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Are you worried that you may have a drinking problem? You are not alone. Whether you are misusing alcohol or exhibiting signs of alcohol use disorder (AUD) in the form of alcohol abuse, dependence, addiction, or alcoholism - having an alcohol problem is actually more common than you think.
Nearly one-third of American adults are considered excessive drinkers, and 10 percent of them are considered alcoholics. This means that an estimated 15 million people cope with alcoholism across the country.
Being around friends or family members with drinking problems, or spending time with people who struggle with addictive substance use, increases your risk of developing an alcohol problem. Similarly, if you or your family have a history of mental health disorders, it’s likely that you will have alcoholism.1
There are many factors leading to alcohol use disorders.2 Although generally, it starts with a drinking problem. Unless a person stops misusing alcohol, it will eventually lead to dependence and alcohol addiction. It’s important to understand the difference between problem drinking, like binge drinking and heavy drinking, versus suffering from alcoholism.
The sooner you can recognize your drinking problem, the earlier you can take steps to quit alcohol. This gives you better chances for a successful recovery, before it leads to alcohol dependence and addiction.
What is the Difference Between a Drinking Problem & Alcoholism?
Alcoholics have drinking problems, but not everyone with a drinking problem has alcoholism. Here is the difference between the two:
Drinking problems refer to unhealthy drinking patterns. Think of them as bad habits which you picked up due to various influences.
If you regularly consume excessive amounts of alcohol, or if you find yourself drinking more frequently than usual, it’s likely that you have an alcohol problem. Some concrete examples of problematic drinking include heavy drinking and binging on alcohol.
- Binge drinking is clinically defined as a pattern of drinking that raises your blood alcohol concentration (BAC) to 0.08 g/dL. This can happen if you consume excessive amounts of alcohol in a single occasion.
- Heavy drinking or heavy alcohol use is the frequent consumption of large amounts of alcohol. Men who have more than 4 drinks per day or 14 drinks per week, and women who have more than 3 drinks per day or 7 drinks per week, are considered heavy drinkers.
Generally, it takes women and men about four to five drinks to reach a 0.08 g/dL BAC level. However, what you eat, how much you weigh, any medications you take, your overall health, your hydration level, and other factors can all impact the effects of alcohol. For example, if you haven’t eaten much on a day that you drink alcohol, your BAC level may rise quicker than if you had eaten more.
According to the 2019 survey by the Substance Abuse and Mental Health Services Administration (SAMHSA), 25.8% of Americans aged 18 and above said they engaged in binge drinking. As much as 6.3% engaged in heavy drinking in the past month.3
While binge drinking is certainly not safe, drinking heavily once in a while doesn’t mean you have an alcohol problem. It only becomes a problem if you make a habit out of it, such as drinking several times a week. Consequently, you can consume moderate amounts of alcohol and still be a “problem drinker” if you drink frequently enough.
A drinking problem can be easily be overcome on your own or with the support of family and friends. It doesn’t require treatment, unlike alcoholism.
Alcoholism or alcohol use disorder is an actual medical condition that affects your brain. It develops gradually as a consequence of unhealthy drinking.
People with alcoholism have a physical and psychological dependence on alcohol. The resulting alcohol addiction causes an alcoholic to experience withdrawal symptoms when they’re not drinking.
Alcohol withdrawal is characterized by intense cravings and other unpleasant symptoms. Sometimes, it can even be dangerous. These can make it difficult to quit, even if they’re ready and wanting to stop drinking. People who struggle with alcohol use disorders will also continue to drink despite negative consequences, like:
- Chronic health problems
- Relationship problems
- Occupational issues
- Legal complications
While the support of family and friends is shown to be helpful, alcoholism isn’t something you can overcome alone.4 It requires addiction treatment and additional therapies. An alcoholic can also benefit from support groups like Alcoholics Anonymous.
To summarize, alcohol abusers will find it easier to break their unhealthy drinking habits, whereas alcoholics have to seek treatment for their condition.
Stages of Alcoholism
Alcohol addiction doesn’t just happen overnight. There are stages of alcoholism that turn a problem drinker into a full-blown alcoholic with alcohol dependence.
Stage 1: Pre-Alcoholism
The average person drinks occasionally in social gatherings. But a pre-alcoholic will drink for various reasons, such as:
- Reduce stress
- Feel better
- Ease anxiety
- Forget bad memories
- Dull emotional pain
- Escape reality
As this stage progresses, a person will start to drink more frequently until they develop a tolerance to alcohol. Alcohol tolerance enables a pre-alcoholic to function despite their heavy drinking. Unfortunately, as they start to feel less of the alcohol’s perceived benefits, they also tend to increase their consumption.
Stage 2: Early Alcoholism
During this stage, a person will start to experience alcohol-induced blackouts. A blackout is a temporary loss of consciousness that results from drinking. It’s not the same as being unconscious where a person becomes unresponsive. People who black out may continue to drink and engage socially, but not be able to recall these events the following day.
The early alcoholic will also start to become increasingly obsessed with alcohol. Their drinking will continue to increase, and so will their tolerance. They will try to hide their drinking habits or lie about them. Family or friends usually can’t tell they have a drinking problem.
Stage 3: Middle Alcoholism
A middle alcoholic will start to experience the consequences of their unhealthy drinking. These negative effects are accompanied by outward signs, which family or friends will notice. Some examples include:
- Drinking at inappropriate times (e.g., while driving or caring for kids)
- Being late or missing work or school
- Failure to meet obligations (e.g., unable to pay bills on time)
- Physical changes (e.g., weight gain and bloated stomach)
- Irritability and mood swings (e.g., becoming more argumentative)
- Legal problems (e.g., getting arrested)
Middle alcoholics usually know they have a drinking problem. They might attempt to cut back on their alcohol consumption. But they will also have difficulty controlling their urge to drink.
At this stage, an alcoholic can benefit from joining abstinence-based support groups that will teach them practical ways to control their alcohol cravings. However, seeking medical treatment while in the early stages of alcohol abuse will also drastically improve their chances for recovery.
Stage 4: Late Alcoholism
The late alcoholic will make drinking a priority over everything else. They will also start to suffer from deteriorating health, failing relationships, and declining finances. When someone enters this stage, it is commonly known as “hitting rock bottom”.
Here are signs that you have hit rock bottom:
- Losing a job due to substance abuse
- Being kicked out of your house or homelessness
- Serious financial troubles
- Dropping out of school
- Getting divorced because of alcohol abuse
- Violent outbursts towards loved ones
Even though they are clearly struggling in life, a late alcoholic will continue with their unhealthy drinking patterns. Any attempts to stop drinking typically result in unpleasant and even dangerous withdrawal symptoms. However, it doesn’t mean they don’t want to recover. Studies show that alcoholics who hit “rock bottom” see it as a turning point to start recovery.5
People with late stage alcoholism require professional healthcare services such as addiction treatment. Friends and family members may want to plan an intervention during this time.
Stage 5: Recovery
A recovering alcoholic is anyone that has started taking steps towards sobriety. A few of these steps include alcohol detox, addiction treatment, entering sober living, and joining peer support groups. The goal of recovery is to maintain sobriety and prevent relapse. But this is a lifelong process that alcoholics must actively undertake.
While some may relapse into alcohol use, this shouldn’t be seen as a sign of failure. Alcoholism is a chronic disease, and like many chronic diseases, relapse can’t be completely avoided. In fact, alcohol relapse can occur at every stage of your alcohol treatment. But you can prevent it if you know which signs to look out for.6
Consequences of Excessive Alcohol Consumption
Excessive alcohol consumption can take a toll on your physical, mental, and social well-being. It can also significantly impact your finances.
Physical Effects of Alcohol Abuse and Alcoholism
Excessive alcohol consumption can have physical consequences that include, but aren’t limited to:
- Unhealthy weight gain or loss
- Sleep disturbances
- Liver damage
- Heart complications
- Low blood sugar
- Low libido
- Central nervous system issues
- Weakened immune system
- Some cancers
- Accidents due to impaired judgment
Mental Health Effects of Alcohol Abuse and Alcoholism
Drinking excessively can also lead to mental health problems and related psychological disturbances, such as:
- Memory loss
- Lack of motivation
- Personality changes
- Mood swings
- Compulsive behaviors
Social Effects of Alcohol Abuse and Alcoholism
Unhealthy drinking patterns have social consequences, like:
- Detachment from family and friends
- Skipping school or work
- Dropping once-enjoyable activities
- Getting into legal troubles
Financial Effects of Alcohol Abuse and Alcoholism
You may experience several of these consequences as a result of excessive drinking:
- Loss of home
- Being in debt
- Getting fired
Do You Have a Drinking Problem?
If you have signs of a drinking problem, consider cutting back on your alcohol use. It’s unlikely that you will experience withdrawal symptoms, which should make it easier to quit drinking.
Having the support of family and friends is critical during this stage. But if this isn’t possible, you can always seek help from support groups that are dedicated to abstinence and sobriety.
What to Do If Someone You Know Has a Drinking Problem
If you, a loved one, or someone else you know has a drinking problem, reach out for professional help or call Addiction Group for more information on top rehabilitation and treatment resources.
Treatment Options for Alcohol Abuse & Addiction
- Inpatient Programs — Inpatient treatment is the option for alcohol addiction treatment. These intensive programs are usually 30, 60, or 90 days but can be longer in certain cases. Throughout the duration of your stay at an inpatient rehab facility, you will live on site is a safe, substance-free environment. You will go through medically supervised detoxification first, then behavioral therapy and other services will be added to your regimen. Most programs will will help you set up an aftercare program upon completion.
- Partial Hospitalization Programs (PHPs) — Partial hospitalization programs (also called intensive outpatient programs, or IOPs) are comparable to inpatient programs, but you return home after each session. Some PHPs provide food and transportation, but this varies by program. Their services may include detoxification, medical services, behavioral therapy, support groups, and other holistic or custom treatments. PHPs accept new patients, along with patients who have completed an inpatient treatment program and still require intensive care.
- Outpatient Programs — Outpatient programs are less intensive and offer a more flexible treatment schedule. They are best for people who have responsibilities at work, home, or school and are highly motivated to achieve sobriety. Outpatient treatment programs customize your treatment sessions around your personal schedule. Outpatient programs can help new patients achieve success, and may also be a part of aftercare program once a patient completes an inpatient or PHP.
- Medication-Assisted Therapy (MAT) — Certain patients with Alcohol Use Disorder will qualify for medication-assisted therapy. Medications can help you detoxify, reduce cravings, and normalize bodily functions. Disulfiram (Antabuse), acamprosate (Campral), and naltrexone (Revia and Vivitrol) are the most common medications used to treat Alcohol Use Disorder. MAT is most effective when combined with other treatment therapies.
- Support Groups — Support groups are peer-led groups that help people stay sober. They can be a first step in overcoming alcoholism or a component of an aftercare plan. Many of them follow the 12-step approach, however there are secular options that don't follow the 12-step approach as well.