Alcohol Abuse

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Introduction

What is alcohol abuse?

Alcohol abuse is a type of problem drinking in which a person continues to drink alcohol even in the face of health problems or undesired complications at work, at home, or in relationships. Alcoholism, another type of problem drinking, is complicated by a physical addiction to alcohol. Problem drinking is a common problem, affecting approximately 15% of the U.S. population (Source: PubMedHealth).

The causes of alcoholism and alcohol abuse are not known, although some risk factors have been identified. For example, people who start drinking alcohol at age 14 or younger tend to have more troubles with alcohol than those who start at age 21 or older. Alcohol problems are most common between the ages of 18 and 29; people age 65 or older are the least likely to have alcohol problems. Alcohol problems are more common in men than in women.

Alcohol affects all of your body’s organs and can cause long-term health effects. Alcohol’s effects on your brain account for many of the symptoms of intoxication, including an increased risk of accidents and impaired judgment. Long-term alcohol abuse can lead to liver disease, pancreatitis, gastroesophageal reflux disease (GERD), high blood pressure, heart disease, malnutrition, brain damage, and certain cancers. Excessive alcohol consumption is the third leading preventable cause of death in the US.

Some people are not aware of the troubles alcohol is causing in their lives; honesty and compassion can help them recognize the problems they are having and assist them in setting personal goals for the future. Treatment of alcohol abuse and alcoholism can involve supervised withdrawal and detoxification, recovery programs, support groups, cognitive behavioral therapy, and certain medications. Although treatments have varying rates of success, many people are able to remain abstinent.

Alcohol abuse can have serious, even life-threatening, complications, such as injury, acute alcohol poisoning, and significant medical illness. Seek immediat e medical care (call 911) for serious symptoms, such as thoughts of suicide or self harm, persistent vomiting, seizure, slow breathing or not breathing, trauma, vomiting blood, or bloody stool.

Seek prompt medical care if you think you might have a problem with alcohol.

Symptoms

What are the symptoms of alcohol abuse?

Symptoms of alcohol abuse include those of alcohol intoxication and those related to unfulfilled responsibilities and the social consequences of drinking.

Common general symptoms of alcohol abuse

Alcohol abuse can cause problems in interpersonal relationships, at home, on the job, and with the law. General symptoms of alcohol abuse related to these problems include:

  • Alcohol-related legal problems
  • Deterioration of work performance
  • Difficulty holding a job due to alcohol-related problems
  • Drinking alcohol before or during activities where safety is a concern
  • Drop in school performance
  • Not fulfilling responsibilities
  • Weakening or loss of relationships

Common symptoms of alcohol intoxication

Alcohol consumption can lead to symptoms of intoxication including:

Serious symptoms that might indicate a life-threatening condition

In some cases, alcohol abuse can be life threatening. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms including:

  • Being a danger to oneself or others, including threatening, irrational or suicidal behavior

  • Change in level of consciousness or alertness, such as passing out or unresponsiveness

  • Change in mental status or sudden behavior change, such as confusion, delirium, lethargy, hallucinations and delusions

  • Respiratory or breathing problems, such as shortness of breath, difficulty breathing, labored breathing, slow breathing, not breathing, choking

  • Seizure

  • Severe and persistent vomiting

  • Trauma, such as bone deformity, burns, eye injuries, and other injuries

  • Vomiting blood, rectal bleeding, or bloody stool

Causes

What causes alcohol abuse?

The cause of alcohol abuse is not known, nor is it understood why some people can drink alcohol without its ever causing problems and other people cannot. Alcoholism does tend to run in families, and research suggests there might be genes that increase the risk. Other risk factors related to environment and some psychiatric conditions seem to increase the risk of alcohol abuse and alcoholism. Researchers have identified multiple biologic factors (neurotransmitters and brain cell receptors) and candidate genes that may, going forward, unlock the mystery of alcohol addiction.

What are the risk factors for alcohol abuse?

A number of factors increase a person’s risk of abusing alcohol. Not all people with risk factors will abuse alcohol. Risk factors for alcohol abuse include:

  • Age between 18 and 29 years
  • Alcohol use starting at a young age (14 years old or younger)
  • Anxiety disorders or depression
  • Bipolar disorder
  • Cultural acceptance of alcohol use and easy access to alcohol
  • Low self-esteem
  • Male gender
  • Peer pressure to drink alcohol
  • Relationship difficulties
  • Schizophrenia
  • Stress
Treatments

How is alcohol abuse treated?

Treatment of alcohol abuse begins with seeking regular medical care throughout your life. Regular medical care allows a health care professional to provide early screening tests. Regular medical care also provides an opportunity for your health care professional to promptly evaluate symptoms and your risks for developing alcohol abuse.

The goal of treatment is often to achieve abstinence from alcohol use, although some people are able to turn their problems around by reducing their alcohol intake. For some, it takes another person to point out that they are having problems related to their alcohol abuse, while others may seek treatment on their own or at the advice of a health care professional. Supervised alcohol withdrawal is often recommended, and allows an opportunity to identify coexisting health problems and watch for alcohol withdrawal complications. Whatever route is taken, coexistent behavioral conditions like depression and anxiety must also be addressed in order to achieve a healthy recovery.

Treatment for alcohol abuse may include rehabilitation, cognitive behavioral therapy, and medications. Support groups can be helpful initially and in maintaining sobriety.

Medications that may be used to treat alcohol abuse

Medications are sometimes used in the treatment of alcohol abuse and alcoholism and to help prevent relapse. These medications include:

  • Acamprosate (Campral) to lower the risk of relapse

  • Disulfiram (Antabuse), which lasts two weeks and causes unpleasant side effects if alcohol is consumed during that time

  • Naltrexone (Vivitrol) to decrease cravings

  • Topiramate (Topamax) to chemically mute the pleasure of drinking alcohol

What are the potential complications of alcohol abuse?

Complications of untreated alcohol abuse can be serious, even life threatening in some cases. You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you.

Complications of alcohol abuse include:

  • Bleeding esophageal varices (bleeding from dilated veins around the esophagus)

  • Brain damage

  • Cardiovascular disease

  • Delirium tremens (severe alcohol withdrawal)

  • Depression

  • Gastroesophageal reflux disease (GERD)

  • Head and neck cancers

  • High blood pressure

  • Liver disease (includes any type of liver problem, such as hepatitis, cirrhosis and liver failure)

  • Malnutrition

  • Nerve damage

  • Pancreatitis

  • Stupor or coma

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2019 Jan 4
  1. Alcoholism and alcohol abuse. PubMed Health, a service of the NLM from the NIH. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001940/.
  2. Alcohol and public health. Centers for Disease Control and Prevention. http://www.cdc.gov/alcohol/faqs.htm.
  3. Anton RF, O'Malley SS, Ciraulo DA, et al. Combined pharmacotherapies and behavioral interventions for alcohol dependence: the COMBINE study: a randomized controlled trial. JAMA 2006; 295:2003.
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