Alcohol Addiction

Alcohol use disorders are a major public policy and health problem within the United States. A brief look at prevalence data reveals the following:

• A 2019 study showed nearly 26% of adults had engaged in binge drinking over the past month.
• 1 million adults (6% of all American adults) have an alcohol use disorder or are classified as chronic drinkers.
• Only 8% of adults with an alcohol use disorder have received treatment.
• 95,000 Americans die every year from some sort of alcohol-influenced cause, including disease or accident.
• Men are more likely than women to have an alcohol use disorder.
• More than 1 in every ten children lives with a parent with some sort of alcohol use disorder.
• Children of alcoholics are four times more likely to develop a substance abuse disorder themselves as adults.

Alcohol use disorders rarely develop overnight. Instead, you may notice a slow progression of problem drinking or a drinking problem. These can include:

• Neglecting responsibilities (including work, school, family, or other commitments)
• Increasing alcohol intake to still feel the effects of alcohol intoxication
• Frequent intoxication
• Becoming preoccupied with drinking
• Drinking when feeling stressed, anxious, or to cope with other difficult emotions
• Risky behaviors (such as drinking and driving or unsafe sexual behavior) while consuming alcohol
• Relationship difficulties
• Spending time with new friends who drink
• Poor self-care and hygiene, which can include not eating, showering, or brushing teeth
• Avoiding discussions regarding how much the person drinks
• Becoming defensive when someone mentions their drinking
• Legal difficulties, such as arrests for drunken behavior or driving under the influence
• Not being able to stop drinking
• Withdrawal symptoms (such as shaking, nausea, or vomiting) when not consuming alcohol

Anyone can develop an alcohol use disorder. But genetic, environmental, and psychological risk factors can make a difference.

If you’re worried about your risk of developing alcohol addiction, consider these factors:

• Age when a person begins drinking: Starting to drink at an early age can increase the risk of later developing problems with alcohol.
• Family history: A family environment in which alcohol is always present can affect a person’s perspective on alcoholism. If someone in the person’s family had alcoholism, this may affect what symptoms of alcoholism stand out as dangerous (or not).
• Mental Health Disorders: Mental health conditions (such as depression disorders or trauma-based disorders) can lead to self-medicating, which is when someone uses alcohol to cope with symptoms of mental illness. This is why dual-diagnosis treatment for alcoholism and co-occurring mental disorders can lead to more sustainable recovery.
• Trauma: If you’ve experienced trauma, there is an increased chance of developing an alcohol use disorder. Veterans are at an exceptionally high-risk of abusing alcohol to cope with lingering trauma or symptoms of PTSD.
• Social Environment: When a person has friends or relatives who drink regularly, drinking becomes normalized. Drinking too much can be seen as funny or empowering. Signs of developing alcohol addiction may be missed or misinterpreted.

Drinking alcohol doesn’t always have negative immediate effects, though the World Health Organization said in 2023 that no level of consumption is safe and that even low or moderate drinking may increase the risk of harm, including many cancers. But there are serious health effects caused by long-term alcohol misuse, and it can produce physical symptoms such as cirrhosis of the liver, pancreatitis, heart disease, alcoholic dementia, and nutritional deficiencies, including:

• Nutritional deficiencies
• High blood pressure
• Brain damage
• Cancer
• Liver disease
• Alcoholic hepatitis
• Cirrhosis
• Fatty liver
• Heart disease
• Increased risk of stroke
• Agitation of mental health conditions
• Pancreatitis
• Alcoholic dementia

Alcohol-related cognitive harm is also substantial: about 10% of dementia cases are linked to alcohol, making it the second leading cause of dementia, and long-term misuse can also cause severe cognitive problems and psychiatric disorders. Over time, these health problems can become fatal. But even if a person doesn’t develop massive health problems, there is still a risk of social alienation, emotional trauma, financial instability, domestic dysfunction within families, and personal unhappiness. A person’s life can still be negatively affected by alcohol abuse even if their body does not sustain lasting physical damage.

If a person drinks regularly, their brain adjusts by compensating for its presence. When alcohol use decreases or stops, it can take a long time for the brain and body to readjust. Withdrawal symptoms from heavy or extended alcohol abuse can include:

• Shaking hands
• Nausea
• Irritability
• Minor hallucinations
• Headaches
• Feelings of anxiety

Delirium tremens (sometimes called DTs) describes the phenomenon of intense withdrawal symptoms for alcohol use. It is most frequently seen in people who have been drinking heavy amounts of alcohol for an extended period of time. Delirium tremens can involve seizures and even death, so medical detox is highly recommended for those at risk due to past drinking behavior.

There is not always a universal rule about when someone should enter a treatment program for alcoholism. But a few signs tend to emerge across most cases:

• People in the person’s life have expressed concern about their alcohol use
• Past attempts to quit drinking alcohol failed
• The person’s living situation is not conducive to quitting alcohol
• The person may experience DTs or other physical symptoms upon stopping drinking
• Work or school obligations are consistently not being met
• The person (or the people in their lives) is concerned about their personal safety if they continue drinking
• The person could benefit from specialized therapy modalities, such as EMDR or specialized therapy for trauma

As part of alcohol use disorder treatment, treating alcohol problems may also include FDA-approved medications such as naltrexone (oral and long-acting injectable), acamprosate, and disulfiram to help people stop or reduce drinking and lower the risk of return to drinking. Another option is behavioral treatment, also called alcohol counseling or talk therapy, which helps change drinking behavior and can include brief interventions, reinforcement approaches, or mindfulness-based therapies. In addition, self-help groups and other mutual-support groups can provide peer support for stopping or reducing drinking and are often used alongside medications and disorder treatment.

Residential treatment for addiction (also known as inpatient treatment) is not always the best option for every person. Sometimes, outpatient treatment is more suitable due to the person being able to stay close to people they care about and integrate lessons into their everyday life. There is no “right” choice for addiction treatment — the best option is that which leads to the person overcoming their addiction and staying in recovery after the treatment program is over.

There is not always a universal rule about when someone should enter a treatment program for alcoholism. But a few signs tend to emerge across most cases:

• People in the person’s life have expressed concern about their alcohol use
• Past attempts to quit drinking alcohol failed
• The person’s living situation is not conducive to quitting alcohol
• The person may experience DTs or other physical symptoms upon stopping drinking
• Work or school obligations are consistently not being met
• The person (or the people in their lives) is concerned about their personal safety if they continue drinking
• The person could benefit from specialized therapy modalities, such as EMDR or specialized therapy for trauma

As part of alcohol use disorder treatment, treating alcohol problems may also include FDA-approved medications such as naltrexone (oral and long-acting injectable), acamprosate, and disulfiram to help people stop or reduce drinking and lower the risk of return to drinking. Another option is behavioral treatment, also called alcohol counseling or talk therapy, which helps change drinking behavior and can include brief interventions, reinforcement approaches, or mindfulness-based therapies. In addition, self-help groups and other mutual-support groups can provide peer support for stopping or reducing drinking and are often used alongside medications and disorder treatment.

Residential treatment for addiction (also known as inpatient treatment) is not always the best option for every person. Sometimes, outpatient treatment is more suitable due to the person being able to stay close to people they care about and integrate lessons into their everyday life. There is no “right” choice for addiction treatment — the best option is that which leads to the person overcoming their addiction and staying in recovery after the treatment program is over.