Alcoholism, formally known as alcohol abuse disorder, is the psychological and physical dependence on alcohol. According to the National Institute of Health (NIH), in 2015, 15.1 million adults in the United States had an alcohol use problem. Individuals who are addicted to alcohol will go to extreme lengths to hide their addiction, will go through physical withdrawal symptoms as soon as they stop drinking, and will experience negative consequences in their personal, professional, and social life. Alcoholism can affect any individual, regardless of his or her age, profession, gender, or social status. Individuals who have a family history of alcohol abuse have a higher risk of alcoholism compared to the general population. Individuals who have an alcohol abuse disorder are more likely to have a co-occurring substance abuse disorder or mental health disorder. Excessive alcohol consumption becomes a problem when it takes importance over all other activities or priorities in an individual’s life.
Why do people drink alcohol?
For most individuals, a drink or two can be a means to celebrate a special occasion or an achievement. Others may enjoy a glass of wine with a meal. Some individuals do not drink at all due to religious reasons or simply because they do not enjoy the taste of alcohol or the feeling it gives.
For many who drink alcohol on occasion or for those who do not drink it at all, they may find it hard to comprehend why alcohol can become the center of many other individuals’ lives, leading to addiction and loss of control. The reasons why people drink alcohol can be endless, but there seem to be a few common trends.
Defining moderate drinking
Moderate drinking is usually more than a couple of glasses of wine at dinner or celebrating a birthday or a special promotion. When light drinking turns to moderate drinking, the reasons behind the increase in alcohol consumption also change. The National Institute on Alcohol Abuse & Alcoholism (NIAAA) defines moderate drinking as up to four alcoholic drinks for men and three for women in any single day and a maximum of 14 bottles for men and seven drinks for women per week.
Reasons for moderate alcohol consumption
Alcohol can have pleasing effects on many individuals. Drinking is known to elicit feelings of euphoria and stress relief; however, often, these feelings are very short-lived. When individuals drink more than they should over the long-term, this can result in depression, low self-esteem, and lead to even more stress than before.
For many individuals, alcohol can become a way to manage problems, and to improve social skills, when drinking becomes a coping mechanism; this is a sign that an individual is becoming too dependent on alcohol.
- Stress relief: For moderate drinkers and those who have an alcohol use disorder, alcohol is often used to “unwind” at the end of the day. Alcohol can have anxiolytic properties meaning it can take away anxious feelings or make stressful situations less stressful. As a result, many individuals use alcohol as a coping mechanism; however, over time, these anxiolytic properties wear off, and individuals become physically dependent on alcohol.
- Social camaraderie: Football games, weddings, birthday parties, work functions, graduations, and holiday celebrations are all social environments where alcohol is usually served. Alcohol is known to decrease social inhibitions. Many drink alcohol as a way to “socialize” with others. However, social drinking can quickly turn to drink in isolation in the later stages of alcohol use disorder.
- Peer pressure: There is a lot of peer pressure to “drink a beer” or “have a glass of wine,” especially at social gatherings. Peer pressure is often tied to high school and college-age populations; however, peer pressure to consume alcohol also commonly occurs in adulthood, especially in the workplace or a high-stress environment. Many individuals feel pressured to drink when they are in the company of others or are trying to impress a potential client, a business partner, or a romantic date.
- Loosening up: Alcohol is known to decrease inhibitions for many. This can make first dates or first encounters less intimidating. Alcohol can be a social lubricant, especially for those who are introverts or are shy around other people. One may feel the need to drink a couple of glasses of wine before delivering a speech in front of a big audience or before going on a blind date. Since alcohol can make people comfortable in otherwise uncomfortable situations, it is often known as “liquid courage.”
- Accessibility: Alcohol is legal for anyone 21 years of age and is widely available in many stores, making this a very accessible substance of choice. Many individuals keep alcohol at home, and because it is so readily available, many choose to drink alcohol simply because it is within reach.
When moderate drinking turns into an addiction
Occasional drinking can sometimes turn into moderate drinking. Individuals who use alcohol on a moderate basis usually do so for at least one of the above reasons. Over time, moderate drinking can become an alcohol use disorder.
Chronic alcohol consumption can wreak havoc on the body and mind resulting in chronic medical disorders and mental health disorders. Heart failure, dementia, liver failure, depression, anxiety, and nutritional deficiencies are some of the common side effects seen from chronic alcohol use disorder.
Behavioral signs and symptoms of alcohol use disorder
- Drinking alone
- Drinking in secret
- Hiding alcohol
- Neglecting personal hygiene and self-care
- Needing a drink in the morning to curb the hangover
- Experiencing frequent hangovers
- Drinking while driving
- Drinking on the job
- Constantly thinking about alcohol
- Diverting time and energy away from work, family, and friends in order to drink
- Unable to quit drinking, even if the desire to stop is present
- Conflict with co-workers and loved ones because of alcohol use
- Developing a tolerance for alcohol (needing more and more alcohol over time).
- A decline in work performance
- Having cravings for alcohol
- Spending large quantities of money on alcohol
Physical signs and symptoms of alcohol use disorder
- Stomach ulcers
- Gastric reflux
- Slowed reaction times
- Memory impairment
- Trembling hands
- Malnutrition and vitamin deficiency: ghostly appearance, hair loss, and under-eye dark circles.
- Difficulty falling asleep and staying asleep
- Yellowing of the skin (jaundice)
- Inflammation of the pancreas (pancreatitis): presents as abdominal pain, back pain, nausea, and vomiting.
Warning signs associated with alcohol use disorder
Alcohol use disorder is a disorder that often presents overtime. An individual does not usually go from never drinking to having an alcohol abuse disorder. There are many red flags overtime that can often represent the early, middle, and late stages of alcoholism. It is common for friends, co-workers, and family members to notice these red flags. The individual is usually in denial or ignores these warning signs.
- Do you lie about your drinking?
- Do you drink to relax or feel better?
- Are you unable to stop drinking once you start? For example, can you stop at one drink, or do you usually order 3-4?
- Have other individuals talked to you about your drinking habits?
- Have you switched from drinking top-shelf alcohol to whatever alcohol is available?
- Do you become moody or violent after having a few drinks?
- Are you concerned about your drinking patterns, but are embarrassed to face them?
- Do you make excuses to drink?
- Do you prefer engaging in activities where alcohol is involved?
- Do you “drink on the go” aka put alcohol in concealed containers and drink in public?
Seeking help for alcohol use disorder
Social drinking can turn into moderate drinking, which can morph into an alcohol use disorder, especially if an individual has a genetic component or underlying triggers associated with alcohol use disorder. It is necessary to be mindful of alcohol consumption, even if it just a few glasses of wine each week.
Alcohol use disorder is a disorder that cannot only have adverse effects on your mental and physical health but can also hurt loved ones around you. Admitting you have a drinking problem is the first step in receiving help. Seeking help from a professional treatment center is encouraged for many reasons. Alcohol withdrawals can be deadly, and therefore medical supervision is recommended to ease the withdrawal symptoms and make the withdrawal process as safe as possible. Psychotherapy is also essential to gain confidence, improve self-esteem, and learn positive coping skills that can help you overcome underlying triggers. Social support networks such as support groups are helpful to meet and engage with others who are also on the road to recovery. A community can be a beneficial tool in recovery.