It can be difficult to tell whether your drinking or your loved one’s drinking has shifted from casual to an alcohol use disorder, or alcoholism. Answering some questions may help to determine an answer. Additionally, it is essential to understand the symptoms, health risks, and treatment options available.

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    Alcoholism Quiz

    Alcoholism

    Alcohol use disorder, which includes alcoholism and alcohol addiction, is a type of alcohol use characterized by a lack of control associated with alcohol consumption, preoccupation with alcohol use, a continuation of alcohol use regardless of the consequences it creates, having to drink more to get the same effect at the start of drinking, or experiencing withdrawal symptoms when drinking is rapidly decreased or stopped. 1

    Alcohol use can be considered unhealthy when it causes health or safety risks. Unhealthy alcohol use also includes binge drinking, which occurs when a male consumes five or more drinks in two hours or when a female drinks at least four drinks in two hours. This type of drinking can cause health and safety risks. 1
    Alcohol use disorder can range from mild to severe, but even a mild case can lead to serious, repeated significant distress and problems functioning in daily life. If you suspect that you or a loved one suffers from alcohol use disorder or alcoholism, it is imperative to seek treatment as soon as possible. 1

    Statistics

    Prevalence of binge drinking & heavy alcohol use

    • In 2019, 25.8% of all individuals, 29.7% of men, and 22.2% of women age 18 and older reported binge drinking in the past month 2
    • In 2019, 6.3% of all individuals, 8.3% of men, and 4.5% of women age 18 and older reported engaging in heavy alcohol use in the past month 2

    High-intensity drinking

    High-intensity drinking is characterized by alcohol consumption at levels two or more times the gender-specific binge drinking thresholds described above. 2
    • High-intensity drinkers who drank alcohol twice as much as binge drinking thresholds were 70 times more likely than none binge drinkers to have alcohol-related emergency department visits
    • High-intensity drinkers who drank alcohol three times as much as binge drinking thresholds were 93 times more likely to have alcohol-related emergency department visits

    Ages 12 & older

    • 14.5 million people (5.3%), including 9.0 million men (6.8%) and 5.5 million women (3.9%) ages 12 and older, had an alcohol use disorder in 2019 2

    Youth ages 12 to 17

    • 414,000 adolescents (1.7%) age 12 to 27, including 163,000 males (1.3%), and 251,000 females (2.1%) had an alcohol use disorder in 2019 2

    Additional alcohol-related statistics

    • The rate of all alcohol-related ED visits increased 47% from 2006 to 2014, which is roughly 210,000 a year 2
    • Alcohol contributes to 18.5% of ED visits and 22.1% of overdose deaths, including prescription opioids 2
    • Approximately 95,000 people (68,000 men and 27,000 women) die a year from alcohol-related causes 2
    • In 2019, there were 10,142 deaths caused by alcohol-related driving fatalities, which made up 28% of all driving fatalities 2
    A shot from the inside of a glass full of yellow alcohol

    Signs & symptoms

    The severity of alcohol use disorder depends on the number of signs and symptoms experienced. These signs and symptoms can include: 2
    • Drinking more or longer than planned 3
    • Having an inability to limit the amount of alcohol consumed 1
    • Trying to cut back or stop more than once without success 3
    • Spending a lot of time drinking, getting alcohol, or recovering from alcohol use 1
    • Feeling an intense craving or urge to drink alcohol 1
    • Having an inability to think of anything other than drinking for a time 3
    • Having problems with work, school, or family due to drinking habits 3
    • Continuing to drink even though it causes these problems 3
    • Quitting or cutting back on other vital activities in favor of drinking 3
    • Needing to drink more than before to get the same effect 3
    • Using alcohol in unsafe situations, like when driving or swimming 1
    • Experiencing withdrawal symptoms, including trouble sleeping, shakiness, restlessness, nausea, sweating, a racing heart, a seizure, or hallucinations, after a buzz wears off 3
    Someone with alcohol use disorder may experience periods of both alcohol intoxication and withdrawal symptoms. 1
    Alcohol intoxication occurs when alcohol increases in the bloodstream. It creates changes in behavior and cognitive abilities resulting in: 1
    • Inappropriate behavior
    • Unstable moods
    • Impaired judgment
    • Slurred speech
    • Impaired attention or memory
    • Poor coordination
    High blood alcohol levels can lead to “blackouts,” in which the individual does not remember events that occurred during that time. Very high blood alcohol levels can lead to coma or even death. 1
    Alcohol withdrawal may occur when someone stops or severely reduces heavy and prolonged alcohol use. Symptoms of withdrawal can occur between several hours and up to 5 days after the alcohol use is decreased or ceased. Signs and symptoms can include: 1
    • sweating
    • rapid heartbeat
    • hand tremors
    • problems sleeping
    • nausea and vomiting
    • hallucinations
    • restlessness and agitation
    • anxiety
    • seizures (occasionally)
    Symptoms of withdrawal may be severe enough to impair functioning at work or in social situations. 1
    A man in a hoodie drinking from am bottle next to a stationary train

    Health risks

    There are many health risks associated with excessive alcohol use. These risks include short-term health risks and long-term health risks. 4

    Short-term health risks

    There are immediate health risks associated with heavy alcohol use that usually occur due to binge drinking. These short-term health risks include: 4
    • Injuries, including motor vehicle crashes, falls, drownings, and burns
    • Violence, including homicide, suicide, sexual assault, and domestic violence
    • Alcohol poisoning
    • Risky behaviors, such as unprotected sex or sex with multiple partners
    • Miscarriage, stillbirth, or fetal alcohol spectrum disorders in pregnant women

    Long-term health risks

    Heavy and prolonged alcohol use can lead to long-term health risks like chronic diseases and other serious problems. These long-term health risks include: 4
    • High blood pressure, heart disease, stroke, liver disease, and digestive problems
    • Cancer of the mouth, throat, esophagus, voice box, liver, colon, rectum, and breast
    • Weakening of the immune system
    • Learning and memory problems, including dementia and poor performance at school and work
    • Mental health problems, including depression and anxiety
    • Social problems, including those related to family, friendships, and work
    • Alcohol use disorders, alcohol dependence, or alcoholism

    Effects on the body

    Heavy and prolonged alcohol use can also result in severe impacts on physical health. This type of alcohol use can negatively affect the brain, heart, liver, pancreas, and immune system and can even cause cancer. 5

    Brain

    Heavy and prolonged alcohol use can also result in severe impacts on physical health. This type of alcohol use can negatively affect the brain, heart, liver, pancreas, and immune system and can even cause cancer. 5

    Heart

    Consuming an excessive amount of alcohol over a short or long period can cause damage to the heart. This damage can result in cardiomyopathy (stretching and drooping of heart muscle), arrhythmia (irregular heartbeat), stroke, and high blood pressure. 5

    Liver

    Drinking heavily can lead to several liver problems and liver inflammations, including steatosis (fatty liver), alcoholic hepatitis, fibrosis, and cirrhosis. 5

    Pancreas

    Heavy alcohol use can weaken the immune system, making the body more susceptible to disease. Drinkers who consume alcohol often, in large quantities, and for a prolonged period are more likely to contract diseases like pneumonia and tuberculosis than those who do not drink much. Drinking heavily on one occasion slows the body’s ability to fight off infections for up to 24 hours after consuming the alcohol. 5

    Immune system

    When alcohol is consumed, it causes the pancreas to produce toxic substances. This impact on the pancreas can eventually lead to pancreatitis, characterized by dangerous inflammation and swelling of the blood vessels in the pancreas. Pancreatitis can prevent proper digestion. 5

    Cancer

    Chronic alcohol consumption may cause several types of cancer. It is listed in the National Toxicology Program of the US Department of Health and Human Services as a known human carcinogen. 5
    The more alcohol a person regularly consumes over time, the higher their risk of developing cancer associated with alcohol use. Individuals who only drink one drink per day and those who binge drink have an increased risk of developing certain cancers. 5
    The cancers that may be associated with alcohol use include: 5
    • Head and neck cancer, including oral cavity, pharynx, and larynx cancers
    • Esophageal cancer, particularly esophageal squamous cell carcinoma
    • Liver cancer
    • Breast cancer
    • Colorectal cancer
    Someone laying in a hospital bed with an iv drip

    Causes

    Experts are still not sure of the exact cause of alcohol use disorder. It develops when someone drinks so much that it causes chemical changes in the brain. These chemical changes increase the feelings of pleasure associated with consuming alcohol which causes the drinker to want to drink more often, even if it causes harm. 6
    Over time, as tolerance is developed, the pleasure associated with alcohol consumption diminishes, but the individual will continue to drink to avoid the symptoms of alcohol withdrawal. Withdrawal symptoms can be unpleasant and dangerous. Alcohol use disorder usually develops gradually over time. 6

    Risk factors

    Certain risk factors increase an individual’s chances of developing an alcohol use disorder. These risk factors include: 7
    • Age. Alcohol use disorder most commonly occurs between ages 18 and 24. 7
    • Gender. Men are more likely to develop alcohol use disorder than women. 7
    • Early alcohol use. Individuals who first use alcohol as children or teens are more likely to develop an alcohol use disorder. 7
    • Steady drinking over time. Excessive drinking regularly over an extended period or binge drinking can increase someone’s risk of developing alcohol use disorder. 1
    • Family history. Someone who has parents, siblings, or children with alcohol use disorder is more likely to develop it themselves. 7
    • Genetics. Genetic factors can also increase someone’s risk of developing alcohol use disorder. 7
    • Mental health issues. Individuals with mental health disorders such as anxiety, depression, schizophrenia, or bipolar disorder are more likely to develop alcohol use disorder. 1
    • History of trauma. People who have a history of emotional or physical trauma are more likely to develop alcohol use disorder. 1
    • Parental approval. Teens who have parents who approve of alcohol use are at higher risk of developing alcohol use disorder. 7
    A person may have an alcohol use disorder even if they do not have any of these risk factors; however, the more risks a person has, the greater their chances of developing alcohol use disorder. 7

    Prevention

    Some drinkers may be able to prevent themselves from engaging in excessive alcohol use by 8
    • Choosing not to drink too much
    • Following dietary guidelines which state that women should drink no more than one drink per day and men should drink no more than two drinks per day
    • Talking to their healthcare provider regarding drinking behavior and requesting counseling if necessary
    Unfortunately, some individuals may be unable to control their drinking. If this is the case, it is essential to seek a diagnosis from a healthcare professional as soon as possible. 8

    Diagnosis

    If you suspect that you or a loved one is suffering from alcohol use disorder, alcohol dependency, or alcoholism, it is crucial to seek a diagnosis. The first step in pursuing a diagnosis is contacting your primary care physician. If they suspect you have a problem, they may refer you to a mental health professional for treatment. 9

    To offer a diagnosis, your primary care physician will likely: 9
    • Ask questions regarding your drinking habits. The doctor may ask you questions directly and ask permission to speak with your friends or family regarding your drinking habits. Without your consent, your doctor cannot share any information about you.
    • Perform a physical exam. The doctor may find many physical signs to indicate any complications associated with your alcohol use.
    • Perform tests. These tests can include lab tests and imaging tests that can show abnormalities that may be associated with alcohol use disorder. These tests will also identify any health problems related to your alcohol use.
    • Complete a psychological evaluation. A psychological assessment includes questions regarding any symptoms, thoughts, feelings, and behavior patterns you experience. This evaluation may sometimes include a questionnaire.
    An AA (Alcoholics Anonymous) meeting sign board

    Alcohol Abuse Treatment

    If you or a loved one is diagnosed with alcohol use disorder, alcohol dependence, or alcoholism, it is important to seek treatment from a mental health professional as soon as possible. There are multiple treatment options available, and the right one will depend on each individual’s unique situation. 10
    Many people who suffer from alcoholism find that a combination of treatments is the best option, and different types of treatment programs will often offer a combination. These treatment programs include inpatient residential programs, where the individual stays at the treatment center for a time, and outpatient treatment programs, where the individual lives at home and travels to the treatment center regularly. These programs may require an initial detox. 10

    Detox

    Detox is not a complete alcohol treatment, but it can be the first step to seeking treatment. Detox from alcohol will allow the individual to stop drinking and remove the alcohol from their system. This detox can take a few days to a week. 10
    Many people will go to a hospital or treatment center to detox from alcohol to avoid the withdrawal symptoms mentioned above. During this type of detox, doctors and other professionals administer medicine to help alleviate symptoms. Detox can also occur on an inpatient or outpatient basis. 10

    Psychotherapy

    Meeting with a counselor or therapist can help the individual recovering from alcoholism to learn new skills and strategies to maintain sobriety from alcohol. These mental health professionals can teach how to: 10
    • Change behaviors that cause the desire to drink
    • Cope with stress and other triggers
    • Create a strong support system
    • Set goals and find ways to reach them
    Some individuals will only need one focused counseling session. In contrast, others may require individual therapy for a more extended period, especially if they also experience mental health issues like anxiety or depression. Couples and family therapy can also be helpful. 10

    Medication

    Many medications can help individuals recover from an alcohol use disorder. Some medications that are useful for recovery from alcoholism include: 10
    • Disulfiram (Antabuse). This medication makes the user feel sick or throw up any time they consume alcohol.
    • Acamprosate (Campral). This medication helps to reduce cravings for alcohol.
    • Naltrexone (Revia). This medication blocks the high that usually occurs when alcohol is ingested

    Support

    It can be difficult to stop alcohol use and stay away from it entirely. It can often require the development of healthy habits and coping mechanisms that are useful in daily life. Steps to creating a supportive environment include: 10
    • Staying surrounded by family, friends, and other supportive individuals who are aware that the individual should not drink alcohol
    • Taking care of the body by eating a healthy diet, getting the right amount of sleep, staying active, and managing stress levels
    • Engaging in activities and hobbies that do not involve alcohol
    • Getting involved in group therapy during a treatment program
    • Joining a support group such as Alcoholics Anonymous, SMART Recovery, and other programs

    It can take a long time to recover from alcohol use disorder, alcohol dependence, or alcoholism. Long-term treatment with a dedicated alcohol rehab program may be the best option to prevent future relapse. It is essential to consult a mental health professional to decide the best option if you or a loved one is struggling with a heavy drinking problem. 10

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