What is an alcohol problem?
Researchers use the term "alcohol problems" to refer to any type of condition caused by drinking which harms the drinker directly, jeopardizes the drinker’s well-being, or places others at risk. Depending on the circumstances, alcohol problems can result from even moderate drinking, for example when driving, during pregnancy, or when taking certain medicines. Alcohol problems exist on a continuum of severity ranging from occasional binge drinking to alcohol abuse or dependence (alcoholism).
What is the difference between different types of alcohol problems, such as binge drinking, alcohol abuse and alcohol dependence?
It is important to note that alcohol problems occur along a continuum of severity. The term alcoholism usually refers to alcohol abuse or dependence. Alcohol dependence is the most severe alcohol problem and typically consists of at least three of seven symptoms experienced within one year. These symptoms include repeated unsuccessful attempts to stop or cut down, need for increased amounts of alcohol (tolerance), or symptoms of withdrawal upon cessation of drinking (physical dependence). Many other types of alcohol problems do not entail alcohol dependence but are nevertheless harmful in their effect on a person’s job, health, and relationships. Also, alcohol problems of lesser severity can often progress to alcoholism if untreated.
The most common alcohol problems include:

Binge drinking is the type of problem drinking most often engaged in by young people in the 18-21 year old age range. Within this age group binge drinking is more prevalent among college students than non-students. Researchers often define binge drinking as the consumption of five or more drinks at one sitting for males and three or more drinks at one sitting for females. Binge drinkers on college campuses are more likely to damage property, have trouble with authorities, miss classes, have hangovers, and experience injuries than those who do not. Students living on campuses with high rates of binge drinking experience more incidents of assault and unwanted sexual advances than students on campuses with lower binge drinking rates.

Alcohol abuse often results in absence from, and impaired performance at, school and on the job, neglect of child care or household responsibilities, legal difficulties and alcohol consumption in physically dangerous circumstances such as while driving. Individuals who abuse alcohol may continue to drink despite the knowledge that their drinking causes them recurrent and significant social, interpersonal, or legal problems.

Alcohol dependence is a chronic and often progressive disease that includes a strong need to drink despite repeated social or interpersonal problems such as losing a job or deteriorating relationships with friends and family members. Alcohol dependence has a generally predictable course, recognizable symptoms, and is influenced by a complex interplay of genes, psychological factors such as the influence of family members and friends, and the effect of culture on drinking behavior and attitudes. Scientists are increasingly able to define and understand both the genetic and environmental factors that make an individual vulnerable to alcoholism.
What are the signs and symptoms of an alcohol problem?
Certain behaviors are known to be possible early signs of an alcohol problem. These include any established pattern of drinking, such as heavy regular alcohol consumption and/or frequent intoxication, which poses a high risk of future damage to physical or mental health and which places the drinker at risk of accidents, arrests, poor job performance or other social problems.

Alcohol dependence, sometimes referred to as alcoholism, is the most severe type of alcohol problem and is characterized by three of seven symptoms experienced during a one year time period. According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, the symptoms of alcohol dependence include:
Symptoms of Alcohol Dependence

Neglect of other Activities: Important social, occupational, or recreational activities are given up or reduced because of alcohol use;
Excessive Use: Alcohol is consumed in larger amounts over a longer period than intended;
Impaired control: Ongoing, unsuccessful efforts to cut down or control alcohol consumption;
Persistence of Use: Alcohol consumption is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely caused or exacerbated by alcohol;
Large Amounts of Time Spent in Alcohol Related Activities: A great deal of time is spent in activities necessary to obtain, use or recover from the effects of alcohol; Withdrawal: Withdrawal symptoms, such as nausea, sweating, shakiness, and anxiety when alcohol use is stopped after a period of heavy drinking;
Tolerance: The need for increasing amounts of alcohol in order to feel its effects.
How does a health professional diagnose an alcohol problem?
A diagnosis of an alcohol problem can only be determined after a full examination by a health professional. The examination may include a behavioral and/or medical evaluation.
The behavioral evaluation will review the individual’s history of alcohol use including drinking patterns, attitudes and beliefs as well as environmental factors such as the influence of friends and family members and stress levels.
The medical evaluation includes a physical examination which will assess physical signs and symptoms of alcohol dependence and chronic alcohol use, a review of genetic factors to determine if there is a history of alcoholism within the family, and evaluation of data from laboratory tests.
Who develops alcohol problems?
According to the National Institute on Alcohol Abuse and Alcoholism, nearly 14 million people in the United States-1 in every 13 adults- have alcohol abuse or dependence. More men than women are alcohol dependent or have other types of alcohol problems. Rates of alcohol problems are highest among young adults ages 18-29 and lowest among adults 65 years and older. About 43% of U.S. adults (76 million people) have been exposed to alcoholism in the family; they grew up with, married an alcoholic or problem drinker, or had a blood relative who was an alcoholic or problem drinker. Although alcohol abuse and dependence tend to run in families, risk is not destiny. A combination of genetic and environmental factors determines who develops alcohol problems.
What are the treatments for alcohol problems?
Alcohol problems which do not involve physical dependence can be treated through interventions such as education, counseling and a reduction in the amount of alcohol consumed on a regular basis. A variety of treatments exist for alcohol dependence including self-help groups, medication, detoxification and rehabilitation on either an in-patient or out-patient basis.