Because alcohol abuse has emerged as a major health concern for outreach programs, outreach workers should have a basic understanding of alcohol-related issues. Substance abuse, particularly alcohol use, is a topic that warrants serious consideration when working with many priority populations of outreach programs. Risk factors for substance abuse include: poverty, stress, lack of mobility, and lack of recreational opportunities. These risk factors are often commonplace among the vulnerable and hard-to-reach communities outreach programs serve.
It is important to recognize that not everyone who drinks alcohol experiences problems. There are people that occasionally use alcohol in small quantities and experience few or no problems as a result of drinking alcohol. However, there are patterns of alcohol use that do increase a person’s risk for experiencing alcohol-related problems. The following definitions have been provided in order to clarify commonly used terms associated with patterns of drinking that may produce negative consequences. Information from the National Institute on Alcohol Abuse and Alcoholism’s (NIAAA) most frequently asked questions about alcohol is incorporated into the definitions below.
- Alcohol abuse occurs when a person drinks too much too often. Frequently this pattern of drinking causes health consequences, legal problems, or social problems as a direct result of the individual’s alcohol use. Some of the most typical consequences people experience due to alcohol abuse are related to an inability to fulfill their life obligations. For example, a person abusing alcohol may be repeatedly late or absent from work, have drinking-related medical conditions or injuries, experience relationship problems, be arrested, or cause car crashes.
- Alcohol Dependency, or alcoholism, is considered a chronic disease that can be treated but not cured. Developing alcohol dependency is related to several factors, including lifestyle choices regarding alcohol consumption and family history. An alcohol-dependent person often experiences at least some of the social, legal, and health problems outlined above, but the individual is physically dependent on alcohol as well.
- Alcohol dependency is often associated with an intense desire to drink usually referred to as cravings.
- Once alcohol dependent individuals begin drinking they usually lose control of when they will stop or how many drinks they will have on any one occasion.
- Alcohol dependent people will likely experience some form of withdrawal after they stop using alcohol, a sign of physical dependence. Withdrawal may include nausea, sweating, shakiness, or anxiety. It is also important to note that withdrawal can become serious and life-threatening, leading to a need for immediate medical attention and care.
- Over time, people who are alcohol dependent are likely to notice a difference in their tolerance level to alcohol. Usually it will take more and more alcohol to achieve the same intoxicating effects.
Sometimes it can be difficult to know if a person’s drinking is problematic. There are four questions that can be asked to help determine if a person’s alcohol use is a cause for concern. The NIAAA indicates that if a person answers “yes” to any of the following questions, an alcohol problem is possible.
- Have you ever felt you should cut down on your drinking?
- Have people annoyed you by criticizing your drinking?
- Have you ever felt bad or guilty about your drinking?
- Have you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover?
The NIAAA recommends that a person the interviewee trusts ask these questions in a private setting to maximize the likelihood of honest, direct answers. If a possible alcohol problem has been identified it is best to refer the person to a professional that can assist him or her in determining the extent and need for further treatment. Find out what assistance is available in your community in advance. Have a listing of referrals readily available. When approaching the person, consider your timing and try not to be judgmental. It is best if the person is sober and calm. Be discrete if possible. Choose a safe, quiet, private setting to offer your referral information. Every situation is unique and personal discretion should be used. If there is ever any question about the best possible course of action, it is always a good idea to seek guidance from a supervisor or an addictions specialist.
In conclusion, alcohol abuse and dependency is a serious issue among many populations that outreach staff serve. Being aware of this important, yet sensitive, health topic will better enable outreach staff to guide their clients to the appropriate resources and help. Not every outreach worker can be an addictions specialist, but every outreach worker can help someone with alcohol dependency and abuse problems.
For more information and resources about alcohol, alcoholism, self-help support, and treatment considerations please reference the following resources.
- National Institute on Alcohol Abuse and Alcoholism: www.niaaa.nih.gov
- Alcoholics Anonymous: www.aa.org
- National Clearinghouse for Alcohol and Drug Information: http://ncadi.samhsa.gov/
- The National Drug and Alcohol Treatment Referral Routing Service: