Alcohol is one of the most widely used drugs around the globe. Yet, because it is a legal substance, some may think it isn't as addictive or dangerous as other substances. However, even if a drug is legal it doesn’t mean it isn’t addictive or potentially harmful. Since alcohol is legal and socially acceptable, makes it, at times, difficult to gauge whether a person is an alcoholic or not. In some cases, rampant alcohol use is normal and encouraged. For instance, it’s widely expected that college students indulge (even over-indulge) in alcohol.

There are stereotypes surrounding alcohol and alcoholism, but in truth there is no fixed image of what an alcoholic looks like. Not all alcoholics are “stumbling drunks” who drink away the days. Many successful people are alcoholics. A person is considered an alcoholic when they are dependent on alcohol, need it to feel “normal,” or if they engage in binge-drinking on a relatively regular basis. It may be important to note that a person doesn’t need to drink daily or even weekly to be an alcoholic; some alcoholics are purely binge-drinkers.

Physical Signs of Alcoholism

Physical signs of alcoholism are the most obvious to observers. It is usually what friends and family first notice. This includes obvious symptoms such as lack of coordination and slurred speech. It is similar to the signs that police look for when pulling over potential DUI drivers. However, the physical signs of alcoholism are also often similar to signs of simply being drunk. Occasionally drinking too much does not make someone an alcoholic.

The physical signs of long-term alcohol abuse are a little more subtle. They can include bloodshot eyes and burst blood vessels, particularly on the nose. However, it’s important to remember that these can also be signs of a variety of other issues, including allergies. A non-professional cannot diagnose someone with alcoholism, especially based solely on a few physical symptoms.

Usually, a person self-identifies as an alcoholic before they seek treatment. This often occurs when they’ve hit “rock bottom” and have suffered losses in their personal and/or professional life due to alcohol abuse.

Signs and Symptoms of Alcoholism

There are a number of signs of alcoholism that aren’t necessarily obvious and, like physical symptoms, may overlap with symptoms for other issues—this can include memory loss and impaired thinking. It is relatively common for a person to deny they abuse alcohol no matter how mild or severe their addiction may be. It’s a means of protecting their addiction.

Internally, an alcoholic can obsessively think about alcohol all day, wondering when and how they'll get their next drink. They experience severe stress at the idea of not being able to have a drink. They might sneak alcohol at inappropriate times and lie about the last time they drank or how much they drink.

Drinking alone isn’t necessarily a sign of alcoholism. However, given that alcoholism requires an addict to increasingly drink more and more to feel normal, drinking alone is a common hallmark for many alcoholics. They can drink without judgment, which is an important facet for many alcoholics.

Alcoholism Today

As medical professionals learn more and more about addiction and alcoholism, terms and best practices evolve. For instance, technically the term “alcoholism” is out of date. The new term, as per the Diagnostic and Statistical Manual of Mental Disorders, is “alcohol use disorder.” However, alcoholism is still the colloquial term and it is considered a type of mental disorder as it overlaps with substance abuse disorders.

Under the latest definition of alcoholism, a mental health expert must diagnose the substance abuse disorder. They consider the past 12 months of use, and take into account 11 criteria. These criteria include a person feeling unable to control their alcohol use and increasingly turning down hobbies and social engagements they used to enjoy. They want to stop drinking, but simply can’t. They also usually drink or are drunk in risky situations, such as driving. An alcoholic will spend a lot of time and effort thinking about alcohol and finding ways to access it.

Although many people will build up some type of tolerance to alcohol if they imbibe often, an alcoholic has an incredibly high tolerance. They crave a drink most times when they are not drinking or drunk, and might experience withdrawal symptoms like sweating or shaking if they don’t have alcohol for even a short period of time. Hardcore alcoholics often struggle with work, school, or within their personal relationships—however, they keep drinking even when they realize these issues.

Getting diagnosed is often the first step towards getting help. When a person is a severe alcoholic, they can’t (and shouldn’t) quit “cold turkey.” Ceasing without weaning oneself off of alcohol in a controlled environment, i.e., rehabilitation clinics, can be life-threatening. Withdrawal symptoms can include anxiety, tremors, and delirium. Rapid heart beats and fevers may be experienced along with nausea and vomiting. With long-term abuse, alcoholism can result in brain damage and/or liver failure. Many people are surprised to learn that cardiovascular disorders are also related to alcoholism, as heavy drinking puts a toll on the heart.

Spotting Alcohol Abuse

If you’re concerned that someone you know may be an alcoholic, it can be tricky to assess on your own. Many alcoholics are “high functioning” and do a very good job of hiding their habit for years. However, one sign to note is that alcoholics often begin to disregard their health and nutritional intake. Severe alcoholics might show signs of malnutrition, including a skeletal figure and thinning hair. Under-eye circles are also a common sign.

The reason for this malnourished look is that the brain and tissue requires the B-1 vitamin (Thiamine). Alcoholics often don’t get the correct amount of vitamins and nutrients. They may also have a B6 deficiency, which further adds to their gaunt appearance. However, a lot of the time malnutrition isn’t physically evident until a person is a severe alcoholic.

Living with an alcoholic can make it a little easier to spot signs of alcoholism. Many alcoholics suffer from sleep disorders like insomnia. It’s a myth that alcohol can be used as a sleep aid. There’s a reason non-alcoholics often report poor sleep after a night of drinking. Both anxiety and depression are also comorbidities of alcoholism. In severe cases, cognitive troubles might accompany alcoholism. This can result in shaky hands, which can sometimes be a permanent affliction.

As alcoholism progresses, the addict will likely get into more and more legal trouble. Alcohol use and abuse has been linked to assaults and domestic violence. The person might get fired from work thanks to showing up drunk or being unable to function due to withdrawals or a hangover. However, they are often hypersensitive to any criticism because it’s drawing attention to the fact that they’re struggling. Alcoholics often have financial issues, since most of their funds go to their addiction. They might take out loans, deplete accounts, or even take to stealing to feed their addiction. When alcohol isn’t available, some alcoholics will take the next best option such as cough syrup. Noticing that depressants like cough syrup are suddenly missing or being used a lot is a possible sign that you’re living with an alcoholic.

Unfortunately, one of the riskiest behaviors of alcoholics involves other people—drunk driving. Mothers Against Drunk Driving (MADD) reports that 28.7 million Americans admit to driving after drinking every year. Even one drink can impair a person’s fine motor skills and cognitive thinking. This has resulted in almost 10,000 crashes per year where alcohol is a factor. That’s more than a crash per hour, or 27 fatal crashes every day. However, those who are caught drunk driving or driving while impaired likely “got away with it” many times before. MADD estimates that a person drives drunk about 80 times before their first arrest.

Getting Treatment

It is important to remember that there is still hope for most people struggling with an alcohol addiction. Most alcoholics with brain issues can recover in one year of sobriety and treatment. The best way to get treatment is through a rehabilitation facility. Although, it should be noted that alcoholism is a lifelong addiction. Even if a person never takes another drink, once an alcoholic, always an alcoholic. At no point in time should a recovered alcoholic assume that they can drink again in limited amounts. One drink has the power to cause a complete relapse. However, with the proper support network, an alcoholic can remain sober lifelong.

If you or someone you love suffers from alcohol addiction, the sooner you seek help, the better. It isn't true that every person has to reach rock bottom before they can begin to recover. Knowing the signs and being able to spot them in yourself and others can be the first step to realizing you must get help.

You don't have to feel isolated by your addiction, help and treatment is readily available. Get help today and begin your journey toward a sober and happier life.