Lena Savoie
Alcohol use disorder, commonly known as alcoholism, is a prevalent medical condition. Alcoholism is characterised by an inability to stop drinking, even when it causes significant disruption to one's life and the lives of those around them. While the specific criteria for diagnosing alcoholism vary from mild to severe, the underlying theme is a loss of control over alcohol consumption. This loss of control can manifest as choosing alcohol over essential activities such as eating. The physical and mental health consequences of excessive alcohol consumption are well-documented and include nutrient deficiencies, intestinal inflammation, and an increased risk of developing serious diseases, including numerous cancers. Recognising the signs of alcoholism and seeking appropriate treatment, such as behavioural therapy and medication, are crucial steps towards recovery.
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What You'll Learn
Alcohol use disorder (AUD) diagnosis and treatment
Alcohol use disorder (AUD) is defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as "a problematic pattern of alcohol use leading to clinically significant impairment or distress". It is characterized by a strong craving for alcohol and can cause physical issues like alcohol withdrawal symptoms. AUD can be mild, moderate, or severe, depending on the number of symptoms a patient has experienced in the previous 12 months.
To diagnose AUD, healthcare providers use the criteria laid out in the DSM-5. Treatment for AUD depends on the severity of the condition and can include inpatient medical treatment, residential rehabilitation, behavioral treatment, and medication. Behavioral treatment focuses on counseling that changes drinking behavior, and the U.S. Food & Drug Administration has approved naltrexone and acamprosate as medications for AUD treatment.
While people with AUD may start drinking again, studies show that with treatment, most people are able to reduce their alcohol consumption or stop drinking entirely. However, relapse is common, and individuals may start drinking again to cope with stressful events. To prevent AUD, individuals should avoid high-risk drinking, which is defined as consuming more than four drinks in one day or eight drinks per week for women, and more than five drinks in one day or 15 drinks per week for men.
Additionally, it is important to note that alcohol is not a food replacement and should not be used as one. Alcohol is a toxin, and the body will prioritize breaking it down over food, leading to decreased nutrient absorption and potential health issues such as Wernicke-Korsakoff Syndrome and disruption of the gut microbiome.
If you or someone you know is struggling with AUD, there are resources available to help. SAMHSA's National Helpline is a free, confidential, 24/7 treatment referral and information service for individuals and families facing substance use disorders.
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Alcohol's impact on nutrition and health
Alcohol use disorder (AUD), commonly known as alcoholism, is a common medical condition. People with AUD cannot stop drinking, even if their alcohol consumption negatively impacts their lives and the lives of those around them. AUD can be mild, moderate, or severe, and it can lead to physical issues like craving alcohol or experiencing alcohol withdrawal symptoms. Treatment for AUD may include medication and behavioural therapy.
Alcohol consumption can have a significant impact on nutrition and health. Firstly, alcohol provides "empty calories", meaning it is high in kilojoules or calories but lacks nutritional value. Alcohol contains seven calories per gram, compared to four calories per gram of protein and carbohydrates and nine calories per gram of fat. These empty calories can contribute to weight gain and obesity, increasing the risk of various health issues.
Secondly, alcohol negatively affects the absorption of nutrients. As a toxin, alcohol takes priority over food in the breakdown process, delaying or reducing the availability of nutrients from food. Alcohol is absorbed in the mouth, stomach, and small intestines, and it is processed by the liver. Binge drinking can lead to a significant build-up of free radicals, causing damage to the body over time. Additionally, excessive alcohol consumption causes stomach and intestinal inflammation, further reducing nutrient absorption due to damage to the gastric cells and intestinal lining.
Alcohol abuse can also lead to thiamin deficiency, increasing the risk of developing Wernicke-Korsakoff Syndrome, which includes symptoms such as dizziness, confusion, vision problems, amnesia, tremors, and coma. Alcohol consumption impairs both the innate and adaptive immune systems, increasing the body's susceptibility to viruses, unhealthy bacteria, and other disease-causing microorganisms. It also disrupts the gut microbiome, reducing good gut bacteria and increasing harmful bacteria, which can affect mood and cognitive functioning.
Furthermore, alcohol increases the risk of developing various diseases, including cardiovascular disease, liver disease, digestive disorders, and cancer, especially of the mouth, throat, oesophagus, colon, rectum, liver, and breast in women. Even moderate drinking has been associated with negative health outcomes, and there is no safe level of alcohol consumption when it comes to cancer risk.
It is important to note that the impact of alcohol on health and nutrition is complex and not fully understood. Some studies suggest that moderate drinking may have potential benefits, such as a reduced risk of cardiovascular disease and protection against type 2 diabetes and gallstones. However, these findings may be influenced by other lifestyle factors associated with moderate drinking, such as exercising more and not smoking. Overall, it is crucial to weigh the risks and benefits of alcohol consumption and to make informed choices regarding one's health and nutrition.
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Alcohol relapse triggers
Alcohol use disorder (AUD), or alcoholism, is a common medical condition where individuals are unable to stop drinking despite the negative consequences on their lives and the lives of those around them. While recovery from AUD is possible, relapse is common.
External triggers are elements in one's environment or daily routine that can lead to alcohol cravings. These can include people, places, and things associated with past drinking. For instance, seeing friends or family members that one often drank with can trigger a craving. Similarly, visiting places where one frequently drank can also trigger a relapse. Social events and celebrations where alcohol is present can also be significant external triggers.
Additionally, certain foods can act as external triggers for alcohol relapse. Many foods and cooking processes require alcohol, and even small amounts of alcohol in food can trigger a relapse. Therefore, individuals recovering from AUD should be cautious when consuming food cooked with alcohol and may need to substitute ingredients or avoid certain dishes.
Identifying, understanding, and managing triggers is crucial in maintaining sobriety. By recognizing and addressing these triggers, individuals can take steps to avoid or plan for cravings, thereby reducing their power and increasing control over their recovery.
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Managing cravings
Alcohol use disorder (AUD), or alcoholism, is a common medical condition. People with AUD experience intense cravings for alcohol and are unable to stop drinking, even if their alcohol consumption negatively impacts their lives and the lives of those around them. AUD can be mild, moderate, or severe, and is diagnosed based on criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Treatment options include behavioural therapy, medication, inpatient medical treatment, and residential rehabilitation.
Understand the Causes of Cravings
Alcohol cravings can arise from physiological, psychological, and environmental factors. When an individual drinks regularly or becomes addicted to alcohol, their brain's reward system adapts to the presence of alcohol, leading to a dependence that results in intense cravings. Understanding the underlying causes of cravings is essential for developing effective strategies to manage them.
Avoid Temptation
A practical strategy to manage cravings is to avoid situations that may trigger an urge to drink. At home, keep little or no alcohol, and socially, refrain from participating in activities involving drinking. While it is not possible to avoid all tempting situations, having a range of strategies to handle urges is beneficial. Remind yourself of the reasons for making a change and carry these reminders with you, such as on a wallet card or in an easily accessible electronic message.
Practice Mindfulness and Meditation
Mindfulness and meditation are valuable coping mechanisms that can help individuals become more aware of their feelings and emotions. By learning to be present in the moment, individuals can gain control over their cravings and avoid automatically giving in to the urge to drink.
Challenge Negative Thought Patterns
Negative thought patterns can contribute to cravings. Identifying and reframing unhelpful thoughts and beliefs can lead to a more balanced perspective and a reduced desire to drink. This process, known as "urge surfing," allows individuals to ride out cravings without succumbing to them, gradually weakening alcohol's hold on their behaviour.
Engage in Enjoyable Activities and Hobbies
Healthy distractions, such as enjoyable activities and hobbies, can divert attention away from cravings. These distractions provide an outlet for individuals to channel their energy and focus, helping to reduce the intensity of cravings and the risk of relapse.
Seek Professional Help
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Treatment options for AUD
While choosing alcohol over food does not necessarily indicate that one is an alcoholic, it is true that alcohol use disorder (AUD) is a common medical condition where individuals cannot stop drinking, even if it upends their lives and the lives of those around them. AUD can be mild, moderate, or severe, and is determined by a healthcare provider using the criteria laid out in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).
There are various treatment options available for AUD, and it is important to note that there is no one-size-fits-all solution. Treatment options include:
- Behavioral treatments: These aim to change drinking behavior through counseling with addiction counselors or psychologists.
- Medication: There are currently three medications approved for AUD in the United States: Naltrexone (available as a pill or injection) helps reduce the urge to drink; Acamprosate is a pill that decreases the negative symptoms associated with alcohol abstinence; and Disulfiram discourages drinking by causing unpleasant symptoms when alcohol is consumed.
- Inpatient medical treatment or residential rehabilitation: For severe cases of AUD, inpatient or residential treatment may be recommended.
- Support groups and community organizations: SAMHSA's National Helpline offers a free and confidential referral service for individuals and families facing substance use disorders. They provide referrals to local treatment facilities, support groups, and community-based organizations.
- Online tools: The NIAAA Alcohol Treatment Navigator® is an online tool that helps individuals find qualified treatment providers near them.
It is important to note that treatment for AUD should be tailored to the individual, and relapses may occur. It is crucial to seek help and support to understand the underlying causes of addiction and to find the most effective treatment options.
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Frequently asked questions
Alcohol use disorder, also known as alcoholism, is a common medical condition where people are unable to stop drinking despite the negative impact it has on their lives and the lives of those around them. Symptoms include craving alcohol, experiencing alcohol withdrawal, and planning one's life around the next drink.
Alcohol is a toxin that the body prioritizes over food during breakdown, which delays or decreases the availability of nutrients. Excessive alcohol consumption can lead to stomach and intestinal inflammation, resulting in decreased nutrient absorption and an increased risk of developing certain diseases, including numerous cancers.
For women, it is recommended to not exceed four drinks in one day or eight drinks per week. For men, the recommendation is to not exceed five drinks in one day or 15 drinks per week. Binge drinking, which is consuming more than the recommended number of drinks in a short period with the intention of getting intoxicated, can lead to serious short-term and long-term health consequences.
Recovering alcoholics may be triggered by the taste of alcohol in food, leading to cravings and a potential relapse. While some may be able to tolerate food with alcohol, it is important to understand individual limits and triggers. It is recommended to avoid cooking with alcohol or to use substitute ingredients when cooking for a recovering alcoholic.
