Alcohol Addiction & Abuse: Signs, Symptoms, and Treatment
What is Alcohol Addiction?
Alcohol addiction, clinically referred to as an alcohol use disorder (AUD), is a medical condition characterized by an impaired ability to stop or control unhealthy alcohol use despite adverse consequences. Instances of alcohol abuse and misuse are frequently referred to as an alcohol use disorder, alcohol dependence, and alcohol addiction. This condition may cause downstream mental health and physical health issues as well as social issues and daily life problems. Brain changes resulting from long-term alcohol use or misuse perpetuate AUDs. Fortunately, there are many effective evidence-based treatment approaches to help a person recover from alcohol addiction, which may include a combination of rehab treatment, behavioral therapies, and medications to reduce or remove the urge to drink.1
Short-Term Effects of Alcohol Abuse
The short-term effects of alcohol use vary greatly, depending on an individual’s blood alcohol concentration (BAC) and their level of alcohol tolerance, which is when someone must drink increasing amounts of alcohol to achieve previous desired effects.2 Binge drinking, the potentially dangerous pattern of consuming large amounts of alcohol in a short period of time, can elevate an individual’s BAC quickly.1
As an individual’s BAC level increases, the signs of intoxication change. For example, an individual with a BAC of o.o20% to 0.099% may begin to experience some loss of muscle coordination; changes in mood, personality, and behavior; and a decrease in inhibitions.3 An individual with a BAC of 0.20%-0.299% typically appears intoxicated—all mental, sensory, and physical capabilities become impaired. They may be nauseous, vomit, and exhibit a significant lack of coordination, balance, and speech. The exception? Individuals with a markedly high tolerance.3
Thus, as BAC levels rise, so too do the short-term effects of alcohol, which may include:2
- Changes in mood and behavior.
- Reduced coordination.
- Speech impairment.
- Trouble walking.
- Impaired thinking and judgement.
- Reduced levels of alertness and reaction time.
- Nausea and vomiting.
- Decreased body temperature and blood pressure.
- Slowed pulse and breathing.
- Blackouts and amnesia.
- Excessive sleepiness and loss of consciousness.
Alcohol overdose occurs when there is so much alcohol in the bloodstream that areas of the brain that control basic functions—like breathing, heart rate, and body temperature—begin to shut down. Anyone who drinks excessively on any occasion risks alcohol poisoning or overdose. As previously mentioned, alcohol intoxication varies depending on tolerance and other factors, too. However, a BAC of 0.30% to 0.45% puts individuals at risk of suppressing vital life functions, which can lead to unconsciousness, coma, and death.3 BACs between 0.60% and ) 0.80% are commonly fatal.3 Symptoms of alcohol overdose may include:4
- Mental confusion or stupor.
- Difficulty remaining conscious or unable to be awakened.
- Slowed or irregular breathing.
- Slowed heart rate.
- Clammy skin.
- Dulled responses, such as no gag reflex.
- Dangerously low body temperature or bluish skin.
If you suspect that someone may be experiencing an alcohol overdose, call 911 immediately. Do not assume that someone will “sleep it off.” BAC can continue to rise even after an individual stops drinking or is unconscious since alcohol in the stomach and intestine continue to enter the bloodstream and circulate through the body.4 While you wait for emergency services to arrive, remain with the individual. If they are unconscious, roll them on their side.
Signs and Symptoms of Alcohol Use Disorder
A person is diagnosed with an alcohol use disorder by a medical or mental health professional (such as a psychiatrist). The criteria for mild, moderate, and severe AUD are created and published by the American Psychiatric Association’s (APA) Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). A physician may diagnose someone with a mild AUD if they meet 2–3 criteria—or signs and symptoms—for an AUD, 4–5 criteria for a moderate AUD, and 6 or more criteria for a severe AUD occurring within a 12-month period.1
Some of the APA’s diagnostic signs and symptoms of an AUD include:5,6
- Using alcohol more frequently or in higher amounts than intended.
- Being unable to stop drinking or control alcohol intake despite attempts.
- Spending significant amounts of time getting, drinking, and recovering from the effects of alcohol.
- Failing to fulfill obligations at work, home, or school due to recurrent alcohol use.
- Experiencing tolerance.
- Experiencing withdrawal symptoms when trying to stop or cut back on drinking, such as shakiness, restlessness, nausea, sweating, racing heart, seizures, or hallucinations (seeing or sensing things that aren’t there).
Am I Addicted to Alcohol?
Besides the DSM-5, healthcare professionals might utilize other tools to assess your alcohol use and the severity of an AUD.7 That’s why it’s important to talk honestly to your healthcare provider, who can give you a thorough evaluation and diagnosis.
Additionally, there are many tools you can find online to help you examine the nature of your alcohol use and your behaviors surrounding it. In fact, we have one. It’s important to note that our “Has My Alcohol Use Become a Problem?” questionnaire is intended for educational purposes and should not be used to self-diagnose. This evaluation is not a substitute for advice from a medical doctor.
Take our free, 5-minute alcohol use self-assessment below if you think you or someone you love might be struggling with alcohol misuse. This evaluation consists of 11 yes or no questions that are designed to be used as an informational tool to assess the severity and probability of an alcohol use disorder. The test is free, confidential, and no personal information is needed to receive the result.
Effects of Alcohol Addiction on Your Health
Repeated, prolonged alcohol use impacts an individual’s physical and mental health. It is associated with cognitive and mental health issues, including learning and memory problems as well as worsening or causing mental health conditions like depression and anxiety.7
Alcohol also affects more than just the mind. Evidence indicates that long-term alcohol use increases an individual’s risk of developing certain cancers and cardiovascular conditions such as high blood pressure, heart disease, and stroke. It can also damage the liver, lead to pancreatitis, and weaken the immune system.8,9
Additionally, chronic alcohol use can lead to dependence—wherein the body becomes so used to having alcohol present that without it, potentially dangerous withdrawal symptoms surface. It can also result in addiction.8
What are the Causes of Alcohol Addiction?
Some of a person’s risk in developing an AUD depends on how much, how often, and how quickly they consume alcohol. Certain biological, psychological, and social influences are also believed to play a role in the development of AUDs. Some risk factors that may lead to someone developing an AUD can include:1,10
- A family history of alcohol use disorder.
- Parental drinking patterns.
- Exposure to trauma and stress during childhood.
- Drinking alcohol at an early age. Scientists have found that people who began drinking at age 15 or younger were 5 times more likely to develop an AUD than those who started drinking at age 21 or older. In addition, the risk for women among this group is higher than for men.
Certain psychiatric disorders, including major depression, bipolar disorder, anxiety disorders, and antisocial personality disorder are commonly associated with alcohol use disorder, although whether or not these co-occurring disorders are a result of alcohol use disorder or contributed to the development of an alcohol use disorder is unclear and may differ for each individual. Some studies suggest that schizophrenia, depression, and personality disorders are also predisposing factors for AUDs. This means that if a person has one or more of these psychiatric conditions, they may have an increased risk of alcohol use disorder.11
Alcohol Addiction Treatment
Although there is currently no cure for alcohol use disorders, AUDs—much like many other chronic, relapsing diseases—can be successfully managed and treated.1 Professional addiction treatment in a rehabilitation center can help people suffering with AUDs recover from substance misuse issues and remain sober. If you or someone you care about is struggling with an AUD, you will likely benefit from some form of treatment.
If you’re considering professional addiction treatment for problematic alcohol use, you have a variety of options to treat your AUD, ranging from detoxification, to inpatient and outpatient rehabilitation, behavioral therapies, medication, and mutual-help groups.1
Detox is an ideal first step toward recovery from an AUD, but detox alone is rarely sufficient in helping a person achieve long-term abstinence.12 Detoxification is a set of interventions designed to help someone safely and comfortably withdraw from alcohol, which then positions them to transition into a formal, potentially longer treatment program.
Before entering a detoxification center, a physician will need to perform a thorough assessment of a patient’s experience with alcohol misuse, previous withdrawal experiences (if any), and their medical and psychiatric history in order to determine their withdrawal risk. For the sake of this assessment, patients may also undergo blood tests and screening for the presence of any co-occurring mental or physical health issues.
Individuals at risk of severe, life-threatening withdrawal symptoms, including seizures and delirium tremens (DTs), should undergo detox in an inpatient facility, such as a hospital or other acute care facility, according to the Substance Abuse and Mental Health Services Administration (SAMHSA).2
Alcohol Detox Medications
During the detox process, patients may receive medications to help them safely withdraw from alcohol. Some of these medications may include:2
- Benzodiazepines, such as diazepam, chlordiazepoxide, oxazepam, or lorazepam. Administering benzodiazepines early during alcohol withdrawal may help reduce the severity of withdrawal symptoms, preventing a progression to potentially serious and fatal consequences.
- Anticonvulsants like carbamazepine, gabapentin, or topiramate. These medications help reduce drinking behavior and treat mild-to-moderate withdrawal symptoms. Topiramate has not yet received approval from the U.S. Food and Drug Administration (FDA) but has shown promise in treating alcohol addiction.
- Antipsychotics, like haloperidol, which can reduce extreme agitation, hallucinations, delusions, and delirium during alcohol withdrawal.
Once detox is complete, a patient may transition to a suitable substance use treatment program.2 Depending on the severity of a patient’s addiction, their level of social support at home, and other factors, they may undergo inpatient or outpatient treatment for an AUD following detoxification and withdrawal management.
Residential or Inpatient Alcohol Rehab
Inpatient or residential AUD treatment entails patients living and residing in the rehabilitation center 24/7. Inpatient alcohol rehab may vary in duration, sometimes consisting of short stays of 3–6 weeks, which may or may not be followed by attendance at an outpatient rehab. Some people require longer stays of 6–12 months at facilities known as therapeutic communities (TCs), which provide structured programming and offer assistance with reintegration into their community.
Inpatient and residential rehab stays are beneficial because they remove a person from distractions and environments where they may be surrounded by people, places, or events that can trigger a relapse, allowing them to focus solely on their recovery and building the necessary coping skills to live a sober life. Here, patients also receive around-the-clock care and monitoring, which helps address any post-acute withdrawal symptoms and offers necessary support.12
Outpatient Alcohol Rehab
Outpatient treatment types offer different levels of support. In some cases, people transition from inpatient to outpatient treatment. These levels can include:2,13,14
- Partial hospitalization programs (PHP), the most intensive form of outpatient care, is a level of care that entails patients living at home or in a sober living environment while attending treatment for up to 10 hours every day, most days of the week. This is a highly supportive and structured form of outpatient treatment. It can be beneficial for those unable to commit to an inpatient stay, but who still require a highly intensive level of care.
- Intensive outpatient programs (IOP) is a level of outpatient treatment where patients live at home or in a sober living environment but attend treatment 3 hours per day, 5 days per week to start, then decrease intensity. People may step down to IOP from PHP or inpatient rehab.
- Standard outpatient treatment (OP), which can vary in intensity and duration depending on patients’ needs and various other factors. Standard outpatient treatment may translate to attending treatment sessions several times per week or just once a week.
Behavioral Therapies for Alcoholism
Inpatient and outpatient treatment both provide various types of behavioral therapies that are commonly used to treat AUDs. These therapies may involve individual and group therapy sessions, including:15
- Cognitive-behavioral therapy (CBT), which is an evidence-based form of therapy that focuses on helping people identify and change unhelpful, negative thoughts and behaviors that led or contributed to their addiction. In CBT, people learn healthier ways to cope with stress and develop skills they’ll need to prevent relapse.
- Motivational enhancement therapy, which is a short-term therapy designed to help motivate patients to reduce or stop drinking and to encourage them to make positive changes. It helps patients identify the pros and cons of treatment, make a plan to change, increase their confidence, and develop the skills they’ll need to stick to their recovery-related goals.
- Marital and family counseling, which is a form of talk therapy that incorporates a patient’s loved ones into their therapy sessions, if appropriate for a patient. Those who suffer from substance use disorders often directly or indirectly impact their closest relationships, so this form of treatment can help repair and rebuild relationships with patients’ loved ones, while also addressing issues that may have developed as a result of a person’s drinking.
- Brief alcohol interventions, which may include short, individual counseling sessions that provide people with personalized feedback on their progress with specific goals.
AAC is a leading provider of alcohol rehab programs across the nation. We offer a wide range of tailored, customized programs that are designed to address your specific needs. This includes programs to address co-occurring mental health disorders (like anxiety, depression, or bipolar disorder) as well as alcohol addiction. Some of our research-backed and innovative therapies include CBT, motivational interviewing (MI), dialectical behavior therapy (DBT), eye movement desensitization and reprocessing (EMDR), motivational enhancement therapy (MET), and more.
Medications for Alcoholism
Some medications can help patients quit drinking, treat alcohol withdrawal symptoms (as mentioned above), and prevent relapse. Patients may also receive different medications while in the care of an addiction treatment professional to help address symptoms of co-occurring disorders if necessary.
Some of the anti-alcohol misuse medications patients may receive in the care of an inpatient or outpatient treatment provider to help with alcohol cravings or deter drinking may include:2,16
- Naltrexone, which can help reduce the urge to drink and help to curb problem drinking. It blocks the receptors in the brain that make people feel good when they drink, and it may help to reduce cravings.
- Acamprosate (Campral), which is designed to decrease cravings and urges to drink alcohol.
- Disulfiram (Antabuse), which discourages people from drinking. It blocks the metabolism of alcohol in a person’s body so that they experience unpleasant symptoms, like nausea, if they drink.
Alcoholism Aftercare and Long-Term Health
Recovery from alcohol addiction is a lifelong process that does not end when addiction treatment completes. After finishing a rehabilitation program, many people choose to participate in some form of aftercare. Many of the aftercare methods below are extensions of similar or even the same types of therapy a person receives in primary treatment. Aftercare is the word used to describe long-term, ongoing treatment that begins once intensive forms of rehabilitation end and is designed to provide additional support and help prevent relapse.17
Patients may choose to participate in one or many different types of aftercare, such as:17
- A stay at a therapeutic community (TC), where patients can live with others who are in recovery as a way of gaining support as they re-enter sober daily life.
- Individual counseling to help patients develop insight into the issues that can lead to relapse, and learn alternative coping mechanisms so they do not return to drinking.
- Group therapy, which is led by a counselor and includes others in recovery.
- Mutual-help groups, such as 12-step groups like Alcoholics Anonymous (AA) or non-12 step groups like SMART Recovery.
- Complementary or alternative treatments, such as art therapy or music therapy, which are typically beneficial for people who are also participating in another form of aftercare.
- Couples or family counseling can help address underlying issues and continue to work on the relationship.
Frequently Asked Questions About Alcohol Addiction Treatment