Lena Savoie
Alcohol addiction, or alcohol use disorder (AUD), is a chronic relapsing disorder characterised by compulsive alcohol drinking, a loss of control over intake, and negative emotional states when alcohol is not available. The addiction cycle involves three stages: binge/intoxication, negative emotional states, and executive function. Those addicted experience a strong, often uncontrollable, desire to drink, and drinking becomes a priority over other activities and obligations. The physical and psychological effects of alcohol addiction can be severe, with withdrawal symptoms including sleep disturbances, pain, feelings of illness, dysphoria, irritability, and anxiety. Additionally, progressive changes in brain structure and function may occur, compromising brain function and driving the transition to chronic misuse. Treatment options include behavioural therapy, medication, and residential rehabilitation, with recovery being a gradual process.
| Characteristics | Values |
|---|---|
| Loss of control over intake | Drinking more than intended, drinking faster than intended, or being unable to stop drinking |
| Compulsive drinking | Drinking daily, drinking alone, drinking first thing in the morning, drinking to relieve or avoid withdrawal symptoms, drinking despite social, occupational, or health consequences |
| Negative emotional state when alcohol is unavailable | Irritability, tiredness, depression, nausea, anxiety, insomnia, loss of appetite, shakiness or trembling, dysphoria, emotional pain |
| Tolerance | Needing to drink more to get drunk |
| Craving | A strong urge to drink at inappropriate times, such as before work or driving |
| Priority | Giving priority to drinking over other activities or obligations, such as work or family life |
| Progressive changes in the brain | Compromised brain function, transition from controlled, occasional use to chronic misuse |
| Relapse | Returning to drinking after a period of abstinence |
| Addiction severity | Mild, moderate, or severe |
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What You'll Learn
The psychological effects of alcohol addiction
Alcohol addiction is a chronic relapsing disorder characterised by compulsive alcohol drinking, a loss of control over intake, and negative emotions when alcohol is not available. Alcohol use disorder (AUD) is a condition characterised by an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences. AUD can be mild, moderate, or severe, and can lead to further health complications such as cirrhosis of the liver.
The link between alcohol and mental health is well-established. Many people drink to relieve symptoms of mental health issues, such as depression, stress, and anxiety. However, alcohol is only a temporary solution, and its long-term use can exacerbate these issues. For example, alcohol can deplete neurotransmitters in the brain, increasing the risk of anxiety and depression. Additionally, those with severe or moderate alcohol use disorder who suddenly stop drinking may experience delirium tremens (DT), a severe form of alcohol withdrawal that can cause seizures and hallucinations.
The binge/intoxication stage of the addiction cycle is marked by the rewarding effects of alcohol, including euphoria, anxiety reduction, and improved social interactions. This stage reinforces drinking behaviour through the repeated activation of the basal ganglia's reward system, leading to increased alcohol consumption. Over time, drinking to cope with stress can enhance negative emotional states between bouts of consumption, further motivating drinking and contributing to an unhealthy cycle of alcohol dependence.
Treatment for alcohol addiction often involves behavioural therapy, medication, or a combination of both. Behavioural treatments focus on counselling to change drinking behaviour, while medications such as naltrexone and acamprosate are approved for alcohol use disorder treatment. Seeking treatment is crucial in preventing or reducing the negative effects of alcohol on the brain, which can include memory loss, learning problems, dementia, and severely hindered mental functioning.
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Withdrawal symptoms
Alcohol addiction, or Alcohol Use Disorder (AUD), is characterised by an impaired ability to stop or control alcohol use despite adverse consequences. AUD can range from mild to severe, with addiction falling on the moderate-to-severe end of the spectrum. Alcohol addiction is associated with compulsive alcohol drinking, the loss of control over intake, and negative emotional states when alcohol is no longer available.
When a person who is addicted to alcohol stops drinking, they experience withdrawal symptoms. These symptoms are the opposite of the positive effects of alcohol experienced when drinking it. Withdrawal symptoms can be physical and emotional. Physical symptoms include sleep disturbances, pain, feelings of illness, upset stomach, heart palpitations, increased blood pressure, increased heart rate, hyperthermia, and tremors. Emotional symptoms include dysphoria, irritability, anxiety, nervousness, and emotional pain.
The negative feelings associated with alcohol withdrawal are thought to stem from two sources. Firstly, a diminished activation in the reward systems of the basal ganglia makes it difficult for people to experience pleasure. Secondly, an increased activation of the brain's stress systems in the extended amygdala contributes to anxiety, irritability, and unease. At this stage, the person no longer drinks alcohol for the pleasurable effects but rather to escape the negative feelings caused by chronic alcohol misuse.
The severity and length of alcohol withdrawal vary based on several factors. Mild symptoms typically appear within six to twelve hours of the last drink, including headache, mild anxiety, and insomnia. Within 24 hours of the last drink, hallucinations may occur, and symptoms typically peak between 24 to 72 hours. If the withdrawal is severe, the seizure risk is highest 24 to 48 hours after the last drink. Delirium tremens is a severe and life-threatening form of alcohol withdrawal that can cause serious medical issues such as seizures and hallucinations, requiring immediate medical care.
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Relapse and the cycle of addiction
Alcohol addiction is a chronic relapsing disorder characterised by compulsive alcohol drinking, the loss of control over intake, and the emergence of a negative emotional state when alcohol is no longer available. The cycle of addiction is a repeating cycle with three stages: binge/intoxication, negative emotional states, and executive function. Each stage is linked to and feeds on the others.
Relapse is a common part of the recovery process. It is a slow process that occurs in three stages: emotional, mental, and physical. A person may go through these stages over the course of weeks or months, or they may progress through them several times a day. Understanding these stages can help prevent relapse before it occurs. The emotional stage involves feelings of anxiety, irritability, and unease. During the mental stage, the person may start to believe that they are able to control their alcohol use. The physical stage involves the act of drinking alcohol.
There are many triggers that can lead to relapse. These include having unrealistic expectations of one's new life in recovery, continuing to socialise with drinking friends in places associated with drinking, and being unaware that stopping drinking completely is the first step in recovery. Personal challenges can also lead to relapse, including problems at work, ongoing emotional and psychological issues, and social or economic problems such as financial hardship and rejection by social support networks.
To prevent relapse, it is important to avoid people, places, and situations that used to lead to alcohol use. Building a strong support network of friends, family, and professionals can help avoid negative behaviours and situations. Doing meaningful activities can help build a sense of positive self-image and pride. It is also important to be aware of the early warning signs of emotional and mental relapse and to reach out for help if needed.
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Alcohol's effect on the brain
Alcohol has a powerful effect on the brain. It interferes with the brain's communication pathways and affects the way the brain looks and works. Alcohol makes it difficult for the brain areas that control balance, memory, speech, and judgment to function properly, leading to a higher risk of injuries and other adverse outcomes.
During the early stages of drinking, the brain releases more dopamine, a chemical linked to pleasure. This results in feelings of relaxation and confidence. However, reasoning and memory may be slightly impaired. As alcohol consumption increases, the occipital lobe, temporal lobe, and frontal lobe are affected. Excessive drinking can cause side effects specific to each lobe's role, including blurred vision, slurred speech, hearing impairment, and a lack of control.
Prolonged heavy drinking can lead to progressive changes in the structure and function of the brain, compromising brain function and driving the transition to chronic misuse. These changes can be long-lasting and contribute to relapse. Alcohol abuse can increase the risk of severe and potentially permanent brain damage, including conditions such as Wernicke-Korsakoff syndrome (WKS), which is marked by amnesia, extreme confusion, and eyesight issues.
Additionally, research has linked excessive drinking to an increased risk of dementia and shrinkage in brain regions associated with cognition and learning, such as the hippocampus. Moderate drinking, defined as no more than one drink per day for women and two for men, has been associated with fewer negative effects in observational studies. However, recent research suggests that even moderate consumption may contribute to brain shrinkage.
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Alcohol use disorder (AUD) and treatment options
Alcohol addiction is a chronic relapsing disorder associated with compulsive alcohol drinking, the loss of control over intake, and the emergence of a negative emotional state when alcohol is no longer available. 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. AUD is a common condition, and often goes untreated. However, there are effective treatments available.
AUD can be mild, moderate, or severe. It is characterised by an inability to stop drinking, even when drinking is affecting health, putting safety at risk, and damaging personal relationships. Those with AUD may plan their life around their next drink, craving alcohol and experiencing withdrawal symptoms when they are not drinking. AUD can cause physical issues like craving alcohol, and withdrawal symptoms such as sleep disturbances, pain, feelings of illness, dysphoria, irritability, anxiety, and emotional pain. It can also cause emotional issues, such as a negative emotional state when alcohol is no longer available. This negative emotional state is caused by diminished activation in the reward systems of the basal ganglia, and increased activation of the brain's stress systems in the extended amygdala.
Treatment for AUD can include medication, behavioural therapy, and support/self-help groups. It is important to form a treatment plan with a doctor, and to track progress on that plan. Three medications are approved by the FDA to treat AUD: naltrexone, acamprosate, and disulfiram. Naltrexone helps reduce cravings and can be taken as a pill or injection. Acamprosate is taken as oral tablets and works in the brain to decrease cravings and urges to use alcohol. Disulfiram discourages drinking by blocking the breakdown of alcohol in the body, creating a buildup of toxic alcohol-related compounds, and causing unpleasant physical symptoms if alcohol is consumed. Behavioural treatment focuses on counselling that changes drinking behaviour, and support groups can also play a role in treatment.
To prevent AUD, it is recommended to avoid high-risk drinking. For women, this means no more than four drinks in one day or eight drinks per week. For men, it is recommended to not exceed five drinks in one day or 15 drinks per week. If drinking exceeds these amounts, it is advised to consider cutting back or quitting.
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Frequently asked questions
Alcohol addiction, or Alcohol Use Disorder (AUD), is characterised by an impaired ability to stop or control alcohol use despite adverse consequences. If you are experiencing cravings, physical dependence, or psychological dependence, you may be addicted to alcohol.
There are several signs that may indicate alcohol addiction, including:
- Drinking at inappropriate times, such as before work or driving.
- Experiencing negative consequences due to drinking, such as problems at work, school, or in personal relationships.
- Giving priority to drinking over other obligations or activities.
- Increased tolerance, needing to drink more to achieve the desired effect.
- Experiencing withdrawal symptoms when not drinking, such as sleep disturbances, irritability, anxiety, or more severe symptoms like seizures or hallucinations.
Alcohol addiction can be influenced by various factors, including genes, environment, psychological factors, and stress levels. Alcohol affects the brain's chemistry by raising dopamine levels, which the brain categorises as a gratifying reward. This can lead to cravings and a loss of control over intake.
If you think you may have an alcohol addiction, it's important to seek professional help. Talk to your healthcare provider or a qualified addiction specialist. Treatment options include behavioural therapy, medication, and inpatient or residential rehabilitation programmes. Support groups and peer support can also be beneficial during the recovery process.
