Alcohol Abuse

Medically reviewed by:
Dr. Joshua M. Gleason, M.D.

Understanding Alcohol Abuse

Alcohol, despite being a legal substance that can be safely enjoyed as a way to socialize or celebrate, can also be a dangerous, addictive substance when misused. Misuse includes any kind of excessive drinking, i.e. binge drinking (consuming four or more drinks in a single event for women, or five or more for men) and heavy drinking (a woman consuming eight or more drinks in a week, or a man consuming fifteen or more drinks in a week).

While some individuals are able to indulge in excessive drinking without terrible consequences, others fall into regular alcohol abuse, addiction, and a wide variety of problems with health, relationships, and practical concerns. Some people are predisposed to alcohol abuse and addiction due to genetic or environmental factors, or because they suffer from conditions such as anxiety or depression that make them more vulnerable to substance abuse in general.

Signs and Symptoms of Alcohol Abuse

It is usually easy to recognize when someone has been abusing alcohol. Signs and symptoms can include:

• Uninhibited behavior
• Slurred words
• Coordination problems
• Nystagmus- involuntary eye movements that cause blurred vision and interfere with depth perception
• Confusion
• Memory impairment
• Mood swings
• Unsteady gait
• Stupor
• Coma

Even one instance of overindulgence can lead to dangerous and even life-threatening consequences. But those who participate in this behavior consistently and have trouble stopping are suffering from an alcohol use disorder. The signs and symptoms of this disorder include:

• Wanting to cut back on drinking and not being able to
• Drinking more than you planned to
• Spending lots of time and effort on drinking and recovering from it
• Losing interest in the activities that once mattered to you
• Drinking even when alone
• Not being able to enjoy oneself unless alcohol is available
• Continuing to drink even when it causes multiple problems in your life

These behaviors paint the picture of someone who does not have control over their drinking, which is one of the strongest signs of an alcohol use disorder.

An individual with an alcohol problem will also suffer from withdrawal if they attempt to quit drinking. Symptoms of alcohol withdrawal include:

• Anxiety
• Agitation
• Loss of appetite
• Restlessness
• Insomnia
• Nausea and vomiting
• Tremor
• Sweating
• Palpitations
• Headache
• Alcohol craving

In moderate to severe cases of alcohol withdrawal, hallucinations, seizures, or delirium may occur.

Alcohol hallucinations may begin within 12 to 24 hours after the last drink and resolve in another 24 to 48 hours. Hallucinations are usually visual and commonly involve seeing insects or animals in the room; auditory and tactile hallucinations may also occur.

Alcohol withdrawal seizures occur within 6 to 48 hours after drinking either stops or is reduced, and occur in 10 to 30% of patients in withdrawal.

Delirium tremens, or the “DTs,” is the rapid-onset of fluctuating attention and cognition, sometimes with hallucinations, in the presence of alcohol withdrawal. In most severe cases, DTs are accompanied by agitation and autonomic hyperactivity (i.e. fever, tachycardia, hypertension, sweats).

Dangers of Alcohol Abuse

Unfortunately, there are multiple issues a heavy drinker can face along with addiction. Excessive alcohol consumption can lead to a number of chronic diseases, and issues with memory and mental health. Conditions attributed to alcohol abuse include:

• High blood pressure, heart disease, and stroke
• Liver disease: fatty liver, hepatitis, fibrosis, and cirrhosis
• Cancer of the mouth and throat, esophagus, colon and rectum, and breast

However, the dangers of alcohol abuse don’t stop here. A person who drinks consistently is also likely to become highly tolerant to the effects of the substance, making them drink more in order to experience the same effects they once did. This not only increases the individual’s risk of developing the conditions listed above, but also puts them at risk of alcohol overdose, also known as alcohol poisoning. In cases of alcohol overdose, the individual will often black out or go into a coma, and their breathing will become very shallow. Approximately 6 Americans die of alcohol poisoning each day.

Signs of an Alcohol Overdose

Alcohol is one of the most frequent co-intoxicants used with other drugs but can be toxic in very high amounts by itself. When combined with other depressant drugs such as benzodiazepines, opioids, and barbiturates, death may occur from an alcohol overdose due to marked slowing or cessation of breathing and heartbeat. Confusion, vomiting, low blood pressure, and low body temperature may all be present as well. Symptoms can vary depending upon other substances involved.

When these symptoms and signs of an alcohol overdose occur, your first move should be to call 911 for emergency medical help. If the person is breathing and hasn’t been injured in associated trauma, roll them onto their side to help keep them from choking on vomit. If able, follow the 911 operator’s instructions for rescue breathing and/or chest compressions if needed.

Alcohol Addiction

When a person becomes addicted to alcohol, they will act similarly to someone addicted to drugs. Namely, their desire to drink will become more important than anything else, and they will be likely to participate in dangerous behaviors in order to obtain alcohol or drink more. Once addiction sets in, a person will no longer be able to control their drinking, and they will require help in order to learn to do so.

Am I Addicted to Alcohol?

If you are unsure if your drinking has risen to the level of addiction, ask yourself the questions below.

• Do I have to drink more than I used to in order to experience the same effects?
• Do my friends and family ever express concerns over my drinking? Do I continue to do so anyway?
• Have I tried to cut back and been unable to?
• Do I make excuses for myself to drink?
• Have I ever experienced uncomfortable or frightening symptoms when I’ve stopped drinking suddenly?
• Have I ever experienced alcohol poisoning?
• Do I have any physical or psychological conditions caused or exacerbated by my drinking?
• Have I encountered legal or financial problems because of my substance abuse?
• Am I in danger of losing my job, scholarship, or experiencing other serious consequences because of how my alcohol abuse is affecting me?
• Have I already experienced severe consequences of my alcohol abuse, and yet continue to drink?
• Do I feel incapable of quitting alcohol on my own?

If you answered yes to any of these questions, there is a strong chance that you are suffering from alcoholism. Once you have lost your control over your drinking, it is time to seek help from a professional treatment program.

Alcohol Abuse Treatment

Anyone with more than a mild alcohol addiction should receive alcohol abuse treatment at an inpatient facility that provides medical care during the detox phase of treatment, in case of severe, potentially fatal withdrawal symptoms. Although some people find success with outpatient alcohol abuse programs that allow them to attend rehab in the evenings and on weekends while they live at home and keep to their regular work or school responsibilities, most people will have their best chance of success by first attending an inpatient program, where they will live in a secure treatment environment.

There are many different methods that an alcohol rehab center can use to treat your addiction, including:

• Medications, such as
  • Acamprosate (Campral)
  • Extended release naltrexone (Vivitrol)
  • Oral naltrexone (ReVia)
  • Disulfiram (Antabuse)
• Forms of counseling, such as
  • Cognitive-behavioral therapy (CBT)
  • Motivational enhancement therapy
  • Group therapy
  • Family therapy
  • Individual therapy
• Peer support groups, such as
  • Alcoholics Anonymous (AA)
  • SMART Recovery
  • Secular Organizations for Sobriety (SOS)

Medications can help to manage alcohol cravings while also minimizing the chance of relapse. Behavioral therapies and counseling teach life skills that will help patients avoid substance abuse in the future, as well as to discover and address the root causes of alcohol abuse. Peer support groups provide a supportive and illuminating recovery community that will continue to aid a person in staying sober long after they have completed a rehab program.

With the help of professional treatment, you can put an end to your alcohol abuse and start your life anew.