How Do You Know If You're an Alcoholic?

The occasional glass of wine with dinner or the odd beer with friends tends to be, for most, little more than a chance to unwind or to socialize.

When it gets into abuse territory, or worse — alcoholism, alcohol use disorder (AUD), or dependence stages — that’s when it truly becomes harmful.

In 2018, the National Survey on Drug Use and Health (NSDUH) found:

• 86.3% of adults (18 and older) disclosed that they had consumed alcohol at least once in their lifetime
• 70% had consumed alcohol in the past year
• 55.3% said they’d drank in the last month

Such statistics show that alcohol use is far from rare. When someone’s drinking narrative repeatedly reads as being unable to stop at one or two drinks, it could very well be time to sit this one out and reflect on whether there might be an addiction at play.

Common Symptoms of Alcohol Abuse

First, moderate drinking is defined as up to one drink a day for women, or up to two drinks for men — that’s for adults of legal drinking age.

Imbibing can be problematic in several ways. Sometimes the timing is simply not good. It’s best to avoid alcohol when you are

• Using medications
• Experiencing existing health condition
• Operating a vehicle or machinery
• Taking part in activities that require alertness, skill, and coordination
• A recovering alcoholic
• Pregnant or trying to become pregnant
• Underage

Also of concern are binge and heavy drinking.

Binge drinking occurs when people consume enough intoxicants to bring their blood alcohol concentration (BAC) levels to 0.08% or greater. Usually four drinks for women and five drinks for men in the space of two hours is enough to qualify. More than a fourth of adults in the NSDUH survey admitted to binge drinking in the last month.

Heavy alcohol use is more than four drinks on any day for men, or more than three for women.

All of the above are problematic behaviors — the binging and heavy use in particular being warning signs of alcoholism — and can lead to alcohol use disorder.

Dangers of Alcoholism

There are many risks that come with alcoholism, and they vary between genders. Women tend to experience problems stemming from alcohol abuse much sooner — and at lower intakes — than men. In part it’s because women tend to weigh less than men.

In addition, alcohol lingers in the body’s water. People typically have around 50% water weight, but women tend to have less of it than men, and the differences grow more pronounced in adulthood. As a result, if a man and woman of the same weight drank the same amount, the woman’s blood alcohol concentration typically would be higher.

Drinking to excess, even in the short term, can generate a fair amount of risks of injury and even death.

Alcohol factors into:

• About 60% of fatal burns, drownings, and homicides
• 50% of severe trauma injuries and sexual assaults
• 40% of fatal car crashes, suicides, and deadly falls

Excessive drinking is also linked to more than 200 diseases, including a greater risk of breast cancer in women. It contributes to liver and cardiovascular diseases, depression, stomach bleeding, and a slew of cancers that can manifest anywhere from the mouth down to the rectum. Inebriants also can negatively impact diabetes, blood pressure, and pain management. It can also make a mess of sleep cycles.

Long-term effects of too much alcohol can also occur. It can impair judgment, leading to a greater risk of unplanned pregnancies and sexually transmitted diseases. Speaking of pregnancy, if women drink while pregnant, the prenatal exposure to intoxicants can cause brain damage and other problems for the fetuses. Such fetal alcohol spectrum disorders (FASD) can produce physical, cognitive, and behavioral problems that may have a lifelong impact.

The full range of alcohol’s dangers to a developing fetus are not entirely known yet, either. As a result, it’s advised that women even considering pregnancy should abstain from alcohol, simply to err on the side of caution.

Common Symptoms of Alcohol Dependence

Recognizing alcoholism is a big first step toward getting help, either for oneself or for a loved one.

Alcohol use disorder is diagnosed when people’s drinking interferes with their daily lives. People may

• Damage their family and personal relationships
• Neglect their work, school, or family duties
• Prioritize drinking over important responsibilities and favorite activities
• Drink more alcohol or drink longer than they planned
• Need to drink more alcohol to achieve the same effects it once produced
• Find it difficult to stop, even though they’d like to
• Continue to drink despite negative effects, such as hangovers, depression, or blackouts
• Engage in potentially dangerous or illegal activities, such as driving under the influence and participating in unsafe sex
• Devote a lot of time to drinking, or to recovering from it
• Face legal troubles (arrests, driving while intoxicated, etc.)
• Suffer withdrawal when the alcohol wears off

Adolescent Alcohol Abuse

Even though the legal drinking age across the United States is 21, alcohol remains the most used and abused drug among young people.

According to the Centers for Disease Control and Prevention (CDC), youth ages 12 to 20 consume 11% of alcohol nationwide. More than 90% of that is consumed via binge drinking. (Younger tipplers also generally drink more per occasion compared to adult drinkers.)

The excesses also exact a toll. More than 4,300 underage drinkers die every year, making it a particularly deadly habit. In 2013, more than 119,000 emergency room visits were due to injuries and other health problems incurred by drinkers ages 12 to 21.

Underage drinking causes plenty of other problems too.

School-age sippers are more prone to a lot of the same issues adult drinkers might face, such as being physically or sexually assaulted. Instead of flailing on the job, however, they experience their own equivalent — earning bad grades or missing biology class.

Slowing Alcohol Consumption

Some people eventually abstain on their own. That might be the result of getting older, and stopping at one drink, or starting at and staying with zero, begins to hold greater appeal.

For the man who drinks 15 or more alcoholic drinks every week (or regularly has five or more drinks in one go) or the woman who downs eight or more drinks weekly (or four or more at a time),  health is likely to be compromised and cutting back — or stopping — is strongly recommended.

Having a strategy in place can be a good tactic for lessening alcohol intake:

• Pace yourself by consuming water, juice, or soft drinks in between drinks.
• Eat something beforehand or while drinking to slow the absorption of alcohol, since an empty stomach gives intoxicants a more direct line to the small intestine and from there, right into the bloodstream.
• Subtract yourself from a party hearty crowd; it may be a health (or life) saving tactic.
• Opt for activities that don’t center around drinking.
• Keep booze out of the house; it’ll be one fewer temptation.

Being conscious of why you want to slow down or stop is also good. If you don’t like the things you do while drinking or how you feel the next day after drinking, that can serve as a solid motivator for staying abstinent. And be ready to turn down drinks when they’re offered. Have a polite but firm response ready when someone plies you with alcohol.

Treating Alcoholism

For those with a greater dependency, more steps are likely needed to abstain from alcohol. Fortunately, there are plenty of options to help achieve sobriety.

Support groups, counselors, medications, and rehabilitation facilities can be used separately (or utilized together, which tends to produce better outcomes) to create a plan to achieve recovery.

Twelve step programs and support groups such as Alcoholics Anonymous or SMART Recovery put addicted individuals in touch with others facing similar challenges.

Addiction counselors are trained to work with people with substance use disorders. Health care providers can typically put sobriety seekers in contact with therapists.

Medications are an option to help a person quit drinking by lessening the shock of withdrawal or, later, by blocking the effects of intoxicants. If you are planning on going cold turkey — quitting drinking abruptly and immediately — be warned, that practice could be dangerous.

The most severe heavy drinkers tend to be physically dependent on alcohol and may experience delirium tremens (DT) if quitting too abruptly, which can be deadly without medical intervention.) Symptoms include:

• Sudden confusion
• Trembling
• Mental function changes
• Irritation, anger
• Hallucinations
• Sudden mood shifts
• Seizures

Alcohol withdrawal can also bring on depression or anxiety, headaches, nausea, vomiting, nervousness, and sweating.

Immediate medical intervention is strongly recommended when recovering from drinking, since alcohol use disorder is much worse than your garden variety hangover.

Typically, doctors will immediately try to save the person’s life and then work on potential causes and complications. Keeping the person calm and comfortable while monitoring vitals and body fluid levels is first priority. Once the danger has passed, counseling, support groups, or a stay at a treatment facility (or all three) are strongly recommended.

References

• medlineplus.gov – Alcohol Use Disorder (AUD)
• medlineplus.gov – Delirium Tremens
• cdc.gov – Fact Sheets – Underage Drinking
• medlineplus.gov – How to Stop Drinking
• healthline.com – Medication for Alcoholism
• ncbi.nlm.nih.gov – Reducing Underage Drinking: A Collective Responsibility: Consequences of Underage Drinking
• niaaa.nih.gov – Understanding Underage Drinking
• niaaa.nih.gov – What Are the Different Drinking Levels?
• niaaa.nih.gov – What Are the Risks?
• niaaa.nih.gov – What Are the Symptoms of Alcohol Use Disorder?
• healthline.com – What Is the Average (and Ideal) Percentage of Water in Your Body?
• medlineplus.gov – Alcohol Use Disorder (AUD)
• medlineplus.gov – Delirium Tremens
• cdc.gov – Fact Sheets – Underage Drinking
• medlineplus.gov – How to Stop Drinking
• healthline.com – Medication for Alcoholism
• ncbi.nlm.nih.gov – Reducing Underage Drinking: A Collective Responsibility: Consequences of Underage Drinking
• niaaa.nih.gov – Understanding Underage Drinking
• niaaa.nih.gov – What Are the Different Drinking Levels?
• niaaa.nih.gov – What Are the Risks?
• niaaa.nih.gov – What Are the Symptoms of Alcohol Use Disorder?
• healthline.com – What Is the Average (and Ideal) Percentage of Water in Your Body?
• healthline.com – What Happens When You Drink on an Empty Stomach?
• niaaa.nih.gov – Why Do Women Face Higher Risks?an-empty-stomach”>healthline.com – What Happens When You Drink on an Empty Stomach?
• niaaa.nih.gov – Why Do Women Face Higher Risks?