Many people have confused and contradictory attitudes toward alcohol. On the one hand, among many families and friends,  alcohol is a substance that is often approved for celebrations, such as graduations, birthdays, and holidays. On the other hand, the extreme use of alcohol and the concomitant embarrassing drunken behaviors of family members, coworkers, and others are subject to gossip and criticism, and the alcoholic person is often “convicted” by a jury of his or her peers as guilty when unable to refrain from drinking to excess.  Most experts know that alcohol dependence is a disease.  Some laypeople regard alcoholism as a disease, while others view it as a moral failing or a weakness.

Females who drink are often particularly stigmatized, and this has been true for centuries. The alcoholic man who stops drinking is lionized as a hero; in contrast, the societal attitude toward the female alcoholic in remission is that she should have known better than ever to drink to excess in the first place.

Yet there are reasons for excessive drinking. For example, some individuals apparently have a genetic predisposition toward alcoholism, and if they drink, they are likely to drink to excess.  Some experts believe that it is the feeling of euphoria that they seek to duplicate, while others believe that alcoholics are often individuals with untreated depression or anxiety who turn to alcohol for some emotional relief and escape, however transient. Others drink one or two drinks on occasion and have no particular affinity toward alcohol; clearly there is no family history of alcoholism in this group.

In this section, my coauthor and I cover the key issues of alcoholism and alcohol abuse today, including the latest research on who are the major users and abusers (in terms of gender,  age,  and other factors),  what are the effects of their use on themselves and others, and how alcoholism is treated.  Medications are available for treatment, but the most effective means to resolve alcoholism is with the assistance of Alcoholics Anonymous.

We also describe in detail the common psychiatric “comorbidities”  (disorders that occur concurrently)  that occur with alcohol dependence.

For example,  anxiety disorders and depression frequently occur with alcoholism,  and it is often difficult to tease out which disorder came first, the alcoholism or the comorbid psychiatric disorder.

Adults with attention-deficit/hyperactivity disorder (ADHD)  and antisocial personality disorder (ASPD) have an increased risk for an alcohol use disorder.  In addition,  often there are multiple psychiatric comorbidities,  making diagnosis and treatment challenging for the physician.

We also cover the physical effects of alcohol abuse and alcoholism on the body,  including an increased risk for cancer and many other diseases.

The alcoholic is unlikely to take needed medication and is at risk for harm from existing untreated diseases, including such common and chronic diseases as diabetes and hypertension. An estimated 80 percent of all alcoholics also smoke,  further escalating the risk for disability and death. Alcohol dependence is also harmful to the brain and can lead to an alcoholic dementia.