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Alcoholism

What is alcoholism, or alcohol use disorder?

Alcoholism has been known by a variety of terms, including alcohol abuse and alcohol dependence. Today, it’s referred to as 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 use disorder will continue to drink even when drinking causes negative consequences, like losing a job or destroying relationships with people they love. 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 used to be referred to as alcohol abuse.

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Causes

What causes it?

The cause of alcohol use disorder is still unknown. Alcohol use disorder 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. This makes you want to drink more often, even if it causes harm.

Eventually, the pleasurable feelings associated with alcohol use go away and the person with alcohol use disorder will engage in drinking to prevent withdrawal symptoms. These withdrawal symptoms can be quite unpleasant and even dangerous.

Alcohol use disorder typically develops gradually over time. It’s also known to run in families.

Risk factors

What are the risk factors?

Although the exact cause of alcohol use disorder is unknown, there are certain factors that may increase your risk for developing this disease.

Known risk factors include having:

  • more than 15 drinks per week if you’re male
  • more than 12 drinks per week if you’re female
  • more than 5 drinks per day at least once a week (binge drinking)
  • a parent with alcohol use disorder
  • a mental health problem, such as depression, anxiety, or schizophrenia

You may also be at a greater risk for alcohol use disorder 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
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Symptoms

What are the symptoms?

Symptoms of alcohol use disorder 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 alcohol use disorder 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

Self-test

Self-testing: Do I misuse alcohol?

Sometimes it can be hard to draw the line between safe alcohol use and the misuse of alcohol. The Mayo Clinic suggests that you may misuse 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 AlcoholScreening.org offer more comprehensive self-tests. These tests can help you assess whether you misuse alcohol.

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Diagnosis

Professional diagnosis

Your doctor or healthcare provider can diagnose alcohol use disorder. They’ll 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 couldn’t

Your doctor may also use a questionnaire that assesses alcohol use disorder to help diagnose your condition.

Typically, a diagnosis of alcohol use disorder doesn’t require any other type of diagnostic test. There’s a chance your doctor may order blood work to check your liver function if you show signs or symptoms of liver disease.

Alcohol use disorder 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.

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Treatment

How is it treated?

Treatment for alcohol use disorder varies, but each method is meant to help you stop drinking altogether. This is called 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 alcohol use disorder
  • medications to help control addiction

There are a couple of different medications that may help with alcohol use disorder:

  • Naltrexone (ReVia) 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 a person’s craving for alcohol.
  • Acamprosate 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 person 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.

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Outlook

What’s the outlook for a person with alcohol use disorder?

Recovering from alcohol use disorder is difficult. Your outlook will depend on your ability to stop drinking. Many people who seek treatment are able to overcome the 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. Alcohol use disorder can severely damage your liver. It can also lead to other health complications, including:

Prevention

How can you prevent alcohol use disorder?

You can prevent alcohol use disorder by limiting your alcohol intake. According to the National Institute on Alcohol Abuse and Alcoholism, women shouldn’t drink more than one drink per day, and men shouldn’t drink more than two drinks per day.

See your doctor if you begin to engage in behaviors that are signs of alcohol use disorder 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.

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