A Comprehensive Guide to Alcoholism

Alcohol use disorder, or AUD, is another name for alcohol addiction. It occurs when someone does not have complete control over their drinking, which leads them to compulsively consume alcohol and experience negative emotional and physical states when they aren’t drinking. The impact of alcohol addiction in someone’s life can include:

• Damage to relationships, including romantic, friend, and family connections
• Problems at work and damage to a long-term career, including loss of job or professional licenses in severe cases
• Health consequences, including liver damage and increased risk for issues such as cancer and heart disease
• Loss of freedom because of actions related to seeking alcohol or illegal activity engaged in while drunk, including driving while intoxicated or getting into a fight

A common misconception is that alcoholism is a “bad habit” that someone can break with the right amount of willpower. But the National Institute on Alcohol Abuse and Alcoholism points to science that demonstrates this type of alcohol abuse actually changes the way your brain works.

What Causes Alcoholism?

Scientists don’t know exactly what causes some people to develop a dependency on alcohol while others can drink it occasionally without entering an addictive cycle. Research has found links between alcoholism and numerous factors, including genetics, environment, and other mental health disorders. If your parents struggled with alcohol, for example, or you have been diagnosed with depression, you may be at greater risk of AUD.

While researchers can’t answer why some people may fall into a cycle of addiction while others don’t, they are beginning to understand much more about the biology of addiction. Alcoholism is a chronic disorder caused in part by biological changes in your body that foster physical dependence on the substance. This can be combined with psychological factors and changes that make it nearly impossible (if not impossible) for most people to work through recovery from alcohol on their own.

One example of how addiction rewires your brain is that it can turn your natural instincts against you. A healthy brain is wired to reward you for doing things that are good for yourself, such as spending time with loved ones or exercising. It’s also wired to alert you of danger by raising your anxiety and stress levels. When you’re dealing with addiction, the brain may reward you for using drugs or alcohol and cause you to feel as if you’re in danger when you’re not using.

Alcohol Abuse Disorder and Addiction Statistics

The NIH estimates that around 16 million people in the United States struggle with alcoholism. But only around 6.5% adults suffering with AUD get treatment for it, and only 5.2% of youth who have AUD get treatment. According to an NIH report, only around 20% of people who reported experiencing alcohol addiction in their lifetime said they sought treatment for it.

According to the Substance Abuse and Mental Health Services Administration, alcohol accounts for the highest number of substance abuse disorders among adults.

The Monitoring the Future Survey indicates that alcohol is also the substance most youth are likely to experiment with, narrowly beating out marijuana and illicit drugs in most age ranges. The table below shows the percent of youth in different grades who tried alcohol within the past year as of 2018.

The NIAAA’s Rethinking Drinking page offers a self-test checklist you can take if you’re worried you or someone you love might be dealing with alcohol addiction.

It can be important to research how to understand whether someone is dealing with an addiction or just enjoying a glass of wine with dinner from time to time. Someone drinking regularly to excess can be one indication that AUD is at play. But look at the big picture. Do any of the other symptoms sound familiar?

• Not being able to stop or reduce drinking even if you want to
• Lying about or hiding drinking
• Taking risky or illegal measures just to get a drink
• Using alcohol when it’s not safe or appropriate to do so, such as while working, operating machinery, or driving
• Requiring more alcohol to achieve the same results because you’ve developed a tolerance
• Experiencing withdrawal symptoms when you don’t drink
• Drinking to the point that you black out
• Reducing interactions with people or failing to make good on social, work, or other obligations because of drinking
• Having cravings for alcohol

If you or someone you know is dealing with some of these symptoms, consider talking to a professional about treatment options and how you can break the cycle of alcohol addiction.

While there are best practices that are commonly used in treatment programs, addiction is a personal path that requires customized solutions. What works for one person might not work as well for another, which is one reason it’s important to reach out to professionals for help entering rehab. Some common treatment options for alcohol addiction include:

• Inpatient, or residential, recovery. This involves staying at a facility 24 hours a day for a certain amount of time. The benefit is that you’re in a controlled, safe environment, which can help you take time to address the root causes of your addiction and break away from alcohol use.
• Partial hospitalization or intensive outpatient programs (PHP/IOP). These programs provide regular support daily or throughout the week, and you attend anywhere from 10 to 30 or more hours of treatment each week. However, you don’t remain at the facility overnight, which lets you continue moving forward with some life obligations or be with your family.
• Individual therapy. This involves seeing an individual counselor to work through your addiction. You may start individual therapy in inpatient or outpatient programs and continue afterward or begin with this type of treatment as your first course of action.
• Group therapy. In group therapy, you work alongside other people who are dealing with similar issues to explore your addiction and develop healthier coping mechanisms. Again, this is often part of inpatient and outpatient treatment programs, but it can be a part of continued recovery or where you start.

Approaches to alcoholism treatment differ. They can be sorted into two main categories, and you’ll find versions of each approach available in all of the above treatment levels.

• Abstinence programs. These concentrate on being free of all drugs and alcohol and are used by support groups such as A.A and N.A.
• Medically assisted treatment. This involves the use of medications, at least in the beginning of rehab, to curb alcohol cravings and withdrawal symptoms and help keep you from returning to your substance of choice.

• The National Alcohol Treatment Navigator, offered by the NIAAA, provides some great information about types of alcohol treatment.
• The NIAAA offers a comprehensive guide to when and how to seek treatment.
• Alcoholics Anonymous offers online resources about staying sober as well as information on finding an A.A. meeting near you.
• If you’re a family member of someone suffering from alcohol addiction, you can find resources geared toward you at Al-Anon Family Groups.

This guide is for informational purposes online. It’s meant to educate people on alcoholism and is not recommending a specific treatment or providing medical advice. Always consult with your doctor and other medical professionals when facing addiction disorders or any other type of mental or physical health concerns.