For many people, the facts about alcoholism are not clear. What is alcoholism, exactly? How does it differ from alcohol abuse? When should a person seek help for a problem related to his or her drinking problem? The following information explains both alcoholism and alcohol abuse, the symptoms of each, when and where to seek help, and treatment choices.

Alcoholism, also known as "alcohol dependence", is a disease that includes four symptoms:

• Craving: A strong need, or compulsion, to drink.
• Loss of control: The inability to limit one's drinking on any given occasion.
• Physical dependence: Withdrawal symptoms, such as nausea, sweating, shakiness, and anxiety, occur when alcohol use is stopped after a period of heavy drinking.
• Tolerance: The need to drink greater amounts of alcohol in order to "get high".

People who are not alcoholics sometimes do not understand why an alcoholic can't just "use a little willpower" to stop drinking. However, alcoholism has little to do with willpower. Alcoholics are in the grip of a powerful "craving", or uncontrollable need, for alcohol that overrides their ability to stop drinking. This need can be as strong as the need for food or water.

Alcohol abuse is defined as a pattern of drinking that results in one or more of the following situations within a 12-month period:

• Failure to fulfill major work, school, or home responsibilities;
• Drinking in situations that are physically dangerous, such as while driving a car or operating machinery;
• Having recurring alcohol-related legal problems, such as being arrested for driving under the influence of alcohol or for physically hurting someone while drunk; and
• Continued drinking despite having ongoing relationship problems that are caused or worsened by the drinking.

Alcohol abuse differs from alcoholism in that it does not include an extremely strong craving for alcohol, loss of control over drinking, or physical dependence.

How can you tell whether you may have a drinking problem? Answering the following four questions can help you find out:

• 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 (as an "eye opener") to steady your nerves or get rid of a hangover?

One "yes" answer suggests a possible drinking problem. If you answered "yes" to more than one question, it is highly likely that a problem exists. In either case, it is important that you see your doctor or other health care provider right away to discuss your answers to these questions. He or she can help you determine whether you have a drinking problem and, if so, recommend the best course of action.

Even if you answered "no" to all of the above questions, if you encounter drinking-related problems with your job, relationships, health, or the law, you should seek professional help. The effects of alcohol abuse can be extremely serious, even fatal, both to you and to others.

Although alcoholism can be treated, a cure is not yet available. In other words, even if an alcoholic has been sober for a long time and has regained health, he or she remains susceptible to relapse and must continue to avoid all alcoholic beverages. "Cutting down" on drinking doesn't work; cutting out alcohol is necessary for a successful alcoholism recovery.

However, even individuals who are determined to stay sober may suffer one or several "slips", or relapses, before achieving long-term sobriety. Relapses are very common and do not mean that a person has failed or cannot recover from alcoholism. Keep in mind, too, that every day that a recovering alcoholic has stayed sober prior to a relapse is extremely valuable time, both to the individual and to his or her family.

Accepting the fact that help is needed for alcoholism recovery may not be easy. But keep in mind that the sooner you get help, the better are your chances for a successful recovery.

Any concerns you may have about discussing a drinking problem with your health care provider may stem from common misconceptions about alcoholism and alcoholism treatment. In our society, the myth prevails that a drinking problem is a sign of moral weakness. As a result, you may feel that to seek help is to admit some type of shameful defect in yourself. In fact, alcoholism is a disease that is no more a sign of weakness than is asthma. Moreover, taking steps to identify a possible drinking problem has an enormous payoff-a chance for a healthier, more rewarding life.

If your health care provider determines that you are not alcohol dependent but are nonetheless involved in a pattern of alcohol abuse, he or she can help you to:

• Examine the benefits of stopping an unhealthy drinking pattern.
• Set a drinking goal for yourself. Some people choose to abstain from alcohol. Others prefer to limit the amount they drink.
• Examine the situations that trigger your unhealthy drinking patterns, and develop new ways of handling those situations so that you can maintain your drinking goal.

Some individuals who have decided to stop drinking after experiencing a drinking problem choose to attend AA meetings for information and support, even though they have not been diagnosed as alcoholic.