reduced white blood cell mobilization as great as that in people suffering from severe shock. Heavy drinking over many years may result in serious mental disorders or permanent, irreversible damage to the brain or peripheral nervous system. It can severely diminish mental functions, such as memory, judgment, and learning ability, as well as a person’s personality structure and grasp on reality. PROBLEM DRINKING AND ALCOHOLISM A nationwide survey of American drinking practices showed that more than two-thirds of the adult population drink alcoholic beverages at least occasionally. Adding the number of younger drinkers to that population gives a total of about 100 million people who drink. The overwhelming majority of those who drink do so responsibly. But what of the others, far too many, whose drinking gets out of hand and endangers others and themselves? Distinctions are sometimes made between people with drinking problems and those suffering from alcoholism-alcoholic persons being considered the more  uncontrollable  group.  However,  since distinguishing between the two is difficult, we seldom use hard-and-fast labels. Society usually labels persons as problem drinkers when they drink to such an excess that they lose the ability to control their actions and maintain a socially acceptable lifestyle. One authority describes problem drinkers as follows: 1. 2. 3. 4. 5. 6. Anyone who must drink to function or cope with life Persons who, by their own personal definition or that of their family and friends, frequently drink to a state of intoxication Anyone who goes to work intoxicated Anyone who drives a car while intoxicated Anyone who sustains bodily injury requiring medical attention as a consequence of an intoxicated state Persons who, under the influence of alcohol, do something they contend they would never do without alcohol Other warning signs also indicate problem drinking. They include a person’s need (to drink before facing certain situations, frequent drinking sprees, a steady increase in intake, solitary drinking, and early morning drinking. Some heavy drinkers experience blackouts. During a blackout, drinkers do not pass out (or become unconscious) but are able to walk, talk, and perform other actions. However, afterwards they have no memory of that period. Such blackouts may be one of the early signs of the more serious form of alcoholism. At present no definition of alcoholism satisfies all; however, the following one is widely accepted: Alcoholism is a chronic disease, or disorder of behavior, characterized by the repeated drinking of alcoholic beverages to an extent that exceeds compliance with the social drinking customs of the community and which interferes with the drinker’s health, interpersonal relations, or economic functioning. OPNAVINST 5350.4B defines alcoholism as “a disease characterized by psychological and/or physical/physiological dependence on alcohol.” That instruction defines alcohol abuse as “the use of alcohol to an extent that it has an adverse effect on the user’s health or behavior, family, community, or the Navy, or leads to unacceptable behavior as evidenced by one or more alcohol-induced incidents.” Whichever definition you agree with, you will find that all alcoholics have one trait in common: they are alcohol  dependent. Diagnosing Alcoholism Those who could refer people for help with alcohol problems often don’t recognize the symptoms until the illness is in its advanced stages. By that time the disease may have advanced to the point that victims are unable to control their drinking. They may no longer have an established family life or may be unable to hold a job. In addition, the alcohol may have caused malnutrition or organic damage. Unfortunately, no simple diagnostic procedure exists for detecting alcoholism. Some of the factors involved in diagnosing an alcoholic person include the following: 1. The quantity of alcohol consumed. However, quantity alone is an insufficient measure. 2. The rate of consumption. One pint of distilled spirits consumed during a 10-hour period causes different behavior than that caused by a pint consumed in 1 hour. Drunkenness depends on the rate of consumption as well as the quantity consumed. 3-18