DR. HOOK- Alcoholism: Have a problem with liquor?

Bad habits are hard to break. Cracking chewing gum drives me crazy like someone scratching a chalkboard (the birth of dry markers in classrooms?). Throwing cigarette butts from the car instead of putting them in the ash try! (How would litterers feel if someone threw used toilet paper inside their cars?) Bad talent who keep appearing on American Idol try-outs. Paparazzi continuously following Britney Spears.

Alcohol is touted by Americans to be better than peanut butter, iPods, and Desperate Housewives all in one. Cheers! Prost! Chin-chin! Everybody dance and drink! Whew! Seems glamorous, doesn't it? But when does alcohol become a bad habit?

 Two-thirds of American adults consume alcohol. I'm one of them. In small to moderate amounts, alcohol has been shown to be good for the heart. However, about 10 percent of drinkers are addicted to alcohol, another 10 percent drink so much it leads to harmful things, and up to 25 percent have risky drinking behaviors. Sounds like college, huh?

But folks in the workforce (age 30-64) have the greatest risk for lifetime alcohol abuse. Lifetime prevalence of alcohol abuse is about 17 percent and of dependency is about 12 percent.

Hollywood has shown us this: 80 percent of people dependent upon alcohol smoke, and 30 percent of smokers have alcohol dependency. Cough, cough, burp. Maybe that's why so many actors die of cancer or liver disease.

I learned from Jewish culture that alcohol should "lubricate," not "inebriate," the body and soul. Consistent inebriation can lead to medical problems such as high blood pressure, dementia, neurological disorders, liver disease, pancreatitis, birth defects, and many cancers. (Sounds like a pharmaceutical ad, huh?)

How much is too much? According to the literature, 80g of ethanol a day for 10-20 years is linked to cirrhosis. That's equivalent to about six 12-ounce beers, six 4-ounce glasses of wine, or six 1.5-ounces of 80-proof liquor a day. Moderate drinking is considered to be one to three drinks per day for men and one or two drinks per day for women. Heavy drinking is considered to be more than 14 drinks a week for men and more than seven a week for women; or for binge drinkers more than three drinks per occasion for men and more than two drinks on each occasion for women.

The Diagnostic and Statistical Manual of Mental Disorders-IV defines alcohol abuse to be at least one of the following: 1) failure to fulfill work, school, or social obligation; 2) drinking despite being in physically hazardous situations; 3) recurrent legal problems; 4) family or friend problems due to drinking, but refusal to stop.

Dependence is defined as having three or more of the following: 1) tolerance (need more and more alcohol to achieve the same effect); withdrawal (tremor, shakes, depressive mood, hallucinations); can't stop drinking– no limit; constantly working on drinking less; wasted time (hangovers, drinking away valuable time, etc); drinking instead of working or engaging in social/ or recreational events; drinking despite mental or physical problems from the alcohol.

Bad habits? Bad behavior. A huge percentage of traffic fatalities involve driving while under the influence of alcohol. Of convicted DUI drivers, 91 percent of men and 85 percent of women have a lifelong alcohol problem. Alcohol abuse is often involved in accidents, drownings, violence, rape, murder, and crime. Fun party, huh? Not!

Alcohol abuse is also prevalent in people with mental illness. People living with bipolar disorder, anxiety, depression, or PTSD often self-medicate with alcohol. And as with mental illness, there's a genetic component to alcoholism: family history is strongly associated with alcohol abuse.

I could go on for chapters on alcohol abuse, but I hope this article might stimulate some readers to research more on their own drinking or on someone they love. Good resources are AA and Al-Anon. Life is too short to waste it on alcohol abuse.

Dr. Hook cracks a joke or two, but he's a renowned physician with a local practice. Email him with your questions.