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What Constitutes a Drinking Problem?

While many people can enjoy alcohol responsibly, some develop an unhealthy alcohol consumption pattern, aka a drinking problem.

An unhealthy relationship with alcohol consumption can lead to alcoholism and other severe health conditions. It is essential to recognize a drinking problem early to prevent negative consequences.

Signs Someone Has a Drinking Problem

Many people are scared to admit they have a drinking problem. Others do not even realize their drinking habits affect their lives negatively.

This table shows the symptoms of Alcohol Use Disorder according to the Diagnostic and Statistical Manual of Mental Disorders (DSM–5).

These are the questions that a doctor may ask to determine if you have an Alcohol Use Disorder.

In the past 12 months, have you:

  • wound up drinking more alcohol, or for longer than you planned?
  • wanted or tried to reduce or quit drinking but were unable to?
  • spent a lot of time drinking or recovering from drinking?
  • wanted to drink so badly you couldn't think about anything else?
  • realized that drinking or being hungover has caused problems for you while taking care of your home or family, at work, or school?
  • kept drinking even though it caused problems with your friends or family?
  • chose to drink over other hobbies or events that were important or interesting to you?
  • gotten into multiple situations that increased your chances of getting hurt while or after drinking. (driving, walking in dangerous areas, having unsafe sex, using machinery, swimming etc.)
  • continued to drinking even though it made you feel depressed or anxious? Or if it made another health problem worse? Or after you blacked out?
  • gained an alcohol tolerance? (need to drink more to feel the same effect)
  • felt alcohol withdrawal symptoms? (restlessness, trouble sleeping, shakiness, nausea, sweating, racing heart, seizures, and sensing things that are not there)

If at least two of these symptoms are present, you may be diagnosed with an Alcohol Use Disorder (AUD).

The severity of the AUD is defined as:

  • Mild: two to three symptoms are present
  • Moderate: four to five symptoms are present
  • Severe: six or more symptoms are present
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Drinking Problem vs. Alcoholism 

Problem Drinking Definition:

The Centers for Disease Control and Prevention (CDC) defines a drinking problem as any chronic alcohol consumption over what is considered a safe amount. The Centers for Disease Control (CDC) recommends that Americans don’t consume more than one standard drink daily (for women) and two standard drinks daily (for men).

Drinking problems include binge drinking, heavy drinking, and drinking by pregnant women or people younger than 21.

A problem drinker is not dependent on alcohol and can go days, weeks, or months without drinking if they want to. They may consume a lot, or they may drink occasionally. If they abstain, they will not have withdrawal symptoms.

But when problem drinkers do drink, it causes an issue in their life or in the life of someone they know. 

Problem drinking that becomes severe is diagnosed as Alcohol Use Disorder (AUD) or alcoholism. The National Institute on Alcohol Abuse and Alcoholism defines alcoholism as a brain disorder characterized by an impaired ability to control or stop alcohol use despite social, occupational, or health consequences. 

Individuals with alcoholism have an addiction that includes both physical and mental alcohol dependence. Unlike problem drinkers, alcoholics experience withdrawal symptoms when they try to cut back on alcohol.

The typical warning signs that someone may have a drinking problem include:

  • Missing class, work, or other responsibilities
  • Depression or anxiety
  • Experiencing memory loss or ‘blackouts’
  • Increased anger or violence while drinking
  • Difficulty reducing their alcohol intake
  • An increased tolerance or needing to drink more to feel the effects of alcohol
  • Spending more time drinking
  • Engaging in risky behavior while intoxicated

Is a Binge Drinker the Same as an Alcoholic? 

Binge drinking is the most common, costly, and deadly drinking problem in the United States. Binge drinking is a drinking pattern that brings a person’s blood alcohol concentration (BAC) to 0.08 g/dl or above.

For men, the CDC defines binge drinking as drinking five or more standard drinks in two hours. For women, binge drinking for women is defined as consuming four or more standard drinks in about 2 hours. 

Many heavy drinkers or binge drinkers are not physically or mentally dependent on alcohol. This typically means that they do not have a severe alcohol use disorder. However, they may well have a mild or moderate AUD.

One in six U.S. adults binges on alcohol four times monthly, consuming about seven drinks per occasion. Binge drinking in the United States results in 17 billion total binge drinks consumed by adults annually, or 467 drinks per drinker.

While young adults are more likely to engage in binge drinking, those aged 35 and older tend to consume more alcohol per binge drinking session. Binge drinking is twice as likely among men than among women.

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Risks of Heavy Alcohol Consumption

Heavy alcohol consumption is associated with many negative consequences, including:

  • Cancer of the breast, esophagus, mouth, liver, and colon
  • Chronic diseases, such as heart disease and liver disease
  • Memory and learning problems
  • Unintentional injuries
  • Violence
  • Sexually transmitted infections and unintended pregnancy
  • Poor pregnancy outcomes, including miscarriage and stillbirth
  • Fetal alcohol spectrum disorders
  • Sudden infant death syndrome (SIDS)
  • Increased symptoms of mental health issues like anxiety and depression
  • Alcohol or other substance use disorders

Excessive alcohol use is hazardous and has led to approximately 95,000 deaths each year in the United States. Today, excessive drinking is responsible for 1 in 10 deaths among adults.

Are the Effects of Alcoholism Reversible?

Alcoholism is a condition that can affect both adults and children. However, it does not affect everyone the same way.

For some people, a single drink can lead to intoxication. For others, many more drinks are required to create the same effect. When it comes to the impact on the body and brain, heavy alcohol consumption can increase the risk of many health issues.

Despite the harm linked with alcohol consumption, the effects are reversible most of the time. Pinpointing problematic drinking early on and receiving treatment can reverse many of the mental, emotional, and physical side effects of excessive drinking.

However, at a certain point, the damage from alcohol abuse is too severe. Liver failure and cirrhosis are permanent complications of alcoholism. Permanent health damage should not discourage a person from seeking treatment, as substance use disorder treatment can still significantly improve an individual’s quality of life.

What to Do If Someone You Know Has a Drinking Problem

If you suspect your loved one might have a drinking problem, try to get them to stop drinking and refer them to medical treatment immediately. You should explain to your loved one the short-term and long-term risks associated with their drinking habits so they understand why their drinking is a risk to themselves and others. 

An individual with a drinking problem should first be referred to a healthcare professional to evaluate and diagnose their drinking problem and recommend treatment options. 

Staging an intervention with a professional interventionist’s help can effectively get them into treatment for an individual resistant to treatment. During an intervention, family members and loved ones can urge an individual with a drinking problem to seek help.

An individual with a drinking problem may also benefit from support groups such as Alcoholics Anonymous (AA), where they can receive support from others who understand their unique challenges.

There are also support groups for family members of addicted individuals, such as Al-Anon, which can guide you on helping someone with a drinking problem.

Although, there are different types of alcoholics, alcoholic personalities, and tolerances. The health effects are the same especially long-term so seeking professional help is very important.

Treatment Options for Alcohol Abuse & Addiction

There are many treatment options available for alcohol abuse and addiction, including:

  • Inpatient ProgramsInpatient treatment takes place at a licensed residential treatment center. These programs provide 24/7 comprehensive, structured care. You'll live in safe, substance-free housing and have access to medical monitoring. The first step of an inpatient program is detoxification. Then behavioral therapy and other services are introduced. These programs typically last 30, 60, or 90 days, sometimes longer. Most programs help set up your aftercare once you complete the inpatient portion of your treatment.
  • Partial Hospitalization Programs (PHPs) Partial hospitalization programs (PHP) are sometimes referred to as intensive outpatient programs (IOP). Compared to inpatient programs, partial hospitalization programs provide similar services. These include medical services, behavioral therapy, and support groups, along with other customized therapies. However, in a PHP, you return home to sleep. Some services provide food and transportation, but services vary by program. PHPs accept new patients as well as people who have completed an inpatient program and still need intensive treatment.
  • Outpatient Programs Outpatient treatment is less intensive than inpatient or partial hospitalization programs. These programs organize your treatment session based on your schedule. The goal of outpatient treatment is to provide therapy, education, and support in a flexible environment. They are best for people who have a high motivation to recover and cannot leave their home, work, or school responsibilities. Outpatient programs are often part of aftercare programs once you complete an inpatient or PHP program.
  • Medication-Assisted Therapy (MAT) Sometimes, medications may be used in alcohol addiction treatment. Some medicines can help reduce the negative side effects of detoxification and withdrawal. Others can help you reduce cravings and normalize body functions. Disulfiram (Antabuse), acamprosate (Campral), and naltrexone are the most common medications used to treat AUD. When combined with other evidence-based therapies (such as cognitive behavioral therapy), MAT can help prevent relapse and increase your chance of recovery.
  • Support Groups Support groups such as Alcoholics Anonymous and SMART Recovery are open to anyone with a substance abuse problem. They are peer-led organizations dedicated to helping each other remain sober. They can be the first step towards recovery or part of a long-term aftercare plan.

Resources

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Alcohol Research: Current Reviews Editorial Staff. “Drinking Patterns and Their Definitions.” Alcohol research : current reviews vol. 39,1 (2018): 17-18

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

Binge Drinking Is a Serious but Preventable Problem of Excessive Alcohol Use. 30 Dec. 2019

“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. 2020

Rehm, Jürgen. “The risks associated with alcohol use and alcoholism.” Alcohol research & health : the journal of the National Institute on Alcohol Abuse and Alcoholism vol. 34,2 (2011): 135-43.

“Facts about Moderate Drinking.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 29 Dec. 2020

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