Understanding Alcoholism and Alcohol Abuse Treatment
Alcoholism, clinically referred to as alcohol use disorder (AUD), is a common, chronic, and sometimes-progressive medical condition that entails compulsive drinking of alcohol. For many people, having a beer, a glass of wine, or a cocktail can be an enjoyable part of a meal, occasional social gatherings or celebrations. For others, drinking in moderation may be more difficult and they may find themselves unable to control their alcohol use.
Here we’ll provide an overview of alcohol use in the U.S., define excessive or problematic drinking, review the potential risks of alcohol misuse, and explore your treatment options if you’re struggling with alcoholism or problematic alcohol use.
Did you know most health insurance plans cover addiction treatment?
Alcohol Abuse Information & Statistics
Alcohol use is common in America. In 2018, more than 2/3 of all adults reported drinking alcohol in the past year.1 And it’s not just adults; more than half of all high school seniors surveyed in the 2020 Monitoring the Future survey admitted to past-year drinking.2
While many Americans drink responsibly, excessive drinking results in an estimated 95,000 deaths in the U.S. every year. Excessive drinking includes both heavy drinking and binge drinking, as well as any drinking by a pregnant woman or person under the legal drinking age of 21.3
Heavy Drinking Definition
Heavy drinking is defined as 14 drinks/week or more for men and 7 drinks/week or more for women. The Centers for Disease Control (CDC) provides some insight into heavy drinking among adults in the U.S.:1
- In 2018, just over 5% of American adults 18 years old and older reported past-year heavy drinking.
- Mood problems can lead to heavier drinking. Adults surveyed in 2018 who reported feelings of anxiety or depression were more likely than their peers who did not share these feelings to drink heavily.
- Regular access to healthcare appears to be a factor in drinking behaviors. Adults surveyed in 2018 who said they had a specific location where they receive healthcare services were less likely to engage in heavy drinking than those who did not have a regular place to access care or who cited the emergency room as their location.
Binge drinking is defined as 4 drinks per occasion or more for women and 5 or more for men. The CDC reports that:3
- Binge drinking accounts for about half of all the deaths and ¾ of the costs related to excessive alcohol use in the country.
- One in 6 adults binge drinks weekly, having about 7 drinks each time.
Drinking to excess can be harmful, not only to your physical health but also to your mental health. Binge drinking and heavy alcohol use can increase an individual’s risk to developing an alcohol use disorder, commonly called alcoholism.
Alcohol Use Disorder Definition
Alcohol’s effects on the brain are similar to other drugs of abuse, and for some people alcohol use can become compulsive.4,5 Someone with an AUD will not be able to stop drinking even when their alcohol use is causing harm to their health or to other areas of their life, such as their relationships, job, or social life. Someone with an AUD might also be dependent on alcohol, needing to drink to avoid withdrawal.5 Alcohol dependence adds another layer of difficulty to getting sober.6
Alcohol Use Disorder Criteria
An AUD is not defined by binge drinking episodes, drinking what seems like a lot on a regular basis, or even drinking to excess too often, though these of course may be signs of an alcohol addiction.
There are very specific criteria that doctors and mental health professionals use to diagnose an alcohol use disorder. Meeting 2 of the following 11 criteria is indicative of an AUD:7
- Drinking for longer periods, or in greater amounts, than intended.
- Trying to stop drinking or cut back without success.
- Spending a good deal of time drinking or recovering from drinking (having hangovers).
- Having overwhelming cravings or urges to drink.
- Experiencing disruptions in your domestic or professional obligations due to drinking or being hungover.
- Continuing to drink excessively in spite of it causing problems in your relationships
- Giving up hobbies or other activities you enjoy in favor of drinking.
- Drinking before or during activities where being intoxicated can end up in your or someone else getting hurt (e.g., driving).
- Continuing to abuse alcohol after having a blackout or while knowing that it has worsened a health problem or contributed to feelings of anxiety or depression.
- Needing to drink increasing amounts of alcohol to feel the desired effects.
- Needing to drink to stave off withdrawal symptoms.
The more criteria a person meets, the more severe the alcohol use disorder.7
What Are the Long-Term Effects of Alcohol Abuse?
The immediate dangers of intoxication—such as the risk of accidents and injuries, as well as blackouts and alcohol poisoning—are well-known. However, excessive alcohol use over time can lead to the development of chronic illness and many other serious physical and mental health problems. Some of these include:7,8
- Anxiety.
- Depression.
- Violent behaviors.
- Suicidal thoughts and actions.
- Suppression of the immune system.
- Heart problems, including irregular heart rhythms, heart muscle disease, or stroke.
- Liver disease.
- Inflammation of the pancreas.
- Increased risk of many cancer types, including cancer of the breast, esophagus, head and neck, colon, and liver.
Chronic excessive alcohol use may also result in a very serious, although rare, brain disorder called Wernicke’s encephalopathy, which arises from a deficiency of Vitamin B1 (thiamine). Symptoms include:9
- Confusion.
- Vision problems.
- Dangerously low body temperature.
- Low blood pressure.
- Problems with muscle coordination.
Wernicke’s encephalopathy often develops into a more long-lasting condition called Korsakoff’s syndrome, symptoms of which include:9
- Disorientation.
- Vision problems.
- Tremors.
- Coma.
- Difficulty in making new memories or recalling old ones.
Wernicke’s encephalopathy and Korsakoff’s syndrome occur together so often that they are believed by many to be two phases of one syndrome (Wernicke-Korsakoff syndrome), with the first being the acute phase and the second being the chronic phase.9
Signs and Symptoms of Alcohol Withdrawal
For a person who regularly drinks heavily, quitting isn’t as simple as saying no to alcohol. Sometimes, it can actually be dangerous. The alcohol withdrawal syndrome has a broad range of symptoms from mild to severe. For most people, alcohol withdrawal will be uncomfortable and may prompt serious urges to relapse in order to feel better. For others, alcohol withdrawal symptoms can be dramatic and severe, even dangerous and life-threatening.6
Alcohol withdrawal may bring about symptoms such as:5
- Anxiety.
- Insomnia.
- Purposeless movements, such as pacing.
- Tremors or shakiness.
- Racing heart rate.
- Sweating.
- Nausea.
- Vomiting.
- Confusion.
- Hallucinations.
- Seizures.
Delirium tremens is the most severe form of alcohol withdrawal, manifested by rapid and severe changes to a person’s mental status and nervous system. Symptoms may include tremors, agitation, hallucinations, seizures, delirium (severe confusion), rapid mood changes, and sensitivity to light, touch, and sound.10 DTs is extremely rare in the general population <1% but seen in up to 2% of people diagnosed with alcohol dependence. The mortality rate from DT is about 5% and lower when recognized and treated early on.11
Alcohol Addiction Treatment
While there is no single “cure” for alcohol addiction, people struggling with alcohol misuse or undiagnosed alcohol use disorder can achieve and maintain long-term recovery. However, they may need help to do it. For many people, treatment in some form or another is effective in significantly reducing or promoting complete abstinence from alcohol. Alcohol addiction can be managed with evidence-based treatment approaches that include behavioral and pharmacological therapies.12
Alcohol treatment comes in many forms, and often people will engage with more than one type. Treatment for alcoholism may include:
- Medical detox. Because alcohol withdrawal can be very serious, the Substance Abuse and Mental Health Services Administration (SAMHSA) recommends medical support for those attempting alcohol detox and some form of medically managed detox for those going through moderate to severe alcohol withdrawal.6
- Inpatient rehab. 24/7 support in a structured residential treatment program provides an environment away from temptations to drink and offers intensive medically managed or monitored treatment that can set the stage for long-term recovery.
- Partial hospitalization program (PHP). This outpatient option provides physician or clinician oversight and about 20 hours of therapy across most days of the week and lets you return home at night.
- Intensive outpatient program (IOP). This outpatient option still includes clinical treatment but requires fewer hours than partial hospitalization. A n IOP provides 9 or more hours of therapy spread throughout the week.
- Outpatient therapy. A starting point for those with mild AUDs or a step-down option for those who’ve participated in one of the above, outpatient therapy typically involves less than 9 treatment hours per week.
- Sober living. An alternative to returning home directly after treatment, sober living is a residence that is designed to be supportive of addiction recovery and that usually provides recovery meetings and transport to therapy. Completion of chores and adherence to rules are often required.
- Medication–assisted treatment (MAT). Certain medications, when combined with behavioral therapy, counseling and education can be incredibly useful in supporting recovery from alcoholism. Medications for alcoholism recovery include acamprosate, disulfiram, and naltrexone.13 Programs that offer MAT can go over these options with you while you’re in treatment.
Not every person’s treatment path will look the same, nor should it.6 At Desert Hope, we individualize your recovery plan to your specific needs. We’re here to help you determine what is right for you or your loved one when you call us at .