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Alcoholism, alcohol abuse, and alcohol addiction are common terms for alcohol use disorder (AUD).
The three main signs of alcoholism are:
Alcoholism or alcohol use disorder (AUD) is a chronic disease that arises from alcohol misuse. This can include any excessive drinking habit. Long-term alcohol use leaves lasting effects on a person’s health. It may also cause social and legal problems.
Unless treated, alcohol use disorder will worsen with time. In some cases, it can even be fatal. Knowing the signs and symptoms of alcoholism can help you get early treatment and prevent complications.
Alcohol use is the second most common substance use disorder in the United States. The 2019 National Survey on Drug Use and Health (NSDUH) shows the prevalence of alcohol use disorder in the United States.1 Based on their findings:
Studies also show that alcoholism often goes undiagnosed.2 This means there could be more Americans struggling with alcohol use disorder who have not sought help from a medical professional.
Alcohol misuse or alcohol abuse is a mild form of alcohol use disorder. It can refer to the unhealthy habit of excessive drinking, which increases a person’s risk for negative consequences.
On average, women who consume more than one drink per day and men who consume more than two drinks per day suffer from alcohol misuse.3 Heavy drinking and binge drinking are also considered symptoms of alcohol use.
Alcohol use that isn’t managed in time will often lead to addiction. Alcohol addiction is a severe form of alcohol use disorder that requires medical intervention. Although chronic, it’s also preventable if you know which signs to look out for.
A person with worsening alcohol misuse will start spending more time drinking. They will also begin to lose track of their lives as they become increasingly preoccupied with alcohol. This includes:
Unfortunately, most people ignore these early signs of alcohol addiction. What this does is create a missed opportunity for early recovery.
Once alcoholism sets in, it’s usually hard to ignore. You may have mild, moderate, or severe alcohol use disorder, depending on the signs and symptoms.
Below are the six definitive signs of alcohol use disorder:
Why it happens: The brain releases dopamine whenever you engage in certain activities, like eating food. The “feel-good” hormone induces pleasure and encourages you to repeat these behaviors. However, research shows that alcohol affects the brain differently.4
With normal stimuli such as food, the brain eventually stops releasing the hormone. As a result, you will no longer feel the same level of satisfaction. On the other hand, alcohol continues to trigger its release despite repeated consumption. The brain then gets used to the presence of dopamine and seeks it out, hence the cravings.
How to recognize it: Alcohol cravings can occur randomly or when triggered by external or internal factors. Mental disorders such as depression, trauma, and bipolar disorder are some internal triggers. Places that remind you of alcohol are other examples of external triggers.
Why it happens: People who drink heavily for too long become physically dependent on alcohol. Alcohol dependence is a symptom of alcohol addiction. Like drug dependence, alcohol causes physiological changes in the brain. However, these changes only become apparent when you experience withdrawal symptoms.
Unlike alcohol cravings, which occur as a behavioral response, withdrawal is a physical reaction to reduced blood alcohol levels. This reaction can be highly unpleasant. It's also associated with a higher risk for relapse in the first month of quitting.5
How to recognize it: Alcohol withdrawal encompasses a range of physical and behavioral signs that appear within the first 6 to 12 hours after the last drink. Withdrawal symptoms can last for 3 to 5 days, depending on the severity of alcohol addiction.
Common symptoms of alcohol withdrawal include shakiness, headaches, trouble sleeping, irritability, mood swings, and gastrointestinal upset. Some people may also experience anxiety, feelings of depression, hallucinations, and seizures.
Why it happens: Problem drinking causes the hippocampus to shrink. The more a person drinks, the greater the shrinkage.6 Research suggests that the loss of hippocampal tissue causes memory decline, impaired reasoning, and reduced cognitive function.6, 7
Alcohol consumption also increases a person’s risk for impulsive behavior such as unsafe sex.8 This impulsivity, along with reduced cognition, can lead to poor life choices.
How to recognize it: People addicted to alcohol often engage in risky behaviors (e.g., unprotected sex, drunk driving, and/or getting involved in legal problems) and usually have impaired judgment from alcohol use.
Why it happens: The inability to control one's drinking isn't something an alcoholic actively chooses. Instead, it is a symptom of the collective physiological and behavioral changes the brain undergoes after being exposed to unhealthy drinking patterns.
How to recognize it: Drinking more alcohol, or drinking for longer periods than intended, are indicators that a person is struggling to control their drinking habits. Some chronic alcohol users will openly express previous failed attempts at quitting alcohol.
Why it happens: Alcohol tolerance can happen for different reasons. The most common cause is the repeated consumption of large amounts of alcohol, which desensitizes the brain to its intoxicating effects.
Tolerance can also develop if you drink in the same environment, or as a metabolic response that speeds up the elimination of alcohol. People with functional alcoholism don’t have the classic signs of an alcoholic. They develop tolerance by learning to function while intoxicated.
How to recognize it: A person with alcohol tolerance doesn’t show signs of intoxication after heavy drinking. It usually takes more for them to get drunk. Some of them even complain about it. To achieve their desired effects, they will drink increasing amounts of alcohol over time.
Why it happens: Alcoholism is a medical condition that affects your behavior and cognitive abilities. The combination of alcohol cravings, difficulty controlling drinking habits, impaired decision making, and withdrawal symptoms are enough to keep someone hooked to the substance.
How to recognize it: A person with AUD will spend most of their time drinking. They will also prioritize drinking above anything else. They might give up activities, interests, and responsibilities to maintain their habit. In spite of worsening consequences, they will continue to drink.
Alcohol use disorder causes a range of physical symptoms. These can appear shortly after drinking alcohol or as a result of prolonged alcohol use and alcohol addiction.
Some people are more at risk of developing alcohol use disorder than others. For example:
Binge drinking is the consumption of large amounts of alcohol on a single occasion. This means five or more drinks for men and more than four drinks for women within two hours. The Substance Abuse and Mental Health Services Administration (SAMHSA) further defines it as excessive drinking for five or more days in a month.
Heavy drinking is the regular consumption of excessive amounts of alcohol. This means having more than four drinks per day or 14 drinks per week in men; and more than three drinks per day or seven drinks per week in women.
Scientists identified genetic factors that increase a person’s ability to metabolize alcohol and make them susceptible to its sedative effects.11 Consequently, having these genes increases your risk for alcohol problems. It also helps explain why alcohol use disorder tends to run in the family.
Certain places put you at risk of alcohol use disorder. Some of them include:
People with mental health problems such as depression and anxiety are also at risk of developing alcohol use disorder.12 A person with AUD who also shows signs of mental disorders has a dual diagnosis.
Children who started drinking between 11 and 14 have a higher risk for alcohol-related problems in older age. Ten years after their first survey, researchers confirmed that 13.5% of participants already suffered from alcohol misuse, and 15.9% had alcohol dependence.13
Long-term alcohol use has wide-ranging adverse effects on a person's health and mental wellness. These include:
The consequences of alcohol addiction are irreversible, with some leading to death. They leave lasting effects and add to the financial and social burdens of alcoholism.
Alcoholism can be mild, moderate, or severe. Symptoms include:
People with 2 to 3 symptoms suffer from mild alcoholism. If you start showing these signs or know someone who does, you should get immediate help. Try not to wait until a person has more than six symptoms before seeking treatment. By that time, they already have severe alcoholism, which can be more difficult to treat.
Patients can access a variety of treatments for alcoholism. The three basic types of alcohol treatment are:
When exploring these options, keep in mind that there is no single treatment for alcoholism. More often than not, a multidisciplinary approach is needed. What matters is that you are able to sustain long-term recovery through the prevention of relapse.
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