Lena Savoie
Alcohol dependence, also known as alcoholism or alcohol addiction, is a serious form of high-risk drinking characterized by an impaired ability to stop or control alcohol consumption despite adverse social, occupational, or health consequences. While psychological and physical alcohol dependence are distinct, they are interconnected. Physiological dependence on alcohol is marked by a person's inability to function or survive without it, with drinking becoming a central and important factor in their life. This is accompanied by a tolerance to alcohol, where an individual needs to consume higher volumes to achieve the desired effect, and the presence of withdrawal symptoms when reducing or ceasing alcohol consumption. These symptoms can include tremors, nausea, sweating, and anxiety, among others. While physiological dependence on alcohol is a factor of addiction, it does not constitute addiction itself. However, heavy drinking caused by physiological dependence can lead to alcohol addiction.
| Characteristics | Values |
|---|---|
| Definition | Physical alcohol dependence is a factor of addiction, but not addiction itself. |
| Cause | There are no clear-cut causes of physical alcohol dependence, but there are predictors of severe dependence, including heavy alcohol use, and comorbid illnesses such as liver, pancreatic, neurological, circulatory, and gastrointestinal diseases. |
| Signs | Building a tolerance to alcohol, experiencing withdrawal symptoms, and having obsessive thoughts about drinking are some signs of physical alcohol dependence. |
| Effects | Physical alcohol dependence can lead to addiction and cause adverse effects on long-term health, including liver diseases such as fatty liver disease, alcoholic hepatitis, and liver cirrhosis. |
| Treatment | Behavioral therapies, mutual-support groups, and medications can help individuals with physical alcohol dependence achieve and maintain recovery. |
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What You'll Learn
Alcohol withdrawal symptoms
Alcohol withdrawal refers to the physical and psychological symptoms that occur when a person with an alcohol use disorder significantly reduces or stops their alcohol consumption. These symptoms arise due to the body's dependence on alcohol, which develops over time with regular and excessive drinking.
With prolonged and heavy alcohol use, the brain adapts to the presence of alcohol and adjusts its functioning accordingly. Alcohol enhances the effects of a neurotransmitter called GABA, which has a calming or inhibitory effect on the brain, and at the same time, it reduces the activity of another neurotransmitter, glutamate, which has an excitatory effect. As a result, when alcohol is removed, the brain is left in a state of hyper-excitability, and the nervous system becomes unbalanced, leading to a range of unpleasant withdrawal symptoms.
The severity and duration of alcohol withdrawal symptoms can vary depending on several factors, including the length and severity of the alcohol use disorder, the person's overall health, and the presence of any co-occurring medical or mental health conditions. Common alcohol withdrawal symptoms include:
- Anxiety and agitation: Restlessness, nervousness, irritability, and a sense of unease are common during alcohol withdrawal. Panic attacks, characterized by sudden feelings of intense fear or impending doom, may also occur.
- Tremors: Shaking, especially of the hands, is a typical early sign of alcohol withdrawal. Tremors are caused by the hyper-excitability of the nervous system and can vary in severity.
- Insomnia: Difficulty falling or staying asleep is common during alcohol withdrawal. This is due to the rebound effect on the brain, as alcohol usually has a sedative effect, aiding sleep.
- Nausea and vomiting: These symptoms often occur as the body tries to rid itself of toxins. They can lead to dehydration, so it's important to encourage fluid intake.
- Headache: Headaches are common during alcohol withdrawal and can range from mild to severe. They are thought to be caused by the changes in brain chemistry and blood vessel dilation.
More severe alcohol withdrawal symptoms may also occur and require immediate medical attention. These include:
- Hallucinations: In more severe cases, individuals may experience auditory, visual, or tactile hallucinations, usually occurring around 12–24 hours after the last drink. These can be very distressing and may include seeing insects or animals that aren't there or hearing voices.
- Delirium tremens (DTs): DTs are the most severe form of alcohol withdrawal, affecting around 5% of people going through alcohol withdrawal. Symptoms include severe confusion, fever, seizures, and profound agitation. DTs usually occur 48–96 hours after the last drink and can be life-threatening, so immediate medical attention is crucial.
It is important to note that alcohol withdrawal can be dangerous and, in some cases, life-threatening. Therefore, it is always recommended to seek medical assistance when attempting to overcome an alcohol use disorder. Medical professionals can provide supervision, medications (such as benzodiazepines) to help manage withdrawal symptoms, and referrals to ongoing support and treatment programs to aid in long-term recovery.
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Alcohol addiction
Signs of Alcohol Addiction
- You may feel like you are unable to function without alcohol and experience obsessive thoughts about drinking.
- You may need to drink more and more to achieve the desired effect, as your body builds a tolerance to alcohol.
- You may experience physical withdrawal symptoms such as trouble sleeping, shakiness, restlessness, nausea, sweating, a racing heart, feeling uneasy or unhappy, a general sense of being unwell, feeling low, or a seizure.
- You may continue to drink despite negative consequences, such as harm to your health or interference with your daily life.
- You may prioritise drinking over other activities or obligations, such as work or family life.
- You may use alcohol to cope with difficult times, negative feelings, or mental health problems such as depression or anxiety.
Treatment Options
It is important to seek professional help if you are concerned about your alcohol consumption. Treatment options include behavioural therapies, mutual-support groups, and medications. Behavioural treatments, also known as alcohol counselling or talk therapy, aim to change drinking behaviour and are provided by licensed therapists. Mutual-support groups provide peer support for stopping or reducing drinking and are typically low or no cost. Medications can also be prescribed by doctors to address withdrawal symptoms and make the process safer and less distressing.
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Physical and psychological effects
Alcohol dependence, or Alcohol Use Disorder (AUD), has a range of harmful physical and psychological effects. It is a medical condition characterised by an impaired ability to stop or control alcohol consumption despite adverse social, occupational, or health consequences. It is considered a brain disorder, encompassing conditions such as alcohol abuse, alcohol dependence, alcohol addiction, and alcoholism.
Physical Effects
Physically, alcohol dependence can lead to the development of a tolerance to alcohol, resulting in the need to consume higher volumes to achieve the same effects. Withdrawal symptoms can occur when reducing or ceasing alcohol consumption, including trouble sleeping, shakiness, restlessness, nausea, sweating, a racing heart, dysphoria, malaise, low mood, and seizures. The fear of experiencing these withdrawal symptoms may contribute to the continued abuse of alcohol and can lead to relapse after periods of abstinence. Alcohol dependence can also cause serious long-term health issues, including liver diseases such as fatty liver disease, alcoholic hepatitis, and liver cirrhosis, which is the permanent scarring of liver tissue.
Psychological Effects
Psychologically, alcohol dependence can result in an intense craving for alcohol and the inability to control consumption. It can become a central part of an individual's life, impacting their ability to function or survive without it. Alcohol-dependent individuals may prioritise drinking over other activities or obligations, such as work or family life, and continue drinking despite the negative consequences. They may use alcohol as a coping mechanism to deal with difficult times, negative feelings, or underlying mental health issues such as depression and anxiety. The presence of withdrawal symptoms, such as anxiety, can further increase the vulnerability to relapse.
Treatment
Alcohol dependence can be treated through behavioural therapies, mutual-support groups, and medications. Behavioural treatments, or alcohol counselling, aim to change drinking behaviour and build motivation and skills to prevent a return to drinking. Mutual-support groups provide peer support and are available in most communities at low or no cost. Medications can also help deter drinking, especially during times of increased risk of relapse.
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Alcohol tolerance
Tolerance to alcohol is influenced by various factors, including body size, weight, and the activity of alcohol dehydrogenases (enzymes that break down alcohol) in the liver and bloodstream. Studies have shown that people with higher body weight and higher levels of alcohol dehydrogenases tend to have higher alcohol tolerance. Additionally, alcohol tolerance is not evenly distributed across different ethnicities and cultures. For example, Native Americans have a higher probability of developing an alcohol use disorder compared to Europeans and Asians.
The development of alcohol tolerance can lead to negative health consequences. While individuals with higher tolerance may not feel the effects of alcohol as strongly, they are still causing damage to their liver. Additionally, higher tolerance can lead to increased alcohol consumption, which can have detrimental effects on the body.
It is important to note that alcohol tolerance is a complex phenomenon that involves both physiological and psychological factors. While this response focuses primarily on the physiological aspects of alcohol tolerance, it is crucial to recognise that the psychological aspects also play a significant role in alcohol dependence and relapse.
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Relapse and excessive drinking
Relapse is a common occurrence on the road to recovery from alcohol dependence. It is characterised by a return to previous levels of alcohol consumption after a period of abstinence or reduced drinking. Relapse is different from a lapse, which is a brief or temporary return to alcohol use, followed by a resumption of abstinence or reduced drinking goals.
There are several factors that can contribute to a relapse. One significant factor is the development of physiological dependence on alcohol. When an individual with a physical dependence on alcohol abruptly stops or significantly reduces their consumption, they may experience withdrawal symptoms. These symptoms can include both physical and psychological effects, such as anxiety, which can be a powerful trigger for relapse. The fear of experiencing withdrawal symptoms may lead some individuals to continue drinking or relapse after a period of abstinence.
Another factor contributing to relapse is the presence of underlying mental health or emotional issues. Pre-existing psychological conditions, such as anxiety or depression, can increase the risk of relapse as individuals may turn to alcohol as a coping mechanism. Social pressures, personal setbacks, and economic problems can also trigger a relapse. Additionally, individuals with a history of alcohol dependence may exhibit heightened sensitivity to alcohol-related cues and stressors, making them more susceptible to relapse.
To manage and prevent relapse, it is crucial to develop strategies that address both the physiological and psychological aspects of alcohol dependence. Seeking professional help and support is essential. Behavioral therapies, such as talk therapy or counselling, can help individuals identify triggers, develop coping mechanisms, and change their drinking behaviour. Mutual-support groups, such as Alcoholics Anonymous, can provide additional support and help individuals stay focused on their recovery goals.
In some cases, medication may be prescribed to manage withdrawal symptoms and reduce cravings, making it easier to avoid relapse. It is important to note that recovery from alcohol dependence is a gradual process, and lapses or relapses are common and do not signify failure. Each setback is an opportunity to learn more about triggers and develop new coping strategies to maintain long-term behavioural changes.
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Frequently asked questions
Physiological dependence on alcohol is when a person's body adapts to alcohol consumption, leading to tolerance and withdrawal symptoms upon reduction or cessation of drinking.
Some common signs include increased tolerance, experiencing withdrawal symptoms when reducing or stopping alcohol intake, and having obsessive thoughts about drinking.
No, physiological dependence and addiction are separate but linked entities. Physiological dependence is a factor of addiction but does not necessarily indicate addiction. However, heavy drinking due to physiological dependence can lead to alcohol addiction.
Physiological dependence on alcohol can have adverse long-term health effects, including liver diseases such as fatty liver disease, alcoholic hepatitis, and liver cirrhosis. Excessive alcohol consumption can also increase the risk of developing various types of cancer.
Overcoming physiological dependence on alcohol often requires professional support and medical treatment. Behavioral therapies, mutual-support groups, and medications can help individuals manage their drinking and achieve recovery. It is important to seek help early to prevent a return to drinking and address any underlying psychological factors contributing to the dependence.
