Alcohol Addiction

Alcohol Addiction Treatment

Alcohol Abuse Facts

  • Alcohol, formally known as ethanol or ethyl alcohol is the active ingredient found in beer, wine and liquor.
  • Alcohol is classified as a “sedative hypnotic” drug meaning it can act as a depressant on the central nervous system at high doses.
  • Alcohol is formed from sugars through fermentation in the presence of yeast and therefore can be produced from grapes, barley, potatoes, apples and other plants that have high sugar content.
  • Alcohol abuse is the fourth leading cause of preventable death in the United States.
  • Alcohol addiction costs the United States $249 billion per year.
  • Approximately 88,000 lives are lost each year in the United States and 3.3 million worldwide from alcohol-related deaths.
  • Is alcohol addictive?

    Alcohol consumption overtime increases the release of “feel good” neurotransmitters in the brain resulting in decreased inhibition and euphoria in individuals. Overtime more alcohol is needed to produce the same effects in the brain, a concept known as tolerance. In other words, individuals must drink more and more alcohol to experience the same effects from alcohol, which begins a cycle of increased drinking, followed by a greater tolerance that eventually leads to dependence and addiction. When an individual develops alcohol dependence their body will go through a state of withdrawal in the absence of alcohol producing withdrawal symptoms such as tremors, hallucinations and convulsions. Alcohol addiction creates turmoil in every aspect of an individual’s life including their personal life, professional life and social life.

    Defining alcohol abuse disorder

    Alcoholism, alcohol abuse or alcohol use disorder is defined by alcohol dependence, which is the body’s physical inability to stop drinking and the presence of alcohol cravings. Individuals with an alcohol addiction may go to extreme measures such as stealing, lying, hiding alcohol, drinking household cleaners that contain alcohol and other unhealthy behaviors to obtain alcohol due to cravings and the fear of withdrawal.

    How long do the effects of alcohol last?

    Alcohol abuse can have chronic effects on both the mind and the body but intoxication is only temporary, lasting for several hours depending on the weight, gender and age of the individual. Alcohol is metabolized by the liver but is absorbed into the bloodstream where it eventually travels to the brain resulting in symptoms of intoxication. The average, healthy adult will usually feel the effects of one drink with 15-45 minutes of consumption. At a BAC of 0.1% an individual will be clearly intoxicated and depending on the individual, this level of intoxication could be reached with 4 drinks in one hour. A BAC higher than 0.08% is considered driving under the influence and these levels can be tested from an individual’s breathe, saliva, urine and hair. Alcohol is detected up to six hours in blood, 12-24 hours in breath, saliva and urine and up to 90 days in hair. On average, the liver can metabolize 1 standard drink per hour for men, which is a reduction of blood alcohol level by 0.015 per hour). A standard drink is defined as 12 fluid ounces of regular beer, 8-9 fluid ounces of malt liquor, 5 fluid ounces of wine, 1.5 fluid ounces of a distilled spirit such as vodka, gin, tequila, or rum. Age, gender, weight, metabolism, food consumption and the type of alcohol consumed are all factors that influence how fast alcohol is broken down in the body.

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    How do you I know if I have an alcohol addiction?

    The diagnosis of alcoholism is based on the individual’s drinking history. There are many different assessments health care professionals use to screen individuals for alcohol use including the 10-question Alcohol Use Disorders Identification Test (AUDIT), the abbreviated 3-question Audit-Consumption (Audit-C) and the CAGE questionnaire. The CAGE questionnaire is probably the most widely used screening tool among both medical and mental health professionals and includes the following questions:

    • Have you ever felt the need to cut down on your drinking?
    • Have people annoyed you by criticizing your drinking?
    • Have you ever felt bad or guilty about your drinking?
    • Have you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover?

    The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-V), defines alcohol use disorder as having two or more of the following in a 12-month period

    • Alcohol is often taken in larger amounts or over a longer period than was intended.
    • There is a persistent desire or unsuccessful efforts to cut down or control alcohol use.
    • A great deal of time is spent in activities necessary to obtain alcohol, use alcohol, or recover from its effects.
    • Craving, or a strong desire or urge to use alcohol.
    • Recurrent alcohol use resulting in a failure to fulfill major role obligations at work, school, or home.
    • Continued alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol.
    • Important social, occupational, or recreational activities are given up or reduced because of alcohol use.
    • Recurrent alcohol use in situations in which it is physically hazardous.
    • Alcohol use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by alcohol.

    Effects of alcohol abuse on family and friends

    As an individual sinks deeper into their alcohol addiction, they will begin to stray away from social interactions; distancing themselves from family and friends. They may even lash out at loved ones, and resort to telling lies in order to cover up their drinking habits. Financial problems are likely to arise due to not only the costs of supporting an alcohol addiction but also the loss of productivity and regular work hours due to increased illness, hangovers and other adverse effects. Individuals who abuse alcohol will often find themselves in messy romantic relationships. Alcoholism is strongly liked to codependency in relationships as well as abusive behavior both verbally and physically. Deterioration in married or unmarried couples often stems from arguments, financial troubles, and acts of infidelity or, worse, domestic violence. Alcoholism also decreases sex drive, which can bring even more problems into an already strained relationship and can eventually lead to divorce.

    How does alcohol affect the brain?

    Once alcohol is absorbed in the bloodstream, it travels to the brain resulting in an immediate firing of neurotransmitters. Chronic alcohol use changes the brain chemistry and communication systems by rewiring the reward and pleasure pathways in the brain creating more intense cravings for alcohol rather than for natural rewards. Addiction results in compulsive and harmful behaviors. Depending on the amount of alcohol consumed and the extent of alcohol abuse overtime, alcohol can have devastating effects on the brain ranging from impaired balance and high executive functioning which can be reversed to irreversible damage such as Wernicke-Korsakoff Syndrome, which is a neurological disorder presenting in the clinical tried of memory impairment, ataxia (loss of coordination) and nystagmus (repetitive uncontrolled eye movements). Overtime, reversible effects on the brain such as memory recall, fine motor skills, and coordination can become permanent if the individually continues to abuse alcohol.

    • Memory impairment (short term and long term)
    • Loss of coordination
    • Aggressive behavior
    • Impairments in speech
    • Impairments in reaction time
    • Impairments in attention
    • Loss of consciousness
    • Violent and aggressive behavior
    • Personality changes

    Alcohol abuse treatment

    Seeking professional treatment for your alcohol use disorder (alcohol addiction, alcohol abuse) is the best way to stop drinking. Many individuals turn to alcohol (and other substances) as a coping strategy to deal with stress, negative feelings, boredom, and past traumas with no intention of becoming a heavy drinker or addicted to alcohol however alcohol is a very addictive substance and overtime the individual will experience physical withdrawals after abstaining from chronic alcohol use.

    Alcohol abuse treatment initially aims to ease the withdrawal symptoms by close monitoring and prescribing a slow taper of benzodiazepines. Benzodiazepines work on the same receptors as alcohol in the brain and can help prevent and worsen the deadly withdrawal effects associated with alcohol. If an individual is experiencing withdrawal symptoms he or she will need to be closely monitored in a hospitalized or residential treatment for approximately 72 hours until withdrawal effects are no longer present. Once the acute withdrawal phase is over, treatment aims to identify the underlying triggers resulting in the alcohol abuse behavior.

    The goal of treatment is to replace negative coping skills and patterns with positive cognitive behavioral skills. Alcohol treatment includes both a pharmacological approach and a psychotherapy approach. Medications are used to prevent cravings associated with alcohol, to lessen or prevent withdrawal effects associated with alcohol and to induce unpleasant side effects when alcohol is consumed. The following medications are used to treat alcohol disorder in teens:

    • Acamprosate (Campral): Decreases cravings associated with alcohol and reduces alcohol related withdrawal symptoms.
    • Disulfuram (Antabuse): Prevents alcohol use by causing severe unwanted side effects when alcohol is consumed after taking this medication.
    • Naltrexone: An opioid antagonist that works to prevent alcohol consumption by blocking the positive reinforcement effect of alcohol.

    Psychotherapy approaches for alcohol abuse treatment include family therapy, cognitive behavioral therapy, community support groups, interpersonal therapy and dialectal behavioral therapy.