Are you CAGEd in by Alcohol

Do you have an alcohol problem? Ask yourself these four questions:

1. Have you ever felt you ought to Cut down on your drinking?
2. Have people Annoyed you by criticising your drinking?
3. Have you ever felt bad or Guilty about your drinking?
4. Have you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover (an 'Eye-opener')?

If you have answered yes to two or more of the questions, if you drink more than 36 units of alcohol (for men) or more than 21 units of alcohol (women) then you have a problem with alcohol consumption that you may wish to follow up with your doctor. Alcohol causes physical and mental problems-if you believe that you have difficulty with your drinking then seeking early advice may reduce the likelihood of subsequent disease.

Most people drink alcohol and small amounts are not harmful. It is likely that one or two units of wine daily protects against heart disease. However, as the quantity of alcohol consumed goes up health suffers. Alcohol is measured in units; one unit of alcohol is half a pint of beer, a single measure of spirits, or a standard glass of wine. Sensible drinking is keeping to 21 units/week in men and 14 units/week in women. You should spread this throughout the week rather than drink it all in one or two binges.

An alcoholic or a person with an alcohol problem has become dependent on alcohol. The CAGE questionnaire above is very good at revealing whether this has happened. Dependence will affect physical and mental health. It may cause problems with work, relationship difficulties or problems with the law. With increasing alcohol consumption blackouts or memory loss of what happened while drinking occur. Insomnia (inability to sleep), depression, aggressive episodes and attempted suicide are possible.

The damage to physical health can include serious liver problems (cirrhosis and alcoholic hepatitis), stomach ulcers and inflammation as well as cancer of the mouth, gullet, stomach and liver. Permanent damage to the brain, heart and the nerves of the feet will occur with heavy drinking. Abruptly stopping drinking can cause a condition known as delirium tremens (the 'DTs'). This results in nausea and vomiting, shaking attacks, frightening hallucinations and fits. It is very dangerous and requires admission to hospital.

Detoxification is needed if the problem drinker cannot abstain or suffers withdrawal symptoms. 'Drying out' can be done under supervision in hospital or in the community. Any physical or mental problems which occur as a result of coming off alcohol can then be treated. Goals are agreed with the problem drinker. The object is either total abstinence or reducing drinking to 'safer' levels. Abstinence is better. Drugs may be used to counteract any depression, problems with DTs or any vitamin deficiency. Alcohol-sensitizing drugs can be useful in helping people to stay off alcohol. Disulfiram (Antabuse) is taken daily; if alcohol is taken with it, then serious side-effects such as palpitations, nausea and faintness occur. These are dangerous and very unpleasant. The whole lifestyle is examined with the alcohol counsellor. This may involve looking at how stress is dealt with and understanding how the need for alcohol arose.

Alcoholism is a dangerous condition. If no treatment is sought, and drinking continues, health will suffer; recovery may be impossible. However, treatment can be very successful, especially if started early.