Feature Article

Understanding Alcohol Dependence

Alcohol dependence, or alcoholism, is a health concern that many people face, including individuals with developmental disabilities. Some of the individuals who you support may be struggling with alcohol dependence. Other individuals may be at risk of developing this disease. By taking the time to learn about alcohol dependence, you may be better able to assist the individuals who you support to lead happy and healthy lives.

What is alcohol dependence?

Alcohol dependence (alcoholism) is a disease. People who have alcoholism are addicted to alcohol; they have a strong need to drink alcohol and once they start drinking they often cannot control how much alcohol they drink.

Should the individuals who I support be drinking alcohol at all?

For many people, drinking a small amount of alcohol once in awhile is okay. As a direct support provider, you should make sure that the individuals you support have talked with their health care provider before they decide whether or not they would like to drink alcohol. Certain medical conditions can be made worse by drinking alcohol, and certain medications should not be mixed with alcohol; by talking with their doctor or nurse the individuals you support will be able to find out if their medications and medical conditions make it unsafe for them to drink alcohol.

Certain people should never drink alcohol. You should discourage those who you support from drinking alcohol if they:

  1. Are pregnant or trying to become pregnant
  2. Are younger than age 21
  3. Are recovering from alcoholism
  4. Have a medical condition that can be made worse by drinking alcohol (ask a doctor or nurse)
  5. Are taking a medicine that should not be mixed with alcohol (ask a doctor, nurse, or pharmacist)

You should also remind the individuals you support about the dangers of drinking and driving. People who drink alcohol before driving have a much greater chance of being involved in a car accident and hurting themselves and others. Tell the people you support not to drink and drive and never to get into a car if the driver has been drinking alcohol. Remind them of alternative ways of getting where they need to go, such as calling a friend or relative to come and pick them up, using public transportation, or calling a taxi.

It is also important to educate individuals about resisting peer pressure and making their own choices about drinking alcohol. For some of the individuals who you support, drinking alcohol is not safe because of their medical conditions or medications. Other individuals will choose not to drink alcohol for their own reasons. Support these individuals to stand up for themselves and say no to alcohol even when they are around other people who are drinking.

Who is at risk for alcohol dependence?

Anyone who drinks alcohol can develop alcoholism, but people have a greater chance of developing this disease if one of their parents is dependent on alcohol. People who have a parent with alcoholism should be especially careful about how much and how often they drink alcohol.

What are the risks of alcohol dependence and heavy drinking?

Alcohol dependence and heavy drinking can lead to many serious health issues. People who drink a lot of alcohol over time have a greater risk of developing health conditions such as:

  1. High blood pressure
  2. Brain and heart damage
  3. Liver damage (cirrhosis)
  4. Certain kinds of cancer (such as cancer of the liver, mouth, throat, stomach, breast, and pancreas)

Drinking large amounts of alcohol at one time can cause loss of consciousness, or even death.

In addition to these health risks, drinking large amounts of alcohol at once can increase the risk of injury among the individuals who you support. For instance, people who have been drinking alcohol are more likely to hurt themselves and others by:

  1. Being involved in a car accident
  2. Being involved in other types of accidents (such as drowning accidents and accidents with guns or fire)
  3. Falling down
  4. Getting in a fight

Alcohol dependence and heavy drinking can also lead to trouble in other parts of a person's life. People who have alcoholism often spend most of their time thinking about alcohol, drinking alcohol, and recovering from drinking alcohol; they often ignore their jobs, school assignments, family, and friends. This type of behavior can lead to unemployment, school failure, and fights with friends and family members.

How much alcohol is too much?

According to the Centers for Disease Control, heavy drinking can be defined as:

  1. For men, drinking an average of more than 2 drinks per day (14 drinks per week)
  2. For women, drinking an average of more than 1 drink per day (7 drinks per week)

You should support individuals to talk to their health care provider about what amounts of alcohol, if any, are safe for them to drink.

What are the signs of alcohol dependence?

Alcohol dependence can be hard to recognize because many people with alcoholism will deny that their drinking interferes with living a healthy life. Some signs that a person who you support may be struggling with alcoholism include:

  1. Drinking alcohol alone or in secret
  2. Keeping alcohol in unlikely or hidden places at home or at work
  3. Not remembering conversations that they had while they were drinking
  4. Using alcohol to relax, to cheer up, to sleep, or to deal with problems
  5. Making a ritual of having a drink at a certain time of day and becoming annoyed when this ritual is disturbed or questioned
  6. Not being able to stop drinking after having one or two drinks
  7. Building up a tolerance to alcohol so that they need an increasing number of drinks to feel the effects
  8. Losing interest in activities or hobbies that used to bring pleasure
  9. Experiencing physical withdrawal symptoms if they try to stop drinking, such as nausea, sweating, and shaking

If you think that an individual who you support is dependent on alcohol or drinking too much, you should encourage them to talk to their health care provider right away. If the individual does not want to see a doctor about their drinking, try to help them to understand how their drinking is affecting their health and the people they care about.

What is the typical treatment for alcohol dependence?

The goal of treatment for alcoholism is to help the individual to stop drinking alcohol completely. Both medications and counseling can help people to stop drinking. If an individual who you support has alcoholism, their health care provider will tell them about their treatment options. Once a person with alcoholism has stopped drinking alcohol, they should never drink alcohol again.

You can support individuals to change their behavior as they try to stop drinking alcohol. For instance, it may help them to:

  1. Avoid spending time with people who drink a lot of alcohol
  2. Avoid places where people are drinking
  3. Find new friends who do not drink alcohol

Joining a support group such as Alcoholics Anonymous (AA) may also help the people who you support to stop drinking and not start again.

Is there anything I can do to prevent alcohol dependence?

If you notice that a person who you support is drinking a lot of alcohol, you should talk to them about it or encourage them to talk to their health care provider. Make sure that they understand the risks of drinking alcohol and developing alcoholism.

With the help of their doctor or nurse, individuals can set limits on the amount of alcohol they should be drinking. Help the individuals who you support to remember and stick to these limits.


For explanations of alcohol dependence and the health effects of alcohol that you can use to educate the people who you support, see this month's DDS Safety Net PowerPoint presentations:

You can use this Alcohol Dependence Checklist to help the people who you support decide whether or not they should talk to a doctor or nurse about a possible dependence on alcohol:

For more information on alcohol and alcohol dependence check out these websites and articles:
  1. A DDS Safety Net article about alcohol and drug abuse: https://ddssafety.net/Archives/Archives/Providers/AbuseEducation.aspx
  2. WebMD: http://www.webmd.com/content/article/7/2950_853.htm
  3. The American Psychiatric Association: http://healthyminds.org/aam2006.cfm
  4. Healthlink: http://healthlink.mcw.edu/article/1018795126.html
  5. Centers for Disease Control: http://www.cdc.gov/alcohol/faqs.htm
  6. American Academy of Family Physicians: http://familydoctor.org/755.xml

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