Understanding Alcohol Addiction
What Is Alcohol Addiction?
Alcohol addiction (also known as alcohol use disorder or AUD) is considered a long-term brain disorder characterized by the inability to stop or control alcohol use despite consequences.
AUD is associated with risks such as high blood pressure, heart disease, dementia, fetal alcohol spectrum disorders, or birth defects.
What Are Alcohol Cravings?
Alcohol cravings are when an individual experiences a strong urge to drink alcohol, which can be caused by physical, environmental, and neurological factors.
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), cravings are recognized by a loss of control, the anticipation of drinking, and a high relapse risk.
How Does Alcohol Dependence Develop?
Alcohol dependence develops according to a three-stage addiction cycle that includes binging, negative effects, and anticipation stages.
The binge stage is also known as intoxication, when alcohol triggers a dopamine release in the brain to produce short-term euphoria. Negative effects or withdrawal occur as the chemicals leave the brain, which can cause anxiety, irritability, or physical sickness (withdrawal).
The preoccupation or anticipation stage is known for a loss of control, when those with alcohol addiction typically start drinking again.
How Does Alcohol Addiction Differ From Alcohol Misuse?
Alcohol addiction differs from alcohol misuse due to different behaviors, the element of physical dependence, and the way the brain changes.
Misusing alcohol may involve heavy or binge drinking at times, but is not a chronic inability to stop or cut back. The individual still retains some ability to decrease their alcohol use or stop drinking, and isn’t physically dependent or experiencing withdrawal symptoms when not drinking.
Signs of Alcohol Addiction
How Do You Know If Someone Has a Drinking Problem?
The key signs that someone has a drinking problem include the following:
- Loss of control or the inability to cut down on alcohol use
- Increased tolerance or requiring more alcohol to achieve the same effect
- Neglecting work, school, family, or social responsibilities
- Continued use despite risks or danger
- Withdrawal symptoms, including tremors, sweating, nausea, hallucinations, sleep issues, anxiety, or seizures
What Are the Warning Signs of Alcohol Addiction?
The most glaring warning sign is being unable to control your drinking despite consequences.
A loss of control may include being continually unsuccessful when trying to stop drinking. You may give the majority of your time to getting, locating, or hiding alcohol, drinking, or recovering from drinking. Other signs include being secretive or isolating yourself due to alcohol use.
What Are 3 Primary Signs of Alcohol Addiction?
The three primary signs of alcohol addiction include intense cravings, a loss of control, and a physical dependence or withdrawal.
Is Binge Drinking a Sign of Alcohol Addiction?
No, binge drinking is not always a sign of alcohol addiction.
According to the Centers for Disease Control and Prevention (CDC), roughly 90% of excessive binge drinkers do not have alcohol use disorder (AUD).
The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines binge drinking as having blood alcohol levels (called blood alcohol concentration or BAC) of 0.08% or higher. This occurs when a man has five or more drinks, or a woman has four or more drinks, within two hours.
Causes of Alcohol Addiction
What Causes Alcohol Use Disorder?
Genetics, brain chemistry, and environmental factors all contribute to the development of alcohol use disorder.
For example, approximately 40% to 60% of those with AUD have a family history of alcoholism. In addition, the effect that alcohol has on brain chemistry by stimulating the release of dopamine may affect tolerance to alcohol, withdrawal symptoms, and cravings. Being raised in a heavy drinking environment also brings an increased risk of alcoholism.
How Do Genetics Affect the Risk of Alcohol Use Disorder?
Genetics account for about 45% to 65% of the risk of alcohol use disorder.
Alcohol metabolism genes include ADH and ALDH, and variants in ADH1B and ALDH2 change how the body breaks down alcohol.
Do Mental Health Conditions Affect the Risk of Alcohol Addiction?
Yes, mental health conditions, including depression, anxiety, and post-traumatic stress disorder (PTSD), can also influence the rate of alcoholism.
Antisocial or borderline personality disorders, attention-deficit/hyperactivity disorder (ADHD), bipolar disorder, or schizophrenia can also influence the risk of alcohol addiction.
How Do Trauma and Stress Contribute to Alcohol Addiction?
Trauma and chronic stress alter brain chemistry, deregulating the way you react to stress, increasing the desire to self-medicate with alcohol.
Those with serious trauma or post-traumatic stress disorder (PTSD) may be overtaken by emotions, stress, or numbness, and use alcohol to cope.
Risks & Dangers Associated With Alcohol Addiction
What Does Alcohol Do to Your Body?
Alcohol affects most, if not all, major organs and body systems, including the liver, heart, digestive system, and immune system.
How Does Alcohol Addiction Affect Mental Health?
Alcohol addiction affects mental health by changing brain chemistry and harming emotional regulation.
With alcohol use comes an increased feeling of calm while slowing down brain activity, which leads to rebound anxiety and agitation when withdrawing from alcohol. It also changes how dopamine is processed, which makes it difficult to feel pleasure when not drinking.
Alcoholism also leads to issues around memory formation that often end up in blackouts. This is due to alcohol’s damaging effect on the prefrontal cortex (PFC), the part of the brain responsible for judgment, reasoning, and planning.
How Can Alcohol Addiction Affect Relationships?
Alcohol addiction can place significant strain on relationships with family members, friends, and romantic partners.
Changes in behavior, communication difficulties, broken trust, and emotional withdrawal can lead to conflict, resentment, and isolation. Loved ones may also experience stress, anxiety, or frustration as they navigate the effects of a loved one’s alcohol use.
What Are the Health Risks of Long-Term Alcohol Use?
Alcohol is associated with the following health risks:
- Damage to balance and memory in the brain
- Alcohol poisoning
- Fatty liver, alcoholic hepatitis, fibrosis, and cirrhosis
- Increased blood pressure, irregular heartbeat, heart failure, and stroke risks
- Higher risk of cancer (including breast cancer)
- Weakening of the body’s digestive and immune systems
What Are the First Signs of Alcoholic Liver Damage?
The first signs and symptoms of alcoholic liver disease include:
- Persistent fatigue or low energy
- Weakness or muscle loss
- Loss of appetite or inability to eat enough
- Nausea or mild vomiting
- Sudden weight loss
- Discomfort, pain, or fullness in the upper right side of the abdomen (where the liver is)
Can Alcohol Cause Cirrhosis?
Yes, chronic alcoholism causes cirrhosis, which is the irreversible scarring of the liver.
Your liver breaks down alcohol with enzymes. When fat builds up in liver cells, toxins build up and can lead to cirrhosis or long-term inflammation.
Can Alcohol Abuse Cause Depression or Anxiety?
Yes, alcohol use disorder is connected to conditions such as depression and anxiety.
Alcohol addiction can affect brain signals that cause you to feel calm or stimulated. Your mood and anxiety level become less manageable over time. Periods of withdrawal often cause depressive or anxiety-filled symptoms, in addition to irritability, anhedonia (the inability to feel pleasure), and, in extreme cases, brain damage.
Finding Treatment for Alcohol Addiction
How Can Someone Overcome Alcohol Addiction?
Overcoming alcohol addiction involves seeking professional help and medical supervision during detox to manage withdrawal symptoms.
Align Recovery Centers offers medically assisted detox and treatment programs for alcohol use disorder with 24/7 nursing and medical oversight.
Do I Need Detox for AUD?
The need for detox depends on how severe your history of alcohol misuse is, your physical dependence level, and the risk of your withdrawal symptoms.
Detox is ideal for long-term drinkers who have a physical alcohol dependence or those experiencing withdrawal symptoms, such as tremors, anxiety, rapid heart rate, sweating, or nausea. Those with health conditions also have a higher need for medical detox.
What Happens During Alcohol Detox?
Alcohol detox involves medical supervision to safely stabilize withdrawal symptoms.
During Align Recovery Centers’ seven-day medical detox, clients receive an individualized treatment program to address their unique needs. We provide psychiatric support, 24/7 clinical monitoring, and medication management, as needed.
Throughout detox and treatment, clients have access to evidence-based therapies to address addiction and co-occurring mental health conditions.
What Medications Are Used to Treat Alcohol Withdrawal and AUD?
Benzodiazepines are the most common medication used to treat withdrawal symptoms.
At Align Recovery Centers, common medications used include the following (depending on the substance):
- Suboxone
- Naltrexone
- Disulfiram
- Acamprosate
- Benzodiazepines (including lorazepam/Ativan)
- Gabapentin
- Methocarbamol (muscle pain)
- Hydroxyzine (anxiety)
- Clonidine (blood pressure)
- Ondansetron/Zofran (nausea)
What Evidence-Based Therapies Are Used in Alcohol Treatment?
Evidence-based therapies utilized during treatment for AUD include cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), and Conscious Recovery.
CBT focuses on the connection between thoughts, feelings, and behaviors. DBT combines elements of CBT with mindfulness, acceptance, and dialectics to address emotional dysregulation, self-destructive behaviors, and distorted thinking patterns. Conscious Recovery focuses on the underlying factors that drive alcohol addiction.
Can Treatment Address Co-Occurring Mental Health Conditions?
Yes, dual diagnosis treatment addresses co-occurring mental health conditions, including anxiety, depression, chronic stress, or PTSD.
Treating both addiction and underlying mental health issues helps long-term recovery outcomes and can reduce the risk of relapse.
Helping Loved Ones With Alcohol Addiction
How Can I Help a Loved One Struggling With Alcohol Addiction?
You can help a loved one with alcohol addiction by having a heartfelt conversation when they’re sober, calm, and feeling safe.
Suggest that they get professional help, and assist them in finding appropriate treatment options.
How Do You Talk to Someone About Drinking Too Much?
Have a conversation with someone you love about drinking too much when they aren’t drinking and feel safe, while using “I” statements and avoiding labels.
Saying something such as “I feel worried about your well-being” is much better than saying “Your drinking hurts everyone around you.” Avoid words like “alcoholic” or other triggers that may cause them to feel defensive. Let them know that AUD is a treatable medical condition and offer to help get them professional care.
Facilities such as Align Recovery Centers offer detox and continuing treatment programs to help individuals with AUD get the help they need.
How Can Families Set Healthy Boundaries?
Set healthy boundaries by sticking to your personal limits and letting others know what may happen if they continue to cross boundaries.
Identify which of your family members’ actions cross your boundaries and how it makes you feel when it happens. Continue to use “I” statements and let them know the steps you will take if they cross boundaries. Use the 3 C’s when speaking to them: clear, consistent, and compassionate.
How Should Families Respond During an Alcohol-Related Crisis?
During an alcohol-related crisis, make sure your loved one remains physically safe from harm while practicing empathy instead of hostility.
Speak to them in a calm voice without lecturing, threatening, or cornering them, especially if they have been drinking recently. Avoid screaming, pleading, or arguing, which may only trigger anger or defensiveness.
At Align Recovery Centers, we offer a weekly virtual family dynamics group to help support loved ones, as well as couples and family therapy sessions. Align also holds weekly on‑site family visits on Sundays, with clinicians present to manage conflicts and facilitate conversation.
Long-Term Recovery From AUD
What Happens After Alcohol Treatment?
Post alcohol treatment, cognitive functions begin to recover, as do organ systems, depending on the severity of the alcohol use disorder.
Attention, memory, and executive function improve after treatment, while liver inflammation (including cirrhosis) can also decrease significantly. Sleep cycles also become more balanced.
Post-treatment, clients may also receive referrals for placement in outside sober living, intensive outpatient programs (IOP), partial hospitalization programs (PHP), and outpatient therapy programs. Other aftercare services at Align include an assigned counselor, support groups, a client-facing app, alumni events/reunions, and family follow‑up.
How Does Relapse Prevention Support Long-Term Recovery?
Relapse prevention supports long-term recovery by teaching individuals to recognize triggers, manage cravings, and build healthy coping skills.
Identifying and coping with triggers is an important aspect of CBT. CBT is about identifying and modifying negative thought patterns to help people overcome addiction, prevent the risk of relapse, and maintain long-term recovery.
How Can Someone Manage Triggers During Recovery?
It’s possible to manage triggers during recovery by identifying both internal and external triggers that bring about a desire or craving to drink.
Internal triggers may include mental health issues, such as stress, anger, loneliness, boredom, and fatigue. External triggers may include certain people, places, social events or holidays, times of day, or sensory cues, such as scents or sounds.
FAQs
Do all alcoholics get cirrhosis?
No, not everyone experiencing alcohol use disorder or binge drinking develops cirrhosis.
Approximately 10% to 15% of chronic heavy drinkers develop liver disease.
Can someone have alcohol use disorder without drinking every day?
Yes, someone can have alcohol use disorder (AUD) without drinking every day.
Alcohol use disorder is not defined by the number of days a week a person drinks, but by their chronic inability to control their drinking and the negative consequences that their drinking leads to in their life. For example. binge drinkers may go for periods at a time without drinking and then drink heavily for short bursts, so much that they black out.
Can alcohol addiction be treated successfully?
Yes, like any type of substance use disorder (SUD), alcohol addiction can be successfully treated through medically supervised detox and treatment.
At Align Recovery Centers, we offer a supervised seven-day detox program with 24/7 nursing and medical oversight, in addition to medication-assisted treatment (MAT) as needed.
Our 30-day residential program provides personalized care to suit our clients’ needs, including evidence-based and experiential therapies, plus holistic activities. Clients have access to individual and group therapy, a structured schedule, and ongoing support in a family-style environment.
How long does alcohol recovery take?
Alcohol recovery varies depending on the individual situation and how severe the alcohol consumption is.
Typically, acute withdrawal or detox physically lasts between 3 and 10 days, while the brain begins to recover within a month. Cognitive recovery may take between 6 and 24 months; long-term healing lasts a year and beyond.
At Align, our residential treatment programs usually last around 30 days, including 6 to 7 days for detox. Our clients enjoy aftercare support once their program is complete. We do not treat our clients as numbers, but as part of our family.
If you are experiencing alcohol use disorder, take the first step today. At Align Recovery Centers, we provide personalized, integrated care to address your unique needs. Contact our admissions team for more information about our medical detox and treatment programs. Recovery is possible, and we’re here to help whenever you’re ready.