IntroductionAlcoholism is a persistent addiction to the use of alcohol (Ehrlich, 2017). If one overly consumes alcohol, he or she becomes diagnosed as an alcoholic. The disease is very common and affects around 70 million families yearly (Ehrlich, 2017). Roughly $235 billion is spent on alcohol yearly in the United States (Horvath et al., 2017). Alcoholism can cause damage to individuals and their family members. This topic was chosen due to a strong interest in the psychological background of substance abuse. Alcoholism is a problematic disease, and without proper treatment can lead to a variety of negative side effects, both physically and psychologically.AlcoholismAlcoholism falls under the category of substance abuse disorders (Gazzaniga, Heatherton, & Halpern, 2016). Alcoholism can be described as a disease defined by the repetitive intake of alcohol (Taylor, 2016). When one is an alcoholic, they are controlled by alcohol, which inhibits their ability to perform daily tasks, such as work or social activities (Taylor, 2016). One can be both psychically and psychologically addicted to alcohol (Taylor, 2016). Because alcohol is a central nervous system depressant, it causes the brain to slow down (Taylor, 2016). When one is under the influence of alcohol, it can cause a lower amount of alertness, it impairs perception, the ability to judge a situation, and it decreases coordination skills (Taylor, 2016). In serious cases, alcoholism can cause loss of consciousness. (Taylor, 2016). Long term effects of alcoholism can cause many negative problems. If one is an alcoholic, her or she may have a higher risk of developing cancer, heart and liver failure, stroke, and sometimes death (Taylor, 2016). There are many different ways somebody can die from alcoholism. There has been a total of 88,000 alcohol related deaths yearly, causing alcoholism to be the third leading lifestyle caused death in the United States (National Council on Alcoholism and Drug Dependence, NCADD, 2015). One way someone can die from alcoholism is through suicide (Martel, 2014). Alcohol has been involved in over a quarter of the suicides that occur yearly, an estimated 7,500 times (MCES, n.d.). It has been proven through studies that both attempted and committed suicides are more likely to occur in alcoholics than nonalcoholics (MCES, n.d.). However, there is a 40% greater risk for alcoholic individuals to attempt or commit suicide if they abuse other substances as well (MCES, n.d.) Therefore, alcoholism is a harmful disease that can cause numerous effects on individuals who overuse alcohol. Case StudyA fifty year old man goes to the emergency room stating that he was ready to end his life and claimed that life was not worth living anymore (Shivani, Goldsmith, & Anthenelli, 2002). The man was in a depressive state, had feelings of guilt, and had suicidal attempts within the past week after his wife left him (Shivani et al., 2002). The man denied having any sleeping or eating issues since his wife has separated from him (Shivani et al., 2002). He did not show signs of healthy hygiene, but claimed he has been going to work up until his wife divorced him (Shivani et al., 2002). His breath smelled strong of alcohol, and when questioned about it, he claimed he had a “few drinks to ease the pain,” (Shivani et al., 2002). The man avoided the discussion of alcohol and stated he did not want to actually kill himself, he just wanted his old life back (Shivani et al., 2002). The patient does not come to the hospital seeking help with his alcoholism, but to treat the psychological distress of his wife leaving him (Shivani et al., 2002). ComorbidityComorbidity is the co-occurrence of two different chronic disorders (Valderas, Starfield, Sibbald, Salisbury & Roland, 2009). Many other disorders are present when one suffers with alcoholism (APA, 2013). About 80% of alcoholics seeking treatment also suffer another mental disorder (Shivani et., al, 2002). Some of the major disorders present along with alcoholism is major depressive disorder, bipolar disorder, and anxiety disorder (Shivani et., 2002). Reports in the United Kingdom suggest that drinking alcohol can either be done to try and lessen symptoms of depression, or drinking alcohol can cause one to feel depressed (Timms, 2015). Alcohol affects the brain chemistry, which can help prove the previous statement (Timms, 2015). There is also a significant amount of individuals who suffer with both alcoholism and bipolarism. A study from the National Institute of Alcohol Abuse and Alcoholism (2002) states that 27% of people diagnosed with any type of bipolar disorder also present signs and symptoms of alcoholism (Sonne, PharmD, & Brady, 2002). Another research done by Sonne, PharmD, and Brady (2002) concludes that alcohol abuse can worsen the severity of all types of bipolar disorders. However, it was noted that alcoholics with a relation to a bipolar disorder show more improvement in substance abuse treatment than regular alcoholics (Sonne et al., 2002). Anxiety disorders are also commonly associated with alcoholism. Although there is researched information on how the two are related, minimal research has been presented on how it affects the individual (Smith & Randall, n.d.). Roughly 19% of alcoholics have an anxiety disorder as well (Shivani et al., 2002). The reason for the lack of knowledge on the correlation of the two is because the symptoms of anxiety can be similar to the withdrawal symptoms of alcohol (Smith & Randall, n.d.). It can be confusing to determine whether individuals drink to relieve symptoms of anxiety or if the symptoms are caused by drinking or the lack of drinking (Smith & Randall, n.d.). Overall, it has been proven that there are many other disorders that can be diagnosed along with alcoholism. Incidence, Prevalence, and EpidemiologyAlcoholism is a very common disease, affecting close to 18 million people (NCADD, 2015). One in every twelve adults have a diagnosis of alcoholism, while millions of others are on the verge of becoming an alcoholic (NCADD, 2015). Research has found that alcoholism is most commonly found in adult men (APA, 2015). Roughly 12.4% of all males are alcoholic while 5% of females are alcoholic (APA, 2015). The presence of alcoholism also varies depending on different age groups. Individuals between ages 18-29 are ranked to have the most alcoholics for their age group; 16% of them suffer with alcoholism. (APA, 2015). Adults eighteen years old and older, have about 8.5% of their population as alcoholics (APA, 2015). Alcoholics make up about 5% of the adolescent population (APA, 2015). Of the 5% of adolescents diagnosed with alcoholism, the majority of them are Hispanics, Alaskan Natives, and Native Americans (APA, 2015). In relation, Native Americans and Alaskan Americans make up 12% of all adult alcoholics (APA, 2015). Second after Native Americans and Alaskan Americans, 8% of alcoholics are caucasian (APA, 2015). EtiologyThere is no single cause for alcoholism, but a few different factors that can be grouped into four possible causes (Horvath Mirsa, Epner, and Cooper, 2017). The four different causes are biological, psychological, sociocultural, and spiritual causes (Horvath et al., 2017). Biological Biological factors of alcoholism include genetics and physiology (Horvath et al., 2017). Each individual has a different brain chemistry that controls the brain’s ability to resist impulses (Horvath et al., 2017). Normal brain chemistry causes individuals to want more of what makes them feel good; however, they are able to control their impulses (Horvath et al., 2017). Alcoholics feel a strong sense of enjoyment when they drink, and because their brain chemistry differs from non-alcoholics, they are not able to stop their impulses as easily (Horvath et al., 2017). Typically, imbalances in the brain are genetic, which gives alcoholics’ offspring a higher chance of developing as well (Horvath et al., 2017). A quarter of children from alcoholic parents, develop alcoholism (Horvath et al., 2017). Psychological It can be more difficult for certain people to cope with stressors in their lives than others. Some alcoholics develop a drinking problem due to a poor ability to cope with stress (Horvath et al., 2017). If individuals do have poor coping skills, they’re more prone to developing an addiction (Horvath et al., 2017). Alcoholics may drink in order to relieve stress, boredom, receive a pleasurable feeling, control negative emotions, or prevent symptoms from withdrawal (Horvath et al., 2017). Another key component to developing alcoholism is one’s motivation skills (Horvath et al., 2017). It can be hard to overcome an addiction, especially if one has a lack of motivational skills. Alcoholics with low motivation skills have a lower chance of receiving treatment because they have little to no motivation to try and fix his or her addiction, even if they have noticed an issue (Horvath et al., 2017). Sociculture Culture can play a big role in the diagnosis of alcoholism (Harvath et al., 2017). A culture can be defined as a group of people who all practice and believe the same values as one another (Harvath et al., 2017). If a specific culture practices a heavy use of alcohol, the chances of others picking up on that are very high (Harvath et al., 2017). If someone in a culture is an alcoholic, other members of the culture may think that the of action the alcoholic is normal, causing them to be more vulnerable for addiction as well (Harvath et al., 2017). The continuation of alcoholism will more than likely be passed down to younger generations due to genetics, along with growing up around the misuse of alcohol (Harvath et al., 2017).SpiritualityThere are many different types of beliefs that one may believe and practice. People involved with the thought of spirituality believe in some type of higher power (Harvath et al., 2017). People typically use the thought of a higher power to help guide them through life (Harvath et al., 2017). If someone does not believe in a higher power, he or she may lack the sense of meaning and purpose (Harvath et al., 2017). When lacking meaning and purpose, one may feel disconnected from the universe, which may make them more vulnerable to addiction (Harvath et al., 2017). Although spirituality is not the cause of all alcohol related disorders, it can have a strong impact on the development of the disorders (Harvath et al., 2017). Alcohol’s Effect on the BrainAlcohol can affect the brain in many different ways. The brain is made up of millions of control nerves, called neurons, and alcohol plays a big role in damaging and killing those neurons (ScienceNetLinks, 2017). Alcohol also affects the prefrontal cortex, which is responsible for the brain’s reward system, and the behavior of impulses (ScienceNetLinks, 2017). The brain releases extra amounts of dopamine when alcohol is drank, causing the ‘high’ that pleases the individual (Ehrlich, 2017). The two together would cause alcohol to highly please the individual while making it more tempting to continue to drink (ScienceNetLinks, 2017). The hippocampus can also be affected in an alcoholic’s brain (ScienceNetLinks, 2017). Memories are stored in the hippocampus, so if one is alcoholic, his or her memory may be very poor (ScienceNetLink, 2017). It is also common for alcoholics to be very forgetful, especially when he or she is heavily intoxicated (ScienceNetLinks, 2017). Both the cerebellum and the frontal lobe are also affected in an alcoholic’s brain (ScienceNetLink, 2017). They are responsible to help control the body’s motor skills, cognitive skills, and behavior mechanisms (ScienceNetLinks, 2017). When one is an alcoholic, he or she may have impaired functions, which sometimes can cause slow movements, strong emotions, and poor judgment skills (ScienceNetLinks, 2017). Another part of the brain affected by alcoholism is the reticular activating system, which is the brain’s sleeping and waking control center (ScienceNetLinks, 2017). After one has been drinking for too long, he or she may either have trouble sleeping at night or waking up in the mornings (ScienceNetLinks, 2017). Alcohol depresses the reticular activating system which can also cause one to pass out (ScienceNetLinks, 2017). Another major affected section of the brain from alcoholism is the medulla (ScienceNetLink, 2017). The medulla controls vital functions such as breathing and the pumping of the heart, so an alcoholic may risk complications from either functions, which can result in death (ScienceNetLink, 2017). Diagnostic Criteria Although the symptoms of alcoholism may vary in different individuals, it can be described as over-using the use of alcohol, along with showing specific factors while drinking (American Psychiatric Association APA, 2013). There is a list of twelve factors that are prominent in alcoholism, and two of them must be shown in an individual within one year to classify he or she as an alcoholic. The twelve different factors include: consuming alcohol in larger amounts or longer periods of time than intended, showing little to no effort to eliminate alcohol use, much of one’s time is spent on alcohol related activities, having a strong desire for more alcohol when one is without it, negatively affecting the performance one shows in work, school, or home, ignoring any social or personal issues that may occur due to alcoholism, lacking time dedicated for important tasks because of alcohol, continuing to drink even in potentially dangerous situation, avoiding the presence of alcohol even though it has caused physical or psychological issues, always needing to consume more alcohol due to a growing tolerance, and using alcohol to avoid a withdrawal or showing symptoms of alcohol withdrawal when attempting to quit drinking (APA,2013). The severity of alcoholism is determined by how many symptoms are expressed within an individual (APA,2013). One who is mild will show two to three symptoms, a moderate alcoholic will show four to five symptoms, and a severe alcoholic will show signs of six or more symptoms (APA, 2013). Alcoholism will be diagnosed by a professional. However, most alcoholics deny there is an issue present, so it can be difficult to diagnose and help them (Ehrlich, 2015). TreatmentMany different treatment styles that may be used to help correct alcoholism. However, the first step in recovery is realizing that drinking is becoming problematic in the individual. (Ehrlich, 2015). Family members and friends often encourage an alcoholic to seek treatment since alcoholics tend to deny having any drinking problems (Ehrlich, 2015). When an alcoholic begins the recovery process, it is recommended that he or she stays in either a hospital or treatment center and detox their body from alcohol (Ehrlich, 2015). The process of detoxing the body can take anywhere from four to seven days (Ehrlich, 2015). After detox, alcoholics should engage in group therapies that can help encourage them to stay sober (Ehrlich, 2015). An example of a therapy program for alcoholics is Alcoholics Anonymous (AA). It may be beneficial for family members to attend AA as well so they can help support the alcoholics outside of therapy. The withdrawal effects of correcting alcoholism can be harmful, sometimes causing death (Ehrlich, 2015). Some medication, such as Benzodiazepines or Anticonvulsants, may be prescribed to help with withdrawal symptoms (Ehrlich, 2015). Further medication may be needed to help prevent the alcoholic from relapse (Ehrlich, 2015). Medication works by either blocking the brain receptors that causes the ‘high’ from alcohol, by changing the chemicals in the brain so they are normal, or by causing negative effects like nausea and vomiting when one drinks alcohol. (Ehrlich, 2015). It is recommended that one goes through more therapy sessions while taking medication to help correct alcoholism (Ehrlich, 2015). Cognitive behavioral therapy (CBT) is typically used with treating alcohol addictions (Ehrlich, 2015). CBT is an one-on-one therapy where a psychologist will meet with the alcoholic and discuss any problems they may have (Ehrlich, 2015). The purpose of CBT is to help alcoholics express their feelings along with changing their beliefs on drinking (Ehrlich, 2015). Additional steps may be taking in helping one overcome alcoholism, such as nutrition, herbs, and homeopathic methods (Ehrlich, 2015). When one is alcoholic, he or she may suffer from vitamin deficiencies that were caused from overusing alcohol (Ehrlich, 2015). It can be beneficial for alcoholics to take vitamin B, magnesium, and zinc (Ehrlich, 2015). Along with vitamins, specific herbs can contribute to the recovery of an alcoholic (Ehrlich, 2015). The herb Kudzu can help an alcoholic avoid the temptation of wanting to drink (Ehrlich, 2015). A study concluded that alcoholics that were given Kudzu for a week drank less alcohol when it was offered than individuals who were given a placebo (Ehrlich, 2015). Two other herbs that can be beneficial to alcoholics is dandelion and milk thistle (Ehrlich, 2015). The two herbs can work together help prevent and treat liver issues that may form from consuming too much alcohol (Ehrlich, 2015). Another possibility one can use to help treat withdrawal symptoms is homeopathic remedies (Ehrlich, 2015). The following are some of the homeopathic options one can use: Arsenicum album, Nux vomica, Lachesis, and Staphysagria (Ehrlich, 2105). Each remedy has it’s own beneficial factor but the main purpose of them is to help relieve symptoms without the use of heavy medication (Ehrlich, 2015).