Alcohol Abuse Facts
- Alcohol, formally known as ethanol or ethyl alcohol, is the active ingredient 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.
- Sugars form alcohol through fermentation in the presence of yeast. Alcohol 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.
- There are approximately 88,000 alcohol-related deaths per year in the United States, and 3.3 million worldwide.
Is alcohol addictive?
Alcohol consumption increases the release of “feel good” neurotransmitters in the brain, resulting in decreased inhibition and euphoria. Over time, more alcohol is needed to produce the same effects in the brain. This is called tolerance. In other words, individuals must drink more and more alcohol to experience the same effects. This leads to a cycle of increased drinking and an increased tolerance that eventually leads to dependence and addiction.
When someone develops alcohol dependence, their body will go through a state of withdrawal in the absence of alcohol. Withdrawal symptoms include 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.
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Defining alcohol abuse disorder
Alcoholism, alcohol abuse, and alcohol use disorders are 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, consuming dangerous chemicals or medications in an attempt to get drunk, and other unhealthy behaviors. Intense cravings and the fear of the painful withdrawal drive these behaviors.
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. Alcohol is metabolized by the liver and 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 within 15-45 minutes of consumption.
At a Blood-Alcohol Content (BAC) of 0.1%, an individual will be clearly intoxicated. Depending on age, weight, gender, and tolerance, this level of intoxication could be reached with around 4 drinks in one hour.
How long does alcohol stay in the body?
On average, the liver can metabolize 1 standard drink per hour. Age, weight, metabolism, food consumption, and gender can affect this rate.
What is a standard drink?
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.
How do 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 an alcohol addiction, they may 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 stormy romantic relationships. Alcoholism is strongly linked to codependency, verbal abuse, and physical abuse. Deterioration within a couple 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.
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 over time, alcohol can have devastating effects on the brain:
- Impaired high executive functioning, including reaction time
- Long- and short-term memory impairments which may become permanent
- Fine motor skills impairments which may become permanent
- Balance impairments which may become permanent
- Violent or aggressive behavior
- Personality changes
- Seizures and loss of consciousness
- Wernicke-Korsakoff Syndrome, which is an irreversible neurological disorder causing memory impairment, ataxia (loss of coordination), and nystagmus (repetitive uncontrolled eye movements)
Alcohol abuse treatment
Seeking professional treatment for an 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. However, alcohol is very addictive. Over time, 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, they will need to be closely monitored in a hospital or residential treatment for approximately 72 hours. 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, and to induce unpleasant side effects if alcohol is consumed.
The following medications are used to treat alcohol disorder:
- Acamprosate (Campral): Decreases cravings associated with alcohol and reduces alcohol related withdrawal symptoms.
- Disulfuram (Antabuse): Discourages alcohol use by causing severe, uncomfortable side effects when alcohol is consumed after taking this medication.
- Naltrexone: An opioid antagonist that works to prevent alcohol consumption by blocking the positive effects of alcohol.
Psychotherapy approaches for alcohol abuse treatment include:
- Family therapy
- Cognitive behavioral therapy (CBT)
- Dialectical behavioral therapy (DBT)
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