Understanding Alcohol

Learn about alcohol and substance abuse

Since drinking alcohol is common in so many cultures, it can be difficult to discern when you have crossed the line between social drinking and problem drinking. Essentially, if drinking alcohol is causing problems in your ability to function normally in your life you may have a problem. Some other signs of alcohol abuse include:

Drinking makes you feel guilty or ashamed
You find yourself lying to others about your drinking behavior or you keep your drinking habits secret
You have family or friends who express concern about your drinking
You notice you are drinking more than you intended to on a regular basis

You feel the need to drink in order to relax or feel better about something that went wrong that day
You find yourself forgetting what you did during the time when you were drinking.

Traditionally, when considering those with alcohol related problems, the focus has primarily been on those who were severely dependent over a long period of time. This is partially due to the fact these individuals have experienced serious consequences and are, in general, highly visible. Yet we now know this only encompasses the minority of those suffering from alcohol abuse problems, and that even those considered mildly dependent still experience significant problems in daily life and may need treatment.

Since those with mild to moderate dependence are not the focus of treatment and prevention efforts, they may not be identified as needing help. In addition, due to the emphasis placed on those experiencing severe dependence, those with milder dependence may believe they are not in need of help, despite also experiencing adverse consequences related to their alcohol consumption.

Despite the history of focusing on those with severe alcohol dependence, the fact is that every day thousands of families are affected by alcohol abuse, the majority of which involve an individual with mild to moderate alcohol abuse. While we may have experience with a friend or loved one suffering from this disorder, unless we’ve gone through similar problems to what these individuals are experiencing, we may find it difficult to fully understand just how devastating even lighter alcohol use and abuse can be.

Many may be sympathetic to the plight of individuals with severe problems such as inability to function without the alcohol, numerous adverse consequences, and refusal to stop using alcohol even in hazardous situations. However, little understanding may be shown for those who have less severe alcohol related conditions, with the assumption being that these individuals should be able to get the problem under control and that the inability to do so reflects poor judgment or lack of positive values.

Although most of us have likely seen the effects of this illness on a friend or family member, those who haven’t suffered from the disorder often don’t understand just how difficult or devastating it is for the individual themselves. This is especially the case for those who are experiencing less severe addiction related problems.

Statistics

Alcohol addiction statistics

Estimates for the previous year prevalence rate for American adults, age 18 and above, has been reported at 8.5%. In contrast, for those age 12- 17, the past year prevalence rate has been estimated at 4.6%. Gender differences have been found with rates in women (4.9%) being significantly lower than in men (12.4%). The highest rates are found in 18-29 year olds (16.2%) with those age 65 and older showing the lowest rages of alcohol abuse (1.5%).

Co-Occurring Disorders

Alcohol addiction and co-occurring disorders

Disorders that have been found to co-occur with Alcohol abuse include:

Other Substance Abuse Disorders – most frequently stimulants, which are used to decrease fatigue that often results from alcohol use
Anxiety Disorders
Post-Traumatic Stress Disorder
Major Depressive Disorder
Dysthymia
Bipolar Disorders
Schizophrenia
Antisocial Personality Disorder
Infections
Cancer

Causes and Risk Factors

Causes and risk factors of alcohol addiction

Genetic – There appears to be a strong genetic link for the development of alcoholism. It has long been recognized that alcoholism runs in families, and those with a first degree relative with the disorder are more likely to develop the disorder.
Brain Chemistry – One of the chemicals in the brain responsible for neural communication, serotonin, has been shown to be associated with greater tolerance for alcohol in some people.
Brain Structures – The amygdala, a brain structure shown to be important in coping with cravings for alcohol, has been shown to be shaped differently in individuals suffering from alcohol addiction.
Stress – Alcohol can improve mood, but it can also lead to emotional numbing. For those who experience a high level of uncontrollable, unpredictable stress, leading to feeling helpless and overwhelmed by negative emotions, alcohol can provide an escape.
Social and Cultural Pressures – When alcohol consumption is presented in the media, the positive effects generally are over represented, while the negative effects are underrepresented.

Signs and Symptoms

Signs and symptoms of alcohol addiction

Symptoms of Alcohol Use Disorder include:

Psychological/Mood symptoms:
- Altered mood state
- Numbing of emotions
- Psychological dependence, leading to the belief that the individual won’t be able to function normally in major life areas
- The person keeps using alcohol despite knowing that alcohol has led to or worsened psychological problems
- Social withdrawal, due to negative mood or perceived rejection
- At high doses, paranoia

Physical symptoms:
- Alcohol used for longer duration or in greater amounts than intended
- Attempts to cut down using alcohol, which fail
- Legal problems resulting from breaking the law while under the influence of alcohol
- Physical cravings when there is a decrease in the amount used
- The individual continues to use alcohol despite knowing that it has led to or worsened medical problems

Behavioral symptoms:
- A great deal of time is spent obtaining, using, or recovering from alcohol
- Inability to fulfill major role obligations and responsibilities
- Lack of participation in enjoyed activities due to alcohol use
- Recurrent use in situations that could be hazardous
- Continued drinking, despite the knowledge that it is leading to aggression or violent outburst
- Tolerance
  - Larger amounts needed to achieve the desired sensations
  - The same amounts consumed results in decreased effect
Withdrawal
- Alcohol used as a means of preventing withdrawal symptoms
- Physiological or psychological effects result following cessation of alcohol use

Effects

Effects of alcohol addiction

Effects of Alcohol Abuse include:

Unintentional injuries due to lack of coordination
Violence against others, due to increased anger combined with lack of inhibition
Risky sexual behaviors due to poor judgment
Miscarriage and stillbirth in pregnant women using alcohol
Fetal Alcohol Syndrome in children of mothers who used alcohol while pregnant
Alcohol poisoning
Decreased respiration
Suppressed central nervous system
Low blood temperature
Lowered body temperature
Coma
Death

Withdrawal Symptoms

Withdrawal symptoms of alcohol addiction

There are a number of withdrawal symptoms associated with no longer using alcohol after dependence has been established, which often are alleviated through a medical detox. Some of the most common include: