Alcoholism 101

Alcoholism isn’t always easy to recognize, and it can be even harder to admit. That’s why it’s important to first understand the basics about this disorder, including common causes, telltale symptoms and risk factors that may be involved.

You should know:

  • Alcohol kills. In the United States alone, the government ranks alcohol-related incidents as the third-leading cause of preventable death. Alcohol plays a role in approximately 88,000 deaths each year, whether from liver disease, car accidents or other reasons.
  • Only one in six adults has ever discussed their drinking with a health care professional, according to the Centers for Disease Control and Prevention (CDC).
  • There are many factors that can put you at risk for becoming an alcoholic – from the age at which you had your first drink (the earlier drinking began, the more likely someone is to become an alcoholic) to your family history.
  • If you or a loved one is screened for alcoholism, a health care practitioner will look at 11 criteria to determine if alcohol use disorder is an issue. (See the Symptoms section below.)


While there’s no single cause of alcoholism, experts think a combination of the following are most likely to play a role:

  • Your childhood. Your early years – including your mother’s and father’s parenting styles – and whether you believe one or both parents abused alcohol or other substances can affect whether your alcohol consumption becomes excessive. For better or worse, early role models influence our behavior as well as how we handle difficult times.
  • Your environment. A stressful lifestyle, availability of alcohol and how much your friends and family drink as well as relationship problems are all associated with a greater likelihood to develop a drinking problem.
  • Your psychological makeup. How you feel about yourself – especially your self-esteem – and whether or not you’re impulsive may play roles, too.

Symptoms of Alcoholism

Doctors, therapists and addiction counselors look at a variety of factors when deciding whether someone has a drinking problem. If you have two of the indicators below, it can point to a mild problem with alcohol, while having four or five symptoms can underscore a moderate drinking problem. Six or more of these symptoms may signal severe alcoholism. No matter how serious a drinking problem is, recognizing the symptoms of an alcohol use disorder is the all-important first step to getting help — and recovering. So ask yourself these questions:

Are you or a loved one…

  • Drinking larger amounts over a longer time period of time than planned?
  • Making unsuccessful attempts to cut down on drinking?
  • Spending a lot of time finding alcohol, using alcohol or sobering up from alcohol?
  • Experiencing cravings for alcohol?
  • Failing to fulfill major expectations at work, school or home?
  • Continuing to use alcohol despite problems it’s causing in relationships?
  • Giving up activities once enjoyed?
  • Using alcohol regularly while in situations where it poses physical danger (such as driving, operating machinery or boating)?
  • Ignoring physical or psychological problems resulting from alcohol use?
  • Developing a tolerance for alcohol’s effects?
  • Experiencing withdrawal symptoms or masking them with other substances?

Risk Factors

The more you know about alcohol use, the better your chances of avoiding a drinking problem before it starts. Here are several red flags that raise the risk of becoming an alcoholic:

  • Drinking too much. Some 38 million adults in the U.S. overdo it when it comes to alcohol. Excess drinking doesn’t mean someone is an alcoholic, but it is, of course, a risk factor for alcoholism. Sticking to the CDC’s guidelines for moderate drinking — which recommend no more than one drink per day for women and no more than two daily for men — may help prevent a problem. And if you didn’t drink at all and you’re starting to drink one or two drinks every day, that’s something worth discussing with your doctor. Experts are clear on what constitutes heavy drinking: For men, it means consuming five or more drinks on one occasion; and for women, it’s drinking four or more drinks at one time or at a single event. For weekly consumption, heavy drinking for men is 15 or more drinks in a week, and for women, it’s eight or more drinks. Drinking too much also includes any alcohol use by a pregnant woman or a child under 21 years old.
  • Dealing with a mental health issue. If you or someone you love suffers from a psychiatric disorder such as depression, anxiety, attention deficit disorder, post-traumatic stress disorder, an eating disorder or schizophrenia, among other conditions, there’s a chance that drinking could become or may already be a problem. Research indicates that over 50% of those treated for alcohol use disorder have a mental health issue, too (this is referred to as “co-occurring disorders”).
  • Starting drinking at a young age. Underage drinking is risky business. Researchers report that drinking before age 15 makes teens four times more likely to develop a problem with alcohol later in life compared to those who didn’t take their first drink until they were 21 or older.
  • Inheriting the genes. Researchers have done plenty of studies looking at whether the way the body responds to alcohol tends to run in families. As it turns out, a number of genes have been identified that contribute to a tendency toward heavy drinking or alcohol use disorders. Everything from opioid receptors in the brain (these reduce pain and increase a feeling of euphoria) to transporters of serotonin, a brain chemical that helps regulate mood and sleep, may be influenced by our genetic legacy. But the genes with the biggest impact on how we respond to alcohol are those that control how the body metabolizes alcohol.


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