The biological mechanisms underpinning alcoholism are uncertain, however, risk factors include social environment, stress, mental health, genetic predisposition, age, ethnic group, and sex. Long-term alcohol abuse produces physiological changes in the brain such as tolerance and physical dependence. Such brain chemistry changes maintain the alcoholic's compulsive inability to stop drinking and result in alcohol withdrawal syndrome upon discontinuation of alcohol consumption. Alcohol damages almost every organ in the body, including the brain; because of the cumulative toxic effects of chronic alcohol abuse, the alcoholic risks suffering a range of medical and psychiatric disorders. Alcoholism has profound social consequences for alcoholics and the people of their lives.
Alcoholism is the cyclic presence of tolerance, withdrawal, and excessive alcohol use; the drinker's inability to control such compulsive drinking, despite awareness of its harm to his or her health, indicates that the person might be an alcoholic. Questionnaire-based screening is a method of detecting harmful drinking patterns, including alcoholism. Alcohol detoxification is conducted to withdraw the alcoholic person from drinking alcohol, usually with cross-tolerance drugs, e.g. benzodiazepines to manage withdrawal symptoms. Post-medical care, such as group therapy, or self-help groups, usually is required to maintain alcoholic abstention. Often, alcoholics also are addicted to other drugs, most often benzodiazepines, which might require additional medical treatment. The alcoholic woman is more sensitive to alcohol's deleterious physical, cerebral, and mental effects, and increased social stigma, in relation to a man, for being an alcoholic. The World Health Organisation estimates that there are 140 million alcoholics worldwide. Moderate use is defined by The Dietary Guidelines for Americans as no more than two alcoholic beverages per day for men and no more than one alcoholic beverage per day for women.