Alcohol Addiction and Treatment Guide
In the United States, alcohol is everywhere. It can be purchased at grocery stores, gas stations, and pharmacies. It’s enjoyed at bars, clubs, restaurants, movie theaters, sports games, and more. Many people use alcohol socially and overuse it on occasion. However, alcohol abuse and addiction can occur quickly. You may feel like you don’t drink any more than your friends do, so how can you have a problem if they don’t? Still, you could be developing an alcohol use disorder (AUD), which is more common than you think.
In fact, 1 in every 12 adults aged 18 and older in the U.S. meets the criteria for alcohol addiction. Alcohol addiction is a chronic disease that can have destructive, potentially fatal effects on the person who is dependent on alcohol and the people around them as well.
An alcohol use disorder is defined by the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) as a chronic relapsing brain disease, generally characterized by an inability to control one’s alcohol intake, compulsive alcohol use, and a negative emotional state when someone is not using.
Alcohol is classified by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) as the third leading preventable cause of death in the country, claiming nearly 90,000 lives per year. The longer an alcohol use disorder goes untreated, the more likely the physical and psychological damage it can cause will become permanent, and possibly even fatal. This is why it is crucial for someone with an addiction to alcohol to get into recovery treatment as soon as possible.
But how do you know if your drinking is normal alcohol use or an alcohol use problem? What’s the difference between occasional alcohol abuse and addiction to alcohol? Is it possible to recognize the signs in a loved one? Learn more about alcohol addiction below and how you can start taking steps to address this dangerous disorder.
What Is Alcohol Addiction?
Alcohol addiction is officially diagnosed as a substance use disorder that is commonly called alcoholism. It’s a disease affecting the brain and causes you to crave alcohol like it’s a vital, life-sustaining resource. To understand alcoholism, it’s important to understand how alcohol works in the body. Alcohol is known as a central nervous system depressant, which means that when you drink, alcohol slows down, or depresses, activity in the central nervous system.
Alcohol does this by mimicking and binding to a neurotransmitter called gamma-aminobutyric acid (GABA). GABA is a brain chemical that calms you down by blocking signals that cause stress and anxiety from reaching the brain.
So when alcohol enters the body disguised as GABA, it activates the GABA receptors in the brain, stimulating them into overproduction and creating far more GABA than the body would ever be able to on its own. This is why alcohol uses causes feelings of relaxation and a general lowering of inhibitions. It’s also why drinking results in slurred speech, slowed breathing, and impaired movement, as these are all caused by too much GABA.
When someone regularly abuses alcohol for an extended period of time, the brain becomes hardwired to depend on the GABA supplied by the alcohol, as it will have started making much less natural GABA balance things out in the brain.
As a person’s drinking progresses to alcohol dependence and addiction, when they stop drinking, the brain becomes starved of GABA, which is what causes withdrawal symptoms like anxiety, panic attacks, and more. This problem will, of course, only increase as they grow tolerant to alcohol’s effects, needing to drink more to attain the same calming effects as before.
Addiction is related to dependence, but it is a distinct problem. Addiction occurs when alcohol affects the brain’s reward center. Alcohol creates positive feelings by releasing dopamine in the brain. Dopamine is a “feel-good” chemical tied to reward and motivation. It’s one of several chemicals that encourages you to repeat healthy activities, like eating a good meal and sleeping in a comfortable bed.
However, alcohol can cause an unnatural release of dopamine, which your reward center confuses for life-sustaining activities. Repeated alcohol abuse trains your brain to seek alcohol above other priorities in your life. Addiction can cause you to use alcohol compulsively despite the consequences.
Signs of Alcohol Abuse
Alcohol abuse is something many people engage with, even if they never develop a severe alcohol use disorder. Abuse is using alcohol to the point that it causes problems in your life. Frequent binge drinking or heavy alcohol abuse may fall under the category of alcohol abuse. Binge drinking is consuming enough alcohol to elevate your blood alcohol concentration to 0.08%.
More severe alcohol abuse could mean drinking and driving under the influence, and social problems caused by drinking or drinking to the point of alcohol poisoning.
You may notice the signs of abuse in loved ones too. It could involve the following:
Drinking more than they intended to
Frequent excessive drinking
Drinking to the point of blacking out
Non-social binge drinking
Needing to drink at odd times, like the morning
Irritability or anxiety when not drinking
Alcohol use disorders are separated into three categories based on severity: mild, moderate, and severe. In many cases, someone who binges drinks may meet the qualifications of a mild alcohol use disorder.
Symptoms of Alcohol Use Disorder
It can be difficult to identify the signs of a growing problem early on with alcohol abuse that is blossoming into alcohol addiction because they are not always obvious. If you are not paying close attention to the changes in someone else’s or even your own behavior, you may not start to realize there is a problem until the signs of alcohol addiction have begun to interfere with life in a way that is impossible to ignore.
One means of early self-diagnosis involves four simple questions known as the CAGE Questionnaire. These questions can be used by a doctor on a patient as well and are as follows:
Have you ever felt you needed to Cut down on your drinking?
Have people Annoyed you by criticizing your drinking?
Have you ever felt Guilty about drinking?
Have you ever felt you needed a drink first thing in the morning (an Eye-opener) to steady your nerves or to get rid of a hangover?
While this is a very simplistic means of diagnosis, giving a “yes” answer to at least two of the questions is a sign of a growing dependence on alcohol.
As obtaining and drinking alcohol becomes the highest priority in someone’s life and the driving force behind nearly all of their major decisions, there are many behavioral signs of a growing addiction, including:
Experiencing withdrawal symptoms when not drinking
Being unable to function or perform daily tasks without drinking
Drinking multiple times a day
Attempting to rationalize or justify alcohol use
Drinking in risky situations such as while at work or driving
Developing a tolerance and needing more alcohol to get the same effects
Regularly engaging in binge drinking
Being unable to control how much they drink once they start
Blacking out from excessive alcohol use
Choosing alcohol over relationships and responsibilities
A decline in academic or workplace performance
Lying about how much they drink or hiding their alcohol use
Wanting to stop drinking but being unable to
And as abuse progresses into full-blown alcohol use disorder, the behavioral signs of alcohol addiction are both much harder to miss and even more potentially dangerous to both the person who has become dependent on alcohol and those around them. Some of these signs of alcohol addiction include:
Domestic arguments and violence
Legal trouble, including arrests
Child welfare issues
DUI charges or accidents caused by drunk driving
Hospitalization
Apart from behavioral signs of alcohol abuse and addiction, there are also many physical signs of alcohol abuse that, unlike many early behavioral signs, are much more difficult to hide. These physical effects of regularly abusing alcohol include:
Significant changes in weight
Extremely dry skin
Constantly flushed appearance
Frequent stomach cramps
A noticeable decrease in personal hygiene
Impotence and erectile dysfunction
Broken capillaries on the nose and face
A very sudden increase in age spots and wrinkles
Yellowed skin and eyes from liver damage
Injuries that were sustained while intoxicated
Signs like jaundiced skin, in particular, are indicative of severe chronic alcohol abuse and, if left untreated, can have potentially fatal consequences.
Effects of Addiction to Alcohol
Despite its acceptance as a normal, even harmless, activity, alcohol misuse and abuse is anything but harmless. Chronic alcohol abuse and long-term alcohol addiction can, among other things, result in:
Serious heart problems, including abnormal changes in blood pressure and arrhythmia
A weakened immune system leads to an increased risk of infections and disease
Disrupted communication within the brain, resulting in impaired judgment, motor skills, and emotional and behavioral problems
Severe liver damage, including alcoholic hepatitis fibrosis, and cirrhosis
A much higher risk of throat, liver, mouth, esophageal, and breast cancers
Fetal alcohol spectrum disorders such as fetal alcohol syndrome (FAS), developmental disorders, and birth defects resulting from drinking while pregnant
These are just a small sampling of the ways that alcohol can permanently damage someone’s brain and body as well as kill them. These also do not account for the many ways that alcohol can cause serious harm to those around someone engaging in alcohol abuse, such as driving drunk, which accounts for roughly one-third of all traffic-related deaths in the country. It’s important to stay up to date with all medical and health news.
Facts and Statistics
Alcohol addiction is a significant problem in the United States. It has been a problem for decades, but the rising addiction and overdose crisis has made it even worse. Here are some facts and figures according to the 2020 National Survey on Drug Use and Health:
50% of people 12 years old or older used alcohol within a month of the survey.
22% engaged in binge drinking.
6.4 engaged in heavy drinking.
6 million people between the ages of 12 and 20 engaged in underage drinking.
10.2% had an alcohol use disorder in 2020.
How Addictive Is Alcohol?
Alcohol can be extremely addictive after a period of chronic heavy drinking. Alcohol’s pleasurable effects and social acceptance can encourage repeated use and binge drinking. Consistent binge drinking can lead to tolerance, dependence, and addiction.
Tolerance
Alcohol tolerance is the feeling that you need more alcohol to achieve the same effects over time. As your body gets used to the presence of alcohol, it will start to counteract it by changing your brain’s chemical balance. This makes it so that drinking moderate amounts no longer causes the same level of intoxication as it did when you first started drinking.
Alcohol Dependence
Alcohol dependence is when your body has adapted to alcohol to the point of needing it to maintain chemical balance. Cutting back or quitting drinking will cause withdrawal symptoms like anxiety, insomnia, general discomfort, heart palpitations, confusion, and other potentially dangerous symptoms.
Alcohol Addiction
Alcohol addiction is diagnosed as an alcohol use disorder. It’s related to dependence, but it involves the reward center of the brain. Chronic alcohol use can manipulate your brain’s reward center by influencing natural chemicals related to a reward like dopamine. Chronic alcohol use trains your brain to treat alcohol like the rewarding tasks necessary to sustain life. Alcohol addiction will cause you to drink compulsively, even if drinking has caused serious problems in your life.
Alcohol Withdrawal
While some drugs are uncomfortable but not deadly during withdrawal, alcohol withdrawal can be life-threatening. Withdrawal is caused by the sudden lack of alcohol in a brain that has become dependent on it. Withdrawal symptoms can be severe. In addition to physical symptoms, you will also experience powerful cravings to use that can deepen your addiction.
Treatment for Alcoholism
During alcohol addiction treatment, the addicted individual will learn to understand the issues behind their addiction behaviors and be better able to control and manage them. An alcohol addiction treatment program is a person’s best chance at maintaining long-term sobriety.
Alcohol addiction treatment can be done on an inpatient or outpatient basis, depending on the severity of someone’s alcohol use disorder and what will best suit their individual needs. This will also be the determining factor in the length of treatment, although the general recommendation is at least 90 days for minimum effectiveness.
In terms of treatment elements, someone’s alcohol addiction treatment program will typically be somewhat customized based on what is deemed to be the most effective combination of therapies for them. This recovery treatment plan will likely include at least some mix of the following:
Individual therapy
Group therapy
Family therapy
Educational workshops
Holistic therapy (mindfulness, yoga, etc.)
Stress management
Medication-assisted treatment
Dual diagnosis treatment
There are also many post-treatment resources and services available, including support groups such as Alcoholics Anonymous, and treatment center alumni programs, which allow those who bonded through their shared treatment experience to remain in contact as a network of support.
Detox
Central nervous system depressants, including alcohol, have some of the most uncomfortable and potentially dangerous withdrawal symptoms, which is why it is essential for someone’s safety to detox from alcohol in the safety of a professional detox treatment center.
Recovery treatment from alcohol, or really any substance, should start with detoxification. Detox is the process during which alcohol and any accompanying toxins are flushed out from someone’s system in order to both treat intoxication and stem the mental and physical damage caused by long-term alcohol abuse.
Medical detox will cleanse the body of any alcohol and prepare it for the next level of treatment. This can be done through the gradual tapering of alcohol use, as well as professionally administered medications.
A person cannot enter recovery while they are still intoxicated or have alcohol in their system. There is also the issue of struggling with withdrawal symptoms while attempting to try and focus on recovery. Detoxing from alcohol before starting a recovery treatment program leaves a person’s body free of alcohol and their mind free to focus on the challenge of recovery.
Several medications can be used alongside therapies in alcohol addiction treatment, including:
Naltrexone
Naltrexone is a medication that’s often associated with opioid overdose treatment because it can be used to block opioid receptors, but it’s also used to treat alcohol use problems. These same receptors are involved in the rewarding effects of alcohol. Blocking them can diminish the positive effects of using alcohol. A once-per-month injection is FDA-approved to treat alcoholism.
Disulfiram
Disulfiram is a medication sold under the brand name Antabuse. It’s used to act as a deterrent to alcohol consumption. It disrupts your body’s ability to break down alcohol. If you take the medication and then drink alcohol, you’ll experience unpleasant side effects, such as nausea and heart palpitations. The idea is that the drug will discourage alcohol use, and if you do use it, your brain will be trained to associate alcohol with negative feelings. The drug is FDA-approved and may be effective, but it works only if you continue to take it.
Topiramate
Topiramate doesn’t have FDA approval for treating alcohol use disorders yet, but it is being used to treat alcohol use disorders. It’s an anti-epileptic drug that has also been shown to improve treatment outcomes for alcohol use problems.
Residential or Inpatient
Once you’ve completed a detox program or made it to sobriety, you may move on to the next level of care. Residential (inpatient treatment) involves 24-hour care and clinical services. Inpatient treatment involves the medically monitored treatment, which may be necessary for someone who has gone through alcohol withdrawal. In some cases, alcohol can cause post-acute withdrawal symptoms that should be monitored. Residential care involves 24-hour clinically managed treatment.
In terms of treatment elements, someone’s alcohol addiction treatment program will typically be somewhat customized based on what is deemed to be the most effective combination of therapies for them. This recovery treatment plan will likely include at least some mix of the following:
Individual therapy
Group therapy
Family therapy
Educational workshops
Holistic therapy (mindfulness, yoga, etc.)
Stress management
Medication-assisted treatment
Dual diagnosis treatment
Outpatient (PHP or IOP)
Outpatient treatment allows you to live at home while you go through addiction treatment services during the day. It’s broken into smaller levels based on the amount of time you spend in treatment each week. In partial hospitalization (PHP), you will spend 20 hours in treatment each week or more. In Intensive outpatient treatment (IOP), you will spend at least nine hours of treatment per week.
Frequently Asked Questions
If you or someone you know might have an alcohol use disorder, you may have many questions about alcoholism and treatment. Here are some answers to frequently asked questions about addiction treatment:
Can Alcohol Addiction Be Genetic?
Finally, addiction research studies have determined that alcohol use disorders are generally not an isolated event in a family line and can occur across generations. However, the line between what can be considered genetic and what is environmental can seem a bit blurred, as we have already illustrated that children raised by people with alcohol use disorders are likely to develop them as well.
On the other hand, while scientists have yet to identify anything as specific as a gene that indicates susceptibility to alcohol abuse, what we do know is that there are some genetic variations in people that can contribute to raising their risk of alcoholism.
There are certain genes that cause a boost in the intoxicating effects of alcohol in people as compared to people who do not have the gene. Similarly, there are genetic mutations that reduce the effects of a hangover. For someone with both of these genetic variations who experiences more intense effects when they drink with less of a hangover, this can easily lead to them being more likely to misuse or abuse alcohol.
Can Alcohol Addiction Be Cured?
There is no known cure for alcoholism. Alcohol use disorder is a chronic progressive disorder that can last for a very long time. If it’s not addressed, alcoholism can get worse over time, affecting your health and relationships. But, even though alcohol addiction can’t be cured, it can be treated so that you can live a fulfilling life. Addiction treatment is a complex process, and recovery is a lifelong commitment, but many people achieve lasting recovery, even after going through relapses.
Can Alcohol Addiction Kill You?
Yes, it’s possible for alcoholism to lead to fatal consequences over time. Alcohol addiction can be deadly in several ways. Very heavy drinking can lead to acute alcohol poisoning that causes respiratory depression, loss of consciousness, coma, or death. Frequent heavy drinking also increases your risk of an accident or injury. If you get behind the wheel of a car, accidents can be fatal. According to the National Highway Traffic Safety Administration (NHTSA), an estimated 28 people die in drunk driving accidents each day. Alcoholism often kills through chronic health deterioration over time. Chronic alcohol abuse can lead to heart disease and liver disease. It can also increase your risk of certain types of cancer.
Can Alcohol Addiction Cause Mental Illness?
Alcoholism and mental health issues often occur at the same time. Around half of the people who experience a substance use disorder will have mental health issues at some point in their lives. Mental health issues can often lead to substance use problems through self-medication and poor coping responses to uncomfortable psychological symptoms. Alcoholism may also lead to the development of mental health problems like depression. In many cases, alcoholism can worsen or trigger mental health issues.
Can Alcohol Addiction Cause Psychosis?
Psychosis is a mental health problem characterized by a break from reality, which can include hallucinations or delusions. Many psychoactive substances can trigger psychotic episodes, especially in people who may have schizophrenia and similar mental health problems. Marijuana, psychedelics, and stimulants have all been linked to psychotic episodes, or they may be triggering psychotic disorders. Alcohol is a depressant, and its acute effects aren’t usually associated with psychosis. However, alcohol withdrawal is associated with psychosis. This condition can be dangerous, and it sometimes involves a condition called delirium tremens, which includes symptoms like panic, hallucinations, and severe confusion.
Can Alcohol Addiction Cause High Blood Pressure?
Alcohol use disorders are often associated with hypertension. Chronic alcoholism can lead to several long-term health effects, many of which involve the heart. Alcohol can also raise your blood pressure temporarily with a single drink. Increased blood pressure can last up to two hours after one drink. Chronic alcohol use can lead to permanently high blood pressure until you address the problem. Hypertension may not cause any symptoms until it contributes to other cardiovascular problems. Hypertension with chronic alcoholism can increase your risk of a heart attack or stroke.
Can Alcohol Addiction Cause Diabetes?
Alcohol isn’t known to cause diabetes directly, but it can be a risk factor in the development of the disease. Alcoholism can contribute to weight gain, which can contribute to diabetes. Alcoholic drinks that are high in sugar or carbs, like beer, can also contribute to your diabetes risk, as sugary foods can.
Can Alcohol Addiction Cause Night Sweats?
As a depressant, alcohol slows down activity in your nervous system. Heavy drinking can even lower your body temperature and lead to hypothermia, especially if you are outside and exposed to the elements. However, alcohol withdrawal will cause the opposite effects, including an elevated body temperature. Someone with an alcohol use disorder may start to go into withdrawal symptoms during the night, which can cause night sweats.