substance use by peers
• Use of alcohol, tobacco, or other drugs at an early age
• Physical or sexual abuse
• Abuse or violence at home or school
• Low income⁴

Men and women may use alcohol for different reasons. Men tend to use alcohol to feel more important and "powerful." Women tend to use drugs and alcohol to fight feelings of hopelessness or anger. Children are often the most vulnerable in families with alcohol problems. Anxiety caused by the lack of a routine, feelings of guilt or shame, and absence of healthy role models and lifestyles may create problems that last through adulthood. If you or someone you know has an alcohol problem, please see the Resources section for more information on addiction treatment and support groups.

For more information for consumers, go to www.samhsa.gov/preventionpathways and click on "courses" to find the online course, "It Won't Happen to Me: Substance Abuse and Violence Against Women."

References

1. National Institute of Health (NIH), National Institute on Alcohol Abuse and Alcoholism (NIAAA). (2001). Alcoholism: Getting the facts. Bethesda, MD: Author. Available online at http://www.niaaa.nih.gov/publications/booklet.htm
2. Cornerstone Treatment Facilities Network. (2001). About substance abuse: Signs and symptoms. New York: Author.
3. NIH, NIAAA. (2001).
4. American Medical Association. (1999). Substance abuse: Why do people use drugs? Chicago: Author.