Alcohol & Health
Treatment
Helping Alcoholics
Medically Reviewed by Dr P. E. Pancoast, MD
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Alcohol (ethyl alcohol) is a simple chemical that can cause significant changes in the complex functions of the human brain and body. Because it causes these changes, alcohol is a highly addictive substance.
Drinking alcohol increases the production of several chemicals in the brain. Dopamine and endorphins, two of such chemicals, produce pleasurable feelings and act as natural painkillers. The pleasurable sensations are why once people start drinking, they often want to carry on.
Alcohol can compromise impulse control and decision-making, which can lead to alcohol misuse and dependence.1 Many people also consume alcohol despite the negative consequences, increasing the risk for addiction.
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During consistent use of an addictive substance, a person’s brain and body chemistry can change.
The pleasurable sensations caused by drug use comes from the extra release of "feel-good" chemicals like dopamine and endorphins. The body then suppresses the normal release of these chemicals, which in turn, makes them drink or use drugs to get the chemicals to be released again. This feeling can make the user crave the substance and feel that they need to use it regularly. This feeling of needing to consume a substance is called dependency, which can quickly develop into addiction.
Addiction is a disease that is characterized by compulsive substance use despite harmful consequences. A person who has an addiction has a compulsion to perform a behavior that they know is harmful. They also feel unable to stop themselves from performing it.
Over time, heavy drinking can make the body dependent on alcohol. If someone who is addicted to alcohol attempts to stop suddenly, they may experience uncomfortable and dangerous withdrawal symptoms, and can even go into shock and die.2
Alcohol negatively impacts the brain areas that control balance, memory, speech, and judgment, resulting in a higher likelihood of injuries and other adverse outcomes.
Alcoholism also affects the brain’s “reward center” and produces pleasurable sensations (such as anxiety reduction) when consumed.
Long-term, heavy drinking causes alterations in brain neurons (such as reductions in size) and permanently damages brain processes and functions.
A developing brain is particularly vulnerable to the effects of alcohol. Misuse of alcohol while a fetus is still in utero, or later, during adolescence and early adulthood can alter the brain's development, resulting in long-lasting changes in brain structure and function.3
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Here are some of the main reasons why alcohol is highly addictive:
Alcohol causes the brain’s chemistry to change, which makes it addictive.
Alcohol suppresses the central nervous system (CNS) and slows down normal brain functions. It does this by slowing the release of and response to normal brain neurotransmitters.
At the same time, alcohol stimulates the release of other neurotransmitters, such as dopamine and endorphins, which create pleasurable sensations. When this happens, the normal release of these neurotransmitters is suppressed, and the person only feels good when they drink alcohol or take drugs.
As these changes occur, people tend to require increasingly more significant amounts of alcohol to become intoxicated. As a result, they often increase the amount they drink.
Over time, these changes to the brain create a vicious cycle of dependence that keeps the person hooked on alcohol.
Some people have a predisposition to alcoholism due to genetic factors. Specifically, some people’s brains release more pleasure chemicals in response to alcohol, making them more susceptible to physical dependency.
Alcohol consumption is often a social activity. People drink because their friends, coworkers, and family are drinking.
Alcohol consumption is prevalent around the world. In 2019, 70% percent of U.S. adults 18 and older reported that they drank in the past year.4
In one study, a third of adult drinkers admitted drinking more than they intended because others encouraged them. Similarly, two-fifths of adult drinkers felt too much pressure to drink when socializing with work colleagues.5
Many people are addicted to alcohol because they don’t want to face the withdrawal symptoms of drinking cessation.
When an alcohol-addicted person suddenly stops drinking, they will likely begin to experience intense cravings for alcohol as well as many other distressing physical withdrawal symptoms, like:
To avoid these symptoms, an alcohol-addicted person may continue drinking or resume drinking after short pauses.
Alcohol manufacturers bombard the public with advertisements in video, digital, and print. They show drinking as a socially acceptable, fun, and relaxing pastime.
From 1971 to 2011, alcohol advertising in the United States increased by more than 400%.
Alcohol is legal in the United States, and is therefore more accessible than other drugs. Alcohol can be found in homes and at family gatherings, barbecues, restaurants, nightclubs, movie theaters, and resorts, among others.
Alcohol is often linked to positive associations such as celebrations. It is often featured at events or used to celebrate (“toastings,” for example). Many people treat alcohol as a reward at the end of the day or after an achievement, which builds a positive association with alcohol.
There is a strong link between alcohol dependence or addiction and mental health disorders. Forty percent of people with AUDs have a concurrent mental health diagnosis. This is known as dual diagnosis.
People who have untreated depression, anxiety, or PTSD have a higher risk for alcoholism because they may self-medicate with the drug. Self-medicating with alcohol can make a person want to drink more and more, leading to alcohol addiction.
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Although, there are different types of alcoholics, alcoholic personalities, and tolerances, the health effects are the same, especially long term.
Certain factors like age, family history, genetics, and others, can make a person more at risk of developing alcohol use disorder (AUD). The presence of any of the below factors can make a person more at risk of developing alcohol addiction.
Binge drinking is a type of alcohol consumption in which a person's blood alcohol concentration (BAC) exceeds 0.08 percent. For men, this means drinking more than 5 drinks in two hours. For women, this means drinking more than 4 drinks in two hours.
Not everyone who binges drinks has an AUD, but they are at higher risk for developing one.
In the United States, 18 million adults have an alcohol use disorder (AUD).
You may have an AUD if you have experienced two or more of the following in the past year:
Alcohol addiction can lead to several devastating consequences. Nearly 90,000 people die each year due to alcohol-related causes. Alcohol is the third leading preventable cause of death in the U.S.
People who are physically dependent on alcohol will need the support of a healthcare professional to stop drinking.
Treatment options for alcohol misuse and addiction include inpatient care, outpatient care, or detox programs. The right treatment option depends on each person's background and individual needs.
If you are struggling with alcohol use and addiction, see your health care provider for an evaluation. Your doctor can provide medical advice, make a treatment plan, and refer you to addiction treatment facilities.
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