Реферат: Drinking: Alcoholism

Virtually all alcoholism treatment programs also include meetings of Alcoholics Anonymous (AA), which describes itself as a "worldwide fellowship of men and women who help each other to stay sober." While AA is generally recognized as an effective mutual help program for recovering alcoholics, not everyone responds to AA's style and message, and other recovery approaches are available. Even those who are helped by AA usually find that AA works best in combination with other elements of treatment, including counseling and medical care.

Can Alcoholism Be Cured?

While alcoholism is a treatable disease, a cure is not yet available. That means that even if an alcoholic has been sober for a long while and has regained health, he or she remains susceptible to relapse and must continue to avoid all alcoholic beverages. "Cutting down" on drinking doesn't work; cutting out alcohol is necessary for a successful recovery.

However, even individuals who are determined to stay sober may suffer one or several "slips," or relapses, before achieving long-term sobriety. Relapses are very common and do not mean that a person has failed or cannot eventually recover from alcoholism. Keep in mind, too, that every day that a recovering alcoholic has stayed sober prior to a relapse is extremely valuable time, both to the individual and to his or her family. If a relapse occurs, it is very important to try to stop drinking once again and to get whatever additional support is needed to abstain from drinking.

Help for Alcohol Abuse

If your health care provider determines that you are not alcohol dependent but are nonetheless involved in a pattern of alcohol abuse, he or she can help you:

Examine the benefits of stopping an unhealthy drinking pattern.

Set a drinking goal for yourself. Some people choose to abstain from alcohol, while others prefer to limit the amount they drink.

Examine the situations that trigger your unhealthy drinking patterns, and develop new ways of handling those situations so that you can maintain your drinking goal.

Some individuals who have stopped drinking after experiencing alcohol-related problems choose to attend AA meetings for information and support, even though they have not been diagnosed as alcoholic.

New Directions

Genetic research: Scientists are now studying 3,000 individuals from several hundred families with a history of alcoholism in order to pinpoint the location of genes that influence vulnerability to alcoholism. This new knowledge will help identify individuals at high risk for alcoholism and also will pave the way for the development of new treatments for alcohol-related problems. Other research is investigating the ways in which genetic and environmental factors combine to cause alcoholism.

New medications: Studies have led to the Food and Drug Administration's approval of the medication naltrexone for the treatment of alcoholism. When used in combination with counseling, this prescription drug lessens the craving for alcohol in many people and helps prevent a return to heavy drinking. Naltrexone is the first medication approved in 45 years to help alcoholics stay sober after they detoxify from alcohol.

Together, these investigations will help to prevent alcohol problems; identify alcohol abuse and alcoholism at earlier stages; and make available new, more effective treatment approaches for individuals and families.

Alcohol Availability.

The availability and accessibility of alcohol may influence employee drinking. More than two-thirds of the 984 workers surveyed at a large manufacturing plant said it was "easy" or "very easy" to bring alcohol into the workplace, to drink at work stations, and to drink during breaks (14). Twenty-four percent reported any drinking at work at least once during the year before the survey (15). In a survey of 6,540 employees at 16 worksites representing a range of industries, 23 percent of upper-level managers reported any drinking during working hours in the previous month (16).

Restricting workers' access to alcohol may reduce their drinking.

Supervision.

Limited work supervision, often a problem on evening shifts, has been associated with employee alcohol problems (2,18). In one study of 832 workers at a large manufacturing plant, workers on evening shifts, during which supervision was reduced, were more likely than those on other shifts to report drinking at work (15).

Alcohol Policies.

There is wide variation in the existence of alcohol policies, in employees' awareness of them, and in their enforcement in workplaces across the country. Researchers found that most managers and supervisors in one large manufacturing plant had little knowledge of the company's alcohol policy. In addition, supervisors were under constant pressure to keep production moving and were motivated to discipline employees for drinking only if the drinking was compromising production or jeopardizing safety. Workers' knowledge that policies were rarely enforced seemed to encourage drinking (14).

Effects of Employee Drinking

Alcohol-related job performance problems are caused not only by on-the-job drinking but also by heavy drinking outside of work (15,19). Ames and colleagues (15) found a positive relationship between the frequency of being "hungover" at work and the frequency of feeling sick at work, sleeping on the job, and having problems with job tasks or co-workers. The hangover effect was demonstrated among pilots whose performance was tested in flight simulators. Yesavage and Leirer (20) found evidence of impairment 14 hours after pilots reached blood alcohol concentrations (BACs) of between 0.10 percent and 0.12 percent. Morrow and colleagues (21) found that pilots were still significantly impaired 8 hours after reaching a BAC of 0.10 percent. Drinking at work, problem drinking, and frequency of getting "drunk" in the past 30 days were positively associated with frequency of absenteeism, arriving late to work or leaving early, doing poor work, doing less work, and arguing with co-workers (19).

Preventing Alcohol Problems in the Workplace

Health promotion programs offered in the workplace may reduce employees' alcohol-related problems (22). An employee health promotion program delivered in three 2-hour sessions at one manufacturing plant was designed to increase participants' awareness of the health risks related to stress and drinking. More than one-half of the 294 workers attended the sessions. Researchers based their results on data from 120 employees who completed prestudy and poststudy evaluations. After 6 months, 76 percent of the heaviest drinkers reportedly reduced their alcohol consumption. Moderate drinkers also reduced their consumption, and participants reported changes in their attitudes toward drinking and drinking and driving, knowledge about problem drinking, and recognition of signs of a drinking problem (23).

A 15-session worksite coping-skills intervention designed to reduce work- and family-related risk, to enhance protective factors, and to reduce negative health outcomes was conducted among 136 female secretaries (24). Six months later, participants reported less work-related stress, higher social support, and less alcohol use compared with a control group. Twenty-two months later, participants reported greater use of coping strategies and less drinking.