Abuse and Addiction Addiction Treatment

Alcoholism: Diagnosis and Treatment

Summary & Participants

What are the symptoms of alcoholism? When should you worry? Our panel discusses the causes and warning signs of alcoholism and how to recognize them.

Medically Reviewed On: July 21, 2008

Webcast Transcript

DAVID MARKS, MD: I'm Dr. David Marks.

Many alcoholics don't even know they have a problem. So what are the symptoms of alcoholism? And when should you start worrying that you might have a problem? Joining us to answer these questions is Dr. Carol Weiss. She's an Addiction Psychiatrist and Clinical Assistant Professor of Psychiatry and Public Health at Cornell University Medical College, New York Presbyterian Hospital. Welcome.

And Dr. Richard Rosenthal, he's Chief of the Division of Substance abuse at Beth Israel Hospital in New York. Welcome.

DAVID MARKS, MD: Now, are doctors failing to pick this up on routine exams? You go in to see your internist?

RICHARD ROSENTHAL, MD: Absolutely. There's not question about it that-- if we want to just talk about diagnoses, in other words, people who actually have what physicians would call diagnosable disorder. Not just problem drinking, but more severs cases where there's bona fide problems. And what we know is that in general practice, although it is getting better, most physicians are not asking those kinds of simple questions about simple drinking behavior.

And that's a shame, because often doctors can have a good effect. Especially, if someone has not made the transition from a problem drinker into a person with an abuse or a dependence problem. And so early intervention by a caring professional can make a difference. There's actually literature on that where it shows recent interventions by primary care physicians can have an impact on drinking behavior. Unfortunately, it's not done with any kind of regularity.

DAVID MARKS, MD: OK, is there a difference in the way men and women manifest the signs of alcoholism?

CAROL WEISS, MD: Yeah. There are a lot of differences. First of all, there are people who say that women manifest with problems with alcohol use after a shorter period of alcohol use. That is a man might be able to drink for many years before developing a problem. But with a woman it happens sooner. Why that is has to do with the physiology of women, perhaps. Women have more body fat, their water concentration is different than with men, and that may affect how it's--it manifests. Women tend to have more shame and guilt associated with their drinking than men do. It's not very socially accepted--it's less socially acceptable for a woman to drink than for a man. It was the case that women were much more reluctant to pursue treatment as a result of that.

That has shifted fortunately over the years that more women now are going to AA and other forms of treatment. But for a long time they were reluctant to show their head. Then of course women because they have different organs have different problems.

They have fertility problems associated with the drinking of alcohol, for example.

DAVID MARKS, MD: Well, leave the doctor out of it, let's say someone out there knows a loved on or friend who they think or suspect is an alcoholic. What should they do?

CAROL WEISS, MD: First of all, they should talk to the person, but not in a judgmental or attacking kind of way. Because they're going to get up the defenses of the person and make them irritable, angry, and even deny more fiercely that they have a problem. But gently discuss with them your concerns about what you've observed and that you're not the only person who's observed. That's often very helpful to point out. And to suggest to the person ways that they might be able to get help, other people that you know have the same problem and help that they've gotten.

DAVID MARKS, MD: So they should take some action?

CAROL WEISS, MD: They should take some action. And you should direct them toward getting help.

DAVID MARKS, MD: Carol Weiss. Rick Rosenthal. Thank you, very much for joining us. Alcoholism is a very severe problem in this country. Diagnosis is the first and possibly the most important step, and we hope this web cast helped out. I'm Dr. David Marks, thank you for joining us.