Enjoying a beer, a glass of wine, or a cocktail can be an enjoyable part of occasional social gatherings or celebrations for many people. For others, drinking may quickly get out of control and become a health issue. According to the most recent report on Behavioral Health Trends in the United States, nearly 140 million people aged 12 and up are current alcohol drinkers. Among this group:
- Around 43.6 percent report binge drinking, which is more than five drinks on one occasion.
- About 11.7 percent report heavy alcohol use (binge drinking on five or more days in a month).
- Of the binge drinkers, 26.8 percent were also heavy users.
- Among young people aged 12-17, 11.5 percent report any alcohol use.
As can be seen by these numbers, alcohol consumption sometimes gets out of control and begins to take over people’s lives. When this happens, it’s time to consider whether or not alcohol abuse or addiction has developed. It can be hard to know when the level of drinking is too much, but knowing more about alcohol, its uses and abuses, and the potential for and signs of addiction can help people who are struggling with a relationship to alcohol and their loved ones decide when it is time to seek medical treatment for alcoholism.
Why Is Alcohol Addictive?
According to the definition offered by the National Institute on Drug Abuse (NIDA), alcohol is a chemical that results from the fermentation of sugar and starches by yeast, a type of microorganism that is also used to make bread. Alcohol, when ingested, is quickly absorbed and acts as a depressant on the nervous system.
Alcohol, also known as ethanol, can be made from a variety of substances, including fruits, grains, seeds, roots, leaves, honey, and other foods. This accounts for the wide variety of alcoholic beverages available. Alcoholic beverages vary in alcohol content and the level of impurities left in the drink, depending on the fermentation or distilling process.
According to the Encyclopedia Britannica, alcohol has been made by just about every culture in the world at some point or another, including a type of beverage created by the Chinese using rice from as early as 800 years BCE. It has a history nearly as old as humanity itself.
The depressive qualities of alcohol create a relaxed state in the brain by suppressing chemicals that excite the nerves and by bonding in the same way as chemicals that relax the nerves. When a large quantity of alcohol is consumed, it can lead to an excessively relaxed state of mind called inebriation, which can result in a state of euphoria. This is also accompanied by decreased brain function, reduction of inhibitions, and loss of control and delay of physical responses.
Methanol vs. Ethanol
Alcoholic beverages are generally used for enjoyment in moderation during celebrations or as an accompaniment for meals. For much of the population, it is an indulgence to enjoy on occasion during social events. Some forms of alcohol also have medical, alternative health, or industrial uses. Alcohol can also be used for the following purposes:
- Dissolving other compounds, such as paint
- Sterilizing biological objects or surgical instruments
- Preserving food or other biological items
- Extracting chemicals from organic matter, such as leaves, fruits, and seeds
- Fueling various types of machinery
Many of the alcohols used for these purposes include methanol, which makes the alcohol unsafe and undesirable to drink. These uses are not as prevalent or as well known as the recreational use of alcohol in beverages.
Alcoholism Genetic Predisposition
While the exact causes of alcoholism and alcohol abuse are not known, the American Psychological Association identifies some specific conditions that may put a person at risk for abusing or becoming addicted to alcohol. These conditions include:
Signs of Alcohol Abuse and Dependence
When a person has moved beyond recreational use of alcohol, it is possible they have developed an alcohol use disorder and may need alcohol dependence treatment.
How is alcohol use disorder diagnosed?
The behavioral signs and physical symptoms of alcoholism are assessed by professionals to diagnose an alcohol use disorder, or AUD. According to the National Institute on Alcohol Abuse and Alcoholism, these signs and symptoms may include:
- Drinking longer or more than originally intended on a regular basis
- Wanting but being unable to stop drinking
- Continuing to drink even when it has severe social consequences
- Feeling the need to drink early in the day or even first thing in the morning in order to function
- Engaging in risky behaviors on a regular basis while inebriated
- Giving up regular activities or relationships for drinking
- Having trouble with work or school responsibilities because of alcohol use
- Cravings for alcohol
- Memory problems and blackouts after drinking
- Redness of the nose and cheeks
- Withdrawal symptoms when drinking is stopped
- Depression of brain function
When these signs and symptoms are observed, it’s time to seek medical treatment for alcoholism or addiction before physical deterioration progresses further. Alcohol use disorders can lead to more severe illnesses, such as dementia (Wernicke-Korsakoff syndrome), or various types of cancer if not treated.
Alcohol Withdrawal Risk Factors
While it might seem tempting to try to quit drinking abruptly in response to an alcohol use disorder, this can be very dangerous. Especially after long-term alcohol abuse or addiction, the body’s level of dependence on the substance can result in severe withdrawal symptoms when alcohol consumption is stopped. As reflected by the National Library of Medicine’s Medline Plus, these symptoms can include:
- Anxiety, irritability, and jumpiness
- Inability to concentrate
- Tremors or shakiness
- Insomnia and fatigue
- Heart palpitations
- Nausea and digestive problems
- Delirium tremens (DTs), which includes hallucinations, psychosis, seizures, and other serious symptoms
Withdrawal from alcohol can be extremely uncomfortable; some of the symptoms, including seizures and DTs, which are more likely to occur with long-term, heavy alcohol use, can result in death. Enrolling in a professional, research-based alcohol use disorder treatment program can ensure safety and increased comfort throughout the medical detox process.
Treatment Options for Alcoholism
While alcohol abuse and alcoholism cannot be cured, they can be treated, and people struggling with these issues can achieve and maintain long-term recovery. Because of the risks of alcohol abuse and addiction and of quitting alcohol abruptly, the best method for treating these conditions is a research-based program customized to address the individual’s specific issues. With an individualized program, a person can detox and learn ways to abstain from alcohol consumption and maintain recovery from alcoholism for the long run.
In addition, a study in Drug and Alcohol Dependence demonstrates that a mixture of medical and behavioral treatments, along with social support post treatment, is most likely to help a person reach and maintain recovery from an alcohol use disorder.
Drugs to Treat Alcoholism
You may be wondering, what can I take to stop drinking? While there is no magic cure for alcoholism, therapy plus medication may make it easier for you to stay abstinent from alcohol long-term.
There are several medications that may be used in the treatment of alcoholism. These medications may curb alcohol cravings and help people stay sober in the long run.
Disulfiram for Alcoholism
Disulfiram, sold under the brand name Antabuse®, deters drinking by producing a bad physical reaction to alcohol. Someone who takes disulfiram and then drinks alcohol may experience symptoms such as:
- Flushing of the skin.
- Heart palpitations.
For individuals who are highly motivated to stay sober and take disulfiram regularly, it can be a very effective medicine for alcohol addiction.
Acamprosate for Alcohol Dependence Treatment
Acamprosate helps with alcohol recovery by reducing the symptoms of protracted, or long-lasting, alcohol withdrawal. Proctracted alcohol withdrawal symptoms which may be lessened with acamprosate, or Campral®, include:
- Low mood.
For those who suffer from severe alcohol dependence, acamprosate has been shown to be quite effective for weeks or even months in helping them to maintain their sobriety through their withdrawal symptoms.
Naltrexone for Alcohol Cravings
Naltrexone helps to curb alcohol cravings and inhibit the euphoric effects of alcohol by blocking the brain’s opioid receptors.
Naltrexone comes in a once-monthly injection, Vivitrol®, that may make it easier for those taking the drug to remain compliant with their medication regimen and to stay sober long-term.
What happens if you drink while taking naltrexone?
If you drink while taking naltrexone, you may still become impaired, for example you may suffer problems with coordination and judgment; however, you may not feel euphoric or like you want to drink more. Unlike Antabuse, naltrexone does not cause an unpleasant physical reaction.
Alcohol Recovery Programs
Alcohol recovery programs typically include a variety of alcohol use disorder treatments and alcohol therapy options to support recovery, including:
- Medically supported detox to help minimize severe or dangerous withdrawal symptoms
- Medical maintenance assistance to help curb cravings
- Behavioral therapy to observe, identify, and manage the underlying psychosocial contributors to alcohol cravings and abuse habits
- Family therapy and interpersonal therapy to build social support structures and encourage healthy relationships
- Training about triggers and situations that increase the likelihood of relapse, and education on tools and strategies to help avoid relapse
- Mutual support groups and other post-treatment support to motivate continued recovery