Alcoholism
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What is Alcoholism ?
Alcohol use disorder (which includes a level that’s sometimes called alcoholism) is a pattern of alcohol use that involves problems controlling your drinking, being preoccupied with alcohol, continuing to use alcohol even when it causes problems, having to drink more to get the same effect, or having withdrawal symptoms when you rapidly decrease or stop drinking.
Unhealthy alcohol use includes any alcohol use that puts your health or safety at risk or causes other alcohol-related problems. It also includes binge drinking — a pattern of drinking where a male consumes five or more drinks within two hours or a female downs at least four drinks within two hours. Binge drinking causes significant health and safety risks.
If your pattern of drinking results in repeated significant distress and problems functioning in your daily life, you likely have alcohol use disorder. It can range from mild to severe. However, even a mild disorder can escalate and lead to serious problems, so early treatment is important.
Causes
Alcohol triggers your brain to release the reward-system chemical dopamine. This leads your brain to link positive feelings with drinking and motivates you to crave more. It also affects serotonin, which plays a role in things like mood and sleep, says a 2020 study in the Journal of Neuroscience.
As you drink more and addiction takes hold, you will experience less pleasure (develop tolerance), and you may have withdrawal symptoms when you try to stop drinking. Heavy drinkers will begin to drink even more in an attempt to keep withdrawal at bay.
Genetic, psychological, social and environmental factors can impact how drinking alcohol affects your body and behavior. Theories suggest that for certain people drinking has a different and stronger impact that can lead to alcohol use disorder.
Over time, drinking too much alcohol may change the normal function of the areas of your brain associated with the experience of pleasure, judgment and the ability to exercise control over your behavior. This may result in craving alcohol to try to restore good feelings or reduce negative ones.
Who Is at Higher Risk for Alcoholism?
These risk factors can make you more likely become addicted to alcohol:

Genetics and family history. If you have a parent or a close relative with alcohol addiction, your risk goes up. Research shows that genes are responsible for about half of the risk for AUD, according to the National Institute on Alcohol Abuse and Alcoholism (NIAAA).
Underage drinking. If you start drinking before you’re 15 years old, you may be four times likelier to develop alcohol dependance later in life, the NIAAA says.
Frequent drinking. The Mayo Clinic says drinking alcohol too often or binge drinking can lead to addiction.
Mental health conditions. According to a 2019 review in Lancet Psychiatry, illnesses like depression or bipolar disorder can predispose you to alcohol addiction, especially if you use alcohol to self-medicate.
Trauma history. Traumatic experiences in the past, including childhood abuse, are strongly linked to developing alcoholism later in life, the NIAAA says.
Male gender. Men are more likely than women to become addicted to alcohol. The 2018 National Survey on Drug Use and Health found 9.2 million men and 5.3 million women in the U.S. had an alcohol use disorder.
Social factors. Social and family customs, culture, poor parental support, and peer pressure can play roles in alcohol addiction, the Mayo Clinic says.
Symptoms of Alcoholism
Alcohol use disorder can be mild, moderate or severe, based on the number of symptoms you experience. Signs and symptoms may include:
- Being unable to limit the amount of alcohol you drink
- Wanting to cut down on how much you drink or making unsuccessful attempts to do so
- Spending a lot of time drinking, getting alcohol or recovering from alcohol use
- Feeling a strong craving or urge to drink alcohol
- Failing to fulfill major obligations at work, school or home due to repeated alcohol use
- Continuing to drink alcohol even though you know it’s causing physical, social or interpersonal problems
- Giving up or reducing social and work activities and hobbies
- Using alcohol in situations where it’s not safe, such as when driving or swimming
- Developing a tolerance to alcohol so you need more to feel its effect or you have a reduced effect from the same amount
- Experiencing withdrawal symptoms — such as nausea, sweating and shaking — when you don’t drink, or drinking to avoid these symptoms

Alcohol use disorder can include periods of alcohol intoxication and symptoms of withdrawal.
Alcohol intoxication
Alcohol intoxication results as the amount of alcohol in your bloodstream increases. The higher the blood alcohol concentration is, the more impaired you become. Alcohol intoxication causes behavior problems and mental changes. These may include inappropriate behavior, unstable moods, impaired judgment, slurred speech, impaired attention or memory, and poor coordination. You can also have periods called "blackouts," where you don't remember events. Very high blood alcohol levels can lead to coma or even death.
Alcohol withdrawal
Alcohol withdrawal can occur when alcohol use has been heavy and prolonged and is then stopped or greatly reduced. It can occur within several hours to four or five days later. Signs and symptoms include sweating, rapid heartbeat, hand tremors, problems sleeping, nausea and vomiting, hallucinations, restlessness and agitation, anxiety, and occasionally seizures. Symptoms can be severe enough to impair your ability to function at work or in social situations.
Getting Help
If you feel that you sometimes drink too much alcohol, or your drinking is causing problems, or your family is concerned about your drinking, talk with your doctor. Other ways to get help include talking with a mental health professional or seeking help from a support group such as Alcoholics Anonymous or a similar type of self-help group.
Because denial is common, you may not feel like you have a problem with drinking. You might not recognize how much you drink or how many problems in your life are related to alcohol use. Listen to relatives, friends or co-workers when they ask you to examine your drinking habits or to seek help. Consider talking with someone who has had a problem drinking, but has stopped.
Treatments
about one third of those treated for alcohol problems have no further symptoms one year later. Many others substantially reduce their alcohol consumption and report fewer alcohol-related issues.
The first step is to speak to your health care provider, who can help decide which treatment is best for you.
- Behavioral treatments
Behavioral treatments, also known as alcohol counseling, for alcohol use disorder aim to identify and change the behaviors that lead to heavy drinking including:
- Cognitive behavioral therapy (CBT)
Cognitive behavioral therapy will help you recognize the feelings and situations (also called ‘cues’ or ‘triggers’) that make you drink heavily, and manage the stress that can trigger relapse. It changes the thought processes that lead to drinking and to develop the skills to cope with triggers. CBT for alcohol use disorder can take place in a group or one-to-one with a therapist.
- Motivational enhancement therapy (MET)
Motivational enhancement therapy is conducted over a short period of time to build and strengthen motivation to change drinking behavior. The therapy focuses on identifying the pros and cons of seeking treatment, forming a plan for making changes in your drinking, building confidence, and developing the skills needed to stick to the plan.
- Marital and family counseling
Family support can help you maintain abstinence (stopping drinking). This type of therapy incorporates spouses and other family members in the treatment process.
- Brief interventions
Short counseling sessions that happen one-on-one or in a small group. The counselor provides personalized feedback about your drinking and helps you set goals to change your drinking behaviors.
- Medication
Medication prescribed by a primary care physician or other health professional helps to stop or reduce drinking and prevent relapse. They can be used alone or in combination with counseling.