What is Alcoholism?
Alcoholism is the excessive consumption of alcohol which leads to alcohol use disorder. There is both a mental and physical aspect to alcohol addiction. You may have an alcohol problem if you have:
- Intense cravings for alcohol
- Drink alone
- Become defensive when others confront you about your drinking habits
- Are unable to control how much alcohol you consume
- Become angry or irritable when you consume alcohol
- Miss important family events or work due to your alcohol consumption
- Feel guilty about your drinking
- Need to drink more and more to feel the effects of alcohol
If you can relate to any of these characteristics, it may be time to talk to your doctor about your drinking habits. Your doctor may have you fill out a questionnaire that may ask you whether any of the above symptoms apply to you. Based on your answers, if they feel that you may have alcohol use disorder they will order a blood test to see if your drinking has affected your liver function.
How Does Someone Become Addicted?
Someone becomes addicted to alcohol when they continue to drink alcohol frequently for an extended period of time. Some people are genetically predisposed to developing alcoholism. This doesn’t mean that if someone has no family members or relations who have an alcohol problem that they will not develop a problem with alcohol, and conversely, if someone has family members who struggle with alcoholism, that they will not automatically develop an issue. It simply means that a family history of alcohol addiction makes some people more likely to have an issue.
After drinking consistently a person will develop a tolerance to alcohol. A tolerance to alcohol means your body has become accustomed to the alcohol, and it no longer has the same effect unless more alcohol is consumed. After tolerance develops and a person continues to drink excessive amounts of alcohol, physiological dependence can take place. This is when your body now relies on the alcohol being consumed, and if you stop drinking, your body will start to go through withdrawals. At this point, it will feel like you must have another drink in order to function properly, and that you cannot control your drinking.
Who Struggles With Alcohol Addiction?
Anyone can develop an alcohol addiction. Some may be more genetically prone to alcohol abuse than others, but ultimately the disease does not discriminate. According to the Substance Abuse and Health Services Association, in 2017, 14.5 million Americans over the age of 12 had alcohol use disorder. 10.6 million of them being 26 years of age or older. This translates to 1 in 19 Americans. These are massive statistics, and clearly indicate that it is more than genetics that can contribute to alcohol abuse. Some factors that can contribute to alcohol abuse are:
- Mental illness such as depression or anxiety
- Genetic predisposition
- Binge drinking (5 or more drinks at a time)
- Drinking too much per week (7 for women, 14 for men)
- Peer pressure
Many people turn to alcohol to cope with difficulties in life, and the pleasurable effects may help numb their problems temporarily, but if misused, alcohol can become a much larger problem.
How Does Alcohol Abuse Affect an Individual?
Alcohol has a staggering effect on the human body, mind, and social relationships. The effect that alcohol has on an individual all boils down to how much a person drinks. In small quantities, alcohol is not harmful, but what amount of alcohol constitutes abuse? Research has shown recently that there is no amount of alcohol that is healthy for you, but one drink a day would only slightly put you at risk for health related problems.
According to the NIAAA, men should not have more than 4 drinks a day, and no more than 14 a week. Women should not have more than 3 drinks a day, and no more than 7 within a week—These would be standard drinks, 12 oz beer (4% alcohol), 5 oz wine (12% alcohol), 8 oz malt liquor(5-8% alcohol), 1.5 oz liquor (80 proof). Women and men have different levels of non-risky amounts of alcohol consumption because of their body size difference, hormones, and bioavailability, as well as the fact that men have more of the dehydrogenase enzyme—an enzyme that breaks down alcohol—than women do. Therefore, women may be affected more severely with lower amounts of alcohol.
Many people know that alcohol abuse can cause health problems such as cirrhosis--a degenerative disease that occurs when healthy cells in the liver are damaged and replaced by scar tissue--which can lead to liver failure and even death. Yet, many do not understand the full health implications that alcohol can have on the body both in the long-term and the short-term. Short-term effects include:
- Changes in cognition
- Slurred speech
- Lack of coordination
- Glassy eyes
- Very emotional
- Nausea & vomiting
Excessive intake of alcohol in one sitting can cause alcohol poisoning which is concerning as it can be fatal. Symptoms include:
- Vomiting, slurred
- Irregular pulse and breathing
- Clammy skin
If someone’s breathing or pulse has slowed down or become irregular, or their lips have turned blue, you should call 911 immediately. Alcohol is a depressant, and alcohol poisoning can be deadly. A person in this state could choke on their own vomit, or their system can become so depressed by the alcohol that it can no longer function.
Long-term alcohol abuse can cause chronic illness and eventually lead to death. According to the National Institute on Alcohol Abuse and Alcoholism, long-term use can cause damage to your brain, heart, pancreas, liver, and has also been linked to multiple cancers.
Alcohol works on the brain by effecting its pathways of communication. It can also change the way the brain works which causes changes to a person’s behaviors, effectively changing their personality characteristics.
A person’s heart can be damaged through alcohol by causing cardiomyopathy (the stretching and drooping of the heart muscle), arrhythmias (an irregular heart beat), stroke, and high blood pressure. Women's hearts tend to be affected more easily from alcohol than men’s, but a man can still certainly suffer from the same heart complications.
Alcohol misuse can also affect a person’s pancreas. Alcohol can cause pancreatitis. This causes a swelling of the pancreas that is dangerous and can cause problems in the digestive tract.
The most well-known long term symptom of alcoholism is the effect that it has on the liver. Damages to the liver include steatosis, or fatty liver, which is generally benign. However, if left untreated can progress to cirrhosis. A more serious complication of alcohols use on the liver is alcoholic hepatitis which is a more serious inflammation of the liver and may include jaundice or fluid retention in the belly. Excessive drinking may also lead to fibrosis which is the scarring of the liver. Fibrosis is extremely serious and indicates that there is permanent damage done to the liver. Symptoms include jaundice, fluid retention, nausea, weight loss, and difficulty thinking.
Cirrhosis of the liver is the final step in liver scarring. For end stage cirrhosis, the only remedy is a liver transplant.
Research has shown that another serious side effect that can come about due to heavy drinking is cancer. Research has indicated that 3.5% of all cancer deaths are related to alcohol and range anywhere from esophageal to colorectal cancer.
While the side effects of alcohol on the body can be life-changing and life-threatening, the side effects on a person’s personal life can be equally debilitating. Often times when someone has a drinking problem their relationships, job and/or academics begin to suffer.
Alcoholics may assume that they are only hurting their bodies with their drinking, but the reality is that they are hurting all of their loved ones as well. Loved ones of people with addictions are negatively affected, and each member of the family may be affected differently. As the addiction progresses, addicts may begin to pull away from society and may lash out at family members or loved ones who try to help them come to terms with their addiction. The alcoholic may face financial troubles due to the cost of supporting an alcohol addiction as well as due to loss of productivity at work or at school due to hangovers, illness, or adverse effects. This can cause a greater strain on the addicts relationships especially if his/her family are financially dependent on them.
Alcoholics may assume that they are only hurting their bodies with their drinking, but the reality is that they are hurting all of their loved ones as well. Loved ones of alcoholics are negatively affected, and each member of the family may be affected differently. As the addiction progresses, addicts may begin to pull away from society and may lash out at family members or loved ones who try to help them come to terms with their addiction. The alcoholic may face financial troubles due to the cost of supporting an alcohol addiction as well as due to loss of productivity at work or at school due to hangovers, illness, or adverse effects. This can cause a greater strain on the person with addiction's relationships especially if his/her family are financially dependent on them.
Why Would Someone Turn To Alcohol?
With all the harmful issues and side effects that can arise from drinking heavily, it makes one question why someone would want to continue drinking on a regular basis. The answer is fairly simple, drinking alcohol can be a very pleasurable experience for many. Understanding alcohol is extremely important if one wants to know why it is addictive.
The effect of a drug on a person’s body is a result of how that drug interacts with neurotransmitters-chemical messengers that facilitate communication in the brain. Every neurotransmitter is responsible for a different process in the brain. The neurotransmitter that alcohol interacts with is called GABA. GABA is an inhibitory neurotransmitter. This means it prevents the brain's neurons from becoming too excited. This creates a calming and tranquilizing effect on the brain. Alcohol is a GABA receptor agonist, this means they bind to certain GABA receptors and increase the calming effect that GABA has on the brain. This calming effect helps people feel relaxed and loose. Alcohol also stimulates the pleasure centers of the brain, making people feel happy. Beyond this, the psychotropic properties of alcohol that render feelings of being drunk may offer relief to some who suffer from problems in everyday life and are looking for an escape.
One such disorder that may increase a person’s desire to start drinking is depression. Major depressive disorder is a serious mental health condition characterized by persistent mood changes, sadness, and loss of interest in activities which a person once enjoyed. Those who have depression have a tendency to isolate themselves, and feel a lot of emotional pain regularly. It can be enticing for someone with this disorder to use alcohol to try and escape how they feeling, and numb their pain. One study found that depressed female drinkers were twice as likely to become heavy drinkers, and depressed male drinkers were three times as likely to become heavy drinkers. Unfortunately, beyond the fact that those with depression are more likely to have an alcohol problem, it has been shown that excessive drinking can make depression worse. This is a result of both the pharmacology of alcohol as well as the effects of alcohol.
While alcohol may make you feel happier in the short term, it can actually cause low serotonin levels. Serotonin is one of the neurotransmitters that lead to feelings of happiness and well being. Often, it is difficult for the person who is depressed to see that alcohol is what is contributing to their depression because in the moment it can make them feel better. Also, someone may stop taking his or her depression medication due to potential interactions with alcohol. This can compound the negative effects of the depression.
Alcohol use disorder is often a dual diagnosis, meaning that there is usually another mental illness that the person suffers from. This is called comorbidity, when one diagnosis is typically followed by another diagnosis. Often times those who are suffering from a mental illness may not realize that they even have a problem, and they will turn to substances to dampen their symptoms.
Alcohol is a common substance that is used by people who are self-medicating for a mental illness. Unfortunately many of the side effects of the mental illnesses are similar to that of the side effects of alcohol, such as disorientation, confusion, anxiety, and hallucinations. Since these both have similar symptoms, the alcohol can make the symptoms of the mental illness much worse. It can also make it difficult for doctors to make an accurate diagnosis since they may at first attribute the symptoms to the person’s alcohol usage. Some of the common comorbid disorders were mood disorders, major depressive disorder, anxiety disorders, bipolar, PTSD, and schizophrenia.
Depression is not the only issue that can lead someone to misuse alcohol. Many people self-medicate with alcohol to numb the pain of the traumas that have occurred in their life. Many veterans for instance come home from war and due to the trauma of combat go on to develop a drinking problem. People who have suffered from abuse use alcohol to suppress their painful memories. Often time’s people with PTSD have difficulty falling asleep, so they use alcohol to try and get some sleep. Yet, drinking can actually make PTSD symptoms worse. Drinking can increase feelings of anxiety, depression, and induce isolation.
Alcohol is known for taking the edge off. Many people have a drink after work to help them relax and calm their mind after a stressful day. Due to this, it may seem that if you are very stressed increasing your alcohol consumption will help you relax more. While this may be tempting, the reality is that you are avoiding your problems.
Treatment For Alcohol Addiction
It is rare for alcoholics to suddenly decide to receive treatment on their own. Usually it takes hitting rock bottom, or an intervention by loved ones and a therapist for a person with addiction to decide that the best course of action for them and their families is to seek treatment. Families often decide to hold an intervention after a particularly bad episode of their loved ones alcoholism. For instance, an intervention may help after a DUI, accident, or large family fight. An intervention is a chance for loved ones to share their concerns with the alcoholic. It is then up to the alcoholic to decide if they would like to pursue treatment. There are many different types of treatment centers that a person with an addiction can choose to receive treatment. And depending on the severity of the person’s dependence, they may need different levels of care to get through the detox and withdrawal process.
Alcohol dependency occurs over a prolonged amount of time of heavy alcohol use. The brain becomes accustomed to the effects of alcohol, and when the alcohol consumption is stopped the body goes into withdrawals. The symptoms of alcohol withdrawal include:
- Excessive Sweating
In more serious cases, the withdrawal symptoms can include tremors, seizures, hallucinations, and disorientation. These symptoms can last anywhere from 1 to 2 weeks. This process is called detox. It is important that a patient with alcohol use disorder detox under medical supervision. Doctors and nurses can ensure that the patient stays safe, and that any emergencies that arise are met with immediate medical intervention.
Further, they can provide the patient with pain medication to manage some of the more uncomfortable symptoms. Managing the detox process properly can ensure that the patient does not use simply to prevent the symptoms of withdrawal, and makes the entire process less intimidating. After the patient has gone through withdrawals they can then focus on the behavioral therapy that will help them manage their cravings for alcohol. Since alcoholism is a disease of both the mind and they body it is important that withdrawals and the desire to use are treated concurrently.
Intensive Outpatient Treatment
There are many great treatment options for those who suffer from alcohol use disorder. The three general treatment options are inpatient treatment, a partial hospitalization program (PHP), and an intensive outpatient program (IOP). These three options go from most intense to least intense, but all three are good options depending on each person's needs.
Intensive outpatient programs are one of the most popular due to the fact that they allow the most flexibility while still providing lots of support and guidance. In an IOP, the patient will most likely be participating in group therapy sessions with other recovering drug and alcohol addicts. Treatment staff create a safe space for recovering addicts to share their feelings and emotions without judgment. IOPs’ are a good solution for those who are less acute, and who do not need a higher level of medical care. They offer the freedom to work full time, and fulfill their responsibilities as usual. These are often great alternatives to full time treatment, and one study even found that the results were comparable to inpatient treatment results. It is also not unusual for someone who has gotten a DUI to be required by law to attend an IOP.
During this treatment process, patients will begin to understand and confront their reasons for drinking. Once these emotions are excavated, professionals are able to provide techniques that patients can take into daily life which will help them avoid drinking alcohol and falling into old habits.
Ultimately, treatment is about what the patient puts into it. If there is a desire to live a sober and healthy life, then the support and encouragement found in treatment can positively change the life of someone who suffers from alcoholism. After finishing treatment, it is always strongly recommended that recovering alcoholics continue to use programming and support groups such as AA (Alcoholics Anonymous). These programs are free and help people who are dedicated to sobriety stay on the right path.
Take the First Step
If you are not ready to seek treatment, or just feel that you would like to cut back on your alcohol use, there are steps you can take. Be open and honest with your doctor about your desire to pull back on your alcohol consumption. He/she will help you figure out the best way to cut back on your drinking. Reach out to family or friends for support. Surround yourself with people who do not regularly drink for fun.
Alcohol use disorder is serious and can affect every aspect of a person’s life. Not only is it extremely harmful to the body, it takes an emotional toll on both the person and their loved ones as well. If you or someone you know suffers from alcohol addiction, it is imperative that you seek treatment. Help is readily available if you are open to receiving it.