The reasons for alcohol dependency are numerous and for many too complex or painful to detail. What is uniform though is the effect it has on the sufferers and their families and friends. It is a painful trial which can result in loss of earnings, loneliness, and in some cases death.

It is because of Researcher experiences, like the one below, that we asked the h2g2 Community to turn its attention to dealing with alcohol abuse. This is the heartfelt, wise and all-round excellent Entry that resulted.

It's very difficult to watch someone you care about slowly drinking themselves to death. The screaming DTs, blindness for the last couple of years, steadily failing health, repeated hospitalisations towards the end. Deadly stuff indeed for those who don't find the strength and support to break the addiction.

University Drinking Culture

Alcoholism is a problem, however, alcohol abuse is a much wider issue. What concerns a lot of people is the excessive drinking culture which exists with students and other young people when they are at college or university.

When I arrived as an innocent new undergraduate at Durham University, I was completely unprepared for the scale of alcohol abuse. When I went out with my friends at home we only ever had one or two drinks and never had a problem. However, I soon realised that things were different at university.

In the freshers' week¹ I was introduced to college drinking games, the idea that to go out every night and drink five to ten pints was normal, and a myth that to get drunk was desirable. Anxious to fit in and make friends I went along with all this, for a few weeks, until one night I drank far too much, was thoroughly sick and made a complete fool of myself. After that I didn't drink at all for six months.

Drinking is a problem, not only at Durham University, but at many educational establishments throughout the world. For one thing, the beer is usually ridiculously cheap. There's often also a macho, male, competitive sports-team culture vibe to many colleges and universities, where binge drinking is a rite of passage.

Some Good Advice to Students

• Don't let anyone talk you into drinking more than you know you can handle.

• Don't get involved with drinking games.

• Don't pretend that getting drunk is desirable. If you think it is, you have got a problem. Seek help.

• If someone asks you to get them half, don't buy them a pint.

• If you ask someone to buy you a half and they buy a pint, just drink half of it.

My experience with alcohol was a shock. I know many people think I'm being silly - 'everyone gets drunk once or twice, can't you handle it?' - however, alcohol abuse kills thousands of people each year, far more than any illegal drugs. I was given hours of drugs education at school, but I've never found that a problem. I knew people at university who took drugs, but it was always accepted as something some people did. Some people didn't, but nobody was under pressure to try anything they didn't want to. Unfortunately, that was not the case with alcohol.

It's Your Choice

Although it might be a shock for new students to go to college and experience a 'drinking schedule' unlike anything they've ever experienced before, there are those that argue that it's all part of the college experience, and not necessarily damaging or harmful. It is a choice, after all.

When was I ever going to get the chance to live this way again? After college, I got a job and assumed more responsibility than I'd ever known. Drinking in college equates to (for most students), hanging out with friends, socialising, trying to meet members of the opposite sex, being a little more comfortable with yourself at a very crucial and transitional stage in your life. I'm not saying that drinking on college campuses is wise, or even right. But, let's face it, I prefer for these students to get their heavy-drinking years out of the way, before they hold down jobs, have families, and are out in the 'real world'. And it sure beats students doing 'e' and coke!

OK, each of us does have the choice to drink or to abstain, but the thing that comes through here is that there's an enormous amount of pressure on students (newbies, especially) to drink and get drunk, even if their better instinct tells them not to. The mentality that you must drink, found in so many JCRs (Junior Common Rooms), can exert, at worst, a slightly pernicious influence goading folk into mad boozing binges.

In my first week at uni, all you got from every direction was 'hey come to this club/pub/ball and get absolutely hammered.' A lot of people went because they thought it was the 'done thing' and wanted to fit in. A lot went out of sheer boredom. What is there to do in fresher's week if you don't go to all these places and get rat-arsed?

Drinking Culture at Work

There is a massive drinking culture in some professions too:

I used to be a full-time journalist, and it was a case of - 'Right, work done, whose round is it?' after work every night. All too tempting, after a stressful day dealing with deadlines and nagging, idiotic PR people. I enthusiastically participated in said drinking culture, to the detriment of my mental, physical and financial well-being.

It wasn't just after work, either. Put it this way: 'Private Eye' magazine called their journalist character 'Lunchtime O'Booze' for good reasons. God, it's a wonder we ever got anything written...

Drowning Your Sorrows

You can't drown your sorrows because sorrow floats.

How often do you see this situation portrayed on TV or in films? Someone has just suffered some heavy loss; maybe they've lost their job, their spouse has left them, their kids say they hate them, for whatever reason they are suddenly feeling very depressed. So they walk into a bar or pub, and start drinking heavily. The dialogue is usually cliché-ridden.

I'll have a whisky. Actually make it a double. No, a triple...

I've done it from time to time. I've found it to be a useful temporary distraction. It doesn't solve problems, but some problems don't have immediate solutions. They have to be dealt with in the morning. Having a drink is something to do until then. I wouldn't recommend it to a person prone to alcoholism, but I don't seem to be.

Usually the person drinks spirits, usually whisky, downs the first glass in one and then straightaway asks for another. In film/TV terms it's an easy way for the scriptwriters to show that someone is very depressed and upset - but it's all too common an occurrence in real life, and can lead to serious problems. Getting drunk doesn't solve depression, which doesn't go away, and instead it can make it far worse.

As a society we can try to encourage people not to turn to drink when they are depressed, making drinking a social act rather than a solitary one. As individuals we can try and provide people with support and a sympathetic ear when they are depressed or suffer some kind of loss, and let people know that it is okay to turn to these kinds of support networks.

This won't solve alcoholism, but it could be a step in the right direction.

No Easy Answers

What must have been a very painful posting to write (and the h2g2 Community was quick to recognise this and praise the Researcher for her strength and courage) the following tale will help other people to understand some of the dangers associated with alcoholism.

My mum was an alcoholic.

The thing is they can never see they have a problem then when they can't ignore it any longer they blame everyone around them for that problem. The only thing you can try to do is not get drawn into their mind games, do not accept the blame thinking you are making it easier on them, point out that you are not holding a gun to their heads and forcing them to drink they do that all by themselves. The following is a tale of caution.

My mum had had several falls and had done quite a lot of damage to her head. She was so drunk one day she fell down the stair and really bashed her head, she had to go into hospital and a blood clot formed on her brain. She could not be operated on as she had pernicious anaemia which causes the blood not to clot properly so the doctor wanted to wait until the clot had hardened so he could do a much smaller operation where he would just be able to suck the clot out.

My Dad got a call from the doctor on the Tuesday morning saying that the pressure had built up to such an extent in mum's head that he had to operate - he was still hoping to do the smaller operation.

He went ahead and on Tuesday night and we went to see her. When we got there, the nurse was tickling mum's feet to check for a response, and she was responding to it (before she couldn't feel any thing) so I got really excited. The nurse said she was not out of the woods and not to get our hopes up.

When we went to see her on Wednesday they had her sitting up in bed which was fantastic. But on Thursday we got a phone call asking us to go to the hospital straight away as mum was very sick. When we got there they had taken all the machines off her and she just had a tube draining fluid off her head and a tube up her nose draining off what looked like blood.

We asked what was wrong. Alcoholics get varicose veins on the inside of their throats, these had burst, there was nothing the doctors could do - and she basically bled to death. Not a pleasant way to die.

We got to the hospital at 8pm; she died at 5am Friday morning.

There are no easy answers - just lots of clichés, prejudice and innumerable 'good' and 'plausible' explanations. And the above Researcher is painfully right - it is very difficult for an abuser of alcohol to admit that he or she is one.

I am presently in treatment for alcohol abuse. And still I do not see myself as an alcoholic, incurable or unwilling to change my habits. It is so difficult to admit that there are factors in life you cannot control. I would ask everyone who knows somebody who drinks too much, to break 'the news' to them. In a proper way of course. Respectfully, but also seriously. Explaining how you feel, what you see, and what you wish for this friend, colleague or family member of yours.

An abuser of alcohol is a person whose abuse creates emotional and social problems for the abuser and dependant people, most obviously, the family. WHO's (the World Health Organisation) definition of Alcohol Dependency (paraphrased) involves having three of the following six symptoms:

• An urge, need or lust for alcohol
• An increasing usage (tolerance)
• Abstinences (restlessness, unease, fast pulse, sweat)
• You continue to drink although you know the negative consequences
• A slighter interest in the social world surrounding you - because of alcohol
• Loss of control (to continue to drink although you have made the decision 'not to')

But What Can You Say?

It's hard to know what to say. People who have any kind of medical condition needing treatment have to accept help, and sometimes they just aren't willing to do this - for whatever reason. Each person has their own reasons, though they may never have put them into words. Fear is probably the most likely reason. For example, someone may be afraid to see a doctor in case they are told they have cancer. Yet if the doctor starts treatment as soon as possible, their chances of recovery are much higher. And where alcohol is involved, shame and embarrassment are difficult barriers to overcome.

Probably the best way for others to bring up the subject with someone who has a problem is for them to choose a time when the person is in a conversational mood and, hopefully, able to remember. They could perhaps chat about how they themselves felt washed out, ill and depressed after drinking a lot at a social event, and they felt a lot better after 'resting their body' for two days (ie, abstaining from alcohol) plus taking vitamins/minerals (especially B-complex and zinc), sleeping naturally, eating good food, doing some kind of enjoyable activity, mixing with positive company and tackling any difficult issues/problems in a realistic and systematic way.

If the person with the problem thinks you're just sharing your own experience of a bad hangover, they'll listen more readily, perhaps open up a bit, and be willing to talk. If you haven't experienced a hangover yourself, tell them you knew someone who used to have terrible hangovers a lot. You can then suggest other things they can do. You can also mention guidelines for their drinking:

• 'Resting' for the next two days, and then ensuring they have a rest from alcohol for at least two consecutive days in each and every week

• Limiting their drinking to a maximum of 21 units per week for men and 14 units per week for women

• Spreading their drinking over a number of days, instead of drinking 21 units in one day

• Drinking at a reasonable time (ie, not before midday and preferably not before going to bed)

• Drinking only with or after food

• Drinking socially, but not with people who will encourage drinking

If any of these guidelines present difficulties (and they will, if the person has a problem), you can encourage the person to see that alcohol is a central part of their life, that it's an obstacle and a hindrance, and that it controls them and deprives them of freedom, health, and opportunities. Parts of it or all of it will be difficult, but support from others is available in many forms, 24 hours a day and seven days a week, from doctors, medication, counselling, AA groups, other groups. Different people/agencies/methods focus on different aspects of the problem, in different ways and at different times. And all are available, so the person with the difficulty can work out and choose their own path to recovery, and choose their own means of support for each aspect of the problem.

When the person is challenged or made to feel shameful, they can become defensive or secretive, or feel that they are different from others and hopelessly lacking in self-control. It's important to make the person feel they will be able to take control, even in small things and for short periods of time.

A More Open Attitude is Needed

It must be exceedingly hard to give up alcohol when so many people advocate its consumption. People are always going to drink, prohibition not being generally noted for its success.

What is needed, some would argue, is a more open attitude to the fact that alcohol can be addictive, that it's dangerous, can kill and should be respected as such rather than thought of as simply a jolly good laugh.

The misuse of alcohol to dangerous levels seems to be part of a view of the world in which a crutch is needed, be it smoking, drugs, whatever. Other than the chemical addictions which can occur from these it is the mental addiction which is causing the problem. the feeling that we need these things to get us through the day. to get us from work to home and from tea to bed. Is life so awful for so many people?

Well, basically, yes, life can stink. For some people there really seems to be no light at the end of the tunnel. But a lot can be solved or at least made easier by altering how we look at the world. Accepting there are some things we can change and some we can't and by learning healthier coping mechanisms. And a lot of our drinking is habit, a sort of unconscious reflex that we no longer really think about.

Breaking the Habit

Quite a lot of people go for the drinking lifestyle, and then eventually, out of force of habit they choose drinking over everything else on offer. It's not a conscious choice, but one that creeps up on you. You find yourself being able to answer any question with: 'Sod it, let's just go down the pub instead'. It's when 'habitual' becomes 'compulsive' that problems start to crop up. There are so many people who are just 'in the habit' of pickling themselves daily. The best thing to try and do is to find another way to cope. Buy a big dog or go to an evening class instead of the pub. Or learn to talk out your problems rather than drinking through them till they go away. Try and find a different way to cope.

Beware the Hair of the Dog

Having some experience of this subject, I'd like to suggest that the point at which you're really getting in trouble with drinking is when you start regularly succumbing to the 'hair of the dog' syndrome. That is, waking up in the morning with a stinking hangover and then drinking more booze to cure the hangover.

And it works! The 'hair of the dog' is an effective remedy! But then, after your 'medicinal' drink, it's all too easy to fancy another one. Or two. Or six. And then you're well on your way to another hangover... which you might want to fix with another drink. And so it goes on. Beware the hair of the dog...

My Experience, Strength and Hope

We'll leave the final word of this Entry to a Researcher who knows deeply the struggle that recovery presents, but also knows hope and progress, and who provides us all with a message that things really can change for the better, that we can get well in the end.

I am a recovering drug addict with a little over six years clean. Alcohol was the drug I used most, the one that got me in the most trouble, and the one that led to my being arrested, which led me to a 12-Step fellowship and a new way of life. I could go on for pages about my story, but I will try to limit myself to addressing the questions asked.

It's usually easy for an outsider to recognise if someone has a problem: when she drinks, is it always to excess? Does she black out? Does she put herself in dangerous situations? Does she spend too much money on alcohol? Does she do things in order to get alcohol that she wouldn't do otherwise? Does she break promises or commitments because she's too busy partying or too hung over? When I started asking myself these questions and answering them honestly, I began to believe my life had become unmanageable. I believe that Alcoholics Anonymous UK has a pamphlet of 40 or so questions that if answered a certain way indicate the likelihood of a drinking problem. I'm sure it's available online.

I don't know if there is a tactful way to broach the subject nor is it something to be taken lightly. Many have tried interventions - close friends and family members with the help of a professional drug counsellor surround the drinker and confront her with examples of her behaviour and its consequences. You can always simply let the person you're concerned for know, with love, that you have seen A, B, and C which leads you to believe there may be a problem and you are afraid for their health and their safety. Negative attacks are never going to work - they will only serve to make the drinker want to isolate further.

I have found that I need two different kinds of help in my life: I need unconditional understanding and support, but I also need to pay the consequences of my actions. Many loved ones make the mistake of getting the drinker out of trouble or rescuing her by paying her debts or letting her live at home no matter how outrageous her behaviour. It is vital that the problem drinker be made accountable - unfortunately, many of us will not quit until we are in so much pain that we are willing to try something different. If we are always saved from our pain we will never understand exactly how damaging our behaviour is. But we also need - at least I need - a group of people who have been where I've been and understand what it means to be an addict. They understand how my brain works, how I am my own worst critic, and how to teach me to live life one day at a time without drugs.

Though we as a fellowship try not to distinguish between drugs, alcohol does stand out as one of the only legal, readily available ones. Someone in the grip of addiction is already full of fear and self-loathing - some turn it inwards into depression and some turn it outwards into anger, but it usually all boils down to fear. I still find myself acting like a shrew against my will - I'll revert to being bitter and judgemental simply because I'm afraid I am 'less than', envious of someone's success, or feeling some other emotion I don't feel strong enough to express.

Try to remember that the drinker is in at least as much pain as she is causing others and that recovery cannot begin for her until she admits that it is necessary. The good news is that the higher power I've found only needed the tiniest little crack in my defensive armour to get through. I'm far from well but I am better than I used to be, and as long as I am clean and breathing there is hope.

Please Note: h2g2 is not a definitive medical resource. If you have any health concerns you must always seek advice from your local GP. You can also visit NHS Direct or BBC Health Conditions.