Theo Nash
Alcoholism, or alcohol use disorder (AUD), is a common medical condition where individuals are unable to stop drinking despite the negative impact on their health, safety, and personal relationships. It is characterised by a strong craving for alcoholic beverages, continued consumption despite adverse consequences, and the development of tolerance and withdrawal symptoms upon cessation. While binge drinking and heavy alcohol use are indicators of AUD, it is important to note that any amount of drinking can be associated with harm, and the level of risk generally increases with the quantity consumed. The treatment for AUD typically involves medication and behavioural therapy, including counselling and detoxification.
| Characteristics | Values |
|---|---|
| Definition | Alcoholism is a form of alcohol addiction, also known as Alcohol Use Disorder (AUD) |
| Symptoms | Craving alcohol, withdrawal symptoms, drinking despite adverse consequences, high alcohol tolerance, drinking to avoid withdrawal, impaired ability to stop or control alcohol use, changes in mood and behaviour |
| Risk Factors | Amount, frequency, and speed of alcohol consumption, drinking at an early age, genetics and family history, mental health conditions, drinking during pregnancy |
| Diagnosis | Criteria outlined in the DSM-5, severity based on number of matched criteria |
| Treatment | Medication, behavioural therapy, mutual-support groups |
| Prevention | Adhering to recommended drinking limits, seeking help early |
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What You'll Learn
Alcohol Use Disorder (AUD) symptoms
Alcohol Use Disorder (AUD) is a medical condition characterised by an impaired ability to stop or control alcohol consumption despite adverse social, occupational, or health consequences. It is considered a brain disorder, and the severity of AUD can range from mild to moderate to severe. AUD encompasses the conditions that some people refer to as alcohol abuse, alcohol dependence, alcohol addiction, and alcoholism.
The risk of developing AUD depends on various factors, including how much, how often, and how quickly one consumes alcohol. Alcohol misuse, including binge drinking and heavy alcohol use, increases the risk of AUD over time. Other factors that increase the risk include drinking at an early age, genetics, and family history.
- Craving beverages containing alcohol
- Experiencing withdrawal symptoms when the effects of alcohol wear off, such as trouble sleeping, shakiness, restlessness, nausea, sweating, a racing heart, dysphoria, malaise, feeling low, or seizures
- Continuing to drink despite the negative impact on relationships, work, or health
- Drinking to avoid withdrawal symptoms
- Giving up or reducing activities that were once important, interesting, or pleasurable to prioritise drinking
- Getting into dangerous situations while drinking, such as driving drunk or engaging in unsafe sex
- Drinking despite having a medical condition or mental disorder that worsens with alcohol consumption
- Developing a high tolerance for alcohol
- Experiencing hangovers and withdrawal symptoms
- Drinking larger quantities of alcohol than most
- Being unable to cut down on drinking despite attempts to do so
It is important to note that AUD takes many forms, and individuals struggling with alcohol addiction come from diverse backgrounds and age groups. If you or someone you know is exhibiting signs of AUD, seeking professional help early is crucial. Treatment options include behavioural therapies, mutual support groups, and medications.
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Stereotypes of alcoholics
Alcoholism is a disease that can affect anyone, regardless of their social status, education, income, or place of residence. However, various stereotypes and myths surrounding alcoholism persist and can hinder understanding, treatment, and support for those affected. Here are some common stereotypes associated with alcoholics:
Unreliability and Emotional Instability:
Alcoholics are often stereotyped as unreliable and emotionally unstable. This perception can lead to negative judgments, devaluation, and exclusion, making it challenging for them to access necessary support and treatment.
Financial Dependence and Self-Pity:
Another stereotype suggests that alcoholics are financially dependent on others and engage in self-pity. These assumptions can create barriers to seeking help, as individuals may not identify with these stereotypes and internalize the stigma, believing they cannot achieve long-term recovery.
Violence and Destructive Behaviour:
Alcoholics are often associated with violence and physical destruction towards themselves or their surroundings. This stereotype has been influenced by popular culture and historical gender norms, where alcoholism was predominantly associated with men. While this gap has narrowed, stereotypes about women being less likely to drink excessively or develop addictions can also deter them from seeking help.
Homelessness and Unemployment:
There is a common misconception that people with alcoholism are incapable of holding jobs or having functional families. In reality, most individuals with alcoholism are hardworking, contribute to their communities, and have families. This stereotype can prevent people from recognizing their addiction and seeking timely treatment.
Choice and Personal Failure:
Alcoholism is often stigmatized as a choice or a personal failure. It is important to recognize that alcoholism is a disease, and individuals struggling with alcohol dependence cannot control their cravings due to changes in their psyche and central nervous system. This understanding can help reduce blame and encourage a more supportive approach to treatment and recovery.
Challenging these stereotypes is crucial to ensuring that individuals struggling with alcoholism can access effective treatment without fear of judgment or discrimination. Open conversations about alcohol dependence and recovery can play a vital role in breaking down these stereotypes and fostering empathy and support for those affected.
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Withdrawal symptoms
Alcohol withdrawal symptoms can range from mild to severe and typically occur within 8–12 hours after the last drink, but they can also occur days later. The severity of the symptoms depends on how much and how often a person drinks. Withdrawal symptoms are a sign that a person is becoming dependent on alcohol.
Mild symptoms of alcohol withdrawal include:
- Trouble sleeping
- Shakiness
- Restlessness
- Nausea
- Sweating
- Racing heart
- Dysphoria (feeling uneasy or unhappy)
- Malaise (general sense of being unwell)
- Feeling low
More serious symptoms can develop 12–48 hours after the last drink. These include:
- Hallucinations
- Seizures
Delirium tremens (DTs) is a severe form of alcohol withdrawal that includes confusion, severe agitation, fever, hallucinations, and seizures. DTs can be fatal, and urgent treatment is essential. About 1–1.5% of people with alcohol withdrawal will experience DTs, which typically occur 24–72 hours after the last drink but can continue for several days.
Alcohol withdrawal can be potentially life-threatening, and people with moderate-to-severe symptoms may need to be treated at a hospital or other facility. Doctors can prescribe medications to address these symptoms and make the process safer and less distressing.
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Risk factors for AUD
Alcohol use disorder (AUD) is a medical condition characterised by an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences. It is considered a brain disorder, and AUD can be mild, moderate, or severe.
The risk factors for AUD are multifaceted and varied. Firstly, the quantity, frequency, and speed of alcohol consumption are crucial factors. Alcohol misuse, encompassing binge drinking and heavy alcohol use, increases the likelihood of developing AUD over time. Binge drinking, which involves consuming enough alcohol to reach a blood alcohol concentration (BAC) level of 0.08% or higher, places individuals at higher risk. This typically translates to 5 or more drinks for men and 4 or more drinks for women within a few hours.
Starting to drink at an early age is another risk factor. Research indicates that among individuals aged 26 and older, those who began drinking before turning 15 were more prone to AUD in the past year compared to those who started drinking at 21 or older. Notably, females in this category face a higher risk than males.
Genetics and family history also play a significant role in AUD risk. Heritability accounts for approximately 60%, and the interplay between genes and environmental factors influences an individual's susceptibility. Mental health conditions, such as depression, post-traumatic stress disorder (PTSD), or attention-deficit/hyperactivity disorder (ADHD), can further increase the chances of developing AUD.
It is important to recognise that AUD can affect people from all walks of life, and stereotypes do not always hold true. Treatment options are available, including behavioural therapies, mutual-support groups, and medications, offering hope and support for those struggling with AUD.
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Treatment options
There are several treatment options available for Alcohol Use Disorder (AUD). The National Institute on Alcohol Abuse and Alcoholism (NIAAA) provides an online tool called the Alcohol Treatment Navigator to help individuals find the right treatment for them. The Navigator offers a step-by-step process to finding a highly qualified professional treatment provider.
Behavioural Treatments
Behavioural treatments aim to change drinking behaviour through counseling. Talk therapy with a licensed therapist can help individuals build coping strategies and skills to stop or reduce drinking. Treatment can include one-on-one, family, or group sessions. Computer-based cognitive-behavioural therapy programs are also available.
Medications
Medications can be prescribed by a primary care clinician or a board-certified addiction doctor to help individuals stop drinking and avoid relapse. There are currently three medications approved for AUD in the United States: naltrexone, acamprosate, and disulfiram. Naltrexone is available as a pill or injection and helps reduce the urge to drink. Acamprosate is a pill that decreases the negative symptoms associated with abstinence from alcohol. Disulfiram is a pill that discourages drinking by causing unpleasant symptoms when alcohol is consumed.
Intensive Outpatient or Partial Hospitalization
This level of care involves coordinated outpatient care for complex needs. It can include regular office visits for counseling, medication support, or both.
Residential Programs
Residential programs offer low or high-intensity treatment in a 24-hour setting.
Intensive Inpatient Programs
Intensive inpatient programs provide medically-directed 24-hour services and can manage withdrawal symptoms.
Mutual Support Groups
In addition to professionally led treatment, many people benefit from mutual support groups such as Alcoholics Anonymous (AA). These groups can provide a sense of community and support for individuals struggling with alcohol addiction.
It is important to note that there is no one-size-fits-all solution for treating AUD. Treatment should be tailored to the individual's specific needs and may involve a combination of the above-mentioned approaches. Seeking professional help early can prevent a return to drinking.
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Frequently asked questions
Alcohol use disorder (AUD), sometimes called alcoholism, is a common medical condition in which people can’t stop drinking, even when drinking negatively impacts their health, safety, and personal relationships.
Some signs that someone might be struggling with alcoholism include:
- Craving alcoholic beverages
- Drinking despite negative consequences on personal relationships
- Drinking more or longer than intended
- Spending a lot of time obtaining or recovering from alcohol consumption
- Failing to meet work or family obligations due to drinking
- Giving up important activities in favour of drinking
- Using alcohol in hazardous situations
- Continuing to drink with a medical condition or mental disorder that worsens with alcohol
- Experiencing withdrawal symptoms or drinking to avoid them
- Building a high tolerance to alcohol
Alcohol misuse, including binge drinking and heavy alcohol use, increases the risk of short- and long-term negative consequences, including accidental injuries, worsened mental and physical health, and death. Even low levels of alcohol consumption have been associated with increased risks of certain harms, such as a higher risk of breast cancer in women.
Recognising that you may have a problem with alcohol is a crucial step. It is recommended that you consult a medical professional, such as your GP, who can advise you on the services and treatments available. Treatment options may include medication, counselling, detoxification, and behavioural therapy.
Yes, it's important to note that a person struggling with alcoholism does not always fit the stereotype of someone whose life is in turmoil and who drinks all day. They can be functioning members of society with good jobs and active social lives. Alcoholics may only drink in the evenings, and their drinking may not always be apparent to others.
