Theo Nash
Alcoholism, also known as alcohol addiction, alcohol misuse, or alcohol dependence, is a term used to describe the most serious form of high-risk drinking. It is characterized by an impaired ability to control or stop alcohol use, even when faced with adverse social, occupational, or health consequences. While the term alcoholism is commonly used among the general public, it is not a recognized diagnosis and is discouraged due to its stigmatized connotations. Instead, medical professionals refer to this condition as Alcohol Use Disorder (AUD), which can range from mild to severe and is considered a brain disorder. AUD is diagnosed when a person exhibits two or more specific symptoms, such as increased alcohol tolerance, withdrawal symptoms, and giving priority to drinking over other activities or obligations. Treatment for AUD typically involves behavioral therapies, mutual-support groups, and medications, with detoxification being a crucial first step under medical supervision.
| Characteristics | Values |
|---|---|
| Definition | Alcoholism is a term used to describe the most serious form of high-risk drinking, with a strong, often uncontrollable, desire to drink. It is also referred to as alcohol addiction, alcohol misuse, or alcohol dependence. |
| Prevalence | 17.6 million people are diagnosed with alcoholism, and millions more engage in binge drinking. |
| Risk Factors | The risk of alcohol dependence increases with the volume of alcohol consumed and a pattern of drinking larger amounts on an occasion, to the point of intoxication. Other risk factors include drinking at an early age, genetics, and family history. |
| Signs and Symptoms | Increased priority given to drinking over other activities or obligations, continued drinking despite harmful consequences, increased tolerance to alcohol, and physical and mental withdrawal symptoms when trying to quit. |
| Treatment | Treatment options include behavioural therapies, mutual-support groups, and medications. Detoxification under medical supervision is also recommended. |
| Terminology | The term "alcoholism" is discouraged due to its stigmatized connotations and imprecise definition. Instead, terms such as alcohol abuse, alcohol dependence, or alcohol use disorder are preferred. |
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What You'll Learn
Alcohol dependence
Alcohol use disorder (AUD), commonly referred to as alcoholism, is a medical condition characterised by a person's impaired ability to stop or control their alcohol consumption despite adverse social, occupational, or health consequences. It is considered a brain disorder that can be mild, moderate, or severe. AUD is often used as a diagnostic term in clinical contexts to avoid the stigma associated with the word "alcoholism".
The development of alcohol dependence is a complex process influenced by various neurobiological, genetic, and environmental factors. These factors shape an individual's expectations about the consequences of alcohol use, which in turn influence their decision to engage in drinking behaviour. For example, drinking may be triggered by specific circumstances or stressors, and the fear of experiencing withdrawal symptoms can perpetuate alcohol abuse.
The continued excessive consumption of alcohol can lead to dependence, which is associated with a withdrawal syndrome when alcohol intake is ceased or reduced. This syndrome includes both physical and psychological symptoms, such as anxiety, nausea, seizures, delirium tremens, hallucinations, and possible heart failure. The presence of withdrawal symptoms can also contribute to relapse after periods of abstinence, as alcohol-dependent individuals are more sensitive to relapse-provoking cues and stimuli.
Treatment for AUD typically includes medication, behavioural therapy, and mutual-support groups. Evidence-based treatments aim to help individuals develop skills to avoid and manage triggers, such as stress, that may lead to drinking. It is important to seek professional help early, as alcohol withdrawal can be life-threatening and requires medical management.
Alcoholism can have significant negative consequences on various aspects of an individual's life, including their health, employment, finances, and relationships. It can lead to social isolation, legal problems, and family issues, including child neglect and emotional development problems in children of people with AUD.
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Alcohol cravings
Alcoholism, or 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. The World Health Organization (WHO) estimated that there were 283 million people with AUD worldwide as of 2016.
The intensity of alcohol cravings diminishes the longer you go without drinking. However, cravings can be extremely challenging to overcome, especially if you are in early alcohol addiction recovery. To manage cravings, it is important to understand what drives them. Knowing what's causing your desire to drink can help you confront and overcome the urge.
There are several strategies to manage alcohol cravings. It is recommended to avoid keeping alcohol at home and to stay away from activities involving drinking. You can also remind yourself of your reasons for making a change and carry them on a wallet card or in an electronic message that you can easily access. Additionally, behavioural treatments, such as alcohol counselling or talk therapy, can help change drinking behaviour and develop skills to avoid and overcome triggers. Mutual-support groups can also provide valuable peer support for stopping or reducing drinking.
Medications such as naltrexone, acamprosate, and disulfiram are also approved to help reduce drinking and prevent a return to drinking. It is important to seek professional help early, as alcohol withdrawal can be life-threatening and may require medical intervention.
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Withdrawal symptoms
Delirium tremens (DTs) is a severe form of alcohol withdrawal that can be life-threatening. It typically occurs two to three days after the last drink, but it can be delayed for more than a week. It causes dangerous shifts in breathing, circulation, and temperature control, leading to a racing heart, increased blood pressure, and dehydration. DTs can cause confusion, disorientation, stupor or loss of consciousness, nervous or angry behaviour, irrational beliefs, soaking sweats, sleep disturbances, and hallucinations.
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Alcohol addiction
The risk of developing AUD depends on how much, how often, and how quickly an individual consumes alcohol. AUD is characterised by an impaired ability to stop or control alcohol use, despite adverse social, occupational, or health consequences. Individuals with AUD may continue to drink even when it causes problems and negatively impacts their health, safety, and personal relationships. They may experience withdrawal symptoms such as trouble sleeping, shakiness, restlessness, nausea, sweating, a racing heart, dysphoria, malaise, feeling low, or seizures when they stop drinking.
Treatment for AUD includes medication and behavioural therapy. Three medications approved by the U.S. Food and Drug Administration to help reduce drinking and prevent relapse are naltrexone, acamprosate, and disulfiram. Behavioural therapies, such as alcohol counselling and talk therapy, aim to change drinking behaviour and develop skills to cope with triggers. Mutual-support groups also provide valuable peer support for those in treatment.
Alcoholism, a term first coined in 1852, is considered stigmatising and is often avoided in clinical contexts. However, it refers to the continued drinking of alcohol despite causing problems and can lead to various negative consequences, including loss of employment, financial problems, legal issues, and relationship difficulties.
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Alcohol abuse
The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines binge drinking as consuming enough alcohol to reach a blood alcohol content (BAC) of 0.08, which is typically five drinks for men or four for women over a two-hour period. Men may be at risk for alcohol-related problems if they consume more than 14 drinks per week or four drinks per day, while women may be at risk if they consume more than seven drinks per week or three drinks per day.
Early symptoms of AUD include drinking more than intended, continuing to drink despite concerns expressed by others, and frequent unsuccessful attempts to cut down or quit. As the disorder progresses, individuals develop a tolerance to alcohol, requiring them to consume more to achieve the desired effects. When alcohol consumption is reduced or stopped, individuals may experience withdrawal symptoms such as headache, nausea, vomiting, anxiety, fatigue, restlessness, agitation, hallucinations, delirium, and seizures. In its most severe form, alcohol withdrawal can be life-threatening.
AUD can lead to significant personality changes, including increased aggression and a deterioration in the ability to function in social and occupational settings. It can result in the neglect of important social, work, or recreational activities, as well as hazardous behaviours such as drunk driving or risky sexual behaviour. Additionally, AUD can cause physical health issues, including inflammation of the stomach and liver, bleeding in the stomach and oesophagus, impotence, and permanent nerve and brain damage.
Treatment for AUD typically involves a combination of medication and behavioural therapy. Inpatient treatment often begins with detoxification, which is supervised withdrawal from alcohol, along with medication to manage withdrawal symptoms. Behavioural therapies, such as alcohol counselling or talk therapy, aim to change drinking behaviour and develop skills to avoid triggers and prevent relapse. Mutual support groups also provide valuable peer support for those in recovery.
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Frequently asked questions
Alcoholism is a term used to describe the most serious form of high-risk drinking, with a strong, often uncontrollable, desire to drink. It is also referred to as alcohol addiction, alcohol misuse or alcohol dependence.
Signs of alcoholism include giving increasing priority to alcohol, experiencing withdrawal symptoms, and using alcohol to prevent or alleviate these symptoms. Other signs include an increased tolerance to alcohol, and continuing to drink despite negative consequences.
Withdrawal symptoms can include agitation, tremors, hot flashes, increased heart rate and blood pressure, nausea and vomiting, seizures, trouble sleeping, shakiness, restlessness, sweating, dysphoria, malaise, and a general sense of being unwell.
Alcoholism is a term that is commonly used by laypeople, but it is poorly defined and carries heavily stigmatized connotations. Alcohol abuse is a preferred term in professional and research contexts, along with alcohol dependence or alcohol use disorder.
If you think you might be an alcoholic, your GP surgery or a local self-referral alcohol or substance use support service should be your first port of call. You can also bring someone along with you or ask for a telephone appointment.
