Alcohol is the most commonly used addictive substance in the United States, with over 17.6 million individuals either abusing it or dependent on it, according to the National Council on Alcoholism and Drug Dependence. Despite its legal status, alcohol can cause multiple problems for those who are dependent on it.
The National Institute on Drug Abuse describes alcohol as a central nervous depressant, meaning that it slows the automatic processes that are essential to living: breathing, heart rate, blood pressure, and more. It is absorbed quickly, both in the stomach and small intestine. Since the liver can only break down small amounts of alcohol at a time, the rest of the alcohol is left to circulate through the bloodstream.
Long-term alcohol use can cause numerous health problems, as alcohol affects every organ in the body. The National Institute on Alcohol Abuse and Alcoholism gives several examples of issues alcohol can cause, including:
- Alcoholic hepatitis
- Cancer of the mouth, esophagus, throat, liver, and breast
- Cardiomyopathy (stretching of the heart’s muscles)
- Cirrhosis of the liver (scar tissue taking over the liver, causing decreased liver function)
- Dementia (memory loss and impairment in judgment)
- Fatty liver disease (also called steatosis)
- Fibrosis (scarring) of the liver
- Heart attack
- Hypertension (high blood pressure)
- Irregular heart rate
- Neuropathy (nerve damage)
- Weakened immune system
Behavioral changes can also occur with longtime alcohol use. These changes can include mood swings, depression, anxiety, suicidal thoughts or actions, and alcoholism.
The National Organization on Fetal Alcohol Syndrome warns that when women consume alcohol while pregnant, the unborn baby is at risk for developing fetal alcohol spectrum disorder (FASD). FASD is a term that encompasses several effects that an unborn child may develop if exposed to alcohol prenatally. These effects may include disabilities that can be physical, mental, behavioral, and/or related to learning. Children who have developed FASD often present with growth problems, like low birth weight; facial dysmorphia; and abnormalities in the development of the central nervous system, such as intellectual impairment.
The Substance Abuse and Mental Health Services Administration reports that in the 2014 National Survey on Drug Use and Health, 139.7 million individuals, aged 12 and older, who were surveyed stated that they currently used alcohol. Of those, approximately 17 million individuals met the criteria for an alcohol use disorder, and only 8.9 percent of those individuals were able to obtain the treatment they needed.
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has 11 criteria that apply to alcohol use disorder (AUD), or alcoholism. Of these, individuals must meet two in the same 12-month period to be diagnosed with AUD. The criteria include:
- Drinking more than intended or for longer than intended
- Desire to quit drinking but cannot do so
- Devoting large amounts of time to drinking or recovering from drinking
- Cravings for alcohol
- Continued drinking, even if there is a strain on relationships or other negative life effects
- Drinking interferes with responsibilities at home, work, and school
- Giving up pleasurable activities or hobbies to drink
- Drinking even after dangerous experiences with alcohol
- Continued drinking even if it has exacerbated physical or mental illness
- Developing a high tolerance to alcohol (needing to drink more alcohol to achieve the same effect)
- Experiencing withdrawal symptoms when without alcohol
If individuals meet the criteria for alcohol use disorder, they should explore treatment options. Per NIAAA, those who have been diagnosed with AUD benefit from treatment.
As stated by NIAAA, one treatment option may work for some individuals, but not for others. Therefore, it’s essential that treatment is tailored to meet the specific needs of the person in question. The treatment plan should also be reassessed as the person progresses in recovery. It may need to be adjusted at certain points in the treatment process.
Medical detox is needed for those who suffer from alcoholism. Alcohol is one of the substances that can lead to potentially life-threatening withdrawal symptoms in some cases. As a result, people should never just stop drinking altogether on their own. Withdrawal must be overseen by medical professionals.
Behavioral therapy is one of the most beneficial treatments for any substance use disorder, including AUD. Behavioral therapies can help individuals develop skills needed to stop drinking, build a strong support system, set attainable goals, and cope with or avoid any triggers that may lead to relapse.
This therapy helps individuals identify thoughts and behaviors that are linked to their alcohol use. Therapists will then assist individuals in changing these thoughts and behaviors, as well as developing the coping skills needed to avoid situations that may trigger alcohol use.
Motivational Enhancement Therapy is a short-term therapy that is designed to help individuals gather motivation to achieve and maintain sobriety. Individuals will focus on the pros and cons of seeking treatment, create a plan for making needed changes, build confidence, and develop skills to help them stay on the road to recovery. Therapists monitor clients’ progress and continue to encourage individuals to stay sober, describes NIDA.
Support groups, such as Alcoholics Anonymous, can help individuals to both provide and receive peer support.
Some of these groups facilitate a 12-Step model, which, according to NIDA, can promote abstinence. Individuals learn to accept the fact that alcoholism is a chronic disease with no cure, but one that can be effectively managed for life. With the help of these peer support groups, individuals become actively involved in their own recovery.
Medicated treatment is also a possibility in some cases for those who suffer from alcoholism. The medications approved to treat AUD are nonaddictive, and should be used in tandem with behavioral therapy and support groups. NIDA lists four medications that are commonly used in treatment of AUD: naltrexone, acamprosate, disulfiram, and topiramate.
Naltrexone is an agent that blocks opioid receptors. It has been shown to reduce the chance of relapse in some individuals. Acamprosate has been shown to decrease some withdrawal symptoms in those who have severe AUD, and it may help individuals maintain sobriety. Disulfiram interferes with how alcohol is broken down in the body and creates unpleasant side effects if individuals consume alcohol while taking the medication. Lastly, topiramate has been shown to help with AUD, but its action in the body is still unknown.
While alcoholism is a serious disorder on all fronts, complete recovery is possible if high-quality care is provided.
Each day, people suffering from severe alcoholism make the choice to turn toward a brighter future that doesn’t include alcohol.
If you see the signs of alcoholism in yourself, or in someone you love, it’s time to get help. A healthier and happier future awaits.