Many adults drink alcohol in the form of beer, wine, or liquor. People drink alcohol to relax, celebrate, and socialize. Alcohol affects people in different ways, and people have different relationships with alcohol. Many people can enjoy a glass of wine with food, or drink moderate amounts of alcohol in social settings, without any problems. Having one or fewer drinks per day for women and two or fewer drinks per day for men is defined as moderate drinking (CDC, 2013).
But drinking alcohol too much or too often, or being unable to control alcohol consumption, can cause or indicate alcohol abuse or alcohol dependence (also called alcoholism).
The National Institute on Alcohol Abuse and Alcoholism says that about 18 million people in the U.S. struggle with what it terms “alcohol use disorders” (NIAAA). These disorders can be disruptive and life threatening.
People who abuse alcohol may not have a physical dependence on alcohol. But they are more focused on intoxication than on safely enjoying alcoholic beverages. Abuse can affect relationships and lead to failure to meet obligations at home, work, or school. People who abuse alcohol often have legal or financial troubles related to their drinking. Long-term alcohol abuse may lead to alcoholism.
Alcoholism is likelier to be a physical dependence on alcohol. It is a serious medical condition. People with alcoholism find drinking moderately or stopping drinking very difficult. They often struggle to live their lives normally. And they may face serious health consequences.
For many people, alcohol abuse or alcoholism is caused by psychological or social factors. Others use alcohol to cope with psychological issues or stress in their daily lives. Alcohol abuse and alcoholism may also seem to run in families, but a genetic tendency doesn’t guarantee problems with alcohol.
The causes of alcohol abuse and alcoholism are not known for sure. Often, alcoholism is the product of many factors.
Alcohol abuse is more common at certain points in life. Men, college students, and people going through serious life events or trauma are more likely to abuse alcohol. People who suffer from depression, loneliness, emotional stress, or boredom could be more likely to turn to alcohol to deal with their problems, and this can lead to dependence (APA, 2012).
Alcohol abuse or alcoholism may cause serious health conditions. Alcohol worsens aging disorders such as osteoporosis. It can lead to certain cancers. And alcohol abuse may make it difficult to diagnose other health issues, such as heart disease, because of how alcohol affects the circulatory system.
Women who are pregnant are advised to completely avoid alcohol. Breastfeeding mothers should drink only with caution. Children, also, should not drink alcohol. In the U.S., people younger than 21 are prohibited from drinking alcohol.
A high concentration of alcohol in the blood causes symptoms such as:
- slurred speech
- physical and motor impairment
- difficulty concentrating
- memory problems
- poor decision-making abilities
- risky behavior
In rare cases, very high concentrations of alcohol in the blood can cause breathing problems, coma, or death.
Many people use alcohol with no ill effects. But even someone who is not alcoholic may experience effects such as illness, vomiting, or hangovers. Using alcohol can also lead to accidents, falls, drowning, fighting, or suicide. People should not attempt to drive or operate heavy machinery while under the effects of alcohol.
Symptoms of alcohol abuse or alcoholism include:
- a strong desire to drink (cravings)
- an inability to control cravings
- an inability to stop drinking
- an increased tolerance for alcohol
- lying about drinking
- attempting to drink without others knowing
- an inability to get through everyday activities without drinking
Many alcoholics will continue to drink even when they develop drinking-related health problems. Loved ones often perceive a problem before the affected person does.
If someone who is dependent on alcohol stops drinking, he or she may have withdrawal symptoms including nausea, shaking, sweating, irritability, and anxiety.
Alcohol withdrawal can become a medical emergency. If seizures, severe vomiting, hallucinations, or fevers occur, seek immediate medical help. If you are an alcoholic and have had past difficulty with withdrawal symptoms, see a doctor before quitting. Also see a doctor before quitting alcohol if you are an alcoholic and you have other health conditions.
Alcoholism or alcohol abuse is considered a diagnosable condition when it impacts relationships, causes harm or injury, or has a negative effect on a person’s quality of life. Diagnosing alcohol abuse can be subjective. Often, concerned family and friends will help the person understand that drinking has gotten out of control, although he or she might not believe it.
In order to diagnose alcohol abuse or dependence, your doctor will ask you about your drinking habits and your health history. He or she will use blood tests to assess your overall health. A doctor will pay special attention to parts of the body most impacted by alcohol: the brain, heart, liver, and nervous system.
Treatment for alcohol abuse and alcoholism usually focuses on learning to control the disease. Most people who recover from alcohol dependence choose to abstain from alcohol because learning to consume alcohol safely can be very challenging. Abstinence is often the only way to manage.
The treatment is frequently mostly psychological. Patients work on understanding their alcoholism and underlying problems, and then they commit to staying sober or practicing healthier drinking habits. Maintaining recovery from alcohol dependence can be a long process. Treatment for alcohol abuse often includes therapy, leaning new coping skills, and finding healthy ways to manage stress.
Doctors sometimes prescribe medications that lessen some symptoms of withdrawal. Other medications can help a person quit drinking by blocking the feeling of intoxication, making him or her feel sick when alcohol enters the body, or reducing cravings.
Having support and seeking professional treatment increases chances for recovery from alcohol from alcohol dependence (Moos, et al., 2006). Groups such as Alcoholics Anonymous (AA) focus on providing support for recovering alcoholics.
People who abuse alcohol for an extended time and alcoholics may have other health complications, such as an increased risk for cancer, mental health issues, liver problems, brain damage, and a weakened immune system.
Even people who successfully complete treatment will always have a risk of relapse. It’s important to recognize warning signs and enlist support when you fear a relapse is coming. Continued therapy and support help minimize the risk of relapse (Moos, et al., 2006).
Written by: Anna Zernone Giorgi
Medically reviewed by George Krucik, MD, MBA