"The overuse or abuse of alcohol or drugs is called substance abuse. It is common, costly and associated with many medical problems," says the Healthwise Handbook.
Though there are no reliable official figures of alcohol abusers, the high rate of drunken driving incidents speaks volumes.
The effects of alcohol abuse can be devastating, ranging from violence, poor performance, and reckless behaviour to trauma. But that's not to say people should not drink. "An occasional drink isn't a bad thing - do it responsibly," says Dr Richard Nethonomba, a medical scholar at Oxford University.
WHAT IT MEANS
 In SA foetal alcohol syndrome is high
No recognised addiction medication
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Head of psychiatry & mental health at the University of Cape Town Prof Dan Stein cites data from a recent study of alcoholism that points to a worrisome trend in SA. "We have the second-highest rate of alcohol dependence worldwide, after Ukraine. We also have the highest rate of foetal alcohol syndrome."
But who is an abuser? According to the handbook, if you "continue to drink even though alcohol is interfering with (your) health or daily living (you have a problem)". Alcoholism is defined as a physical or psychological dependence on alcohol.
Some studies suggest that alcoholism may be inherited genetically, says Nethonomba. "Peer pressure and a lack of awareness and information are an obvious problem area that should be attended to urgently," he says.
"Problems of alcoholism are multiple. They can be social, psychological and medical in that it weakens the heart and damages the liver. That can be fatal. Unless done moderately, drinking can also lead to progressive loss of memory," Nethonomba warns.
Unfortunately, says Stein, there is widespread "under-diagnosis and under-treatment", which compound the problem. Even worse, he says: "Addiction medicine has not yet been formally recognised as a medical sub-speciality in SA, and relatively few psychiatrists and psychologists focus on this area."
Elsewhere in the world, things don't look any better. "In rich countries, people are amenable to support structures and have access to good health care. In developing countries, things are different," says Nethonomba.
If you suspect that you or someone you know has a drinking problem, don't wait until it's too late. Contact Alcoholics Anonymous on 0861-4357-22 or the Narcotics Anonymous 24-hour help line on 083-900-69-62.
