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Closet drinker definition


SAMHSA’s National Helpline | SAMHSA

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  • SAMHSA’s National Helpline is a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English and Spanish) for individuals and families facing mental and/or substance use disorders.

    Also visit the online treatment locator.

SAMHSA’s National Helpline, 1-800-662-HELP (4357) (also known as the Treatment Referral Routing Service), or TTY: 1-800-487-4889 is a confidential, free, 24-hour-a-day, 365-day-a-year, information service, in English and Spanish, for individuals and family members facing mental and/or substance use disorders. This service provides referrals to local treatment facilities, support groups, and community-based organizations.

Also visit the online treatment locator, or send your zip code via text message: 435748 (HELP4U) to find help near you. Read more about the HELP4U text messaging service.

The service is open 24/7, 365 days a year.

English and Spanish are available if you select the option to speak with a national representative. Currently, the 435748 (HELP4U) text messaging service is only available in English.

In 2020, the Helpline received 833,598 calls. This is a 27 percent increase from 2019, when the Helpline received a total of 656,953 calls for the year.

The referral service is free of charge. If you have no insurance or are underinsured, we will refer you to your state office, which is responsible for state-funded treatment programs. In addition, we can often refer you to facilities that charge on a sliding fee scale or accept Medicare or Medicaid. If you have health insurance, you are encouraged to contact your insurer for a list of participating health care providers and facilities.

The service is confidential. We will not ask you for any personal information. We may ask for your zip code or other pertinent geographic information in order to track calls being routed to other offices or to accurately identify the local resources appropriate to your needs.

No, we do not provide counseling. Trained information specialists answer calls, transfer callers to state services or other appropriate intake centers in their states, and connect them with local assistance and support.

  • Suggested Resources

    What Is Substance Abuse Treatment? A Booklet for Families
    Created for family members of people with alcohol abuse or drug abuse problems. Answers questions about substance abuse, its symptoms, different types of treatment, and recovery. Addresses concerns of children of parents with substance use/abuse problems.

    It's Not Your Fault (NACoA) (PDF | 12 KB)
    Assures teens with parents who abuse alcohol or drugs that, "It's not your fault!" and that they are not alone. Encourages teens to seek emotional support from other adults, school counselors, and youth support groups such as Alateen, and provides a resource list.

    After an Attempt: A Guide for Taking Care of Your Family Member After Treatment in the Emergency Department
    Aids family members in coping with the aftermath of a relative's suicide attempt. Describes the emergency department treatment process, lists questions to ask about follow-up treatment, and describes how to reduce risk and ensure safety at home.

    Family Therapy Can Help: For People in Recovery From Mental Illness or Addiction
    Explores the role of family therapy in recovery from mental illness or substance abuse. Explains how family therapy sessions are run and who conducts them, describes a typical session, and provides information on its effectiveness in recovery.

    For additional resources, please visit the SAMHSA Store.

Last Updated: 08/30/2022

Alcohol, Tobacco, and Other Drugs

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Misusing alcohol, tobacco, and other drugs can have both immediate and long-term health effects.

The misuse and abuse of alcohol, tobacco, illicit drugs, and prescription medications affect the health and well-being of millions of Americans. NSDUH estimates allow researchers, clinicians, policymakers, and the general public to better understand and improve the nation’s behavioral health. These reports and detailed tables present estimates from the 2021 National Survey on Drug Use and Health (NSDUH).

Alcohol

Data:

  • Among the 133.1 million current alcohol users aged 12 or older in 2021, 60.0 million people (or 45.1%) were past month binge drinkers. The percentage of people who were past month binge drinkers was highest among young adults aged 18 to 25 (29.2% or 9.8 million people), followed by adults aged 26 or older (22.4% or 49.3 million people), then by adolescents aged 12 to 17 (3.8% or 995,000 people). (2021 NSDUH)
  • Among people aged 12 to 20 in 2021, 15.1% (or 5.9 million people) were past month alcohol users. Estimates of binge alcohol use and heavy alcohol use in the past month among underage people were 8.3% (or 3.2 million people) and 1.6% (or 613,000 people), respectively. (2021 NSDUH)
  • In 2020, 50.0% of people aged 12 or older (or 138.5 million people) used alcohol in the past month (i.e., current alcohol users) (2020 NSDUH)
  • Among the 138.5 million people who were current alcohol users, 61.6 million people (or 44. 4%) were classified as binge drinkers and 17.7 million people (28.8% of current binge drinkers and 12.8% of current alcohol users) were classified as heavy drinkers (2020 NSDUH)
  • The percentage of people who were past month binge alcohol users was highest among young adults aged 18 to 25 (31.4%) compared with 22.9% of adults aged 26 or older and 4.1% of adolescents aged 12 to 17 (2020 NSDUH)
  • Excessive alcohol use can increase a person’s risk of stroke, liver cirrhosis, alcoholic hepatitis, cancer, and other serious health conditions
  • Excessive alcohol use can also lead to risk-taking behavior, including driving while impaired. The Centers for Disease Control and Prevention reports that 29 people in the United States die in motor vehicle crashes that involve an alcohol-impaired driver daily

Programs/Initiatives:

  • STOP Underage Drinking interagency portal - Interagency Coordinating Committee on the Prevention of Underage Drinking
  • Interagency Coordinating Committee on the Prevention of Underage Drinking
  • Talk. They Hear You.
  • Underage Drinking: Myths vs. Facts
  • Talking with your College-Bound Young Adult About Alcohol

Relevant links:

  • National Association of State Alcohol and Drug Abuse Directors
  • Department of Transportation Office of Drug & Alcohol Policy & Compliance
  • Alcohol Policy Information Systems Database (APIS)
  • National Institute on Alcohol Abuse and Alcoholism

Tobacco

Data:

  • In 2020, 20.7% of people aged 12 or older (or 57.3 million people) used nicotine products (i.e., used tobacco products or vaped nicotine) in the past month (2020 NSDUH)
  • Among past month users of nicotine products, nearly two thirds of adolescents aged 12 to 17 (63.1%) vaped nicotine but did not use tobacco products. In contrast, 88.9% of past month nicotine product users aged 26 or older used only tobacco products (2020 NSDUH)
  • Tobacco use is the leading cause of preventable death, often leading to lung cancer, respiratory disorders, heart disease, stroke, and other serious illnesses. The CDC reports that cigarette smoking causes more than 480,000 deaths each year in the United States
  • The CDC’s Office on Smoking and Health reports that more than 16 million Americans are living with a disease caused by smoking cigarettes

Electronic cigarette (e-cigarette) use data:

  • In 2021, 13.2 million people aged 12 or older (or 4.7%) used an e-cigarette or other vaping device to vape nicotine in the past month. The percentage of people who vaped nicotine was highest among young adults aged 18 to 25 (14.1% or 4.7 million people), followed by adolescents aged 12 to 17 (5.2% or 1.4 million people), then by adults aged 26 or older (3.2% or 7.1 million people).
  • Among people aged 12 to 20 in 2021, 11.0% (or 4.3 million people) used tobacco products or used an e-cigarette or other vaping device to vape nicotine in the past month. Among people in this age group, 8.1% (or 3.1 million people) vaped nicotine, 5.4% (or 2.1 million people) used tobacco products, and 3. 4% (or 1.3 million people) smoked cigarettes in the past month. (2021 NSDUH)
  • Data from the Centers for Disease Control and Prevention’s 2020 National Youth Tobacco Survey. Among both middle and high school students, current use of e-cigarettes declined from 2019 to 2020, reversing previous trends and returning current e-cigarette use to levels similar to those observed in 2018
  • E-cigarettes are not safe for youth, young adults, or pregnant women, especially because they contain nicotine and other chemicals

Resources:

  • Tips for Teens: Tobacco
  • Tips for Teens: E-cigarettes
  • Implementing Tobacco Cessation Programs in Substance Use Disorder Treatment Settings
  • Synar Amendment Program

Links:

  • Truth Initiative
  • FDA Center for Tobacco Products
  • CDC Office on Smoking and Health
  • National Institute on Drug Abuse: Tobacco, Nicotine, and E-Cigarettes
  • National Institute on Drug Abuse: E-Cigarettes

Opioids

Data:

  • Among people aged 12 or older in 2021, 3. 3% (or 9.2 million people) misused opioids (heroin or prescription pain relievers) in the past year. Among the 9.2 million people who misused opioids in the past year, 8.7 million people misused prescription pain relievers compared with 1.1 million people who used heroin. These numbers include 574,000 people who both misused prescription pain relievers and used heroin in the past year. (2021 NSDUH)
  • Among people aged 12 or older in 2020, 3.4% (or 9.5 million people) misused opioids in the past year. Among the 9.5 million people who misused opioids in the past year, 9.3 million people misused prescription pain relievers and 902,000 people used heroin (2020 NSDUH)
  • According to the Centers for Disease Control and Prevention’s Understanding the Epidemic, an average of 128 Americans die every day from an opioid overdose

Resources:

  • Medication-Assisted Treatment
  • Opioid Overdose Prevention Toolkit
  • TIP 63: Medications for Opioid Use Disorder
  • Use of Medication-Assisted Treatment for Opioid Use Disorder in Criminal Justice Settings
  • Opioid Use Disorder and Pregnancy
  • Clinical Guidance for Treating Pregnant and Parenting Women With Opioid Use Disorder and Their Infants
  • The Facts about Buprenorphine for Treatment of Opioid Addiction
  • Pregnancy Planning for Women Being Treated for Opioid Use Disorder
  • Tips for Teens: Opioids
  • Rural Opioid Technical Assistance Grants
  • Tribal Opioid Response Grants
  • Provider’s Clinical Support System - Medication Assisted Treatment Grant Program

Links:

  • National Institute on Drug Abuse: Opioids
  • National Institute on Drug Abuse: Heroin
  • HHS Prevent Opioid Abuse
  • Community Anti-Drug Coalitions of America
  • Addiction Technology Transfer Center (ATTC) Network
  • Prevention Technology Transfer Center (PTTC) Network

Marijuana

Data:

  • In 2021, marijuana was the most commonly used illicit drug, with 18. 7% of people aged 12 or older (or 52.5 million people) using it in the past year. The percentage was highest among young adults aged 18 to 25 (35.4% or 11.8 million people), followed by adults aged 26 or older (17.2% or 37.9 million people), then by adolescents aged 12 to 17 (10.5% or 2.7 million people).
  • The percentage of people who used marijuana in the past year was highest among young adults aged 18 to 25 (34.5%) compared with 16.3% of adults aged 26 or older and 10.1% of adolescents aged 12 to 17 (2020 NSDUH)
  • Marijuana can impair judgment and distort perception in the short term and can lead to memory impairment in the long term
  • Marijuana can have significant health effects on youth and pregnant women.

Resources:

  • Know the Risks of Marijuana
  • Marijuana and Pregnancy
  • Tips for Teens: Marijuana

Relevant links:

  • National Institute on Drug Abuse: Marijuana
  • Addiction Technology Transfer Centers on Marijuana
  • CDC Marijuana and Public Health

Emerging Trends in Substance Misuse:

  • Methamphetamine—In 2019, NSDUH data show that approximately 2 million people used methamphetamine in the past year. Approximately 1 million people had a methamphetamine use disorder, which was higher than the percentage in 2016, but similar to the percentages in 2015 and 2018. The National Institute on Drug Abuse Data shows that overdose death rates involving methamphetamine have quadrupled from 2011 to 2017. Frequent meth use is associated with mood disturbances, hallucinations, and paranoia.
  • Cocaine—In 2019, NSDUH data show an estimated 5.5 million people aged 12 or older were past users of cocaine, including about 778,000 users of crack. The CDC reports that overdose deaths involving have increased by one-third from 2016 to 2017. In the short term, cocaine use can result in increased blood pressure, restlessness, and irritability. In the long term, severe medical complications of cocaine use include heart attacks, seizures, and abdominal pain.
  • Kratom—In 2019, NSDUH data show that about 825,000 people had used Kratom in the past month. Kratom is a tropical plant that grows naturally in Southeast Asia with leaves that can have psychotropic effects by affecting opioid brain receptors. It is currently unregulated and has risk of abuse and dependence. The National Institute on Drug Abuse reports that health effects of Kratom can include nausea, itching, seizures, and hallucinations.

Resources:

  • Tips for Teens: Methamphetamine
  • Tips for Teens: Cocaine
  • National Institute on Drug Abuse

More SAMHSA publications on substance use prevention and treatment.

Last Updated: 01/05/2023

A drunkard and an alcoholic are not the same / Articles of specialists / Family clinic "Tanar"

accidentally. The fact is that in society there is a wrong idea about drunkenness. Alcohol abuse does not always mean that a person has alcoholism. But another thing is strange that people suffering from alcoholism hide behind a screen of drunkards.

Domestic drunkards do not suffer from illness, but simply lead such a lifestyle and at any moment are able to change drunkenness for a healthy lifestyle. An alcoholic, on the other hand, cannot independently change either his lifestyle or his addiction to alcohol, because his illness is deeply rooted in the genes, that is, it is hereditary. He needs specialized help. Like any other disease, alcoholism has its own cause, beginning, development and end of the disease.

In alcoholism, if a person does not stop drinking alcohol, memory loss or severe dementia occurs against the background of brain intoxication, which leads to disability if they live to see it and do not die from alcohol poisoning or other consequences of uncontrolled behavior.

When we talk about alcoholism as a disease, we must not forget that the culture of relations between people is at such a level that they are simply not ready to recognize alcoholism as a disease. And this recognition will not come soon. Therefore, first of all, patients with alcoholism do not go to a specialist for help, but hide in other medical institutions, removing binges. God forbid someone finds out. What a shame. After all, they do not care about their own attitude towards themselves. They care about other people's attitude towards them. It is in their eyes that they want to be good by deceiving themselves. Even if they turn to a specialist, it is only in order to remove alcohol poisoning, that is, hard drinking, in order not to let themselves die, and that's all. The basic core of psychological dependence remains. A person suffering from alcoholism is ashamed to admit it to other people, because he will be perceived as inferior. It is better to destroy yourself to the end, but let others think well of him. Even though these others don't care about you. These others also suffer from other chronic diseases and are honest about it. Many relatives of addicts already understand that this is a disease. They sincerely want to help their loved ones, but do not know how. After all, an alcoholic does not recognize himself as sick. And these are also signs of a disease associated with low criticism, as a psychological feature of addiction.

Recognizing the illness is the first step in treatment. The second stage of treatment is the relief of pathological craving for alcohol, which can be achieved with the help of coding, and the third stage is supportive psychotherapy aimed at stabilizing sobriety. Each person can change his life, make sobriety the norm for the well-being of himself and his family.

The family clinic "TANAR" provides treatment for alcohol addiction using the method of enhanced double coding, followed by psychotherapy not only for the addict, but also for his family members.

Flyura Mavzeeva, narcologist-psychotherapist of the highest category.

Lonely old age - NOT A COMPLY FOR DREAM - DW - 09/16/2012

Photo: Picture -alliance/DPA

Marlis Shaum, Alexander Varkentin September 16, 2012

glass of wine for mood , a shot of vodka for digestion, a bottle of beer for the coming sleep - something, but old people have plenty of time and reasons to drink. But does it make sense to treat alcoholics over 70?

https://p.dw.com/p/166vK

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Young people drink from dope, old people - from loneliness. Young swagger: here, they say, cool rest. Old people are ashamed of their weakness. Anna-Lisa is 76 years old. She hid for a long time and successfully that she could no longer live without pills and alcohol. Now she is undergoing therapy in a clinic in the city of Essen.

“The elderly are ashamed to admit to alcoholism, because for them it is associated with guilt, weakness of character or even sin,” Anna-Lisa admits.

We live longer - we drink longer

Alcohol consumption in old age is lower than in youth, and cases of drunkenness and alcoholism are less common. This is an empiricism, an external impression. There are no exact statistics. But the federal government, in its annual report on drug and alcohol addiction in the population, points to a simple correlation: an increase in life expectancy will also lead to an increase in the number of older people with alcohol dependence.

Approximately two-thirds of older alcoholics are just old drunks, psychotherapists say. Good food, good quality alcoholic beverages, and good medical care enable many drunkards to live to a ripe old age.

Most older alcoholics started out young Photo: picture alliance/dpa

There are also "dry" alcoholics, such as Anna-Liza, who have decided: life is lived, why now hold back, why protect health? "I knew that one glass was enough for a relapse. But why can't I live like other people at least in my old age?" she says.

Drunkenness from worthlessness, from loneliness

There are those who begin to drink only in old age. Here is a hospice in Marzan - a poor sleeping area in Berlin. Separate rooms with bathroom, telephone, old TV. Clean, tidy. Food can be ordered. True, they don’t cook it on the spot, but only warm up ready-made frozen dishes. And in the dining room - cognac, in the refrigerator - wine, beer. Patients buy alcohol themselves. Nobody forbids them to drink. But this is a hospice - incurable patients are waiting in the wings here.

Heidi Bolzen is the director of a regular nursing home in Essen. Of its guests, about one in ten became addicted to drugs or alcohol. How does the staff notice this? The guests withdraw into themselves, do not allow the nurses to clean up the cabinets and bedside tables. And on common holidays, they are diligently applied to the glass.

Alcohol is cheap in Germany. A bottle of unpretentious table wine is about 2 euros, but there are cheaper ones. Beer - anywhere from 50 cents a bottle. So there is enough for a drink and a small pension. And the most bashful do not drink, but are treated. For example, they buy an infusion of lemon balm, it is also known as "Carmelite water". It is believed to be both calming and aids in digestion. But this "vodichka" on alcohol - 79percent. So it turns out, mixed with cola or fanta, the Farewell Youth cocktail.

Does it make sense to treat old alcoholics?

Psychologist Arnulf Vosshagen is often asked: what is the point of treating a person who has not been working for a long time? What will society gain from this? He replies that every extra day lived is a joy. Unless, of course, he lives on a sober head, and not in a drunken stupor.

Dr. Fosshagen leads a special project for the treatment of senile alcoholism. He emphasizes that alcoholism is easily treated, but on condition that the patient himself wants it. And old people are especially ashamed to admit that they are sick.

Photo: Fotolia/Roman Sigaev

Heidi Bolzen also emphasizes that it is necessary to touch this topic with the elderly carefully. After all, many people drink from loneliness, from the feeling that no one needs them. It is no coincidence that among the elderly who ended up in nursing homes, there are more alcoholics than among those who still live at home, in the family.

Drunkenness - death by installments

But it needs to be treated. The old body needs more time to remove alcohol, because the metabolism is slower. Drinking old people become more forgetful, worse on their feet. The risk of injury increases.

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