Alcoholism is also known as alcohol dependence and alcohol use disorder. It occurs when you drink so much that your body eventually becomes dependent on or addicted to alcohol. When this happens, alcohol becomes the most important thing in your life.
People with alcohol dependence will continue to drink even when drinking causes negative consequences, like losing a job. They may know that their alcohol use negatively affects their lives, but it’s often not enough to make them stop drinking.
Some people may drink alcohol to the point that it causes problems, but they’re not physically dependent on alcohol. This is sometimes referred to as alcohol abuse.
The cause of alcoholism is still unknown. Alcohol dependency develops when you drink so much that chemical changes in the brain occur. These changes increase the pleasurable feelings you get when you drink alcohol, which makes you want to drink more often, even if it causes harm. Eventually, just like other drugs of abuse, the pleasurable feelings associated with alcohol use go away and person with alcohol dependency will engage in drinking to prevent withdrawal symptoms, which can be quite unpleasant and even dangerous. Alcoholism typically develops gradually over time, and it’s also known to run in families.
Although the exact cause of alcoholism is unknown, there are certain factors that may increase your risk for developing this disease.
Known risk factors for alcoholism include having:
- more than 15 drinks per week if you’re male
- more than 12 drinks per week if you’re female
- more than five drinks per day at least once a week (binge drinking)
- a parent with alcoholism
- a mental health problem, such as depression, anxiety, or schizophrenia
You may also be at a greater risk for alcoholism if you:
- are a young adult experiencing peer pressure
- have low self-esteem
- experience a high level of stress
- live in a family or culture where alcohol use is common and accepted
- have a close relative with alcohol use disorder
Symptoms of alcoholism are based on the behaviors and physical outcomes that occur as a result of alcohol addiction.
People with alcohol use disorder may engage in the following behaviors:
- drinking alone
- drinking more to feel the effects of alcohol (having a high tolerance)
- becoming violent or angry when asked about their drinking habits
- not eating or eating poorly
- neglecting personal hygiene
- missing work or school because of drinking
- being unable to control alcohol intake
- making excuses to drink
- continuing to drink even when legal, social, or economic problems develop
- giving up important social, occupational, or recreational activities because of alcohol use
People with alcoholism may also experience the following physical symptoms:
- alcohol cravings
- withdrawal symptoms when not drinking, including shaking, nausea, and vomiting
- tremors (involuntary shaking) the morning after drinking
- lapses in memory (blacking out) after a night of drinking
- illnesses, such as alcoholic ketoacidosis (includes dehydration-type symptoms) or cirrhosis (scarring) of the liver
Self-Testing: Am I an Alcoholic?
Sometimes it can be hard to draw the line between safe alcohol use and alcohol abuse or dependence. The Mayo Clinic suggests that you may have a problem with alcohol if you answer “yes” to some of the following questions:
- Do you need to drink more in order to feel the effects of alcohol?
- Do you feel guilty about drinking?
- Do you become irritable or violent when you’re drinking?
- Do you have problems at school or work because of drinking?
- Do you think it might be better if you cut back on your drinking?
The National Council on Alcoholism and Drug Dependence and the Partnership at Drugfree.org offer more comprehensive self-tests. These tests can help you assess whether you have a problem with alcohol.
Your doctor or healthcare provider can diagnose alcoholism. They will do a physical exam and ask you questions about your drinking habits.
Your doctor may ask if you:
- drive when you’re drunk
- have missed work or have lost a job as a result of your drinking
- need more alcohol to feel “drunk” when you drink
- have experienced blackouts as a result of your drinking
- have tried to cut back on your drinking but could not
Your doctor may also use a questionnaire that assesses alcoholism to diagnose your condition.
Typically, a diagnosis of alcoholism does not require any other type of diagnostic test. There is a chance your doctor may order blood work to check your liver function if you show signs or symptoms of liver disease. Alcohol abuse can cause serious and lasting damage to your liver. Your liver is responsible for removing toxins from your blood. When you drink too much, your liver has a harder time filtering the alcohol and other toxins from your bloodstream. This can lead to liver disease and other complications.
Treatment for alcoholism varies, but each method is meant to help you stop drinking altogether (abstinence). Treatment may occur in stages and can include the following:
- detoxification or withdrawal to rid your body of alcohol
- rehabilitation to learn new coping skills and behaviors
- counseling to address emotional problems that may cause you to drink
- support groups, including 12-step programs such as Alcoholics Anonymous (AA)
- medical treatment for health problems associated with alcoholism
- medications to help control addiction
There are a couple of different medications that may help with alcohol addiction:
- Naltrexone (ReVia, Vivitrol) is used only after someone has detoxed from alcohol. This type of drug works by blocking certain receptors in the brain that are associated with the alcoholic “high.” This type of drug, in combination with counseling, may help decrease an individual’s craving for alcohol.
- Acamprosate (Campral) is a medication that can help re-establish the brain’s original chemical state before alcohol dependence. This drug should also be combined with therapy.
- Disulfiram (Antabuse) is a drug that causes physical discomfort (such as nausea, vomiting, and headaches) any time the individual consumes alcohol.
You may need to seek treatment at an inpatient facility if your addiction to alcohol is severe. These facilities will provide you with 24-hour care as you withdraw from alcohol and recover from your addiction. Once you’re well enough to leave, you’ll need to continue to receive treatment on an outpatient basis.
Recovering from alcoholism is difficult. Your prognosis will depend on your ability to stop drinking. Many people who seek treatment for alcoholism are able to overcome addiction. A strong support system is helpful for making a complete recovery.
Your outlook will also depend on the health complications that have developed as a result of your drinking. Alcoholism can severely damage your liver. It can also lead to other health complications, including:
- bleeding in the gastrointestinal (GI) tract
- damage to brain cells
- cancer in the GI tract
- dementia (memory loss)
- high blood pressure
- inflammation of the pancreas (pancreatitis)
- nerve damage
- changes in mental status, including Wernicke-Korsakoff syndrome (a brain disease that causes symptoms such as confusion, vision changes, or memory loss)
You can prevent alcoholism by limiting your alcohol intake. According to the National Institute on Alcohol Abuse and Alcoholism, women should not drink more than one drink per day, and men should not drink more than two drinks per day. See your doctor if you begin to engage in behaviors that are signs of alcoholism or if you think that you may have a problem with alcohol. You should also consider attending a local AA meeting or participating in a self-help program such as Women for Sobriety.