Lena Savoie
Alcoholism, or severe alcohol use disorder, can manifest in various ways, and it can be challenging for individuals to determine if their drinking habits are problematic, especially if they are high-functioning in other areas of their lives, such as academics or work. College students often view drinking as an integral part of their college experience, and this environment can exacerbate existing drinking habits or lead to the development of harmful drinking behaviours. Binge drinking is prevalent among college students, and it can have negative consequences on their health, academics, and social lives. This raises the question: Am I an alcoholic, or am I just exhibiting typical college behaviour?
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What You'll Learn
College students and harmful drinking
College drinking culture has become a ritual that students often see as integral to their higher education experience. Many students arrive at college with established drinking habits, and the college environment can exacerbate the problem. The first six weeks of freshman year are a vulnerable time for heavy drinking due to student expectations and social pressures. Students attending schools with strong Greek systems or prominent athletic programs tend to drink more than students at other types of schools. Alcohol consumption is highest among students living in fraternities and sororities and lowest among commuting students who live with their families. Research has shown that students who choose not to drink often do so because their parents discussed alcohol use and its adverse consequences with them.
Harmful and underage college drinking is a significant public health problem, and it exacts an enormous toll on the intellectual and social lives of students on campuses across the United States. About one in four college students report experiencing academic difficulties from drinking, such as missing class or getting behind in schoolwork. In a national survey, college students who binge drank alcohol at least three times per week were roughly six times more likely to perform poorly on a test or project as a result of drinking. Binge drinking is defined as consuming a large amount of alcohol at one time: for men, it's five or more drinks within two hours, and for women, it's four or more drinks in that time frame.
Alcoholism, or severe alcohol use disorder (AUD), can manifest in different ways. Some individuals find it difficult to identify whether their drinking is a problem because they may be high-functioning in other areas of life, such as at work or school. Others may notice more obvious red flags, such as daily blackouts, frequent hangovers, or strained relationships due to alcohol. Common signs that might indicate alcoholism include difficulty limiting alcohol consumption, spending a significant amount of time obtaining or recovering from alcohol, and experiencing alcohol withdrawal symptoms.
The young adult subtype makes up the largest of the five subtypes of alcoholics. Accounting for 31.1% of alcoholics, people within this group begin drinking around age 19 and develop alcoholism by around age 24. This group tends to be college-aged males who binge drink. The functional subtype group, which makes up 19.5% of people addicted to alcohol in the U.S., manages to prevent their drinking from interfering with other areas of their lives, such as relationships or work. The negative consequences of their drinking typically go unnoticed by others, and their loved ones may not realize they are alcoholics until a serious mental or physical issue arises.
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Binge drinking and its consequences
Binge drinking is a common behaviour, especially among college-aged males. It is defined as consuming enough alcohol to reach a blood alcohol concentration (BAC) of 0.08% or higher, which typically means drinking four or more drinks for women and five or more drinks for men within about two hours. Binge drinking can have serious short-term and long-term effects on the body and brain, and it increases the risk of severe health and safety consequences.
The immediate signs of intoxication include poor coordination, poor judgment, and impaired executive functioning. Binge drinking can also lead to blackouts, alcohol poisoning, and overdoses. It increases the likelihood of unsafe sexual behaviour and the risk of sexually transmitted infections and unintentional pregnancy. The risk of injury is also heightened due to impaired judgment and coordination, and injuries sustained while intoxicated may have more severe complications and take longer to heal.
Binge drinking can also have serious long-term health effects. Frequent binge drinking can lead to health problems such as acute pancreatitis (inflammation of the pancreas) and acute inflammation and irritation of the stomach and liver. Research has also shown that even a single episode of binge drinking can compromise the function of the immune system.
In addition to the physical health risks, binge drinking can also impact mental health and relationships. It can contribute to or exacerbate existing mental health issues such as depression, social phobias, and bipolar disorder. Binge drinking can also strain relationships and lead to social and financial problems. For college students, it can interfere with academic performance and future career prospects.
Recognising the scope of the problem and addressing it through public health interventions, such as alcohol taxes, advertising guidelines, and restrictions on alcohol availability, can help reduce the negative impact of binge drinking on individuals and society. If you think you may have a drinking problem, it is important to seek help from a doctor or other professional resources.
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Alcoholism subtypes and treatment
Alcoholism, or alcohol use disorder, is a complex condition that affects individuals differently. The National Institute of Health and the National Institute on Alcohol Abuse and Alcoholism (NIAAA) have identified five distinct subtypes of alcoholics, challenging the notion of a "typical alcoholic". These subtypes are based on various factors, including age, family history, mental health conditions, and substance use disorders. Recognizing these subtypes can help individuals understand their relationship with alcohol and seek appropriate treatment.
Young Adult Alcoholics
This subtype includes individuals in their late teens or early 20s, with a high proportion being college students. They start drinking at a young age and may develop alcohol dependence early on. Many experience excessive social drinking due to the cultural norms surrounding them. According to the 2019 Monitoring the Future survey, 12% of college students and young adults engage in high-intensity or binge drinking. Unfortunately, alcohol-related injuries and deaths are prevalent in this age group.
Young Antisocial Alcoholic
This subtype is characterized by a high prevalence of psychiatric disorders, such as major depression, anxiety disorders, and bipolar disorder. They often have a family history of alcohol dependence and high rates of substance use disorders, including tobacco, cannabis, and cocaine use. Approximately three-fourths of this group smoke, and many struggle with additional addictions. While they may appear successful and well-adjusted, only about one-third seek treatment for their drinking problems.
Intermediate Familial Alcoholic
This subtype has a strong family history of alcoholism and a high probability of mental health disorders, including depression, bipolar disorder, and anxiety. They often use alcohol as self-medication to cope with emotional symptoms. Nearly half of this group have a close family member who is also an alcoholic. While they tend to have higher education levels and full-time jobs, their income levels are lower compared to other subtypes. They are less likely to seek treatment but may attend self-help groups and specialty treatment programs when they do.
Functional Alcoholic
Individuals in this subtype maintain their daily responsibilities and successful careers while regularly consuming alcohol. They often conceal their alcohol dependence and may have a family member with alcohol dependence. They have moderate rates of depression and smoking but lower rates of other substance use disorders. Functional alcoholics are less likely to seek treatment, but when they do, they may turn to 12-step programs and private healthcare professionals.
Chronic Severe Alcoholic
This subtype is characterized by a compulsive need to drink daily, and they often experience withdrawal symptoms without alcohol. They start drinking at a young age and have a high prevalence of antisocial personality disorder. They have the highest rate of close family members with alcoholism. This group makes up the smallest percentage of alcoholics, and they are more likely to seek treatment, including detox programs and inpatient programs.
Treatment for alcoholism typically involves detoxification, therapy (individual and group sessions), medication to reduce cravings, and support groups. It is important to address the root causes of alcoholism and manage both the physical and psychological aspects of the disorder.
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Signs of alcohol addiction
Alcoholism, or severe alcohol use disorder (AUD), is defined as the inability to stop using alcohol excessively despite negative impacts on one's life. It is considered a disease that affects the brain and can manifest in different ways. While some individuals may exhibit obvious signs such as daily blackouts and strained relationships, others may be high-functioning, successfully maintaining jobs, families, and stable lives. This makes it difficult for them and those around them to identify their drinking as a problem.
- Drinking in secret and alone: Drinking in isolation can be a sign that a person is ashamed of their drinking habits and doesn't want others to know about it.
- Loss of interest in other activities: Alcohol addiction can cause a person to lose interest in activities they once enjoyed, as their focus shifts to obtaining and consuming alcohol.
- Making drinking a priority: Alcohol becomes a priority over responsibilities, work, and other commitments.
- Alcohol withdrawal symptoms: Experiencing withdrawal symptoms when not drinking, such as nausea, sweating, shaking, or anxiety.
- Mood swings and irritability: Alcohol addiction can lead to extreme mood swings and irritability, impacting relationships and social functioning.
- Inability to control alcohol consumption: Difficulty limiting the amount of alcohol consumed and an inability to stop drinking, even when facing health, financial, or family problems.
It's important to note that these signs may not be indicative of alcohol addiction in every case, and only a healthcare provider can provide an accurate diagnosis. If you or someone you know is struggling with alcohol misuse, seeking professional help is crucial.
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Alcohol's impact on health and relationships
Alcoholism, or severe alcohol use disorder, can impact different people in different ways. Some individuals may not realize they have a drinking problem because they are high-functioning in other areas of their lives, such as at work or school. However, the negative consequences of their drinking may be apparent to others, and their loved ones may not realize they are alcoholics until a serious mental or physical issue arises.
Alcoholism is considered a disease that affects the brain, and it can be a mild, moderate, or severe disorder. Alcohol intoxication affects the brain, behavior, and bodily functions. It interferes with the brain's communication pathways and can affect the way the brain looks and works. These disruptions can cause mood swings, irritability, and a lack of coordination.
Excessive alcohol use can have serious immediate and long-term health risks. It can negatively impact the whole body, including the liver, brain, gut, pancreas, lungs, cardiovascular system, and immune system. Even low amounts of alcohol consumption can have health risks, and the more a person drinks, the higher their risk of developing alcohol-associated cancer. Alcohol use can also cause high blood pressure, heart disease, liver disease, digestive problems, reproductive dysfunction, and an increased risk of developing type 2 diabetes.
Alcoholism can also impact a person's relationships. Studies have shown that spouses of individuals with alcohol problems report elevated rates of anxiety and depression, decreased levels of marital satisfaction, and more frequent reports of mood disorders and physical and emotional abuse. Alcohol use can serve as a source of conflict and tension in committed romantic relationships, and it can be challenging for partners to determine what constitutes acceptable and unacceptable drinking behavior.
If you or someone you know is struggling with alcohol addiction, it is important to seek help. There are resources available to support individuals and their loved ones in managing alcohol addiction and improving their health and well-being.
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Frequently asked questions
Alcoholism, or severe alcohol use disorder, can manifest in different ways. Some common signs that might indicate alcoholism include:
- Craving alcohol
- Drinking alone and in secret
- Losing interest in other activities
- Making drinking a priority over responsibilities
- Experiencing alcohol withdrawal symptoms
- Continuing to drink despite health, financial, and family problems
- Inability to stop or control the amount of alcohol consumed
People who struggle with alcohol addiction tend to fall into one of five different alcoholic subtypes:
- Young adult subtype: This group makes up the largest subtype, accounting for 31.1% of alcoholics. They begin drinking around age 19 and develop alcoholism by around age 24. This group tends to consist of college-aged males who binge drink.
- Functional subtype: This group manages to not let their drinking interfere with other areas of their life, such as relationships or work. The negative consequences of their drinking often go unnoticed by others.
- Intermediate familial subtype: This group starts drinking much earlier, usually around age 17. They are mostly male, and they typically develop alcohol dependency in their early 30s. People in this group often have family members who are also alcoholics and may use other substances.
- Young antisocial subtype: This group begins drinking at a very young age, as early as 15, and becomes dependent on alcohol by 18. They have high rates of depression, social phobias, bipolar disorder, and co-occurring substance abuse.
- High-functioning subtype: These individuals are often successful, with families and stable jobs. They make up about 19.5% of people addicted to alcohol in the US.
Drinking in college can have several negative consequences, including:
- Academic difficulties: About one in four college students report experiencing academic difficulties from drinking, such as missing class or falling behind in schoolwork.
- Alcohol-related sexual assaults: Research has found that one in five college women experience sexual assault during their time in college, with a majority of these assaults involving alcohol or other substances.
- Health complications: Binge drinking can lead to health issues and increase the risk of alcohol poisoning, which can be life-threatening.
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