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What Qualifies Someone as an Alcoholic? 

An alcoholic is someone who is physically and mentally dependent on alcohol. They are also known as a person who misuses alcohol.  

Alcoholics exhibit a strong, uncontrollable desire to drink. For them, drinking is a priority and they tend to neglect all their other obligations such as family and work. People with an alcohol use disorder continue to use alcohol despite its many negative effects.

Alcoholism is a drinking problem - and the most serious one, at that. Also known as alcohol use disorder, alcoholism is a chronic, progressive disease that affects the alcoholic and the people around them.

According to the fifth edition of the American Psychiatric Association's (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM-5), alcohol use disorder (AUD) is often characterized by:

  • The inability to control the amount of alcohol intake and the length of time that drinking occurs
  • Having withdrawal symptoms when quitting alcohol drinking
  • Exhibiting extreme changes in daily habits due to the effects of alcohol drinking
  • Continuously failing attempts to control and/or quit drinking
  • Having the need to consume increasingly larger amounts of alcohol to be intoxicated
  • Drinking alcohol despite clear evidence of danger
  • Continued alcohol consumption resulting in neglect of responsibilities at work, home, or school
  • Having relationship problems with family and friends because of alcohol consumption

In the United States, 14.5 million people ages 12 and above had alcohol use disorder in 2019.

~ National Institute on Alcohol Abuse and Alcoholism

What’s the Difference Between Casual Drinking and Alcoholism?

Understanding certain terminologies related to alcohol use will help facilitate a better understanding of the disorder. 

Casual drinking is having a few drinks with friends, having a glass of wine with dinner, or enjoying one glass of champagne. It is a pattern of low-risk drinking where a person consumes alcohol in low doses on an infrequent basis. Also referred to as social drinking, casual drinkers drink alcohol no more than once a week or a few times per month.

A casual drinker:

  • Knows when to stop drinking
  • Doesn’t engage in dangerous behaviors like drunk driving
  • Drinks only a few times each month
  • Doesn’t drink to the point of intoxication

Alcoholism, on the other hand, refers to alcohol use disorder. It starts with dependence. As a person drinks more, the body learns to compensate by adjusting. As dependence develops, it becomes difficult for the person to stop drinking.

A person with alcoholism:

  • Has a psychological or physical compulsion to drink alcohol
  • Regularly thinks about their next drink
  • Tried to cut back or stop drinking but never succeeded 
  • Exhibits alcohol withdrawal symptoms when stopping alcohol consumption

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Is Binge Drinking Considered Excessive Drinking?

There are actually two types of excessive drinking. They are defined as follows:

  1. Binge Drinking: This refers to a person consuming large amounts of alcohol at one time which brings the blood alcohol concentration (BAC) level to 0.08% or more. For women, binge drinking refers to having four or more drinks within 2 hours. For men, it’s having five or more drinks within the same time frame.
  2. Heavy Drinking: For men, having two drinks per day or having more than 14 drinks per week is considered heavy drinking. For women, it’s having more than seven drinks per week. 

Binge drinking is a dangerous activity. It can have serious effects on the heart, kidneys, lungs, and pancreas and can cause high blood pressure.

The Different Stages of Alcoholism

In 1946, a scientist named E. Morton Jellinek published a paper on alcohol addiction and its progressive nature. He proposed a theory that problem drinking develops in stages. Today, the Jellinek Curve illustrates the four main stages of alcoholism. These include:

  • Pre-Alcoholic Stage
  • Early Stage Alcoholism
  • Middle Stage Alcoholism
  • End-Stage Alcoholism

Jellinek has contributed to how medical professionals understand alcoholism to this day. Below are the four stages of alcoholism, discussed in detail.

Pre-Alcoholic Stage

This stage is characterized by the following:

  • There is very little evidence of problem drinking
  • The alcoholic’s behavior is typical to a casual observer
  • At the beginning, drinking is confined to social drinking but progresses to stress-reduction
  • The person relies on alcohol as a coping mechanism
  • The person begins to develop alcohol tolerance
  • The person drinks to feel better, to reduce anxiety, to avoid worrying, or to dull physical pain

Early Stage Alcoholism

This stage is easier to notice and is characterized by the following:

  • The person experiences growing discomfort with alcohol but is unable to resist drinking
  • The person starts to lie about drinking to family and friends and may hide drinks
  • Tolerance continues to grow
  • The person obsessively thinks about alcohol
  • The person starts to drink heavily, exhibiting regular binge drinking and blackout episodes 

Middle Stage Alcoholism

This stage is more evident to family and friends and is characterized by the following:

  • The person downplays the amount of alcohol that they drink while finding ways to explain the behavior away
  • Alcoholism starts to affect school or work
  • The person regularly craves more alcohol
  • Hangover episodes are more frequent
  • The person engages in dangerous and reckless behavior such as drinking at work, drinking while looking after children, and drunk driving
  • The person becomes more irritable and starts to act differently
  • The person often passes out due to alcohol
  • Tolerance continues
  • This is the best stage to begin treatment

End-Stage Alcoholism

Also called Late Stage Alcoholism, this stage is the most serious. This is characterized by the following:

  • The long-term effects of alcohol misuse are starting to become obvious
  • The person have tried to stop or cut down on alcohol consumption several times but have failed
  • The person’s priorities changes and drinking takes precedence over everything else
  • Paranoia is often seen in this stage
  • Alcoholism severely impacts finances, employment, relationships, health, and overall quality of life
  • The person needs treatment ASAP

9 Warning Signs of an Alcoholic

The warning signs of an alcoholic are:

1. Denial

People who misuse alcohol lie about or hide their drinking in an attempt to downplay the issue. They refuse to admit that they have a problem.

2. Drinking to find “relief”

People with substance use disorders do so for emotional reasons. People who misuse alcohol, in the same vein, drink to find relief from anxiety, depression, stress, or sadness. They use alcohol as an emotional crutch.

3. Experiencing regular blackouts

Sometimes, alcoholics consume too much alcohol that they black out. This means that they have no memory of the things that happened while they were drunk. 

4. Inability to stop drinking

People who misuse alcohol have repeatedly tried to stop drinking but have also repeatedly failed. They are no longer in control of their drinking.

5. Drinking despite the presence of danger

Drunk driving, drinking before or while at work, or drinking against doctor’s orders are clear indications of alcoholism. These kinds of reckless behaviors indicate that alcohol has taken top priority and almost always has serious consequences. 

6. Neglect of responsibilities

Alcoholism negatively impacts day-to-day life. A person who misuses alcohol often experiences problems at home, in school, or at work because their drinking problem has caused them to neglect their responsibilities and obligations.

7. Having relationship troubles

A person who misuses alcohol exhibits strained relationships with friends, significant others, and other members of their family. When the most important people in a person’s life have been relegated to the sidelines in favor of alcohol, it is a clear sign of alcoholism.

8. Showing tolerance

Alcohol tolerance is the ability to drink more than one used to in order to get drunk. This means that the body has adapted to constant alcohol exposure.

9. Experiencing withdrawal

When a person who misuses alcohol hasn’t had a drink, their body craves alcohol. They begin to show withdrawal symptoms such as being irritable and tired, feeling nauseous, depressed, and anxious.

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What are Withdrawal Symptoms? (+ When Do They Occur)

Withdrawal symptoms appear when the body’s need for alcohol isn’t met. This usually happens when an alcoholic decides to suddenly stop drinking or has not consumed alcohol for a long period of time.

Alcohol withdrawal symptoms can appear as soon as eight hours after a person’s last drink. A person severely dependent on alcohol will usually experience severe withdrawal symptoms.

Common withdrawal symptoms include:

  • Anxiety
  • Convulsions
  • Enlarged pupils
  • Hallucinations
  • Headache
  • Increased heart rate
  • Insomnia
  • Irritability
  • Nausea
  • Shakiness
  • Sweating
  • Tremors in hands
  • Upset stomach
  • Vomiting

When Should You Seek Treatment for a Drinking Problem?

Drinking has become a socially acceptable behavior in society that sometimes, it can be difficult to determine if a person is suffering from alcohol use disorder. 

As soon as the warning signs of alcoholism have become apparent, it is best to seek treatment right away and not wait for the disease to progress further. When alcoholism starts to affect day-to-day life, an intervention is needed. 

Best Treatment Options for Alcohol Use Disorder (AUD) 

There are various treatment options for alcoholism. There is no one-size-fits-all solution for alcohol use disorder (AUD). A certain addiction treatment program may work for someone but may not necessarily work for another person. 

Here are some treatment options available for AUD:

  • 12-step programs
  • 28-day inpatient rehab
  • Behavioral Therapy (BT)
  • Mutual-Support Groups such as Alcoholics Anonymous (AA)
  • Medications

Is Alcoholism Reversible?

Here’s a piece of good news: alcoholism can be treated, no matter how severe the problem may be. With the variety of substance abuse treatment options available, there is always something for everyone. 

Research studies have shown that a third of people being treated for alcohol use disorders exhibited no symptoms after a year of treatment. Many others reportedly reduced their alcohol consumption and had fewer problems related to alcohol.

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Resources

MORE
LESS

"Alcohol Facts and Statistics." National Institute on Alcohol Abuse and Alcoholism.

"Alcohol and Public Health Frequently Asked Questions." Centers for Disease Control and Prevention.

"College Students and the Dangers of Binge Drinking." University of Rochester Medical Center.

"Treatment of Alcohol Problems: Finding and Getting Help." National Institute on Alcohol Abuse and Alcoholism.

"Alcohol Addiction." Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition), National Institute on Drug Abuse.

Newman, Tim. "What is Alcohol Abuse Disorder, and What is the Treatment?." Medical News Today, 29 May 2018.

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