Summer often feels like that three-month long vacation with lots of parties and social gatherings. Inevitably there is alcohol present and most people drink. Drinking can be relaxing, a little freeing and can make the social moments seem like more fun. However, sometimes what started as one drink can become two, four or more. When do you have a problem?

Alcohol is a depressant, in the same class of drugs as the benzodiazepines like valium. It is both psychologically and physiologically addictive. It is not how much alcohol you drink so much as the symptoms you develop when you don’t drink anymore. If you have a hand tremor (the shakes), feel sweaty, agitated, anxious, nauseous and can’t sleep without having another drink then you are experiencing alcohol withdrawal. This is because your body has gotten use to the alcohol in your system and needs it if you take it away. This is why a drink later (an eye-opener or the hair of the dog that bit you) makes you feel better physically.

Alcohol dependence is when you experience three of the following symptoms:

Because people are different sizes and have different metabolisms how many drinks they have does not define a problem. It is the effect of the alcohol and the need for continued use. Many people believe they don’t have a problem because they never try to cut down, but when finally in a situation where they can’t drink then they realize it is not possible to stop.

It is both socially acceptable and common to drink. About half of Americans do drink. About a third of adults have had one alcohol-related problem like driving drunk or missing work due to a hang over. 10% of women and 20% of men qualify for alcohol abuse (alcohol use causing problems with a job, personal life, the law or taking hazardous risks). 5% of women and 10% of men have alcohol dependence.

Alcohol abuse lowers ones life expectancy about 10 years. The effects range from heart disease, liver disease and cancer to suicide, homicide and driving fatalities. People with alcohol problems often suffer from depression and anxiety disorders. They may even use the alcohol to try to cope with the depressed or anxious feelings they suffer from. Unfortunately it doesn’t work and now they have an alcohol problem too.

Like most things in life, alcohol is fine, even potentially good, in moderation. Studies show that a glass of wine or two can even be beneficial in lowering heart and vascular disease. So enjoying a cocktail with your friends is not a problem. But if you find one cocktail has crept up to four, or if you find that on the nights you aren’t drinking you feel bad, or even that you are really tying one on every weekend (called bingeing) you may have an alcohol problem with which you need help.

What should you do?

1. Give yourself the CAGE questionnaire (Have you tried to Cut down unsuccessfully?, Are you Annoyed by others criticizing your drinking?, Do you feel Guilty about drinking?, Do you need an Eye-opener?) If you answer yes to any of these you may have a problem.

2. Try cutting down on your own.

3. Educate yourself about the health risks. It is very motivating.

4. Go to a group meeting like Alcoholics Anonymous.

5. Get individual help. Therapy and outpatient detoxification with medication can be done.

6. Some people with a significant problem may require an inpatient detoxification and rehabilitation.

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