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Alcoholism, also known as alcohol use disorder (AUD), is defined by the National Institute on Alcohol Abuse and Alcoholism
(NIAAA) as “a chronic relapsing brain disorder characterized by an impaired ability to stop or control alcohol use despite adverse social, occupational or health consequences.” According to the 2019 National Survey on Drug Use and Health (NSDUH), there are more than 14 million adults in the U.S. living with Alcohol Use Disorder. Men make up the larger portion of that group at 8.9 million, while women comprise the remaining 5.2 million. Unfortunately, alcoholism doesn’t just affect adults over the age of 18. The same survey found that 414,000 kids ages 12 to 17 also struggled with AUD in 2019. Only about 8% of adults and 5% of youth with AUD sought treatment according to the survey.
Signs and Causes of Alcoholism
There are many factors believed to influence whether or not someone develops a problem with alcohol. Genetics, environment, and childhood trauma are some of the influences that experts believe increase a person’s chance of developing AUD. Researchers are still studying other potential causes to help develop a more complete picture of not only the disease of alcoholism but also how to best treat it. Signs that someone has a problem with alcohol include:
- experiencing cravings or urges to drink
- being unable to stop drinking, even when the person wants to
- engaging in dangerous situations, such as driving a car, while drinking
- foregoing activities an individual once enjoyed because of alcohol use
- needing to increase the amounts a person drinks to achieve their desired level of intoxication
- having physical withdrawal symptoms, such as nausea, tremors or seizures if the person stops drinking
Short and Long Term Effects of Alcohol Abuse
In addition to safety concerns stemming from drinking and driving, drinking can also damage a person’s health both in the short and long term. According to the Centers for Disease Control and Prevention
(CDC), short-term risks include:
- violence, including homicide
- sexual assault and intimate partner violence
- alcohol poisoning, a medical emergency that results from high blood alcohol levels
- risky sexual behaviors, including unprotected sex or sex with multiple partners
- miscarriage and stillbirth or fetal alcohol spectrum disorders (FASDs)
Chronic illness and concerns that result from excessive use of alcohol over time can include:
- High blood pressure, heart disease, stroke, liver disease, and digestive problems
- Cancer of the breast, mouth, throat, esophagus, liver, and colon
- Weakening of the immune system, increasing the chances of getting sick
- Learning and memory problems, including dementia and poor school performance
- Mental health problems, including depression and anxiety
- Social problems, including lost productivity, family problems, and unemployment
- Alcohol use disorders or alcohol dependence
How Does Alcohol Affect the Body?
A standard alcoholic drink in the U.S. contains 0.6 ounces of pure alcohol. This translates to a 12-ounce of beer with a 5% alcohol content, 5 ounces of wine with a 12% alcohol content, or 1.5 ounces of 80-proof distilled spirits or liquor (such as gin, rum, vodka, whiskey) with a 40% alcohol content. Excessive drinking includes both binge drinking
and heavy drinking
. The CDC defines binge drinking as four or more drinks per occasion for a woman and five or more for a man. Heavy drinking is eight or more drinks for a woman during one week, 15 or more for a man. A person is considered to have an alcohol use disorder when their drinking — no matter what form it takes — has become chronic and harmful to their lives and the lives of those around them. Because alcohol has a sedating effect on the brain, long-term abuse of alcohol causes the brain to change its own chemistry by producing higher levels of neurotransmitter chemicals like serotonin (similar to adrenaline) to offset this slowing reaction. Obvious effects of alcohol can occur after only a few drinks, including slurring of words, problems walking, and memory issues. These typically go away after the alcohol has left the person’s system. But excessive drinking over a longer period can result in longer-lasting, even permanent, changes. For instance, while impaired memory is a side effect of several drinks, longer memory lapses, and even complete memory blackouts are possible when individuals consume large quantities of alcohol regularly. Excessive drinking over a longer period of time can also result in a deficiency of thiamine, or vitamin B1. All tissues need this vitamin, including the brain. Vitamin B1 helps the body turn sugar into energy. Without sufficient vitamin B1, a person is at a higher risk of developing Wernicke–Korsakoff syndrome. Though short-lived, Wernicke–Korsakoff syndrome can lead to mental confusion, double vision or other eye problems, paralysis of the nerves that move the arms and legs, and difficulty with muscle coordination. Another part of this syndrome, Korsakoff’s psychosis, is more debilitating. A chronic syndrome, Korsakoff’s can lead to persistent learning and memory problems, as well as hallucinations and issues processing information. The resulting problems typically can’t be reversed, although if it is caught early enough some recovery is possible. While liver damage as a result of alcoholism is a common concern, alcohol-induced liver damage can also cause hepatic encephalopathy. This condition can impact a person’s sleep patterns, mood, and personality. It may also result in anxiety and depression, shortened attention spans, and problems with coordination. It is even possible for someone to slip into a coma, which can be fatal.
The Importance of Seeking Treatment
If you or a loved one has shown several of the symptoms of alcohol use disorder listed above, it may be time to consider treatment. The more symptoms the person has, the more serious the need for them to make lifestyle changes to preserve their health and well-being. It is important to seek out a professional, like the trained experts at Forward Recovery, to help overcome an addiction to alcohol. Not only can an addiction treatment professional help diagnose alcohol use disorder, but they can also advise the individual on their best course of treatment. One reason it is vital that a person with AUD consult a health care professional is because of the risks posed by alcohol withdrawal. Quitting alcohol cold turkey typically results in a variety of physical withdrawal symptoms that can include trembling (shakes), insomnia, anxiety, and other physical and mental symptoms. Unlike a hangover, which typically goes away after a day at most, alcohol withdrawal can last for days or even longer. The symptoms of alcohol withdrawal may even get worse with time. Each person will experience withdrawal differently, but the most common symptoms are:
- A craving to consume alcohol. This may be partly to ease the physical feelings of withdrawal, but it can also be due to a desire to be drunk.
- Changes in mood. While drinking excessive amounts of alcohol can result in temporary euphoria or happiness, withdrawal from alcohol can have the opposite effect and leave the person feeling anxious and miserable.
- Issues sleeping. Alcohol withdrawal may leave an individual feeling exhausted yet unable to sleep.
- Vomiting. Nausea and vomiting are common symptoms of withdrawal for many with AUD.
- Physical reactions. Tremors, increased heart rate, and sweating are a few of the physical manifestations of alcohol withdrawal.
- Hallucinations. People who are in the process of alcohol withdrawal may hallucinate. These substance-induced periods of psychosis can be frightening or even make the person doubt their sanity.
- Seizures. Seizures are also possible when someone is going through alcohol withdrawal.
The risks that arise from alcohol withdrawal symptoms make it important that someone with AUD seeks out professional help before attempting to detox on their own.
Three Safe Strategies for Alcohol Detox
When it comes to treatment for alcoholism, most people are familiar with 12-step programs or inpatient rehab. However, these are not an option until the individual has undergone detox to remove the addictive substance from their system. No matter how long someone has been dealing with alcohol addiction, they can always seek treatment. There is no optimal time to seek help for alcohol abuse. But to be safe, individuals should always start with medically supervised detox from a licensed professional provider. While you may be tempted to detox on your own, an at-home detox does not provide the same level of support or safety as a supervised program. For example, many at-home detox plans suggest simply tapering off alcohol usage over time. Unfortunately, this can provide a false belief that stopping drinking is an easy process that requires minimal effort and is not dangerous. In reality, detoxification from alcohol can pose significant health risks, including:
- Intestinal difficulties
- Heart attack
- Panic attacks
- Breathing challenges
- Delirium tremens, a life-threatening hallucinatory condition
The following are three safe ways to start on a path to addiction recovery through safe, supported detox.
1. Hospital-based alcohol detox
- Hospitals are good choices for detox for individuals with high medical needs, such as severe alcoholism, which may require the resources of hospital staff. Most individuals, however, are able to safely detox under the care of a residential detox facility.
2. Residential alcohol detox
- This type of detox program is the most accessible option for most people seeking to begin their recovery. These programs provide safe and comfortable residential treatment that is overseen by a licensed, professional medical staff 24 hours a day, 7 days a week. These detox programs can provide medications to help individuals through the detox process when needed, as well as offer referrals to appropriate addiction treatment programs.
3. Outpatient alcohol detox
- This detox option doesn’t require a person to live on-site as they undergo the detox process. Outpatient detox is, therefore, more flexible and well-suited for someone who can’t separate themselves completely from their work and family obligations. This option works best if an individual’s home environment is stable or if they are dealing with a less serious drinking problem.
Choosing the Right Alcohol Detox Program
There is no single treatment that works for everyone when it comes to overcoming an addiction to alcohol. A responsible first step should include a conversation with a primary care doctor or an addiction treatment professional about available options. Working together with the individual in recovery, they can assess their overall health and help to craft a detox plan that will work best for that person’s needs and lifestyle. When choosing a detox program, individuals in early recovery should consider the following questions:
- Does the detox program being considered offer the best methods to address the person’s specific needs? Different programs and facilities use different approaches, as well as offer different levels of medical care and supervision. Make sure to fully understand the detox approach of a potential provider before making a choice.
- Does the program customize the detox process for each individual? There is no one magic program that helps every individual through detox the same way. For example, an individual undergoing detox for severe alcoholism will have different medical needs than someone detoxing from cocaine use. A responsible detox facility should work to tailor treatments to each unique person to be as safe and effective as possible.
- Does the detox program make it clear what is expected of each person seeking help? It is also the responsibility of each patient to play a role in managing their alcohol detox process. Be sure that all expectations are clear up front before selecting a detox program.
- Does the detox program provide any measurement of its success rate and the criteria it uses to measure success? When selecting a detox facility, it can be helpful to have some understanding of how many patients go on to successfully complete addiction treatment, for example.
- Does the detox program provide round-the-clock medical supervision? Most residential detox providers will provide 24-hour medical supervision. Outpatient programs, by design, offer less medical care. Make sure the level of medical care matches the needs of the individuals, their addiction history, and their recovery goals.
Whichever detox program a person chooses, they should feel respected and validated by that facility and its staff. While the detox process can be uncomfortable, a team of doctors, nurses, and other health care professionals should guide patients through a safe and supervised process that is respectful and non-judgmental.
After Alcohol Detox: Ongoing Recovery
After the initial detox period, there is a range of behavioral treatments and even medications that can assist someone in maintaining their sobriety.
Behavioral treatments for alcohol abuse
Behavioral treatments typically involve working with a trained counselor who can help guide a client through changing harmful or negative behaviors. The therapist can also assist the individual in gaining a better understanding of any underlying issues that may be contributing to their drinking problem. The goal of this type of therapy is to help the individual develop the skills they need to stop their drinking and maintain their sobriety. Behavioral treatments show someone how to set reachable goals and how to cope with triggers that may lead them to relapse. It also can guide them towards creating a strong support system. Types of behavioral treatments include Cognitive-Behavioral Therapy (CBT), neurofeedback, and Eye Movement Desensitization and Reprocessing (EDMR).
- Cognitive-Behavioral Therapy (CBT) aims to change a person’s thought processes, including those that may have influenced their excessive drinking in the first place. This therapeutic approach also promotes skills to help identify feelings that have led to heavy drinking as well as ways to cope with those same stressful situations without alcohol. CBT can be done one-on-one with a therapist or in a group setting.
- Therapeutic techniques like neurofeedback and EMDR use technology to help individuals better manage stressful or anxiety-provoking triggers that can prompt a return to drinking. For example, if individuals are struggling with traumatic memories and using alcohol to self-medicate, they can use these therapies to better identify and cope with these intrusive experiences.
Additionally, a person in active recovery may want to pursue family counseling to help incorporate their loved ones in their recovery journey. Not only can this play a powerful and positive role in the individual’s treatment process, but it also can help to repair any relationships that were damaged as a result of the person’s excessive drinking. Many reputable treatment programs include family therapy programs that involve family members and loved ones in the therapeutic process. Most research indicates that some combination of behavioral therapy, peer support, and detoxification is most effective for long-term recovery. For some individuals, medication may also be able to assist with recovery. It’s important to note, however, that medication is not an instant solution to addiction and should be used in combination with behavioral therapy.
Medications for alcohol abuse
NIAAA currently recognizes three medications that are available to help people stop or prevent their drinking, as well as prevent possible drinking relapses. These prescriptions work to counterbalance the damage alcohol may have done to a person’s brain. Individuals should always use these medications in conjunction with other treatments, such as support groups, therapy, or both to further strengthen someone’s sobriety. These medications require authorization and a prescription from a healthcare provider. The three medications currently approved by the U.S. Food and Drug Administration (FDA) are:
- Naltrexone — helps reduce heavy drinking
- Acamprosate — works to maintain abstinence
- Disulfiram — stops the metabolism of alcohol in the body, causing nausea and other unpleasant symptoms, which assists some to avoid drinking
Peer support groups
Finally, there are peer-directed groups that can offer support and encouragement for someone trying to stay sober. The most famous is Alcoholics Anonymous. These 12-step group programs can be especially helpful in terms of establishing accountability for an individual’s sobriety. They also provide coping skills and advice on topics including managing triggers and repairing relationships. And, because of their focus on anonymity, individuals can rest assured that their participation will remain confidential. Family and friends of a person dealing with alcohol issues can help in the process of recovery by also participating in a peer support group. Care and compassion from loved ones can play a crucial component in an individual’s ability to achieve and maintain sobriety. If a family member is unsure of how to best support their loved one, contacting a support group for family and friends, such as Al-Anon Family Groups
or Adult Children of Alcoholics
, can be a good resource. Remember that overcoming an alcohol addiction is not an easy or fast process. It will take time, and most likely there will be relapses. Try to have patience with your family member or loved one as they work toward a sober life. Finally, recognize the effort that your loved one is making. Simply letting them know that you recognize the work they are doing can help them and provide the support they need. If you are concerned that you or someone you know is struggling with alcohol abuse, Forward Recovery can help. Our staff has decades of combined experience treating addiction, and those years have given us a grounded perspective and expert knowledge about which available treatment methods are effective. If you are in the Los Angeles area, contact us today at (844) 387-6889