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What is Alcohol Addiction (Alcohol Use Disorder)?

Alcohol use disorder (AUD), previously called alcohol addiction, occurs when a person excessively drinks on a regular basis. They are unable to control their alcohol use.

Someone with an AUD also experiences physical alcohol dependence. Severe withdrawal symptoms will develop if they suddenly stop drinking.

In some cases, small daily amounts of alcohol offer health benefits. Drinking one glass of red wine each night delivers antioxidants that can help reduce your risk of heart disease. It may also lower bad cholesterol.

When alcohol consumption exceeds moderate amounts and begins to take over your life, it no longer offers these health benefits. Over time, excessive alcohol consumption often leads to an alcohol use disorder (alcohol addiction).

60 percent of all Americans over the age of 18 report drinking within the past month. Of these, 8 percent suffer from alcohol addiction.

The National Institute on Alcohol Abuse and Alcoholism report from 2017

Moderate Alcohol Consumption vs. Alcohol Addiction

The U.S. Department of Health and Human Services defines moderate drinking as one drink per day for women and two drinks per day for men.

Regular alcohol consumption does not increase your risk of alcohol addiction.

Signs of alcohol addiction can include:

  • Binge drinking, which is defined as five or more drinks for males and 4 or more drinks for females.
  • Becoming preoccupied with alcohol and looking for your next drink. For example, instead of coffee, your day starts with a morning drink.
  • Continuing to drink, even when it causes physical, emotional, or social problems.
  • Developing an alcohol tolerance and requiring more to achieve the desired effects.
  • Experiencing alcohol withdrawal symptoms when alcohol is not available. When heavy drinkers reduce or stop drinking alcohol, they will develop alcohol withdrawal syndrome.
  • Denying you have a problem with substance abuse, even if it interferes with your daily life. This is also common among other substance use disorders (SUD).
  • Drinking alcohol interferes with your regular daily activities and obligations. This may include missing work or canceling social obligations due to drinking.

Not all those who have an alcohol use disorder (AUD) notice an impact on their lives. Functional alcoholics can hide and keep their alcohol use from affecting their daily lives. Unfortunately, this type of alcohol use continues until it causes severe health problems.

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Common Symptoms of Alcoholism

Alcohol addiction, or alcohol use disorder (AUD), can be mild, moderate, or severe. It depends on the number of symptoms you suffer from. These symptoms can include any of the following:

  • Inability to limit the amount of alcohol you drink
  • Inability to cut down how much you drink
  • Spending more time drinking or recovering from drinking
  • Experiencing regular cravings for alcohol
  • Building an alcohol tolerance
  • Drinking in unsafe situations, such as drinking and driving
  • Continuing to drink despite medical problems
  • Allowing alcohol to affect personal and professional relationships
  • Losing interest in hobbies or activities you used to enjoy
  • Suffering from withdrawal symptoms when you are unable to drink. These can include nausea, sweating, and “the shakes"

Who Is At Risk of Alcohol Addiction?

Alcohol addiction can run in families. Research shows that different genes affect how your body and alcohol work together. 

For example, some people of Asian descent carry a specific gene that affects how their body metabolizes alcohol. They experience a rapid heartbeat, flushing, and nausea when they drink, leading many to avoid alcohol. In this case, the gene reduces their risk of alcohol addiction. Other genes increase the risk of alcohol addiction.

The National Institute on Alcohol Abuse and Alcoholism reports that genes account for up to 50 percent of a person’s risk of alcohol addiction.

The National Institute on Alcohol Abuse and Alcoholism

There are different factors that can contribute to a person’s risk for alcohol addiction, and they can include the following:

  • Early drinking – People who begin drinking at a younger age are at a higher risk of developing alcohol addiction. This is especially true in those that participate in regular binge drinking.
  • Mental health disorders – Those with mental health disorders, such as anxiety, bipolar disorder, and depression have an increased risk of developing an addiction. In many cases, people turn to alcohol to combat mental health symptoms. They do so because the medications do not work or cause adverse side effects.
  • High stress – Professionals in high-stress positions (or those with severe financial, social, or relationship stress) often turn to alcohol to cope. Over time, this can increase your risk of alcohol addiction, especially if you struggle with alternative coping methods.
  • Social pressure – Pressure from friends, co-workers, and significant others can contribute to problem drinking and can also increase your risk of developing an alcohol use disorder (AUD).

Why Do People Drink Alcohol?

There are a few reasons why people drink alcohol. Whether they do so in moderation or excessively, drinking always comes with risks.

The most common reasons why people drink include:

  1. To cope with mental health issues, such as depression and anxiety
  2. To relieve stress caused by work, relationships, or daily responsibilities
  3. Social and peer pressure, such as in college
  4. Pressure from the media (because alcohol use is seen as "normal")
  5. Family history of alcohol use or alcoholism

What Are Functioning Alcoholics?

A functioning alcoholic is someone who is addicted to alcohol but can still function in society. These people are also known as high-functioning alcoholics or functional alcoholics.

It is often difficult to tell if someone is an alcoholic if they are “currently-functioning” in society. However, their alcohol problem will become obvious to others around them over time. 

This form of drinking is one of the five subtypes of alcoholism. Common risk factors associated with functional alcoholism include:

  • Someone who is middle-aged (around 41 years old)
  • Someone who has healthy relationships
  • Someone who has a steady job
  • Someone who has a family history of alcoholism

Health Complications Associated with Alcohol Addiction

In addition to affecting various aspects of your life, alcohol addiction can contribute to severe health complications.

Excessive amounts of alcohol destroy the body and, for functional alcoholics, this damage to the body is often the first sign of alcohol problems.

Some health complications associated with alcohol addiction can include:

Liver disease

One health complication associated with alcohol addiction is liver disease. Excessive amounts of alcohol can contribute to hepatic steatosis, or fatty liver disease (increased fat in the liver). 

In addition, alcoholic hepatitis (inflammation of the liver), and, in severe cases, cirrhosis (destruction of the liver) may occur.

Symptoms of liver complications can include:

  • Jaundice (yellowish skin)
  • Abdominal pain
  • Discolored stool
  • Chronic fatigue
  • Nausea
  • Itchy skin
  • Weakness

Digestive Issues

Heavy drinking can also affect the digestive system, causing inflammation of the stomach lining. It may also contribute to ulcers in the stomach and esophagus.

Common symptoms of digestive issues include:

  • Acid reflux
  • Heartburn
  • Abdominal pain
  • Nausea
  • Weight loss
  • Loss of appetite

Loss of Vitamins and Nutrients

Your body needs a balance of carbohydrates, proteins, and fats to function properly. In many cases, people with an alcohol use disorder (AUD) can consume as much as half of their daily calories from alcohol. 

Even when sufficient calories are ingested, alcohol impairs the body’s ability to regulate blood sugar. It also makes it difficult to absorb certain vitamins and minerals, including vitamin A, B, C, D, E, and K, as well as calcium, magnesium, iron, and zinc.

These deficiencies can lead to many health issues. For example, the inability to regulate blood sugar can cause diabetes or diabetic complications.

Heart Disease

Alcohol addiction increases the risk of atrial fibrillation, heart attack, and congestive heart failure.

Alcohol abuse contributes to a twofold increased risk of atrial fibrillation, a 2.3-fold increase in congestive heart failure, and a 1.4-fold increase in heart attack risk.

Cancer

Alcohol consumption is considered a human carcinogen and is linked to certain forms of cancer. These include:

  • Head and neck cancer
  • Esophageal squamous cell carcinoma
  • Liver cancer
  • Breast cancer
  • Colorectal cancer

Treatment Options for Alcohol Addiction

There are many treatment options available for those struggling with alcoholism. The most common ones include:

Inpatient Treatment

These programs are also referred to as medical detoxification. Inpatient treatment is available on a short- or long-term basis. Patients stay at a professional facility throughout treatment.

Outpatient Treatment

Outpatient programs are flexible treatment options for alcoholism. They are typically best for those with less severe forms of alcoholism. Patients do not live at the facility. They go home at the end of the day and return for routine treatments.

Find Help For Your Addiction

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Resources

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“Alcohol Abuse Increases Risk of Heart Conditions as Much as Other Risk Factors.” American College of Cardiology, 3 Jan. 2017, https://www.acc.org/about-acc/press-releases/2017/01/03/15/27/alcohol-abuse-increases-risk-of-heart-conditions-as-much-as-other-risk-factors.

“Alcohol Questions and Answers.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 15 Jan. 2020, www.cdc.gov/alcohol/faqs.htm#:

“Alcohol and Cancer Risk Fact Sheet.” National Cancer Institute, https://www.cancer.gov/about-cancer/causes-prevention/risk/alcohol/alcohol-fact-sheet

“Alcohol and Nutrition - Alcohol Alert No. 22- 1993.” National Institute on Alcohol Abuse and Alcoholism, U.S. Department of Health and Human Services, https://pubs.niaaa.nih.gov/publications/aa22.htm.

“Alcohol and the Liver - How Alcohol Damages the Liver - Addiction Center.” AddictionCenter, https://www.addictioncenter.com/alcohol/liver/.

“Alcohol Facts and Statistics.” National Institute on Alcohol Abuse and Alcoholism, U.S. Department of Health and Human Services, 6 Dec. 2019, https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/alcohol-facts-and-statistics.

“Drinking Levels Defined.” National Institute on Alcohol Abuse and Alcoholism, U.S. Department of Health and Human Services, 26 Nov. 2019, https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/moderate-binge-drinking.

“Genetics of Alcohol Use Disorder.” National Institute on Alcohol Abuse and Alcoholism, U.S. Department of Health and Human Services, 21 Sept. 2018, https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-use-disorders/genetics-alcohol-use-disorders.

“The Truth about Red Wine and Heart Health.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 22 Oct. 2019, https://www.mayoclinic.org/diseases-conditions/heart-disease/in-depth/red-wine/art-20048281.

“Researchers Identify Alcoholism Subtypes.” National Institutes of Health, U.S. Department of Health and Human Services, 29 Sept. 2015, www.nih.gov/news-events/news-releases/researchers-identify-alcoholism-subtypes.

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