Q: My spouse drinks so much that I fear (s)he is an alcoholic. What should I do? What should I know?

A: Alcoholism is an addiction. There is a difference between drug and alcohol abuse and being addicted.

Abuse is when someone overuses a substance or behavior to the detriment of his or her health; after repeated exposure, this often leads to addiction.

Addiction, including alcoholism, has long been thought to be a moral issue – a defect in one’s character – but the truth is that this issue is a disease.

In the addiction medicine world, addiction is described as a brain disease, in which a person is unable to stop the obsessive-compulsive behavior of using a substance (pain pills, alcohol, sex, gambling) that changes his behavior, despite repeated negative consequences.

Some people are susceptible to addictive behavior while others develop this addictive thinking by repeated exposure to the substance.

There are major changes in the brain chemistry and remodeling of brain structures after repeated exposure to addictive substances that make people want more, despite potential negative consequences.

This is not, however, an excuse or a “pass” for one’s behavior.

Understanding that addiction is a disease, just like diabetes, allows the individual and family to seek treatment that will eliminate the addictive behavior.

Once the addict has been treated, it will then be his or her choice to stay in recovery.

Of course, the most difficult first step is to recognize there is a problem and be willing to seek help.

Once addicted, most people will require some type of treatment to break the habit and come off the substance.

Treatment might consist of detoxification and rehabilitation, which can last anywhere from seven to 90 days, depending on the severity and social issues involved.

Other forms of treatment include 12-step self-help groups, individual counseling and maintenance medications prescribed by a physician.

Recovery and sobriety are the ultimate goals of treatment, which usually requires long-term attendance at 12-step self-help groups.

Twelve-step groups, such as Alcoholics Anonymous and Narcotics Anonymous, are made up of people suffering from the same addiction who are willing to help each other stay sober.

The National Council on Alcoholism and Drug Dependence recommends taking these steps if someone you love is abusing a substance:

  • Speak up and offer your support.
  • Express your love and concern – don’t wait for your loved one to “hit bottom.”
  • Give specific examples of behavior that has you worried.
  • Don’t expect the person to stop without help.
  • Support his or her recovery as an ongoing process.

Remember, any substance or behavior being abused has the potential for health consequences, even death.

Talk to your physician for more information on abuse and addiction.

Dr. William E. Kyle is an internal medicine physician at Memorial Health University Physicians – Legacy Center in Okatie.