Alcohol is the second most widely misused substance in the United States after tobacco. Ten percent of adult men and 5% of adult women struggle with alcoholism—otherwise known as alcohol use disorder (AUD).1 It’s important to know the signs and symptoms of alcohol addiction so you can get treatment for yourself or a loved one.
Signs and Symptoms of Alcohol Addiction
Although many people drink alcohol in moderation to relax or enjoy social activities, alcohol use can progress to a chronic condition known as alcohol use disorder, or an alcohol addiction.
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), uses 11 basic criteria to assess whether a person has an alcohol addiction and how severe it may be. Severity is based on the number of criteria a person meets based on their symptoms—mild (2-3), moderate (4-5), or severe (6 or more).2 These symptoms of alcohol use disorder include:2
- You often take alcohol in larger amounts or over a longer period than was intended.
- You have a persistent desire or unsuccessful efforts to cut down or control alcohol use.
- You spend a great deal of time on activities necessary to obtain alcohol, use alcohol, or recover from its effects.
- You have a craving, or a strong desire or urge, to use alcohol.
- You recurrently use alcohol, resulting in a failure to fulfill major role obligations at work, school, or home.
- You have continued alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol.
- You give up or reduce important social, occupational, or recreational activities because of alcohol use.
- You repeatedly use alcohol in situations in which it is physically hazardous.
- You continue alcohol use despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by alcohol.
- You experience tolerance, which means you need more alcohol to feel intoxicated.
- You experience alcohol withdrawal symptoms when you reduce or stop drinking.
Who is at Risk for Alcohol Addiction?
Certain factors may increase the risk of developing an alcohol use disorder.3The exact cause of alcoholism is unknown. However, some predictors have been linked to the onset of alcoholism. These factors may include:3
- Having more than 15 alcoholic drinks/week if you are assigned male at birth
- Having more than 12 alcoholic drinks/week if you are assigned female at birth
- Having more than 5 alcoholic drinks/day (binge drinking)
- Having a parent with AUD
- Having a mental health condition (e.g. depression, anxiety, panic disorder)
Not everyone who drinks alcohol will become addicted or develop alcohol addiction.3 Additionally, certain factors may influence whether alcohol misuse develops into an addiction or not. Some of these factors may include but are not limited to:4,5,6
- Body composition
- Genetic makeup
- Previous drug use history or concurrent drug use
- Environmental factors
Effects of Alcoholism
Alcohol consumption in excess can have short– and long-term consequences on your health. Depending on how much you drink in one sitting, binge drinking can be lethal and may cause blackouts in which you experience periods of not knowing where you were or what you were doing. Blackouts can lead to hazardous situations and increase your risk of accidents, injuries, or altercations.
Chronic alcohol consumption and alcohol metabolism are strongly linked to several pathological consequences and tissue damage.7 Alcohol Liver Disease (ALD) is the leading cause of liver illness in both North America and Europe.8 Cirrhosis of the liver can occur when people consume too much alcohol, and the liver can no longer process it effectively. If the liver is weak or damaged, it can’t do its job properly, and health problems may arise.
Other long-term effects can include:9
- Cardiomyopathy (stretching of heart muscle)
- Irregular heartbeat
- High blood pressure
- Weakened immune system
- Larynx, pharynx, and oral cavity cancer
- Esophageal cancer
- Liver cancer
- Breast cancer
- Colorectal cancer
- Alcohol poisoning
If you are struggling with an alcohol addiction, call 800-405-1685 (Who Answers?) now.
How to Treat Alcohol Addiction
Several different types of treatment options are available for alcoholism, including:9
- Detox—The first stage of treatment lasting from a few days to 10 days, where the individual goes through alcohol withdrawal under medical supervision to ensure safety and comfort throughout the process.
- Inpatient treatment—The most intensive treatment option, which may last anywhere from 30-90 days, depending on your needs. Inpatient treatment involves residing at the center while receiving a combination of individual therapy, group counseling, and family therapy sessions.
- Outpatient treatment—Outpatient treatment ranges from a couple of hours per week to several hours per day, depending on the level and intensity. But regardless of the frequency, you can live at home while recovering from an alcohol addiction, which allows for more flexibility with your schedule and routine.
Medications for AUD
A few different medications are approved by the Food and Drug Administration (FDA) to treat alcohol use disorder. Here are some of the most common medications used to treat AUD:11,12
- Naltrexone (ReVia) is used only after someone has detoxed from alcohol. This type of drug works by blocking certain receptors in the brain that are associated with the alcoholic “high.” In combination with counseling, this type of drug may help decrease a person’s craving for alcohol.
- Acamprosate is a medication that can help reestablish the brain’s original chemical state before alcohol dependence. This drug should also be combined with therapy.
- Disulfiram (Antabuse) is an older drug that causes physical discomfort (such as nausea, vomiting, and headaches) any time the person consumes alcohol.
Aftercare and Ongoing Support
After your stay at an inpatient or outpatient facility, there is still work to be done. Maintaining your recovery will likely require ongoing care. Many individuals will transition to a second-stage facility with less structure or continue with their group support meetings.
Some common types of ongoing support for alcohol addiction include:
- Step-down treatment: If you completed an inpatient treatment program, then you may want to transition to an outpatient program, which is less intensive and has less structure but still provides you with professional care.
- Sober living homes: Sober living homes are transitional facilities with less structure but are still geared toward supporting a life centered around recovery.
- Group support meetings: Attending support meetings can help you stay sober with the help of peer support and guidance; examples include 12-step meetings, SMART Recovery groups, or online AA meetings that help you stay connected to your recovery community.
If you or a loved one is struggling with alcohol addiction, help is available. Call 800-405-1685 (Who Answers?)
- National Institute on Alcohol Abuse and Alcoholism. (n.d.). Alcohol use disorder.
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
- Yang, P., Tao, R., He, C., Liu, S., Wang, Y., & Zhang, X. (2018). The Risk Factors of the Alcohol Use Disorders-Through Review of Its Comorbidities. Frontiers in neuroscience, 12, 303.
- Brown University. (2015). Alcohol and your body.
- Cedarbaum, A. (2012). Alcohol metabolism. Clinical Liver Disorders, 16(4): 667-685.
- Edenberg, H. (2007). The genetics of alcohol metabolism: Role of alcohol dehydrogenase and aldehyde dehydrogenase variants. Alcohol Research & Health, 30(1): 5-13.
- National Institute on Alcohol Abuse and Alcoholism. (2015). NIAAA steps up search for brain mechanisms of alcohol abuse, alcoholism.
- Gitto, S., Golfieri, L., Caputo, F., Grandi, S., Andreone, P. (2016). Multidisciplinary view of alcohol use disorder: From a psychiatric illness to a major liver disease. Biomolecules, 6(1): 11.
- National Institute on Alcohol Abuse and Alcoholism. (n.d.) Alcohol’s Effects on the Body.
- Center for Substance Abuse Treatment. Detoxification and Substance Abuse Treatment. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2006. (Treatment Improvement Protocol (TIP) Series, No. 45.)
- Lee, J., Kresina, T. F., Campopiano, M., Lubran, R., & Clark, H. W. (2015). Use of pharmacotherapies in the treatment of alcohol use disorders and opioid dependence in primary care. BioMed research international, 2015, 137020.
- Winslow BT, Onysko M, Hebert M. Medications for Alcohol Use Disorder. Am Fam Physician. 2016 Mar 15;93(6):457-65. PMID: 26977830.