Drinking alcohol in excess or as a way to cope with stressors or avoid problems can lead to dependence and then addiction. Nearly 14 million people—more men than women—in the United States are dependent on alcohol or have alcohol problems.
Alcohol-use disorder or alcoholism is when alcohol use becomes excessive and leads to significant impairment or distress. It’s when alcohol consumption begins to interfere with home life, school, or work, and creates interpersonal difficulties with family and friends.
Short-term effects of alcoholism include memory loss, hangovers, and blackouts. Long-term problems of heavy drinking include nutritional deficiencies, stomach ailments, heart problems, cancer, brain damage, memory loss, and liver cirrhosis. There is also an increased risk of death from automobile accidents, homicide, and suicide. It is also linked to a higher incidence of unemployment, domestic violence, and legal issues.
Alcohol withdrawal refers to the symptoms that may develop when an alcoholic person suddenly stops drinking. Alcohol intoxication refers to problematic behavioral or psychological changes developed during, or shortly after, consuming alcohol. Mild alcohol intoxication symptoms typically include talkativeness, a feeling of well-being, and bright mood. Symptoms of higher levels of alcohol intoxication include slurred speech, lack of physical coordination, unsteady walk, involuntary eye movements, poor attention or memory, and in extreme cases, inhibited respiration, stupor or coma.
Alcohol use disorder is defined having two or more of the following within a period of 12 months:
- Drinking more or longer than intended,
- Feeling the need or attempting to cut down or stop drinking,
- Spending a lot of time drinking, or recovering from the effects of alcohol,
- Craving or having the urge to consume alcohol
- Failing to fulfill major work, school, or home responsibilities due to drinking,
- Continuing to drink even though it is causing relationship troubles with your family or friends
- Prioritizing drinking by giving up or cutting back activities that were important to you,
- Drinking before or during situations that are physically dangerous,
- Continuing to drink even though drinking is making you feel depressed or anxious,
- Developing a tolerance for drinking.
Alcohol withdrawal syndrome is characterized by having symptoms such as trouble sleeping, shakiness, restlessness, nausea, sweating, a racing heart, a seizure, or hallucinations.
The DSM-V integrates alcohol abuse and alcohol dependence, into a single disorder called alcohol use disorder (AUD) with the following classification:
- Mild: The presence of two to three symptoms
- Moderate: The presence of four to five symptoms
- Severe: The presence of six or more symptoms.
Asking the CAGE questionnaire is a good screening tool for alcoholism.
- Have you ever felt you should cut down on your drinking?
- Have people been annoyed by or criticized your drinking?
- Have you ever felt bad or guilty about your drinking?
- Have you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover?
One answer of yes suggests a possible problem; more than one indicates that a problem likely exists.
Health hazards of alcohol abuse include:
- Increased incidence of cancer (of larynx, esophagus, liver, and colon)
- Alcoholic hepatitis
- Acute and/or chronic pancreatitis
- Cirrhosis of the liver
- Alcoholic neuropathy
- Alcoholic cardiomyopathy
- High blood pressure
- Nutritional deficiencies (vitamin B12, folate, and thiamine)
- Erectile dysfunction
- Cessation of menses
- Fetal alcohol syndrome in the children of women who drink during pregnancy
- Alcohol-related dementia
- Wernicke-Korsakoff syndrome or Wernicke’s encephalopathy—a syndrome of the central caused by thiamine deficiency leading to brain damage)
Treatments include abstinence, rehabilitation for detoxification, counseling, medication, and Alcoholics Anonymous.