Alcohol related problems are seen in all classes of people. Data strongly indicates a genetic linkage in chronic alcohol consumption. A hereditary defect in the dopamine (D2) receptor gene may contribute to impaired reward mechanism in the brain, which make the individual crave for alcohol. At a psychodynamic level, alcohol consumption is understood as a way of dealing with unconscious conflicts, anxiety, stress, and psychic pain.

Today societal consumption of alcohol is accepted and is a commonality in most countries. Communal and cultural factors play a significant role in promoting use, abuse as well as dependence in vulnerable individuals. Publicity is rampant about the many cardiovascular beneficial effects of alcohol and its ability to lower the risk of cardiac illness; however all these suggestions are controversial; dependence is certainly is not a recommendation..

Prolonged use of alcohol alters neurotransmitters, rendering the human brain dependent. If alcohol consumption is stopped, the nervous system demands it; and this is experienced as restlessness, anxiety, tremors, panic, irritability, anger, frustration, insomnia, nightmares and frequently altered perceptions like illusions and hallucinations. Alcohol decreases one’s confidence and self-esteem. Consumption stops these symptoms; but only for a short while. People continue to drink even after making up their mind to quit (to prevent these effects). The person becomes a slave to the drink and all activities revolve around its procurement.

Ordinarily every alcohol consuming individual does not develop dependence. Protracted alcohol use for its inebriating effect, accelerating the quantity of consumption owing to the diminished impact with the same amount; and experience of negative effects in its absence, characterizes dependence. There is resultant preoccupation with alcohol, thoughts about its procurement, hiding from loved ones who prevent the person from drinking; and frequently medical, social or legal consequences owing to alcohol use.

Alcohol dependence has subtypes based on the pattern of consumption. Some people drink due to loneliness, while others do so for company; some to release stress while many to curb aggression. Binge drinking explains impulsivity while continual daily drinking reveals severe physical dependence. A problem with a mix of biological, psychological and social etiology deserves a similar management strategy. We offer medical and psychological management for alcohol dependence and see at the problem holistically to find appropriate and long-lasting solutions for the problematic drinker and coping strategies for the family. Alcohol dependence is an illness. People with diabetes, cancer and cardiac conditions do get sympathy and understanding from their loved ones; sadly this is not the case with alcohol. Here the best person who can help oneself is oneself. It makes sense to do it sooner than later.