What is alcoholism?
Alcoholism, also called alcohol dependence, is a chronic disease characterized by a physical and psychological addiction to alcohol. Addiction to alcohol is a serious problem that leads to many physical and mental diseases, disorders and conditions, such as cirrhosis of the liver, memory loss, depression, and bleeding esophageal varices. Alcoholism also leads to accidents, injuries, and major life disruptions, including motor vehicle accidents, job loss, legal problems, destruction of relationships, and domestic abuse. Excessive alcohol consumption is the third leading preventable cause of death in the United States.
There are two types of alcohol-related conditions that involve drinking more than what is considered moderate. Moderate drinking is considered no more than one drink per day for a woman and two drinks per day for a man. In the United States, a drink is defined as 12 ounces of regular beer or wine cooler, 8 ounces of malt liquor, 5 ounces of wine, or 1.5 ounces of liquor (such as vodka or rum).
Types of alcohol-related conditions include:
Alcoholism (alcohol dependence) involves an uncontrollable physical and psychological addiction to alcohol that leads to damaged health, relationships, careers, and property. People with alcoholism develop a tolerance to alcohol and may not appear intoxicated even after drinking a significant amount. They also experience withdrawal symptoms if they do not drink consistently.
Alcohol abuse is characterized by excessive drinking that can lead to the same negative effects as alcoholism. However, alcohol abuse is not driven by a physical addiction to alcohol.
Alcoholism and alcohol abuse are common problems. Almost 17.6 million people in the United States (one in 12 adults) have alcoholism or abuse alcohol (Source: NIAAA).
Alcoholism can be difficult to diagnose because of secrecy and the tendency toward denial of a serious problem. In some cases, alcoholism may be a symptom of, or coexist with, an underlying mental health condition, such as depression or schizophrenia. Successful treatment of alcoholism is challenging and may require multiple attempts before sobriety is achieved; relapses are common. Treatment includes medical support for physical withdrawal from alcohol; participation in a support system, such as Alcoholics Anonymous; and counseling therapy.
Cirrhosis of the liver is the best-known physical complication of alcoholism. Chronic abuse of alcohol can also cause serious mental health issues and cause damage to the digestive, neurological, reproductive and cardiovascular systems.
Seek prompt medical care if you drink more than what is defined as moderate alcohol consumption. Prompt diagnosis and treatment of alcoholism or alcohol abuse lowers the risk of adverse effects on your physical and mental health and developing serious problems in relationships and everyday life.
Seek immediate medical care (call 911) if you, or someone you are with, have life-threatening symptoms related to complications of alcoholism. These include confusion, lethargy, unresponsiveness, difficulty breathing, seizure, delusions or hallucinations, vomiting blood or heavy rectal bleeding, or feelings of wanting to hurt or kill oneself or another person.
What are the symptoms of alcoholism?
Symptoms of alcoholism
The National Institute on Alcohol Abuse and Alcoholism cites four main symptoms of alcoholism:
Craving (strong urge to drink alcohol)
Loss of control (inability to stop drinking once drinking has begun)
Tolerance (need to drink greater amounts of alcohol to feel its effects). People with alcoholism may not appear intoxicated even after drinking large amounts of alcohol.
Symptoms of alcoholism and alcohol abuse
The following symptoms may occur with either alcoholism, in which there is a physical addiction to alcohol, or alcohol abuse, in which a person drinks excessively but is not physically addicted to alcohol. In addition to the symptoms listed below, another indication that a person is having trouble with alcoholism or alcohol abuse is arrest for DUI, other offenses, and legal problems. Symptoms include:
Denial, defensiveness or anger when asked about drinking habits
Drinking at certain times of the day and becoming irritable when that is not possible
Hiding alcohol from other people
Inability to maintain employment
Loss of interest in relationships
Memory loss, forgetting entire periods of time, or blacking out
Neglecting basic needs, such as not eating, not maintaining basic hygiene, or not following treatment plans for other illnesses
Quitting activities that used to be pleasurable, such as athletics or hobbies
Social withdrawal and isolation
Violent behaviors, such as domestic abuse and getting into physical fights, especially when drinking
Symptoms of alcohol-related diseases
Symptoms of alcohol-related diseases, disorders and conditions, such as alcoholic liver disease and depression include:
Abdominal pain or swelling
Agitation or problems paying attention
Bleeding in the gums or nose
Blood in the stool or vomit
Fatigue or sluggishness
Mood problems, such as mood swings or extreme sadness
Withdrawal from activities or relationships
Yellowing of the skin and whites of the eyes (jaundice)
Serious symptoms that might indicate a life-threatening condition
If you are an alcoholic who attempts to quit drinking, you may experience symptoms of alcohol withdrawal. Alcohol withdrawal is a serious condition that can lead to a life-threatening condition called delirium tremens. If you drink heavily, seek prompt medical care before you attempt to quit drinking. Safe alcohol withdrawal requires medical care and monitoring. Seek immediate medical care (call 911) if you, or someone you are with, have serious symptoms of alcohol withdrawal including:
Change in level of consciousness or alertness, such as passing out or lethargy
Rapid heart rate or palpitations
Tremors or shakiness
The above symptoms may occur with:
Depression, mood swings, and irritability
Nausea or loss of appetite
Sweating or clammy skin
Alcoholism can also result in other serious and life-threatening diseases and conditions, such as liver disease, liver failure, and depression. Seek immediate medical care (call 911) if you, or someone you are with, have any of these potentially life-threatening symptoms:
What causes alcoholism?
Like many other addictive substances, alcohol can trigger a series of biochemical reactions and pleasant sensations to which some people quickly become accustomed. People who regularly abuse alcohol can eventually develop a need to experience these sensations in order to feel normal.
Once started, drinking can be extremely difficult to stop for some people, while other people can enjoy small to moderate amounts of alcohol without ever developing a problem. The exact underlying cause of this difference is not known. However, there is significant understanding about the risk factors that lead a person to abuse alcohol. For example, health care experts know that alcoholism is more common in men than women and that it runs in families. Researchers have identified multiple biologic factors (neurotransmitters and brain cell receptors) and candidate genes that may, going forward, unlock the mystery of alcohol addiction.
Research shows that both alcoholism and alcohol abuse tend to run in families and statistics show that men are more likely than women to abuse alcohol. However, environmental factors, such as your peer group and stress level are also involved, meaning that you are not predestined to alcohol abuse or alcoholism solely based on your family history. Risk factors for alcoholism include:
Alcohol consumption at age 14 or younger
Exposure to heavy drinking as a lifestyle, such as being around family and friends who drink heavily on a routine basis
Family history of alcoholism
Heavy drinking on a regular basis, such as having five or more drinks on one occasion more than once per week
Psychological traits including impulsiveness and low self-esteem
Young adulthood, particularly ages 18 to 29
How is alcoholism treated?
Alcoholism is a chronic disease that cannot be cured. An alcoholic who no longer drinks is still considered an alcoholic. However, alcoholism can be successfully controlled. The goal of alcoholism treatment is complete abstinence from alcohol. This generally requires a multifaceted treatment program that includes any or all of the following:
Medical detoxification (detox), which is a four- to seven-day process involving counseling and medication to mitigate withdrawal effects, often in an inpatient setting
Medication to help prevent a relapse after detoxification
Psychological therapy, support groups, such as Alcoholics Anonymous, and family and social support to maintain abstinence from alcohol. These interventions can help people understand why they abuse alcohol and develop plans and goals for maintaining abstinence. These therapies can also provide support to help control urges to drink and reduce the symptoms of psychological disorders that tend to occur with alcoholism, such as depression and anxiety.
Treatment of alcohol-related diseases, such as liver disease and malnutrition
Complications and diseases associated with alcoholism and alcohol abuse can be progressive and even life threatening. It is important to contact your health care provider if you, or someone you are with, have symptoms of alcohol abuse, alcoholism, or alcohol-related disease. You can help minimize mental and physical complications of alcohol abuse and alcohol-related conditions by following the treatment plan outlined by your health care provider. Complications include:
Delirium tremens (life-threatening type of alcohol withdrawal that may cause neurological damage)
Digestive conditions, such as gastritis (inflammation of the stomach lining), pancreatitis (inflammation of the pancreas), and esophageal varices, which can rupture and cause life-threatening hemorrhage
Increased risk of cancer
Injuries or fatalities resulting from accidents involving motor vehicles, physical fights, domestic abuse, fires, and drowning
Mental health conditions, such as anxiety disorders, depression, and suicide
Neurological damage that leads to poor cognitive functioning, memory loss, dementia, and other problems
Osteoporosis and bone fractures
Sexual and reproductive problems, such as erectile dysfunction, irregular menstrual periods, low-birth-weight babies, birth defects, and sexually transmitted diseases due to reckless behavior associated with drinking and alcoholism