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Alcoholism is the continued drinking of alcohol despite it causing problems. Some definitions require evidence of dependence and withdrawal. Problematic alcohol use has been mentioned in the earliest historical records. The World Health Organization (WHO) estimated there were 283 million people with alcohol use disorders worldwide as of 2016. The term alcoholism was first coined in 1852, but alcoholism and alcoholic are considered stigmatizing and likely to discourage seeking treatment, so diagnostic terms such as alcohol use disorder and alcohol dependence are often used instead in a clinical context. Other terms, some slurs and some informal, have been used to refer to people affected by alcoholism such as tippler, sot, drunk, drunkard, dipsomaniac, and souse.
Alcohol is addictive, and heavy long-term use results in many negative health and social consequences. It can damage all organ systems, but especially affects the brain, heart, liver, pancreas, and immune system. Heavy usage can result in trouble sleeping, and severe cognitive issues like dementia, brain damage, or Wernicke–Korsakoff syndrome. Physical effects include irregular heartbeat, impaired immune response, cirrhosis, increased cancer risk, and severe withdrawal symptoms if stopped suddenly.
These effects can reduce life expectancy by 10 years. Drinking during pregnancy may harm the child's health, and drunk driving increases the risk of traffic accidents. Alcoholism is associated with violent and non-violent crime. While alcoholism directly resulted in 139,000 deaths worldwide in 2013, in 2012 3.3 million deaths may be attributable globally to alcohol.
The development of alcoholism is attributed to environment and genetics equally. Someone with a parent or sibling with an alcohol use disorder is 3-4 times more likely to develop alcohol use disorder, but only a minority do. Environmental factors include social, cultural and behavioral influences. High stress levels and anxiety, as well as alcohol's low cost and easy accessibility, increase the risk. Medically, alcoholism is considered both a physical and mental illness. Questionnaires are usually used to detect possible alcoholism. Further information is then collected to confirm the diagnosis.
Treatment takes several forms. Due to medical problems that can occur during withdrawal, alcohol cessation should often be controlled carefully. A common method involves the use of benzodiazepine medications. The medications acamprosate or disulfiram may also be used to help prevent further drinking. Mental illness or other addictions may complicate treatment. Individual, group therapy, or support groups are used to attempt to keep a person from returning to alcoholism. Among them is the abstinence-based mutual aid fellowship Alcoholics Anonymous (AA). A 2020 scientific review found clinical interventions encouraging increased participation in AA (AA/twelve step facilitation (TSF)) resulted in higher abstinence rates over other clinical interventions, and most studies found AA/TSF led to lower health costs.
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