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Alcohol use disorder (AUD), more commonly known as alcoholism, is a chronic relapsing brain disease. It develops with continued alcohol abuse or dependency on alcohol. 

Despite alcoholism’s physical and mental health consequences, alcoholics battle an impaired ability to stop or control alcohol intake. This is because alcoholics may struggle when they’re not drinking.

You may be at a higher risk of developing alcohol addiction if:

  • You have a history of alcoholism or substance abuse in your family
  • If you battle depression

If you’re wondering, am I an alcoholic, you’re not alone. An estimated 15 million people cope with alcoholism in the United States. But, to tell if you’re an alcoholic, it’s essential to understand the difference between binge drinking, alcohol abuse, and alcoholism.

NIAAA

Binge Drinking vs. Alcohol Abuse vs. Alcoholism

Binge drinking, alcohol abuse, and alcoholism are all considered alcohol use disorders (AUD). That said, binge drinking can lead to alcohol abuse, which can ultimately lead to alcoholism.

The NIAAA defines binge drinking as a drinking pattern that elevates one’s blood alcohol concentration (BAC) level to 0.08 g/dL. One’s BAC level differs depending on a gamut of factors—from food intake, weight, and medications (or lack thereof). But it typically reaches .08 g/dL after four drinks for women and five drinks for men in about two hours.

Someone who binge drinks now and then is not necessarily an alcohol abuser. Alcohol abusers continue to drink alcohol despite: 

  • Recurrent, alcohol-induced health problems
  • Social consequences
  • Occupational consequences
  • Legal consequences 

Nearly one-third of American adults are deemed excessive drinkers, but only 10 percent of them are considered alcoholics. 

CDC

People who abuse alcohol may have an easier time breaking their heavy drinking habits, while alcoholics will likely experience dependency-induced consequences.

Alcoholism is characterized by an addiction to alcohol. Alcoholics may suffer withdrawal while not drinking that can complicate their already-impaired ability to quit. This is because alcohol addiction causes a chemical change in one’s brain. This drives them to drink more and more often—first for pleasure, then to avoid withdrawal symptoms.

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Signs of Alcoholism (Alcohol Use Disorder)

The 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) lists 11 symptoms that can be used to determine whether someone has an AUD.

  1. You continue to consume more and more alcohol (larger amounts or over a longer period of time).
  2. You find it difficult to limit your excessive drinking.
  3. You spend a lot of time obtaining, drinking, or recovering from alcohol.
  4. You feel cravings or strong urges to drink.
  5. You find yourself letting your obligations and responsibilities like work, school, and relationships with friends and family members fall to the wayside.
  6. You continue to consume alcohol despite alcohol-induced social or interpersonal issues caused by alcohol.
  7. You stop or slow down attending important social, work, or recreational activities due to alcohol use.
  8. You continue to use alcohol in situations that can cause you physical harm.
  9. You continue to use alcohol despite knowing it is harming you physically, psychologically, or socially.
  10. You've developed a high tolerance for alcohol that requires you to drink more and more to achieve the same effect.
  11. You've experienced any alcohol withdrawal symptoms, such as nausea, irritability, or tremors (delirium tremens)

The DSM-5 states that when a person is diagnosed with alcohol use disorder, the severity of their condition depends on the number of symptoms they have:

  • 2 to 3 symptoms is considered mild
  • 4 to 5 symptoms is considered moderate
  • 6 or more symptoms is considered severe

Do I Have A Drinking Problem? Self-Assessment Questionnaire

If you’re asking yourself, am I an alcoholic, this self-assessment questionnaire may be helpful for you.

  1. Have I wanted to cut back on drinking or quit but cannot?
  2. Have I been drinking more or more often than I’d planned to drink?
  3. Do I keep drinking more and more to feel the effects of alcohol?
  4. Do I find that drinking interferes with aspects of my life, such as my job, family, or self-care?
  5. Do I spend a lot of time drinking alone?
  6. Do I spend a lot of time seeking out opportunities to drink or recovering from drinking, including blackouts?
  7. Am I experiencing alcohol-induced health complications?
  8. Do I continue to keep drinking despite health, social, financial, or legal issues?
  9. Do I have severe cravings for alcohol?
  10. Do I experience withdrawal symptoms when I’m not drinking alcohol, such as nausea, irritability, or tremors?

Symptoms of Alcohol Withdrawal

Alcohol addiction changes the way your mind and body works. A physical dependence causes you to experience withdrawal when you stop drinking.

Mild and moderate symptoms of alcohol withdrawal typically show up six to eight hours after your last drink. However, they may spike around 24 to 72 hours after your last drink.

They include:

  • Anxiety and nervousness
  • Irritability
  • Depression
  • Nausea and/or vomiting
  • Extreme fatigue
  • Difficulty sleeping
  • Shakiness
  • Inability to think clearly
  • Nightmares
  • Sweating
  • Headache
  • Rapid heart rate
  • Tremors

Types of Alcoholics

Scientists published a study by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), part of the National Institutes of Health (NIH) that divides alcoholics into five different subtypes:

Young Adult Alcoholics

  • 32 percent of all alcoholics fall in this category (this is mostly due to the high levels of binge drinking in college)
  • The average age in this group is 24 years old
  • Less than 22 percent have a family history of alcoholism
  • Low incidence of mental health disorders
  • Only 9 percent seek help for alcohol (most often from 12-step groups)

Young Antisocial Alcoholics

  • 21 percent of alcoholics
  • Average age of 26
  • Characterized by an antisocial personality disorder
  • 37 percent suffer from major depression, 14 percent from social phobias, 33 percent from bipolar disorder, and 19 percent from obsessive-compulsive disorder.
  • On average, this group drinks 201 days a year and usually consume five or more drinks at a time
  • About 53 percent have multiple generations of alcohol dependency,
  • High occurrence of smoking and drug abuse. 66 percent abuse cannabis, 8 percent abuse amphetamines, 29 percent have a high probability for cocaine abuse and 22 percent abuse opioids.
  • Approximately one-third percent of young antisocial alcoholics seek treatment for their alcohol dependence. The main treatment choices are self-help groups, specialty treatment programs, detox programs, and private health care providers.

Intermediate Familial Alcoholics

  • 19 percent of all alcoholics
  • Average age of 38 years old
  • Genetics is a big factor in this subtype
  • Drinking usually begins around age 17
  • 47 percent have a family member with an alcohol dependency
  • 47 percent suffer from major depression, 22 percent from bipolar disorder, 19 percent from obsessive-compulsive disorder, and 15 percent from a generalized anxiety disorder
  • 27 percent seek help for their drinking, usually via self-help groups, specialty treatment programs, detox programs, and private healthcare providers

Functional Alcoholics

  • 19.4 percent of all alcoholics
  • Functional alcoholics can balance their drinking with their personal and professional life
  • Many people do not expend functional alcoholics to have a problem
  • People in this subtype tend to be in their early 40s
  • On average, this group drinks every other day, averaging 181 days a year. 
  • Almost 50 percent are married, 62 percent work full-time, and 26 percent have a college degree or higher
  • 31 percent have a family member with alcohol dependence
  • 24 percent have major depression
  • 17 percent in this group seek help for their drinking. 12-step programs or private health care professionals are the top treatment choices.

Chronic Severe Alcoholics

  • 9 percent of alcoholics
  • Most at-risk group of alcoholics
  • Heavy drinking is a near-daily recurrence, averaging 247 days out of the year
  • 77 percent have a family member with alcohol dependency
  • Higher probabilities for other substance abuse, including cigarettes, cannabis, cocaine, and opioids
  • Lowest education levels and rate of employment of any other subtype
  • 66 percent seek treatment and have the highest attendance in self-help groups, specialty treatment programs, detox programs, and inpatient programs

Are the Effects of Alcoholism Reversible?

Alcoholism is a condition that affects both children and adults. However, it does not affect everyone the same way. For some, just one drink can lead to intoxication, while for others, more drinks are required to create the same effect.

Regarding the effects of alcohol on the body and brain, excessive alcohol consumption can heighten the risk of many health issues for any user. Despite the harm linked with alcohol consumption, the effects are reversible in most cases.

Identifying and understanding problematic drinking early and receiving treatment can reverse many of the mental, emotional, and physical side effects of drinking. However, at a certain point, the damage from heavy alcohol use may be too severe. For example, liver failure and cirrhosis are permanent complications of excessive alcohol use.

Permanent health damage should not stop a person from seeking treatment as it can still significantly improve an individual’s quality of life.

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Treatment & Support Groups for Alcoholism

There are different addiction treatment options for those facing alcohol problems. These include support groups, therapies, medical treatments, and more typically used in conjunction with detox and withdrawal. Here are some options to get you started.

Alcoholics Anonymous (AA)

There are various support groups for alcoholics, but Alcoholics Anonymous (AA) is arguably the most well-known option. It’s a global, community-driven program that involves regular accountability meetings and group discussions surrounding addiction. It’s “nonprofessional, self-supporting, multiracial, apolitical, and available almost everywhere.”

Alcoholics Anonymous also uses a 12-step approach to overcoming an addiction to alcohol, which members can revisit at any time. These steps include admitting to addiction, making conscious choices to change, and using prayer and meditation to overcome the addiction.

Addiction Rehab Options

There are inpatient and outpatient treatment programs for those interested in enrolling at a treatment facility. Treatment centers can help you to develop new coping skills, get medical support from trusted healthcare professionals, and hold yourself accountable. Inpatient care is ideal for anyone with a severe addiction to alcohol and a need for constant supervision during the withdrawal journey and recovery phase.

Outpatient care, on the other hand, may be appropriate for someone with a less severe addiction to alcohol but who still needs professional help.

Counseling

Counseling through traditional therapy can help you discover any mental or emotional baggage that can trigger your alcohol addiction. Identifying the causes of your alcohol addiction  can help you  overcome your addiction in a healthy way.

Medication-Assisted Treatment

Medication for alcoholism is usually used in combination with other methods of treatment. Medication might include Naltrexone that can help to reduce alcohol cravings. Acamprosate can also help to repair the brain. And Disulfiram can trigger a negative physical reaction to alcohol to help prevent you from drinking it.

Since alcohol can take a toll on your health with abuse and addiction, quitting isn’t easy to do on your own. Seek professional medical advice from a treatment provider today.

Resources

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“Alcohol Questions and Answers.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 15 Jan. 2020

“Alcohol Use Disorder (AUD).” MedlinePlus, U.S. National Library of Medicine, 29 Apr. 2020

“Alcohol Use Disorder.” National Institute on Alcohol Abuse and Alcoholism, U.S. Department of Health and Human Services, 4 June 2020

“Alcohol Use Disorder: A Comparison Between DSM–IV and DSM–5.” National Institute on Alcohol Abuse and Alcoholism, U.S. Department of Health and Human Services, 13 Mar. 2020

“Drinking Levels Defined.” National Institute on Alcohol Abuse and Alcoholism, U.S. Department of Health and Human Services, 26 June 2020

“Drinking Too Much Alcohol Can Harm Your Health. Learn the Facts.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 30 Dec. 2019

“Family History of Alcoholism: Are You at Risk?” Department of Mental Health

“Preventing Chronic Disease.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention

Publishing, Harvard Health. “Alcohol Abuse.” Harvard Health

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