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Alcohol Abuse, Dependence, Intoxication, and Withdrawal Although most of them do not come to the attention of clinicians, anyone whose school, job, or home performance is significantly affected by alcohol could be diagnosed with Alcohol Abuse. Endangering the lives of oneself or others by driving or operating machinery while intoxicated also qualifies as alcohol abuse; continuing to drink despite the problems caused by the drinking also typifies alcohol abuse. If a person has the above symptoms, and in addition has developed tolerance to alcohol, or had withdrawal symptoms after cutting down, or shown evidence of compulsive drinking behavior, the person would be diagnosed with Alcohol Dependence. People who are drunk are diagnosable as having Alcohol Intoxication. The criteria are painfully obvious to everyone; the first is "recent ingestion of alcohol"! There are several consequences of this ingestion that indicate a drunken state: slurred speech, lack of coordination, and an unsteady gait are among the best-known. In order to be clinically certifiable as having Alcohol Intoxication, the person must be suffering clinically significant distress or impairment in one or more areas of functioning as a result of maladaptive behaviors that are attributable to the intoxication. Alcohol Intoxication, Alcohol Abuse, Alcohol Dependence, and Alcohol Withdrawal are the four more immediate and "less serious" alcohol-related disorders. The "cure" for all of them is abstinence, but bringing that about is neither easy nor simple. When a person has developed Alcohol Dependence over a long period and then stops drinking alcohol, very serious symptoms may follow, known as Alcohol Withdrawal. Among them are delirium tremens (the "DTs") and grand mal seizures. Not every person withdrawing from alcohol experiences these symptoms, and they are usually over within a few days, but it is certainly better to avoid them by arranging withdrawal under medical supervision, which may mean that thiamine will be administered to prevent or ameliorate the effects of Korsakoff's psychosis, and Dilantin to prevent seizures. Most alcoholics cannot learn to drink socially without relapsing into dependence on alcohol. Thus abstinence is recommended because it is more likely to result in long-term success. End-stage alcoholics should be hospitalized during a drying-out phase and should then enter a live-in facility if that is financially feasible. In all cases the alcoholic should join an Alcoholics Anonymous or similar group (Rational Recovery is one alternative). With good luck, perhaps individual therapy for the alcoholic, and Al-Anon to help the family, the chances of long-term abstinence are good. Anything less is unlikely to succeed. Abstinence may be easier to endure in the future, if drugs to reduce craving for alcohol come on the market. A recent study indicates that a drug developed to combat nausea in cancer patients, Odansetron, reduces craving in early-onset (at or before 25 years old) alcoholics. Behavior therapy was combined with the drug in this study, so the effects of Odansetron alone are unknown.
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