Alcoholics Avoiding People: A Common Behavior?

Alcohol use disorder (AUD) is a common medical condition, where people are unable to stop drinking despite the negative impact on their health, safety, and personal relationships. AUD is a brain disorder, and those affected are susceptible to relapse due to the lasting changes alcohol misuse causes in the brain. Alcohol addiction is associated with compulsive drinking, loss of control over intake, and negative emotional states when alcohol is not available. This can lead to avoidance of people and places associated with drinking, as well as social withdrawal. While AUD can significantly impact an individual's life, evidence-based treatments, including behavioral therapy and medication, can effectively support recovery and help prevent relapse.

Alcohol use disorder (AUD) is a common medical condition

People with AUD may drink despite the damage it causes to their relationships, or they may plan their lives around their next drink. They may also experience physical issues like craving alcohol or having alcohol withdrawal symptoms. AUD can cause individuals to drink in physically hazardous situations and continue drinking even when they have a medical condition or mental disorder that is exacerbated by alcohol consumption. Those with AUD may also have a high tolerance for alcohol, and drinking may take up a lot of their time.

AUD can cause individuals to repeatedly fail to meet work or family obligations, and it can increase the risk of certain cancers and lead to liver diseases such as fatty liver disease and cirrhosis. It can also cause damage to the brain and other organs.

AUD is influenced by a combination of genetic and environmental factors. Studies show that people with a family history of AUD or alcohol problems are at an increased risk of developing the disorder. Mental health conditions such as depression, post-traumatic stress disorder (PTSD), and attention-deficit/hyperactivity disorder (ADHD) are also associated with an increased risk of AUD.

Treatment for AUD includes behavioural therapy, medication, and support groups. Evidence-based treatments can help individuals with AUD achieve and maintain recovery.

Alcohol addiction is a chronic relapsing disorder

Alcohol use disorder (AUD), or alcoholism, is a common medical condition characterised by an individual's inability to stop drinking despite the negative impact on their health, safety, and personal relationships. While AUD is a significant problem, it is important to note that most people with this disorder recover, reducing their alcohol consumption or achieving abstinence.

The notion of alcohol addiction as a chronic relapsing disorder has been a subject of debate. Some argue that this definition accurately captures the essence of addiction and its severe consequences. However, critics disagree with the characterisation of addiction as a chronic relapsing condition, citing empirical evidence of recovery and remission. They argue that the definition overlooks the multifaceted nature of addiction and recovery.

Indeed, remission rates for alcohol addiction are high, ranging from 57% to 83%, and natural recovery without formal treatment is possible. This challenges the notion of a chronic relapsing disorder. Additionally, the success rates in treating hypertension are judged differently from those in alcohol treatment, further complicating the definition.

While the term "chronic relapsing disorder" may convey the severity of addiction, it may not accurately represent the experiences of most individuals with alcohol dependence. The emphasis on the biological aspect may result from and reinforce the focus on severe cases in neuroscience studies. This narrow perspective can obscure the broader understanding of addiction and recovery.

In reality, many individuals with alcohol dependence do not seek treatment, resolve their issues without formal intervention, and do not repeatedly relapse. Thus, the concept of a chronic relapsing disorder may not apply to the majority of those experiencing alcohol dependence. Instead, it may be more appropriate for a specific subpopulation prone to repeated relapses.

In summary, while alcohol addiction can be a severe and challenging condition, the characterisation as a chronic relapsing disorder is disputed. The evidence suggests that recovery and remission are common outcomes, and the definition may not capture the diverse experiences of individuals with alcohol dependence.

Alcoholics may avoid people to escape negative feelings

Alcohol use disorder (AUD) is a medical condition characterized by an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences. It is a spectrum disorder and can be mild, moderate, or severe. People with this condition can’t stop drinking, even if their alcohol use upends their lives and the lives of those around them. This disorder is sometimes referred to as alcoholism.

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. When a person who is addicted to alcohol stops drinking, they experience withdrawal symptoms, which are the opposite of the positive effects of alcohol. These negative feelings associated with alcohol withdrawal come from two sources. Firstly, a diminished activation in the reward systems of the basal ganglia makes it difficult for people to experience the pleasures of everyday living. 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 to escape the negative feelings to which chronic alcohol misuse has contributed.

Alcohol, like other drugs, has a powerful effect on the brain, producing pleasurable feelings and blunting negative feelings. These feelings can motivate some people to drink alcohol repeatedly, despite possible risks to their health and well-being. The prefrontal cortex, an area of the brain responsible for executive function, is compromised in people experiencing alcohol addiction. As a result, this area of the brain plays a key role in the negative emotional state associated with alcohol withdrawal. This overactive negative emotional state is hypothesized to drive the consumption of alcohol to find relief from negative feelings, and it may be caused by profound changes in the brain's reward and stress systems.

Treatment for alcohol use disorder typically includes medication and behavioral therapy. Behavioral treatment focuses on counseling that changes drinking behavior, and medication can help reduce cravings and manage withdrawal symptoms. Support groups can also provide a valuable layer of support, offering mutual understanding and connection. With treatment, most people with alcohol use disorder are able to reduce their alcohol consumption or stop drinking entirely.

Alcoholics may exhibit reckless behaviour and blame others

Alcohol use disorder, commonly known as alcoholism, is a prevalent medical condition. People with this condition are unable to stop drinking, even when drinking negatively impacts their health, safety, and relationships. Alcoholism often involves a complex interplay between psychological mechanisms and substance abuse.

Individuals with alcohol use disorder may find it challenging to accept personal responsibility for their drinking habits and the consequences. This deflection of responsibility can manifest as blaming others. Playing the blame game is one of the most common characteristics of an alcoholic. Often, substance abuse can lead to problematic behaviour that puts a person with an addiction in defence mode. They may blame their unhealthy behaviour on difficult aspects of their lives. For instance, instead of accepting that they have a problem, they may claim that they need to drink to escape their spouse's nagging or cope with stress.

Alcoholism can impair cognitive functions and lead to aggressive behaviours, further increasing the tendency to blame others. Alcohol consumption can amplify anger and contribute to a cycle of violence and blame. Additionally, individuals may struggle to connect their actions with their outcomes while under the influence, making it easier to externalise blame. The biological predisposition towards aggression and impulsivity, combined with the psychological need to protect one's self-image from the shame associated with addiction, can also result in the alcoholic projecting blame onto others.

Denial and blame create barriers to recovery by preventing individuals from acknowledging their addiction and seeking help. Blame can have a detrimental impact on relationships, eroding trust and communication. It is a defence mechanism that allows alcoholics to avoid confronting their addiction and the associated anxiety and fears. Overcoming blame in recovery involves fostering personal accountability, therapeutic interventions, and peer support.

Treatment includes medication and behavioural therapy

Alcohol use disorder (AUD), or alcoholism, is a common medical condition where individuals cannot stop drinking, even when it negatively affects their health, safety, and personal relationships. While it is unclear whether it is a common behaviour for alcoholics to avoid people, those with AUD may indeed drink despite the damage to their relationships. Treatment for AUD includes medication and behavioural therapy, which can help individuals reduce their drinking or quit entirely.

Behavioural therapy, also known as alcohol counselling, involves working with a healthcare provider, such as an addiction counsellor or psychologist, to identify and change the behaviours that lead to alcohol problems. This form of therapy helps individuals develop the skills needed to stop or reduce their drinking. Cognitive-behavioural therapy (CBT) is a type of therapy that focuses on identifying the feelings and situations that contribute to heavy drinking and managing stress that can lead to a relapse. The goal of CBT is to change the thought processes that lead to alcohol misuse and to develop coping strategies for everyday situations that might trigger alcohol misuse. Motivational enhancement therapy is another form of talk therapy that uses an individual's internal strengths to encourage and motivate change.

Medications are often used in conjunction with behavioural therapy and support groups to treat AUD. Acamprosate (Campral) helps rebalance chemicals in the brain that may have been altered by excessive drinking. Disulfiram (Antabuse) is a medication that causes unpleasant effects, such as nausea, vomiting, and chest pain, if alcohol is consumed. Naltrexone (Revia, Vivitrol) works by decreasing cravings for alcohol. Topiramate (Topamax, Trokendi XR, Qudexy XR) is typically used to treat seizures and prevent migraines but can also reduce cravings in some individuals. Support groups are an essential aspect of treatment, as they provide individuals with a sense of community and understanding.

It is important to note that setbacks are common among people overcoming alcohol problems. Individuals with AUD are more likely to return to drinking during stressful periods or when exposed to people or places associated with past drinking. Regular check-ins with a treatment provider can help prevent relapse, and medications can be particularly useful during times of heightened risk for relapse, such as divorce or the death of a family member. Treatment for AUD can be a long-term process, and it may take several attempts before an individual is able to stop drinking.

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