Noah Vinter
Alcohol dependence is a serious condition that can affect a person's physical and mental health, as well as their personal and professional relationships. It is characterised by a person's inability to stop drinking, even when faced with negative consequences, and the experience of withdrawal symptoms when they try to quit. Alcohol abuse and alcohol dependence are two different conditions, with alcohol abuse referring to excessive drinking that creates problems in a person's life, but does not always result in physical dependence. If you are concerned about your relationship with alcohol, there are several signs of alcohol dependence to be aware of, including increased alcohol tolerance, intense cravings, and withdrawal symptoms such as insomnia, tremors, and mood swings. Treatment options are available, including behavioural therapy, medication, and support groups, and confidential helplines can provide referrals to local treatment facilities.
| Characteristics | Values |
|---|---|
| Body's tolerance to alcohol | You may need to consume a higher volume of alcohol to feel the same effects. |
| Physical withdrawal symptoms | You may experience physical withdrawal symptoms such as visual hallucinations, seizures, hearing disturbances, delirium, etc. |
| Craving | You may have a psychological dependence on alcohol and crave it. |
| Unable to stop drinking | You may not be able to stop drinking despite the negative consequences for yourself and your loved ones. |
| Unable to function without alcohol | You may not be able to perform your job or carry out daily tasks without alcohol. |
| Drinking as the most important thing in life | You may feel that drinking is the most important thing in your life. |
| Compulsive alcohol use | You may compulsively consume alcohol. |
| Drinking excessively | You may drink excessively to feel the effects of alcohol. |
| Loss of interest in activities | You may have lost interest or stopped participating in activities that were once important to you. |
| Dangerous situations | You may find yourself in dangerous or harmful situations as a direct result of drinking. |
| Comorbid illnesses | You may have comorbid illnesses such as liver, pancreatic, neurological, circulatory, and gastrointestinal diseases. |
| Genetic, social, psychological, or environmental factors | Certain genetic, social, psychological, or environmental factors may impact the body's dependency on alcohol. |
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What You'll Learn
Craving alcohol and experiencing withdrawal symptoms
Alcohol affects the neurotransmitters in your brain, leading to a higher tolerance for alcohol over time. This results in the need to consume larger amounts to achieve the same effects. When not drinking, you may experience anxiety, emotional distress, and intense cravings for alcohol. These cravings can be so powerful that they lead to compulsive alcohol consumption, a key characteristic of the end-stage of alcoholism.
Withdrawal symptoms occur when the alcohol level in your system suddenly drops, causing an overactive state in your brain. These symptoms can range from mild to severe and life-threatening. They can include delirium tremens (DTs), visual or auditory disturbances, hallucinations, seizures, and delirium. More severe symptoms, such as DTs, can be fatal, making it crucial to seek immediate medical attention. Withdrawal symptoms typically begin within 6-12 hours after your last drink, with more serious symptoms developing between 12 and 48 hours.
If you are experiencing cravings and withdrawal symptoms, it is important to seek professional help. A doctor or mental health professional can assess your condition and recommend suitable treatment options. Treatment may include medication, such as acamprosate or naltrexone, to reduce cravings and restore brain chemistry, or behavioural therapy to address drinking behaviour. Inpatient or residential treatment may be advised for severe cases. Support groups and community-based organisations can also provide valuable assistance during your recovery journey.
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Inability to stop drinking despite negative consequences
Alcohol use disorder (AUD), or alcoholism, is a common medical condition where people are unable to stop drinking despite the negative consequences on their health, safety, and personal relationships. This condition can be mild, moderate, or severe, and is characterised by intense cravings and consuming thoughts of alcohol. Those with AUD may compulsively drink more to feel the effects of alcohol, and experience severe withdrawal symptoms when they are not drinking.
People with AUD may drink to cope with stressful events, such as losing a job, divorce, or the death of a loved one. They may also experience physical withdrawal symptoms when they try to quit drinking, such as trouble sleeping, shakiness, restlessness, nausea, sweating, a racing heart, dysphoria, malaise, feeling low, or seizures. These symptoms can be very dangerous, and even fatal, so it is important to seek professional help and support when attempting to overcome AUD.
Treatment for AUD includes behavioural therapy, medication, and mutual-support groups. Behavioural treatments, or alcohol counselling, aim to change drinking behaviour and teach skills to cope with and prevent a return to drinking. Medications such as naltrexone and acamprosate can also help deter drinking during high-risk periods. Mutual-support groups provide valuable peer support for stopping or reducing drinking, and are available in most communities at little to no cost.
If you are concerned about your alcohol consumption and think you may have AUD, it is important to seek help from a healthcare provider, who can determine the severity of your condition and recommend appropriate treatment options.
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Increased tolerance and consumption
Alcohol tolerance refers to the body's ability to metabolize alcohol and its toxic by-products. Generally, the larger the body, the higher the alcohol tolerance. For example, a 250-pound weightlifter may consume ten or twelve drinks without showing any ill effects. However, this does not necessarily indicate alcohol dependence. In fact, people of Mediterranean heritage who consume wine with every meal exhibit a high degree of alcohol tolerance without any harmful effects on their immediate or long-term mental or physical well-being.
On the other hand, alcohol dependence occurs when an individual needs to consume alcohol to carry out their normal daily functions or to avoid withdrawal symptoms. Alcoholics build up alcohol tolerance as they drink more to satisfy their physical cravings and psychological addictions to alcohol. As their tolerance increases, they may need to consume higher volumes of alcohol to achieve the desired effects. This can lead to excessive drinking and an increased risk of alcohol dependence.
It is important to note that alcohol tolerance is not equally distributed among different populations. For example, Native Americans have a higher probability of developing an alcohol use disorder compared to Europeans and Asians. Within Asian groups, there are also differences in alcohol tolerance between different ethnicities, such as between Chinese and Koreans. Additionally, the health benefits of moderate alcohol consumption observed in people of European descent are not present in people of African descent.
Genetics also plays a role in alcohol tolerance. The levels of alcohol dehydrogenase, an enzyme responsible for breaking down alcohol, vary among individuals and are influenced by ethnicity. Higher levels of this enzyme increase alcohol tolerance. However, atypical alcohol dehydrogenase levels are less common in alcoholics than in non-alcoholics. Additionally, socio-economic and cultural factors, including diet, average body weight, and patterns of consumption, can also influence alcohol tolerance.
If you suspect that you may have an alcohol dependency, it is important to seek professional help. A medical provider, mental health professional, or addiction counselor can help you safely detox from alcohol and provide ongoing treatment and support to maintain sobriety.
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Physical and mental health complications
Alcohol use disorder (AUD) is a common medical condition characterised by a person's inability to stop drinking, even if their alcohol consumption negatively impacts their life and the lives of those around them. AUD can lead to severe physical and mental health complications, which can be life-threatening if left untreated.
Physically, the body may start to build a tolerance to alcohol, requiring higher volumes to achieve the same effects. Withdrawal symptoms can be dangerous and even life-threatening and may include visual or auditory hallucinations, delirium, and seizures. Cardiovascular and liver diseases are commonly associated with long-term alcohol abuse, including high blood pressure, heart failure, arrhythmias, fatty liver disease, alcoholic hepatitis, and cirrhosis (permanent scarring of the liver). Alcohol abuse can also cause digestive issues such as bloating, gastritis, ulcers, pancreatitis, diabetes, and bleeding. Sexual dysfunction, fibromyalgia, brain damage, dementia, and memory loss are other potential physical complications.
Mentally, AUD often co-occurs with other psychiatric disorders, including attention-deficit/hyperactivity disorder (ADHD). Alcohol abuse, especially in adolescents, can predispose individuals to developing psychiatric disorders, and the two conditions often share genetic risks and environmental vulnerabilities. The presence of both AUD and another mental health disorder can complicate diagnoses and negatively affect the clinical course of both conditions. Additionally, the treatment of psychiatric symptoms alone is generally insufficient to reduce alcohol consumption or AUD symptoms. However, quitting drinking often leads to clinical improvement in co-occurring mental health disorders.
If you or someone you know is struggling with alcohol abuse or dependency, it is important to seek professional help. Treatment options include behavioural therapy, medication, inpatient medical treatment, and residential rehabilitation. Support groups, 12-step programmes, and therapy can also provide valuable assistance and guidance on the road to recovery.
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Treatment options: medication, therapy, detox, and support
Treatment options for alcohol dependency vary, and it is important to remember that there is no one-size-fits-all solution. Treatment should be tailored to the individual, depending on the severity of their condition and their personal circumstances.
Medication
Medications can help deter drinking and prevent a return to drinking. The U.S. Food & Drug Administration has approved naltrexone and acamprosate as treatments for alcohol use disorder (AUD). Disulfiram is another medication that discourages drinking by causing unpleasant symptoms when alcohol is consumed.
Therapy
Behavioural treatments are aimed at changing drinking behaviour through counselling. Therapy can be beneficial, and it is often led by healthcare providers, addiction counsellors, or psychologists.
Detox
Detoxification from alcohol can be dangerous, and it is recommended that individuals seek medical supervision when attempting to detox. Inpatient and residential treatment facilities can provide support and tools to help maintain sobriety.
Support
Support groups and 12-step programs can be beneficial for individuals seeking to reduce their alcohol consumption. Support from friends and family is also important, and resources are available to help them understand alcohol abuse and its treatment.
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Frequently asked questions
Alcohol use disorder (AUD) is characterised by a strong craving for alcohol and continued drinking despite negative consequences. If you are questioning your relationship with alcohol, you can take an alcohol test to find out what type of drinker you are.
Alcohol dependence is characterised by withdrawal symptoms when a person tries to quit drinking. Signs of alcohol dependence include:
- Building a tolerance to alcohol
- Experiencing physical and psychological withdrawal symptoms, such as insomnia, tremors, mood swings, visual hallucinations, and seizures
- Drinking to relieve or avoid withdrawal symptoms
- Craving alcohol
- Inability to cut down or stop drinking
Alcohol abuse refers to continuing to drink excessively even though it creates problems in a person's life, including health, relationship, and work-related issues. Alcohol abuse does not always lead to physical dependence, and it is possible to stop drinking without experiencing withdrawal symptoms.
If you are concerned about your alcohol consumption, there are many support services available. You can seek support through a 12-step program, therapy, medication, behavioural therapy, or support groups. You can also contact a helpline for mental health and substance use disorders to get connected to local treatment facilities and support groups.
