My family member sent me this letter: “Nina: I probably embarrassed you on my last visit as I was skunk drunk and did not know how to apologize or reconnect; however, today, I am proud to say that some of my bottoms led me to forgo my denials and seek help — I am sober today because of my family and friends who stuck with me.” I share this because alcoholism has touched my family.

Although the majority of us can drink responsibly, today it is estimated that nearly 18 million Americans (approximately 15 percent of the adult population) are “problem drinkers.” More shockingly, approximately 30 percent of Americans will experience a problem with drinking during their lifetime. If those numbers don’t make us stop in our tracks, then these will: Alcohol is involved in 50 percent of homicides, 30 percent of motor vehicle deaths and 50 percent of drownings. For those suffering from addiction, alcohol abuse has a devastating impact on an individual’s well-being as well as on their family, friends, career and community.

Dr. Nina’s What You Need to Know About Alcoholism

What is alcohol? Much has been researched and written on alcohol. The best definition I have found is that it is a regulated, legal, sedative drug which changes the way we think and feel. Although most people drink to relax or “loosen up,” having too much can impair vital functions — garbled speech, unsteady movement, disturbed perceptions and impairing the ability to react quickly and wisely.

What is alcoholism? It is when our body becomes physically dependent on alcohol, meaning we experience withdrawals, obsession, and are unable to control how much we drink. It is a behavior where alcohol comes before our physical health and can create problems in our personal life and work.

What causes alcoholism? Recent research has implicated a gene that may increase a person’s chances of developing alcoholism. However, social factors such as the influence of family and peers and other psychological factors, including elevated levels of stress and inadequate coping mechanisms have also been shown to contribute.

Is alcoholism a disease? There is debate as to whether or not it is a disease or a behavioral choice. Regardless, if alcoholism is not diagnosed and treated, it becomes progressive, chronic, and can kill.

What are signs and symptoms of alcoholism? Unlike Lyme disease ,where a patient presents with a red, expanding rash that is accompanied by fatigue, fever, chills, headache, muscle and joint aches, and positive blood testing, it’s not so simple with alcoholism. There are no specific tests and the diagnosis is focused on behaviors and adverse effects on functioning.

A diagnosis of alcoholism is likely when we experience tolerance to its effects (needing more to become intoxicated); withdrawal symptoms (tremors, insomnia, anxiety) when we cut down or stop drinking; drinking more than we intended; having an ongoing desire to cut back on drinking or making unsuccessful attempts to do so; spending a good deal of time drinking, attaining, or recovering from alcohol; or abandoning important activities so we can drink.

Does alcoholism affect physical health? In addition to mental health problems such as depression, anxiety and increased risk of suicide, excessive drinking can ravage our body from head to toe. It can affect our brain with dementia and stroke, as well as cause nerve damage. Alcoholism can also cause significant heart problems such as abnormal rhythms, hypertension and heart attacks. Our liver can experience inflammation and over time develop scarring, known as cirrhosis, which prevents normal functioning. Alcoholism can also contribute to stomach problems, pancreatitis, and cancer of the mouth, breast and colon. In addition, it affects the health and well-being of those around the alcoholic.

If you are an alcoholic, seek or maintain the appropriate treatment options: Talk to your doctor; go to a support group like Alcoholics Anonymous; ask for help from your family and friends. If we know someone struggling with alcoholism, seek help. We too suffer. Educating ourselves on how to set limits and boundaries is one of the most important things we can do. I speak from experience when I say that alcoholism is not a spectator sport, the whole family has to play. Within two months of writing that letter, my family member passed away during a relapse.