Alcohol abuse and alcohol addiction, which are often known colloquially as alcoholism, can damage a person’s life and is the fourth leading cause of preventable death. Alcoholism takes many forms and can have a wide variety of effects on a person’s health, mental well-being, and behavior. Understanding the causes of alcoholism and the nature of the condition is crucial to recovering from this potentially life-threatening disorder.
While alcoholism goes by many names, today it is most commonly referred to by its clinical name, alcohol use disorder. Individuals who suffer from alcohol use disorder find it difficult to stop abusing alcohol even when doing so repeatedly leads to negative consequences. These harms can include social isolation and conflict, health problems, legal problems, losing one’s job, and severe mental health disorders.
People with alcohol use disorder often recognize these harms and have a strong desire to quit drinking, but they generally find that they are unable to do so for any extended period of time, if at all.
Alcoholism has no single cause, and there are a wide variety of factors that contribute to the development of alcohol use disorder. Alcohol use disorder is a legitimate and deeply debilitating medical condition, but it is treatable with outside help. Recognizing alcohol use disorder and seeking treatment, however, is often the most significant hurdle people face.
Part of the difficulty lies in the fact that alcohol plays an important role in our culture. Not only does drinking play a role in social events, work, dating, and religious ceremonies, but the practice of drinking excessively is valued and normalized in many circumstances. People who suffer consequences from alcohol abuse are therefore often criticized for “not handling their liquor,” and those who develop alcohol addictions are often left feeling like they have insufficient willpower or self-control.
As a result, many people spend years trying with little success to conjure up the will power they believe they need to manage their drinking problem. The social stigma surrounding addiction, and around alcohol addiction in particular, prevents many people from seeking help when they most need it.
It cannot be emphasized enough that alcohol use disorder cannot be managed by exerting more self-control or will power. In fact, alcohol use disorder’s very nature makes it impossible for a person to exercise self-control in this area of their lives. Addiction affects the brain on a neurological level. Trying to use one’s brain to combat addiction is like trying to heal a broken leg by running a marathon. As with any severe and progressive medical condition, the only way to recover is to seek outside help and get the treatment you need.
What is Alcohol?
Alcohol, which is a form of the organic chemical compound ethanol, is a type of beverage that produces psychoactive effects. Alcohol is made through the process of fermentation, and thus alcohol can be produced from any high-sugar substance, ranging from fruit to honey. Alcohol is a central nervous system (CNS) depressant. The central nervous system, which consists of the brain and spinal cord, is responsible for processing information and coordinating the activity of all parts of the body.
Alcoholism inhibits the functioning of the central nervous system, resulting in a wide variety of mental, physical, and behavioral symptoms. Common effects include slurred speech, decreased brain function, impaired motor skills, and a higher likelihood of engaging in high-risk behaviors. At higher doses, the effects of alcohol intoxication become more acute and dangerous. This state of intoxication is generally known as being drunk.
Alcohol consumption is expected and normalized in many circumstances, including on dates, at weddings, during religious ceremonies, and as part of college life. People drink to celebrate achievements, to mourn loss, and often simply to “loosen up.” Drinking alcohol feels relaxing, lifts people’s moods, and it tends to remove social inhibitions.
As such, it is often referred to as a “social lubricant,” and it is widely used in social settings to facilitate communication and comradery. While safe alcohol consumption is possible in certain contexts, it is important to note that even in circumstances where alcohol consumption is considered “normal,” it is indeed possible to abuse the substance.
Given its ubiquity and the important role alcohol plays in many aspects of culture, it should come as no surprise that it is also big business. In 2018, alcohol sales in the United States were valued at approximately $253.8 billion. Alcohol is a legal drug, despite being arguably more dangerous than many illegal recreational drugs.
It is aggressively advertised to people and glamorized in movies, TV shows, and music. For many people, purchasing their first drink is seen as an important rite of passage. Thus, for individuals who struggle with alcohol abuse, admitting to a problem or quitting can feel deeply isolating.
What Causes Alcohol Addiction?
It is difficult to answer the question of why some people develop alcohol addiction and others do not. Ultimately, alcohol addiction is affected by a wide variety of factors, ranging from personal genetics to environmental factors. However, researchers have in recent years come to a better understanding of how alcoholism develops. Certain behaviors, such as binge drinking or drinking in the morning, increase a person’s susceptibility to alcohol addiction.
However, alcohol addiction is notoriously difficult to predict. Some people develop addictions soon after their first drink, while others only develop alcoholism late in life. Once a person develops an alcohol addiction, their alcohol abuse tends to escalate quickly.
The harms that alcohol abuse inflicts on a person’s life can drive a person to drink more to relieve themselves of the emotional distress. At a certain point, individuals may find themselves in a vicious cycle, and it may be most accurate to say that the cause of their alcohol abuse is, strangely enough, alcohol abuse itself.
Alcoholism and Brain Chemistry
When people drink alcohol, the beverage causes their brains to release high quantities of a neurotransmitter known as dopamine. Dopamine causes people to feel intense pleasure, and it is sometimes described as the brain’s way of rewarding itself. This neurotransmitter plays an important role in the brain’s motivation and decision making centers, serving as a reinforcing mechanism for important behaviors.
The dopamine and endorphins that alcohol release are in large part responsible for the pleasure and euphoria of drinking, but these neurotransmitters also cause the behavior of drinking to be reinforced, making it more likely that a person will want to drink again in the future.
Alcohol Tolerance and Alcohol Dependence
Over time, people’s brains and bodies adapt to the effects of alcohol. Since alcohol is a central nervous system depressant, their bodies actually respond by learning to habitually keep the central nervous system in a state of heightened overactivity. Once a person’s central nervous system has gotten used to alcohol, it will require a greater quantity of alcohol for a person to achieve the same desired effects.
During the beginning of a person’s drinking career, for instance, two or three beers may have been sufficient to intoxicate them, but after a while it may take five or six. This phenomenon, known as tolerance, can drive people to drink in larger amounts or with greater frequency. There is no upper limit to tolerance, and people with severe addictions often reach a point where astronomically high doses of alcohol have little to no effect.
At a certain point, especially if a person has increased their liquor consumption to combat the effects of tolerance, alcohol dependence can develop. Alcohol dependence occurs when the brain and body are so adapted to alcohol consumption, that they actually fail to function properly when alcohol is absent. When a person has developed a physical dependence on alcohol, they will experience withdrawal symptoms when they stop drinking.
Alcohol withdrawal, often known as a hangover, can range in severity, depending on a person’s alcohol consumption. It can manifest as a painful and debilitating state of body and mind, but in severe cases it can be a dangerous and life-threatening condition. To combat alcohol withdrawal, people with physical dependence will continue to drink. For these individuals, drinking becomes the only way they can function in their everyday lives.
Alcohol addiction often occurs after a person has developed a physical dependence on alcohol, though in many cases it occurs long before physical dependence. Alcohol addiction is characterized by a psychological dependence on alcohol, which leads to cravings and obsessions that go beyond the mere physical demands of the body. For these individuals, alcohol fulfills an important psychological and emotional need. It may be a form of self-medication for an undiagnosed mental health disorder or a form of escapism from life difficulties, such as loneliness or economic hardship.
No matter how or why a person develops an alcohol addiction, the primary effect of alcohol addiction is that it makes people unable to stop drinking. In fact, even people who get through their withdrawal symptoms and are no longer physically dependent on alcohol will often return to alcohol consumption. For this reason, understanding the distinction between physical dependence and addiction is essential to avoiding relapse and achieving long term recovery.
Types of Drinking
When most people think of the word, “alcoholic,” they likely have a specific image in mind. Most likely, this image is culled from depictions of alcoholism in movies, television shows, and other media. They may picture a person who has lost everything, perhaps someone living on the street. The term “alcoholic” generally conjures up an image of someone who drinks alcohol around the clock, from the moment they wake up to the moment when they finally pass out at night.
For many people suffering from alcohol use disorder, this image is accurate. But it is important to recognize that there are many ways of abusing alcohol, and not all of them conform to the stereotypical image of alcoholism.
The most dangerous type of drinking is known as binge drinking. Individuals who engage in binge drinking often do not drink during most of the week, waiting until the weekend to finally let loose. Many appear to live and function very well in their lives. They may be a classic example of the expression, “work hard, play hard.” In fact, this style of drinking is widely valued in our culture. But what is binge drinking?
Binge drinking can be described as a pattern of drinking high quantities of alcohol in a very short period of time. The National Institute on Alcohol Abuse and Alcoholism defines binge drinking as any drinking that brings blood alcohol concentration (BAC) up to 0.08%. For most adult men, this can occur when they drink 5 or more drinks in under 2 hours. For adult women, this occurs after 4 drinks in under 2 hours. For young adults, adolescents, and children, it can take far less for a high BAC to occur.
Binge drinking puts a person at considerable risk. It is the form of drinking most associated with alcohol overdose, and it leads to countless hospitalizations every year. Binge drinking also leads to acute intoxication, which can drive people to engage in risky behaviors, ranging from drunk driving to sexual assault. Over the long term, binge drinking is the type of drinking that puts people at the highest risk of developing alcohol addiction.
Unfortunately, binge drinking is often dismissed. Many people assume that if they only drink on weekends, no matter how much they drink, it is impossible to have an alcohol use disorder. In fact, binge drinking is often even encouraged. College campuses throughout the United States often present binge drinking as a rite of passage, or even an essential aspect of the college experience.
Ultimately, it is important to recognize that if a person regularly engages in binge drinking and experiences negative consequences, they are engaging in a dangerous form of alcohol abuse — and they may have an alcohol use disorder. They do not have to drink every day to suffer from an addiction.
Signs and Symptoms of Alcoholism
The term “alcohol use disorder,” or AUD, is generally more commonly used than the word “alcoholism,” since the clinical term is more specific. Alcohol use disorder is a condition that causes people to be unable to control their own compulsion to drink despite suffering from considerable harms as a result of their drinking. It is important to understand that alcohol use disorder, like other substance use disorders, is a spectrum condition.
Not everyone’s alcohol use disorder manifests in the same way. Unfortunately, it is all too common for people to mistakenly believe that all people who suffer from alcoholism are destitute, poorly groomed, and drinking out of a brown paper bag 24 hours a day. In actual fact, there are many kinds of alcoholics, and not everyone experiences harm from their drinking in the same manner. All too often, people fail to recognize their alcohol addiction or seek treatment because they believe that they don’t “look like an alcoholic.
Alcohol use disorder is a legitimate mental health condition, and it is diagnosed based on a wide range of symptoms. These criteria are listed in the DSM-5, the book used by psychiatrists and mental health professionals to diagnose mental health disorders.
The DSM-5 lists eleven symptoms of alcohol use disorder. Individuals who suffer from 2-3 symptoms are said to have a mild alcohol use disorder. Those who experience 4-5 symptoms can be diagnosed with a moderate alcohol use disorder. Finally, individuals with 6 or more symptoms can be said to suffer from a severe alcohol use disorder. The symptoms of alcohol use disorder, as defined by the DSM-5, are as follows:
- Alcohol is often taken in larger amounts or over a longer period than was intended.
- There is a persistent desire or unsuccessful efforts to cut down or control alcohol use.
- A great deal of time is spent in activities necessary to obtain alcohol, use alcohol, or recover from its effects.
- Craving, or a strong desire or urge to use alcohol.
- Recurrent alcohol use resulting in a failure to fulfill major role obligations at work, school, or home.
- Continued alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol.
- Important social, occupational, or recreational activities are given up or reduced because of alcohol use.
- Recurrent alcohol use in situations in which it is physically hazardous.
- Alcohol use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by alcohol.
- Tolerance, as defined by either of the following: a) A need for markedly increased amounts of alcohol to achieve intoxication or desired effect, or b) A markedly diminished effect with continued use of the same amount of alcohol.
- Withdrawal, as manifested by either of the following: a) The characteristic withdrawal syndrome for alcohol b) Alcohol (or a closely related substance, such as a benzodiazepine) is taken to relieve or avoid withdrawal symptoms.
For concerned friends and family members, it can often be difficult to detect a person’s alcohol use disorder. This is because many people go to great lengths to hide their addictions. However, when a person regularly abuses alcohol, the physical and behavioral signs of alcoholism are difficult to ignore. One might begin by noticing the immediate signs of alcohol abuse. While becoming overly intoxicated does not necessarily mean a person has an alcohol addiction, it is often a warning sign, and at the very least it increases the chances that they will develop an addiction to alcohol. Signs of dangerous and acute alcohol intoxication include:
- Blackouts (especially during periods of binge drinking)
- Slowed reaction times, difficulty walking, or problems with motor coordination
- Memory impairment or lapses
- Slurred speech
- Impaired judgment
- Risk-taking without thinking about the consequences (including drunk driving)
Over time, individuals who develop a physical dependence or addiction to alcohol are likely to experience a wide range of consequences in their lives. Some noticeable patterns that can indicate an alcohol use disorder include:
- Yo-yoing: Repeatedly stopping drinking and then returning to it, over and over
- Reacting negatively to any perceived criticism of their drinking
- Showing up drunk to a family event, meeting, or to work
- Legal problems, including ones related to domestic abuse, assault, or drunk driving
- Engaging in unprotected sex
- Repeatedly engaging in dangerous activities that put themselves or others at risk
- Financial problems
- Taking out loans, asking for money, depleting accounts, or liquidating assets
- Lying or being evasive for no obvious reason
- Lack of attention to personal grooming or appearance
- Lack of interest in activities that were once enjoyable, because drinking seems preferable
- Avoiding family or friends; social isolation
- Social conflicts, arguments, or violence
- Getting fired from work or expelled from school
- Unexplained injuries or health problems
Long Term Consequences of Alcoholism
Individuals who develop alcohol addictions are likely to suffer from consequences that are the direct result of drinking, as well as consequences indirectly caused by the nature of addiction itself. Alcohol has a number of effects on people’s behavior, health, and emotional well-being that can be deeply damaging. However, it is important to note that the compulsion to drink is itself a major cause of harm. Individuals who develop alcohol addictions are likely to withdraw from relationships, hobbies, and other activities that once made their lives feel meaningful and fulfilling.
They often neglect important foundational elements of their lives, including their personal health, finances, and careers. It is often the pursuit of alcohol, rather than alcohol itself, that causes the most damage since individuals who are addicted to alcohol are likely to drop out of their own lives.
Alcohol abuse can, however, directly lead to a number of severe issues. Some common consequences of long term alcohol abuse results include:
- Accidents and injuries. Drunk driving is one of the leading causes of death in the United States. In addition to car accidents, however, alcohol intoxication can cause people to fall, drown, or suffer from other kinds of accidents. These can lead to severe injuries or even death.
- Assault. People who abuse alcohol are more likely to be the victim of a violent or sexual assault, and they are also more likely to engage in assault themselves. Significant injuries, legal problems, and post-traumatic stress disorder (PTSD) can result.
- Risky sex. Having sex while abusing alcohol can lead to a wide range of problems. Nonconsensual sex is a significant risk. Alcohol intoxication can also lead people to have unprotected sex, which can result in unplanned pregnancies or the contraction of a sexually transmitted infection, such as hepatitus or HIV.
- Brain damage. Alcohol is a central-nervous system depressant that inhibits the brain’s functionality. Over time, alcohol abuse can lead to permanent brain damage. Wernicke-Karsakoff syndrome, for instance, which arises due to alcohol-induced malnutrition, can lead to permanent motor impairment, confusion, encephalopathy, and psychosis.
- Chronic medical conditions. Over time, alcohol abuse increases the likelihood of a number of different medical conditions. These include diabetes, heart disease, high blood pressure, liver cirrhosis, Alzheimer’s disease and dementia, and many varieties of cancer. Unfortunately, individuals with alcohol use disorder are unlikely to seek treatment for these conditions, and even when they do they are unlikely to take their medicine or follow through with medical recommendations.
- Financial problems. Chronic drinking can cause people to lose their jobs. It can also put people into considerable debt. An inability to pay the bills, combined with a diminished social support system, can be catastrophic for alcoholics, often leading to homelessness.
- Legal problems. Alcohol causes risky behavior that can put someone behind bars. Furthermore, individuals who have no financial resources but continue to experience a strong desire for alcohol will often use any means at their disposal to obtain liquor, including stealing.
- Isolation. Alcohol can drive people to avoid social contact, and it can also alienate other people. As a result, people with drinking problems tend to lose their relationships with friends and family members.
- Mental health disorders. Alcohol abuse increases the chances that a person will develop a wide range of mental illnesses, including depression and anxiety. It can also exacerbate the symptoms of pre-existing mental health conditions. Unfortunately, these mental health conditions can drive people to drink more alcohol to obtain temporary relief from their emotional stress.
Alcoholism and Mental Health
The relationship between alcohol abuse and mental illness is an important one, because it goes both ways. First and foremost, mental health conditions are often an important factor that drives people to abuse alcohol. Individuals experiencing emotional distress are likely to turn to alcohol to obtain short term relief from their symptoms.
This is especially true for individuals who have undiagnosed or untreated mental health conditions. Unfortunately, the relief that alcohol provides when it is used for self-medication is very short term. In fact, regular alcohol abuse tends to worsen the symptoms of mental health disorders, and in many cases, it can lead to additional mental illnesses.
Alcohol abuse can exacerbate or lead to the development of a wide range of mental health problems. These include bipolar disorder, anxiety disorder, post-traumatic stress disorder (PTSD), and major depression. It also increases suicidal ideation as well as the likelihood that a person will act on their suicidal ruminations.
Ultimately, suffering from these mental health disorders can result in a person drinking more, since alcohol offers temporary relief from the symptoms. This can lead to a vicious cycle from which it is difficult to escape.
Individuals who suffer from alcohol use disorder in addition to one or more additional mental health conditions are said to be “dual diagnosis.” Anyone hoping to recover requires treatment for their alcohol addiction in addition to their comorbid mental health issues.
If one condition is left untreated, it can provoke a relapse very easily. High-quality treatment programs offer a comprehensive form of treatment, known as integrated treatment. Integrated treatment addresses addiction as well as underlying mental illnesses, and pursuing such a comprehensive program is essential for dual diagnosis clients.
Outpatient Treatment for Alcoholism
If you suspect that you or a loved one is suffering from alcohol use disorder or engaging in dangerous patterns of alcohol abuse, it is essential to get outside help. It may be tempting to try to manage or control the problem on one’s own, but if an alcohol addiction has set in this is likely to be unsuccessful in the long run.
Alcohol addiction hijacks the brain on a neurological level, making it impossible for a person to summon up the willpower they need to stay sober. Instead of trying to manage on one’s own, it is best to recognize the reality of alcohol use disorder and get treatment for this debilitating medical condition.
Outpatient treatment programs for alcoholism are widely recommended for individuals suffering from alcohol use disorder. Outpatient programs are addiction treatment programs that clients can attend for a period of time each day. These programs offer many of the same therapeutic modalities as residential treatment programs, but they provide clients with the flexibility to return home each day and pursue their lives in the outside world.
Outpatient rehab for alcoholism thus offers clients a way to develop new skills and coping strategies while also giving them opportunities to put these newfound skills into practice in the outside world.
A wide variety of outpatient programs exist to meet the needs of people suffering from alcohol use disorder at different levels of severity. These levels of care, in order of intensity, include partial hospitalization programs (PHPs), intensive outpatient programs (IOPs), outpatient programs (OPs), and aftercare planning. Individuals who make use of multiple levels of care as they progress in their recovery journeys are often the most likely to achieve long term sobriety.
NuView Treatment Center, an outpatient treatment center located in West Los Angeles, provides outpatient treatment at all levels of care. It is therefore suitable for individuals suffering from alcohol addiction at any level of severity, as well as people with other addictions and mental health disorders. At NuView Treatment Center, our trained and compassionate staff aim to help people build a foundation for long term sobriety.
We offer the latest evidence-based addiction treatment methods and therapeutic modalities. As one of the best alcohol rehab centers in Los Angeles CA, our goal is not only to help people stay physically abstinent, but to develop new lives that are meaningful and fulfilling.
If you are ready to end the vicious cycle of alcohol abuse and begin a new way of life with our alcohol detox program in Los Angeles, reach out to NuView Treatment Center today.