Medically Reviewed by Dr. Francine Mends, MD on August 3, 2020
What is Alcohol Addiction?
In 2015, about 37 million American adults binge drank once a week. But binge drinking is not the same thing as addiction. You can be a heavy drinker without being dependent on the substance.
At least 15 million people in the U.S. are estimated to have an alcohol use disorder (AUD). This refers to compulsive and uncontrolled alcohol use despite negative outcomes. When unable to drink, people with an AUD feel irritable or stressed.
What Causes Alcohol Addiction?
Alcohol addiction can develop over months or years. The following possible factors can cause an Alcohol use disorder:
- Teenage drinking can increase the chances of dependence later on.
- Low taxes on alcohol and easy access to bottle stores.
- Stress, trauma or mental health issues can cause substance abuse.
- Being in an environment where excessive drinking is the norm can set off addiction.
- Research suggests that alcohol boosts dopamine levels to a greater extent in men than in women. This may explain why AUDs are more common among men.
- Genetic factors can play a part.
Why is Alcohol Addiction Considered a Disease?
An alcohol use disorder is a chronic and progressive brain disease brought on by excessive drinking. Alcohol misuse leads to chemical changes in the brain which interfere with your reward system. Drinking boosts levels of dopamine—one of our feel-good hormones. This motivates a person to repeat the act of drinking.
But repetitive use of alcohol causes your brain to try to restore balance. As a result, the brain begins to adapt, making you less sensitive to dopamine. As a result, you develop a tolerance. To get the same rewarding feeling, you have to consume more alcohol.
Alcohol also disrupts the part of your brain which governs sound decision-making. It becomes difficult to resist drinking. This is how many people find themselves in the vicious cycle of an AUD.
As an AUD becomes more severe, the absence of alcohol can cause serious withdrawal symptoms. Cravings can become as powerful as the need for food and water. At this point, alcohol use is less about pleasure than about avoiding discomfort.
How Does Alcohol Affect the Brain?
Alcohol has other effects on the brain too. Chronic use can throw off the balance of the chemical messengers GABA and glutamate. This slows your system down, lowering energy levels and inhibitions with it. It affects clear thinking and coordination and makes you appear to be drunk. These chemical changes can also make you feel depressed.
Is Alcohol Addiction Hereditary?
As mentioned above, genetic factors can contribute to AUDs. Gene variants can affect how you break down alcohol and how sensitive you are to alcohol’s effects. Your internal clock genes may affect whether you drink in response to stress.
Some people release more endorphins—natural opioids—in response to alcohol than others do. This is the case even when consuming the same amount of alcohol. Greater rewards lead to more frequent drinking.
It’s possible to inherit addictive behaviors from your family. If you have a parent who has struggled with an AUD, you are not alone. About 10% of Americans grow up with parents who have a drinking problem. The odds of developing an AUD are four times higher in this population.
But a family history with an AUD can only affect you if you allow it to. It’s important to remember this: Your personal choices and environment can help you lead a healthy lifestyle.
Recognizing Alcohol Addiction
Various problems can occur due to alcohol addiction. The following questions are similar to the questions a primary care doctor or addiction counselor will ask in order to formally diagnose you. They help to indicate the severity of your alcohol misuse:
- Do you have times when you drink too fast or you drink more than you intend?
- Do you need to consume a lot of alcohol to feel its effects?
- Have you, on more than one occasion, tried to reduce your alcohol intake without success?
- Do you experience withdrawal symptoms when abstaining regardless of intensity?
- After drinking, have you engaged in risky behavior? i.e., such as swimming, driving or operating machinery, having unprotected sex, etc.
- Has drinking led to interactions with police officers, arrests and/or legal issues?
- Have you blacked out or been unable to recall what happened when you were under the influence of alcohol?
- Do you drink even though alcohol has caused rifts in your relationships?
- Do you drink even though you know it is making other mental and physical health issues worse?
- Has drinking caused financial troubles or issues with meeting your responsibilities at work, school or home?
- Does getting, using and recovering from alcohol take away from time you used to spend on hobbies or other fun activities?
- Do you have feelings of guilt about your drinking?
If you’ve answered yes to 2 or more of these questions, it may be time to consider getting help for alcohol addiction.
Symptoms of Alcohol Addiction
Alcohol use disorder can take a toll on the body. Some of the most common symptoms of alcohol addiction are:
- Slurred speech
- Poor coordination
- Memory impairment
- Thinking impairment
- Being secretive about alcohol use
- Putting in more time and energy into drinking over family, work and obligations
- Wanting to stop drinking but being incapable
- Engaging in risky behavior
- Being in denial about alcohol abuse
- Becoming distressed if alcohol is inaccessible
Effects of Alcohol Addiction on Health
Long-term effects of alcohol addiction are plenty and extremely damaging to one’s health and wellbeing. The effects of alcohol addiction on health are:
- Damage to the nervous system
- Liver damage
- Heart disease
- Stomach and pancreas inflammation
- Bone loss
- Disrupted menstruation
- Eye-muscle weakness
- Wernicke-Korsakoff syndrome
Physical and Behavioral Effects of Alcohol Addiction
A drinking problem can alter your behavior. You may start to drink heavily when you’re on your own. You may find yourself neglecting your hygiene or lying about your drinking habits. Alcohol can cause you to become aggressive, conflict-prone and violent. It can change your personality.
Alcohol can also cause cognitive impairments. This can impact your spatial processing, your working memory and your ability to stay focused and learn new things. Cognitive damage can also bring about mood disorders, self-harm and suicidal thoughts.
Getting Help with Alcohol Addiction
Treatment for an AUD differs on a case-by-case basis. A physician or therapist will assess you and decide whether tapering or quitting is necessary. If you must quit drinking alcohol, it is important to check into a treatment program. Treatment programs can include:
Inpatient Treatment: Should be considered for people who are at high risk of having severe withdrawal symptoms. Inpatient treatment can be held in a hospital-based setting or a rehabilitation facility. Patients receive around-the-clock care and cannot leave the facility.
Residential Treatment: Should be considered for people who have already attended either inpatient or outpatient treatment, but who still require continued care and supervision in a drug-free environment. Similar to inpatient, patients cannot leave the facility.
Outpatient Treatment: Should be considered for people with less severe AUD. People who are not considered high-risk for severe withdrawal symptoms can receive treatment for a few hours during the week while continuing to live at home.
Other factors of treatment also include:
If your AUD is on the milder end of the spectrum, an at-home detox may be possible. However, withdrawal from alcohol can be deadly. The safest route is a medical detox at a qualified detox center where you can be monitored around-the-clock. Doctors can provide you with medication to minimize discomfort.
Therapy is a major element of any treatment plan. Counseling can take place in small groups or in one-on-one sessions. Often, your therapist will look at how invested you are in recovering. This informs the treatment approach.
Therapy finds solutions for the root causes of substance abuse. One such therapy is Cognitive Behavioral Therapy (CBT), which helps teach patients coping strategies to deal with triggers and cues. Counselors use therapies like CBT and many others to provide patients with tools to prevent relapses and maintain a high quality of life.
There are a number of medications that help with alcohol use disorder. Some can aid during the process of withdrawal, while others serve to help patients refrain from drinking while in recovery. Some of these medications are:
- Antabuse: makes you feel sick if you drink.
- Acamprosate: lessens the discomfort of withdrawal symptoms.
- Naltrexone: reduces the effects of withdrawal. It can also prevent cravings.
A doctor will be able to advise you about the best options for your needs.
Groups such as Alcoholics Anonymous can help you to stay sober after formal treatment ends. Finding a sponsor that you trust can keep you accountable and provide support and guidance in the event of a relapse.
Family therapy and Al-Anon can help family members work through their feelings. It also provides loved ones with the ability to find ways to be there for the user without enabling them.
Find Help Today
If you or someone you know is struggling with an alcohol use disorder, don’t lose hope. Alcohol may be a disease, but it is largely reversible. Quicker actions mean less damage to the body and mind. So, the sooner you act, the better.
Studies show that rehab and medical management can lower a person’s alcohol intake. About a third of people who receive treatment for an AUD have no symptoms a year later. Others reduce their drinking and report fewer alcohol-related issues.
Search through our directory for more information and to find a treatment facility near you.
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