Despite all the information and warnings about alcohol, drinking continues to be a major public health issue in the U.S.. Not only do a majority of adults drink on a monthly basis, but nearly 27% of people 18 and older admitted to binge drinking within the past month, according to the National Institute on Alcohol Abuse and Alcoholism.1
Problematic alcohol use affects millions, but people who engage in excessive alcohol use may not realize they have an issue with the substance. People abusing alcohol and their loved ones would benefit from knowing the signs and symptoms of alcoholism, or an alcohol use disorder (AUD), so they can better identify the problem and respond appropriately.
Am I an Alcoholic?
Alcohol use is very normalized, so people may drink to excess regularly without seeing it as a problem. Over time, though, heavy drinking may begin to impair their lives in numerous ways. When a person continues to drink despite knowing how alcohol is harming their well-being, their careers, their relationships, and other areas of their lives, they may have an alcohol use disorder.
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) points to a set of criteria currently used by mental health and addiction professionals to indicate an unhealthy pattern of alcohol use. If you’re questioning whether you have a problem with alcohol, ask yourself:2
- Do I regularly drink more alcohol than I intended to?
- Have I tried unsuccessfully to take steps to cut down or stop drinking?
- Do I spend a lot of time and energy getting alcohol, using alcohol, and recovering from the effects of alcohol?
- Do I crave alcohol when I’m not drinking?
- Does my drinking stand in the way of how well I function at home, work, or school?
- Do I often suffer interpersonal conflicts and social problems due to my drinking?
- Do I give up activities I enjoy to spend more time drinking?
- Do I continue to drink even though I know it has caused or worsened a physical or mental health issue?
- Do I use alcohol before or while engaging in activities that may be hazardous, such as driving.
- Do I need to keep drinking more and more in order to feel intoxicated?
- Do I get sick and suffer withdrawal symptoms when I’m unable to drink?
The presence of just 2 of the above criteria within 12 months is enough to receive a diagnosis of having an alcohol use disorder.
Remember, just because you don’t “feel” like an alcoholic because you still go to work and have never had a DUI doesn’t altogether rule out an AUD. Each person’s experience is unique.
The DSM-5 criteria for an AUD are not the only indicators of an unhealthy relationship with alcohol.
Physical Warning Signs
A person with an alcohol use disorder may show additional physical warning signs such as:2,3
- Bloodshot, red, or glassy eyes.
- Changes in eating habits, weight, or sleep.
- Declining grooming habits including:
- Showering less often.
- Wearing the same clothes days in a row.
- Looking dirty.
- Having unexplained brushes or scrapes from falls.
- Smelling like alcohol.
- Frequently present indicators of acute alcohol intoxication, such as:
- Slurred speech.
- Poor coordination.
- Inability to walk steadily.
- Poor attention or memory.
- Mood instability.
Behavioral Warning Signs
Along with these physical warning signs, someone with an alcohol problem could begin showing behavioral changes such as:3
- Being very secretive or suspicious.
- Lying frequently.
- Neglecting personal responsibilities.
- Spending time with new people in new places while neglecting old friends or family.
- Getting into legal problems from fighting, traffic accidents, or DUIs.
- Preoccupation with drinking.
- Spending large amounts of money, running out of money, or stealing to get money.
Alcohol’s Far-Reaching Effects
Alcohol is a powerful substance. It can significantly impact a person in the short term and produce far-reaching effects in the long term. Alcohol is also a major contributor to death and disease worldwide. In fact, the substance is responsible for about 88,000 deaths each year.1
Excessive or long-term abuse of alcohol can result in the development of numerous physical health problems affecting:4
- The immune system – Chronic drinkers may have an impaired immune system and subsequently be at higher risk of contracting infectious diseases such as tuberculosis and certain types of bacterial pneumonia.
- The brain – Alcohol disrupts the brain’s communication pathways, leading to problems with mood, behavior, thinking, and coordination.
- The heart – Too much drinking can cause:
- Weakening of the heart muscle.
- The liver – Heavy drinking over time is associated with the risk of:
- Fatty liver.
- Alcoholic hepatitis.
- The pancreas – Alcohol causes the pancreas to produce toxins, resulting in painful and dangerous inflammation and swelling that prevents normal digestion (pancreatitis).
- Cancer risk – people who drink too much alcohol are at increased risk for many cancers including:
- Head and neck cancer.
- Esophageal cancer.
- Liver cancer.
- Breast cancer.
- Colorectal cancer.
Sadly, some of the chronic physical health effects of alcohol are irreversible; however, others may gradually improve over time with proper treatment and alcohol abstinence,5 so getting into treatment as soon as possible is extremely important for your health if you are still drinking heavily.
In some cases, the hazards of alcohol use extend beyond the person who drinks and could potentially affect others who are powerless to avoid them. For example, nearly 10,000 people died from alcohol-related motor vehicle accidents in 2014 alone.1
The risks of alcohol also extend to unborn babies. Alcohol use during pregnancy creates a tremendous risk to the fetus.
Contrary to popular opinion, there is no safe level of alcohol for a pregnant woman to consume, and the occasional glass of wine could definitely affect the child.6
Any level of alcohol could have a profound negative impact on the baby and may result in fetal alcohol spectrum disorders (FASD). FASD encompasses a group of disorders associated with impaired growth and development of a child and the potential to adversely influence many facets of their physical and mental health throughout their lifetime.
Children exposed to alcohol during pregnancy are at increased risk of problems including:6
- Impaired motor skills and poor coordination.
- Lack of emotional regulation.
- Poor decision-making skills.
- Impaired ability to complete school work and succeed in school.
- Poor social skills and the tendency to develop detrimental relationships.
- Inability to maintain long-term employment.
FASD is completely preventable; substance abuse treatment can you help take steps towards reducing the risks or altogether avoiding FASD.
With the proper treatment, you can mitigate the damage that alcohol has done to your body and brain and prevent further harm to you or to those around you.
What Happens in Alcohol Rehab?
Alcohol rehab often begins with medical detox because alcohol withdrawal can be difficult to endure and even life-threatening.
Alcohol withdrawal symptoms may manifest as a range of distressing physical and mental effects such as:7
- Nausea and vomiting.
- Loss of appetite.
- Inability to sleep.
- Delirium tremens (DTs) – a severe withdrawal syndrome that includes profound confusion and other sudden changes to mental status (delirium), severe agitation, and autonomic signs (such as tremors, high blood pressure, rapid heart rate, and fever).
The acute alcohol withdrawal syndrome can be quite severe and is sometimes associated with life-threatening complications and even death. For these reasons, the Substance Abuse and Mental Health Services Administration recommends professional detox treatment for individuals withdrawing from alcohol.8
For many, completing detox on an inpatient basis is the safest option, as this level of care provides:
- 24-hour monitoring.
- A highly trained staff of medical professionals.
- Medications to reduce symptoms and improve comfort.
- A safe, supportive environment to recuperate and avoid relapse.
For alcohol use disorders, medical detox is so vital, but it is only one step toward a lasting recovery. Since detox really focuses on mitigating the immediate medical risks of withdrawal, additional behavioral therapeutic interventions may be needed to fully address the thoughts, feelings, and behaviors that contribute to excessive alcohol use.9
Therapy for alcohol issues can occur in a number of inpatient, residential, and outpatient settings. Your treatment team can recommend a course of care that best fits your symptoms, level of outside supports, and lifestyle.8
The most effective treatments are ones that focus on each aspect of your life rather than only your addiction. Your treatment may include:9
- Individual, group, and family therapy.
- Support groups.
- Drug education classes and skills-building exercises.
- Educational/vocational programs to help you receive schooling or job opportunities.
- Assistance with childcare or parenting skills.
- Medical care for health maintenance and treatment for any pertinent physical health needs.
Many programs also offer medication-assisted treatment to help you achieve lasting recovery. Some medications used in the treatment of alcohol addiction include:9
- Acamprosate (Campral) – Helps to prevent relapse by lessening cravings and urges to drink.
- Disulfiram (Antabuse) – A medication that triggers unpleasant symptoms like nausea and vomiting when the user drinks alcohol while taking it.
- Naltrexone – A drug that blocks the rewarding effects of alcohol to decrease continued drinking behavior.
These medications combined with behavioral therapies have helped many on the path of recovery and health. The best part is you never have to walk the path alone. There is a community of professionals and people in recovery available to help every step of the way.
- National Institute on Alcohol Abuse and Alcoholism. (2018). Alcohol Facts and Statistics.
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
- Indian Health Services. (n.d.). Warning Signs of Drug Abuse and Addiction.
- National Institute on Alcohol Abuse and Alcoholism. (n.d.) Alcohol’s Effects on the Body.
- National Institute on Alcohol Abuse and Alcoholism. (2004). Alcohol Alert.
- National Institute on Alcohol Abuse and Alcoholism. (n.d.). Fetal Alcohol Exposure.
- Richard Saitz, M.D., M.P.H. (1998). Introduction to Alcohol Withdrawal. Alcohol Health & Research World, 22(1).
- Substance Abuse and Mental Health Services Administration. (2015). Detoxification and Substance Abuse Treatment.
- National Institute on Drug Abuse. (2018). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition).