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.

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.

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. However, not everyone with alcohol dependence is addicted, and not everyone with alcohol addiction is physically dependent.

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.

Alcohol tolerance, at least to a certain degree, occurs when anyone drinks, whether they have a substance use disorder or not.

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. 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.

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.

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.

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
• Stealing
• 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

It is important to understand that alcohol use disorder, like other substance use disorders, is a spectrum condition. Not everyone experiences the same degree of severity, and some people are able to function (or appear to function) despite having a problem. However, they might be suffering behind the scenes. Moreover, over time substance use disorders like alcoholism tend to get progressively worse. This means that it is in the best interests of even “high-functioning” alcoholics to get treatment right away. 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.

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.

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.

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.