Alcoholism & Alcohol Abuse
Drinking is woven into the fabric of many societies—sharing a bottle of wine over a meal, going out for drinks with friends, celebrating special occasions with champagne. But because alcohol is such a common, popular element in many activities, it can be hard to see when your drinking has crossed the line from moderate or social use to problem drinking.
If you consume alcohol simply to feel good, or to avoid feeling bad, your drinking could become problematic. Alcoholism and alcohol abuse can sneak up on you, so it’s important to be aware of the warning signs and take steps to cut back if you recognize them. Understanding the problem is the first step to overcoming it.
Understanding drinking problems
Drinking problems are due to many interconnected factors, including genetics, how you were raised, your social environment, and your emotional health. Some racial groups, such as American Indians and Native Alaskans, are more at risk than others of developing alcohol addiction. People who have a family history of alcoholism or who associate closely with heavy drinkers are more likely to develop drinking problems. Finally, those who suffer from a mental health problem such as anxiety, depression, or bipolar disorder are also particularly at risk, because alcohol may be used to self-medicate.
Since drinking is so common in many cultures and the effects vary so widely from person to person, it’s not always easy to figure out where the line is between social drinking and problem drinking. The bottom line is how alcohol affects you. If your drinking is causing problems in your life, you have a drinking problem.
Do you have a drinking problem?
You may have a drinking problem if you…
- Feel guilty or ashamed about your drinking.
- Lie to others or hide your drinking habits.
- Have friends or family members who are worried about your drinking.
- Need to drink in order to relax or feel better.
- “Black out” or forget what you did while you were drinking.
- Regularly drink more than you intended to.
Signs and symptoms of alcohol abuse
Substance abuse experts make a distinction between alcohol abuse and alcoholism (also called alcohol dependence). Unlike alcoholics, alcohol abusers have some ability to set limits on their drinking. However, their alcohol use is still self-destructive and dangerous to themselves or others.
Common signs and symptoms of alcohol abuse include:
- Repeatedly neglecting your responsibilities at home, work, or school because of your drinking. For example, performing poorly at work, flunking classes, neglecting your kids, or skipping out on commitments because you’re hung over.
- Using alcohol in situations where it’s physically dangerous, such as drinking and driving, operating machinery while intoxicated, or mixing alcohol with prescription medication against doctor’s orders.
- Experiencing repeated legal problems on account of your drinking. For example, getting arrested for driving under the influence or for drunk and disorderly conduct.
- Continuing to drink even though your alcohol use is causing problems in your relationships. Getting drunk with your buddies, for example, even though you know your wife will be very upset, or fighting with your family because they dislike how you act when you drink.
- Drinking as a way to relax or de-stress. Many drinking problems start when people use alcohol to self-soothe and relieve stress. Getting drunk after every stressful day, for example, or reaching for a bottle every time you have an argument with your spouse or boss.
The path from alcohol abuse to alcoholism
Not all alcohol abusers become full-blown alcoholics, but it is a big risk factor. Sometimes alcoholism develops suddenly in response to a stressful change, such as a breakup, retirement, or another loss. Other times, it gradually creeps up on you as your tolerance to alcohol increases. If you’re a binge drinker or you drink every day, the risks of developing alcoholism are even greater.
Signs and symptoms of alcoholism (alcohol dependence)
Alcoholism is the most severe form of problem drinking. Alcoholism involves all the symptoms of alcohol abuse, but it also involves another element: physical dependence on alcohol. If you rely on alcohol to function or feel physically compelled to drink, you’re an alcoholic.
Tolerance: The 1st major warning sign of alcoholism
Do you have to drink a lot more than you used to in order to get buzzed or to feel relaxed? Can you drink more than other people without getting drunk? These are signs of tolerance, which can be an early warning sign of alcoholism. Tolerance means that, over time, you need more and more alcohol to feel the same effects.
Withdrawal: The 2nd major warning sign of alcoholism
Do you need a drink to steady the shakes in the morning? Drinking to relieve or avoid withdrawal symptoms is a sign of alcoholism and a huge red flag. When you drink heavily, your body gets used to the alcohol and experiences withdrawal symptoms if it’s taken away. These include:
- Anxiety or jumpiness
- Shakiness or trembling
- Nausea and vomiting
- Loss of appetite
In severe cases, withdrawal from alcohol can also involve hallucinations, confusion, seizures, fever, and agitation. These symptoms can be dangerous, so talk to your doctor if you are a heavy drinker and want to quit.
Other signs and symptoms of alcoholism (alcohol dependence)
- You’ve lost control over your drinking. You often drink more alcohol than you wanted to, for longer than you intended, or despite telling yourself you wouldn’t.
- You want to quit drinking, but you can’t. You have a persistent desire to cut down or stop your alcohol use, but your efforts to quit have been unsuccessful.
- You have given up other activities because of alcohol. You’re spending less time on activities that used to be important to you (hanging out with family and friends, going to the gym, pursuing your hobbies) because of your alcohol use.
- Alcohol takes up a great deal of your energy and focus. You spend a lot of time drinking, thinking about it, or recovering from its effects. You have few if any interests or social involvements that don’t revolve around drinking.
- You drink even though you know it’s causing problems. For example, you recognize that your alcohol use is damaging your marriage, making your depression worse, or causing health problems, but you continue to drink anyway.
Five myths about alcoholism
Myth #1: I can stop drinking anytime I want to.
Maybe you can; more likely, you can’t. Either way, it’s just an excuse to keep drinking. The truth is, you don’t want to stop. Telling yourself you can quit makes you feel in control, despite all evidence to the contrary and no matter the damage it’s doing.
Myth #2: My drinking is my problem. I’m the one it hurts, so no one has the right to tell me to stop.
It’s true that the decision to quit drinking is up to you. But you are deceiving yourself if you think that your drinking hurts no one else but you. Alcoholism affects everyone around you—especially the people closest to you. Your problem is their problem.
Myth #3: I don’t drink every day, so I can’t be an alcoholic OR I only drink wine or beer, so I can’t be an alcoholic.
Alcoholism is NOT defined by what you drink, when you drink it, or even how much you drink. It’s the EFFECTS of your drinking that define a problem. If your drinking is causing problems in your home or work life, you have a drinking problem and may be an alcoholic—whether you drink daily or only on the weekends, down shots of tequila or stick to wine, drink three bottles of beers a day or three bottles of whiskey.
Myth #4: I’m not an alcoholic because I have a job and I’m doing okay.
You don’t have to be homeless and drinking out of a brown paper bag to be an alcoholic. Many alcoholics are able to hold down jobs, get through school, and provide for their families. Some are even able to excel. But just because you’re a high-functioning alcoholic doesn’t mean you’re not putting yourself or others in danger. Over time, the effects will catch up with you.
Myth #5: Drinking is not a “real” addiction like drug abuse.
Alcohol is a drug, and alcoholism is every bit as damaging as drug addiction. Alcohol addiction causes changes in the body and brain, and long-term alcohol abuse can have devastating effects on your health, your career, and your relationships. Alcoholics go through physical withdrawal when they stop drinking, just like drug users do when they quit.
Getting help for alcoholism or alcohol abuse
If you’re ready to admit you have a drinking problem, you’ve already taken the first step. It takes tremendous strength and courage to face alcohol abuse and alcoholism head on. Reaching out for support is the second step.
Whether you choose to go to rehab, rely on self-help programs, get therapy, or take a self-directed treatment approach, support is essential. Recovering from alcohol addiction is much easier when you have people you can lean on for encouragement, comfort, and guidance. Without support, it’s easy to fall back into old patterns when things get tough.
Getting sober is only the beginning
Your continued recovery depends on continuing mental health treatment, learning healthier coping strategies, and making better decisions when dealing with life’s challenges. In order to stay alcohol-free for the long term, you’ll also have to face the underlying problems that led to your alcoholism or alcohol abuse in the first place. Those problems could be depression, an inability to manage stress, an unresolved trauma from your childhood, or any number of mental health issues. Such problems may become more prominent when you’re no longer using alcohol to cover them up. But you will be in a healthier position to finally address them and seek the help you need.
When a loved one has a drinking problem
If someone you love has a drinking problem, you may be struggling with a number of painful emotions, including shame, fear, anger, and self-blame. The problem may be so overwhelming that it seems easier to ignore it and pretend that nothing is wrong. But in the long run denying it will be more damaging to you, other family members, and the person with the drinking problem.
Dealing with a loved one’s alcohol problem can be an emotional rollercoaster. It’s vital that you take care of yourself and get the support you need. It’s also important to have people you can talk honestly and openly with about what you’re going through.
A good place to start is by joining a group such as Al-Anon, a free peer support group for families coping with alcoholism. Listening to others with the same challenges can be a tremendous source of comfort and support. You can also turn to trusted friends, a therapist, or people in your faith community.
- You cannot force someone you love to stop abusing alcohol. As much as you may want to, and as hard as it is to watch, you cannot make someone stop drinking. The choice is up to them.
- Don’t expect the person to stop drinking and stay sober without help. Your loved one will need treatment, support, and new coping skills to overcome a serious drinking problem.
- Recovery is an ongoing process. Recovery is a bumpy road, requiring time and patience. An alcoholic will not magically become a different person once sober. And the problems that led to the alcohol abuse in the first place will have to be faced.
- Admitting that there’s a serious problem can be painful for the whole family, not just the alcohol abuser. But don’t be ashamed. You’re not alone. Alcoholism and alcohol abuse affects millions of families, from every social class, race, and culture. But there is help and support available for both you and your loved one.
When your teen has a drinking problem
Discovering your child is drinking can generate fear, confusion, and anger in parents. It’s important to remain calm when confronting your teen, and only do so when everyone is sober. Explain your concerns and make it clear that your concern comes from a place of love. It’s important that your teen feels you are supportive.
Five steps parents can take:
- Lay down rules and consequences: Your teen should understand that drinking alcohol comes with specific consequences. But don’t make hollow threats or set rules that you cannot enforce. Make sure your spouse agrees with the rules and is prepared to enforce them.
- Monitor your teen’s activity: Know where your teen goes and who he or she hangs out with. Remove or lock away alcohol from your home and routinely check potential hiding places for alcohol—in backpacks, under the bed, between clothes in a drawer, for example. Explain to your teen that this lack of privacy is a consequence of him or her having been caught using alcohol.
- Encourage other interests and social activities. Expose your teen to healthy hobbies and activities, such as team sports, Scouts, and afterschool clubs.
- Talk to your child about underlying issues. Drinking can be the result of other problems. Is your child having trouble fitting in? Has there been a recent major change, like a move or divorce, which is causing stress?
- Get Help: You don’t have to go it alone. Teenagers often rebel against their parents but if they hear the same information from a different authority figure, they may be more inclined to listen. Try seeking help from a sports coach, family doctor, therapist, or counselor.