It is often assumed that problem drinking is only a problem for the drinker. This may be linked with the idea that all problem drinkers are "alcoholics" or heavy-end dependent drinkers who live on the streets and are isolated from normal social contacts. Both of these stereotypes are very far from the truth. The vast majority of problem drinkers are in employment. They may be dependent drinkers or binge drinkers or people who just drink too much on a regular basis. Similarly the great majority of problem drinkers live in families and those families are greatly affected by the consequences of the drinking. It is estimated that for each problem drinker in this country, three or four other people are directly affected and many more suffer indirect harm. Nor should the scale of the problems families suffer be underestimated. Those problems are all-pervasive; they affect the functioning of family systems, relationships and routines; they damage the quality of individual life experience and the life opportunities of those who suffer them during their formative childhood years.
             People drink because alcohol affects a specific reinforcement system in the brain. There are alcohol abusers and there are alcoholics. Alcohol abuse is problem drinking which may result in health or social problems, or both. Chronic exposure to alcohol can result in the development of tolerance for and physical dependence on alcohol. Tolerance develops as a result of changes in alcohol's effect on the brain as well as an increased capacity of the body to reduce alcohol levels via metabolism. Alcohol dependence is alcoholism. While alcohol abusers may experience the same effects from excessive drinking as do alcoholics, alcoholics are distinguished by their physical dependence on alcohol and their impaired ability to control alcohol intake (U.S. Department of HHS, 1993). Physiological dependence is manifested by the development of with
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