Vivian Marlowe
Alcohol addiction, also known as alcohol dependence, alcohol use disorder (AUD), or alcoholism, 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. Alcohol addiction is a brain disorder that can have harmful physical and psychological effects on an individual, and can develop at low levels of drinking, increasing with the volume of alcohol consumed and a pattern of drinking larger amounts on an occasion, known as binge drinking.
| Characteristics | Values |
|---|---|
| Definition | 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. |
| Alternate terms | Alcohol use disorder (AUD), alcohol abuse, alcohol dependence, alcoholism, alcohol addiction |
| Common dual dependence syndromes | Benzodiazepine dependence |
| Brain regions affected | Basal ganglia, extended amygdala, prefrontal cortex |
| Physical symptoms of withdrawal | Shaking, sweating, nausea, trouble sleeping, shakiness, restlessness, dysphoria, malaise, seizures |
| Psychological symptoms of withdrawal | Feeling low, sensing things that aren't there |
| Treatment | Behavioral treatments, medication, support groups, mutual-support groups, clinical interventions |
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What You'll Learn
Alcohol Use Disorder (AUD)
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. AUD is a spectrum disorder, ranging from mild to severe, and encompasses conditions such as alcohol abuse, alcohol dependence, and alcoholism. It is considered a brain disorder, with lasting changes in the brain caused by alcohol misuse perpetuating AUD and making individuals vulnerable to relapse.
The risk factors for developing AUD include genetic predispositions, with hereditability accounting for approximately 60%, as well as environmental influences. Parental drinking patterns may also impact the likelihood of a child developing AUD. Mental health conditions, such as depression, post-traumatic stress disorder, and attention deficit hyperactivity disorder, are associated with an increased risk of AUD, and individuals with a history of childhood trauma are also more vulnerable to developing the disorder.
AUD is characterised by an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences. The cycle of alcohol addiction can be understood through three stages: the binge/intoxication stage, the negative emotional states stage, and the executive function stage. The binge/intoxication stage involves the rewarding effects of alcohol, such as euphoria, reduced anxiety, and improved social interactions. The negative emotional states stage involves the emergence of negative emotions and withdrawal symptoms when alcohol is not available. The executive function stage involves the loss of control and compulsive alcohol drinking.
Treatment for AUD typically involves behavioural therapies, mutual-support groups, and medications. Behavioural treatments aim to change drinking behaviour through brief interventions, reinforcement approaches, motivation-building, and coping skills training. Mutual-support groups, such as Alcoholics Anonymous (AA), provide peer support for stopping or reducing drinking. Three medications have been approved by the U.S. Food and Drug Administration to help reduce drinking and prevent relapse: naltrexone, acamprosate, and disulfiram.
It is important to recognise that AUD is a complex disorder that requires specialised treatment. SAMHSA's National Helpline offers a free and confidential treatment referral and information service for individuals and families facing AUD and substance use disorders.
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Binge drinking
Alcohol addiction is a chronic relapsing disorder characterised by compulsive alcohol drinking, a 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 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 encompasses conditions such as alcohol abuse, alcohol dependence, and alcoholism.
Overall, binge drinking is a harmful pattern of alcohol consumption that carries significant health and social risks, and it is a critical factor in the development of alcohol addiction and related disorders.
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Alcohol withdrawal symptoms
Alcohol addiction, or Alcohol Use Disorder (AUD), is characterised by an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences. It 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 opposite to the positive effects of alcohol that are experienced when drinking it. These symptoms can range from mild to severe, with the most severe being life-threatening. Withdrawal symptoms typically begin within six to 24 hours of stopping or significantly decreasing heavy, long-term alcohol use.
Mild symptoms of alcohol withdrawal include headache, anxiety, nervousness, irritability, insomnia, upset stomach, excessive sweating, heart palpitations, increased blood pressure, increased heart rate, and hyperthermia (high body temperature). These symptoms typically appear within the first six to 12 hours after the last drink and peak within 24 to 72 hours, before beginning to resolve.
More severe symptoms of alcohol withdrawal include hallucinations, which typically begin 12 to 24 hours after the last drink, and seizures, which may occur within the first 48 hours. The most severe form of alcohol withdrawal is delirium tremens (DTs), which can be fatal. DTs occur in about 1%-1.5% of people with alcohol withdrawal and typically begin 24 to 72 hours after the last drink, continuing for several days and becoming most intense around four to five days after the last drink.
Some people may experience prolonged withdrawal symptoms, such as insomnia and mood changes, which can last for weeks or even months. The severity and length of alcohol withdrawal vary based on several factors, including the usual amount of alcohol consumed and the duration of alcohol use.
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Alcohol's effects on the brain
Alcohol addiction is a chronic relapsing disorder characterised by compulsive alcohol drinking, a loss of control over intake, and the emergence of a negative emotional state when alcohol is no longer available. Alcohol is a drug that has a powerful effect on the brain, producing pleasurable feelings and blunting negative feelings. These feelings can motivate people to drink alcohol again and again, despite the risks to their health and well-being.
Alcohol affects the brain in several ways. Firstly, it interferes with the brain's communication pathways, affecting the way the brain looks and works. It makes it harder for the brain areas controlling balance, memory, speech, and judgment to function properly, resulting in a higher likelihood of injuries and other negative outcomes. This can lead to poor decision-making, such as driving under the influence, increased violence, or accidents. Secondly, alcohol intoxication can be divided into two stages: euphoria and excitement. During the euphoria stage, the brain releases more dopamine, a chemical linked to pleasure, leading to feelings of relaxation and confidence. However, reasoning and memory may be slightly impaired. The excitement stage occurs when the blood alcohol content (BAC) reaches the legal limit for intoxication, affecting the occipital lobe, temporal lobe, and frontal lobe. Excessive drinking can cause side effects such as blurred vision, slurred speech, and hearing impairment. Thirdly, progressive changes can occur in the brain's structure and function with long-term alcohol consumption. These changes can compromise brain function and drive the transition from controlled, occasional use to chronic misuse, leading to alcohol use disorder (AUD). Finally, excessive drinking has been linked to an increased risk of dementia and shrinkage in areas of the brain involved in cognition and learning, particularly the hippocampus.
The effects of alcohol on the brain can vary depending on the amount and pattern of consumption. Binge drinking, which is the most common pattern of alcoholism, is defined as consuming a certain number of drinks in a single occasion. For men, it is typically defined as having five or more drinks, while for women, it is four or more drinks. Heavy drinking is defined as consuming more than the recommended daily or weekly limits, which are lower for women and individuals over the age of 65. Moderate drinking, defined as no more than one drink per day for women and two drinks per day for men, has been found to have few ill effects according to some studies. However, recent research suggests that even moderate drinking may be associated with brain shrinkage.
The impact of alcohol on the brain can be long-lasting, and the extent of the brain's recovery following long-term sobriety is not fully understood. However, studies indicate that some AUD-induced brain changes can improve or possibly reverse with months of abstinence from drinking. Additionally, adolescent brains are more vulnerable to the negative effects of alcohol, and misuse during this stage can result in long-lasting changes in brain structure and function.
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Treatment options
Outpatient Treatment
Outpatient treatment allows individuals to maintain their daily routines while receiving care. This option includes various therapies, such as individual, family, or group sessions, aimed at building coping strategies and changing drinking behaviour. Medications, such as naltrexone, acamprosate, topiramate, and gabapentin, may also be prescribed by healthcare professionals to reduce cravings and prevent relapse. These treatments can be tailored to individual needs and combined with outpatient care.
Inpatient Treatment
Inpatient treatment involves 24-hour care in a residential or intensive medical setting. This option is often recommended for severe cases or individuals with complex medical needs. Inpatient treatment can help manage withdrawal symptoms and provide a safe environment for detoxification.
Telehealth and Online Resources
Telehealth services, including phone or video sessions, are now offered by many healthcare providers and are particularly useful in areas with limited access to addiction specialists. Accredited alcohol treatment programs are also available entirely through telehealth services. Online tools and apps, such as the NIAAA Alcohol Treatment Navigator, can help individuals find quality treatment options near them and provide step-by-step guidance.
Support Groups and Counselling
Support groups, such as Alcoholics Anonymous (AA), provide individuals with a community of people who understand their situation. 12-step facilitation therapy, based on the AA program, offers one-on-one counselling for those who prefer not to discuss their problems in a group setting. Brief interventions, lasting 5 to 10 minutes, can provide individuals with advice, risk awareness, and emotional support. Cognitive behavioural therapy (CBT) is another talking therapy that identifies and challenges unhelpful thoughts and beliefs contributing to alcohol dependence.
Medication-Assisted Treatment
Several medications are approved to help reduce drinking and prevent relapse. These include naltrexone, acamprosate, topiramate, and gabapentin. Medication-assisted treatment can be combined with counselling for a more comprehensive approach. For those detoxing at home, regular visits from healthcare professionals and support services are essential for safety and long-term success.
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Frequently asked questions
Alcohol addiction, also known as alcohol use disorder (AUD), 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. AUD is a medical condition characterized by an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences.
Some signs of alcohol addiction include an impaired ability to control alcohol intake, experiencing withdrawal symptoms when reducing or ceasing consumption, and continued drinking despite adverse consequences.
Alcohol addiction can lead to a range of serious physical and mental health issues. The physical symptoms of alcohol withdrawal can include shaking, sweating, nausea, and seizures. Mental health issues can include increased stress, anxiety, and depression.
Treatment for alcohol addiction typically involves behavioural treatments, medication, and support groups. Behavioural treatments focus on counselling and changing drinking behaviour. Medications such as naltrexone and acamprosate are used to treat alcohol use disorder. Support groups, such as Alcoholics Anonymous (AA), provide peer support for those aiming to reduce or stop drinking.
