Alcoholism is a chronic disease that makes the body dependent on alcohol. Alcoholism develops over time, to the point where the alcoholic becomes obsessed over alcohol, can no longer control alcoholic intake, and drinking causes serious problems with health, relationships, finances and work. Left untreated, alcoholism can lead to serious physical and mental consequences. However, alcoholism is a treatable disease, a fact that is often overlooked. Alcoholics display a number of signs, but not all alcoholics will exhibit all of them or at the same time. Some of the signs of alcoholism are:
- Denial that there is a problem with alcohol
- Inability to limit the amount of alcohol consumed
- Drinking alone or keeping consumption of alcohol a secret
- Stashing alcohol for ready access
- Experiencing blackout
- Becoming irritable when it’s time to drink, especially if alcohol is not available
- Drinking rituals, and being extremely annoyed if this ritual is disturbed or questioned by others
- Loss of interest in activities, hobbies and friends
- Feeling compelled to drink
- Increasing tolerance to alcohol, requiring greater quantities of alcohol to achieve the same “buzz” or high
- Gulping drinks, ordering multiple drinks or doubles, getting drunk intentionally to feel good, normal or to overcome shyness
- Problems developing with relationships, job, finances or work
- Experiencing symptoms of withdrawal, such as nausea, sweating, tremors or shaking, when alcohol is not consumed
It is important to remember that people who abuse alcohol can also display many of these symptoms. But alcohol abusers often don’t feel compelled to drink, or don’t feel the same level of compulsion as those who are dependent on alcohol. Alcohol abusers also do not generally experience withdrawal symptoms when they stop drinking.
There is no single cause of alcoholism. Physical addiction, or dependence on alcohol, occurs gradually. Excessive drinking changes chemicals in the brain. These include gamma-aminobutyric acid (GABA), which limits impulsiveness, and glutamate, which excites the nervous system. In addition, alcohol increases the levels of dopamine in the brain, long associated with the pleasurable effects of drinking (the so-called “pleasure center”). Chronic, long-term excessive drinking can increase or deplete these chemicals, resulting in the drinker’s body to crave more alcohol in order to feel good again or to get rid of bad feelings.
Addiction experts point to other contributing factors of alcoholism, including heredity and genetics, emotional state, psychological factors, and social and/or cultural factors. Certain risk factors predispose individuals to vulnerability with alcohol, including steady drinking (more than 15 drinks per week for men and more than 12 drinks per week for women), starting drinking at an early age (16 or younger), sex (men are more likely than women to experience a problem with alcohol dependence), genetics, family history, and emotional disorders. Since alcoholics most often deny that they have a problem with alcohol and won’t seek treatment on their own, it is usually a family member, close friend or co-worker that will try to encourage the alcoholic to seek help for their problem. Screening tests must be done for a person to be diagnosed as having alcoholism. These criteria are spelled out in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association (APA) and include a pattern of alcoholic abuse leading to significant distress or impairment, specifically indicated by the presence of three or more of the following during a 12-month period:
- Tolerance: needing to drink more and more often in order to achieve the same effect.
- Withdrawal symptoms: tremors, anxiety, insomnia and nausea when the individual attempts to stop drinking. To overcome the symptoms, individuals may increase their drinking levels.
- Quantity and duration: drinking more alcohol or over a longer period of time than the individual intended
- Unsuccessful attempts to quit or cut down
- Time: spending inordinate amounts of time in the pursuit of alcohol, using alcohol, and recovering from the effects of alcohol
- Neglecting or giving up important social, occupational or recreational activities
- Continued use of alcohol: despite the fact that it’s causing physical and psychological problems
Alcoholics may suffer from many physical and psychological conditions as a result of their disease. Over time, excessive alcohol use can result in short-term memory loss, fatigue, eye muscle weakness and paralysis, liver disorders, birth defects, bone loss, cancer, cardiovascular problems, diabetes complications, gastrointestinal problems, neurological impairment, and sexual problems. Alcoholism also causes increased accidents in motor vehicles by intoxicated drivers, accidental injuries from other causes, divorce, domestic abuse, violence, poor school or work performance, and a higher incidence of suicide and murder. Alcoholism is a treatable disease and may involve use of certain medications, counseling, both individual and group, and participation in self-help groups such as Alcoholics Anonymous (AA).