For decades the only way we could understand problem drinking was under the general term of alcoholism rather than alcohol use disorder. This conjured images of meetings in smoky basements and people pouring over the 12 steps. This may have worked for some, but it was not grounded in science, and others found it off-putting.
In recent years, medical science has come to understand alcohol abuse and dependency in more rigorous terms. Studies on addiction more generally, and on alcohol, in particular, have given doctors and addiction treatment specialists a much better understanding of problem drinking and alcohol use disorder.
Alcohol use disorder is now treated as a specific form of addiction. There is a range of scientifically based treatments for alcohol use disorder. Finally, recovery from alcohol use disorder has become far more promising.
What Is Alcohol Use Disorder?
Alcohol use disorder is a serious and potentially fatal form of substance abuse disorder.
Alcohol abuse becomes alcohol use disorder when your drinking is characterized by compulsive alcohol use, loss of control over how much your drink, and negative feelings associated with alcohol use.
Alcohol use disorder interferes with your life. It can damage personal and professional relationships. It can make it impossible to function at work, and it destroys families.
Alcohol use disorder can even be fatal. The long-term effects of alcohol abuse can cause kidney problems, heart disease, and neurological problems. Alcohol poisoning is effectively an alcohol overdose and it is fatal.
It is estimated that over 16 million people in the United States are living with alcohol use disorder.
Thankfully, there are effective treatments for alcohol use disorder. Medical science has progressed apace as alcohol abuse remains a feature of modern life. There are now multiple effective treatments for alcohol use disorder.
What Is the Difference Between Alcoholism and Alcohol Use Disorder?
The traditional term for alcohol dependence has been alcoholism. The word remains in widespread use.
The reason for the change in language was to bring the multiple symptoms of alcohol abuse, cravings for alcohol, and the medical conditions associated with alcohol abuse under a scientific umbrella. This allows doctors to study these conditions and treat them more effectively.
While alcoholism still persists as a general term for problem drinking, the medical term is now alcohol use disorder, thus bringing the condition under the view of scientific study and treatment.
Alcohol Use Disorder Symptoms
Again, the medical term for the complex of symptoms and conditions which come from dangerous drinking patterns is alcohol use disorder. Medical science now lists some standard criteria to assess whether or not you are suffering from alcohol use disorder.
Like all other forms of substance abuse disorder, there are several clear signs which indicate that you may be dealing with alcohol abuse.
Here are some obvious signs of alcohol abuse disorder:
- An uncontrollable urge to drink (cravings).
- Lack of control over how much you drink.
- Negative thoughts about drinking while you are drinking.
- Drinking in dangerous situations (while driving, at work, in illegal or inappropriate places, etc.).
- Drinking that interferes with responsibilities.
- Continuing to drink even after it has caused problems or made them worse.
- Giving up other important activities in order to drink.
Alcohol abuse can be mild to severe. Obviously, recognizing the signs early, before you have experienced serious consequences can make it easier to treat. If you experience any of the following, it is likely you are tending toward alcohol abuse:
- You need to drink in order to relax or fall asleep
- You find yourself drinking in the morning
- You need to drink in order to be social
- Using alcohol to escape your feelings
- Drinking and driving
- Lying about how much or how often you drink
- You experience memory loss after drinking
- Legal problems as a result of drinking
- You have tried to stop drinking and failed
- You are preoccupied with thoughts of drinking
- Drinking more in order to get the same effect
- Withdrawal symptoms such as shakiness, nausea, and sleeping difficulties
If you experience any of these symptoms, you may be dealing with alcohol abuse disorder. The sooner you recognize the problem, the easier it will be to treat the problem.
Alcohol abuse does not get better on its own. You will not return to normal drinking simply by trying to manage your drinking.
Alcohol Use Disorder Causes
Since alcohol use disorder is really a complex of issues, the causes are equally complex. No one factor directly leads to the development of alcohol use disorder. There are, however, some clear causes which together tend to contribute to the development of alcohol use disorder:
Scientific research has established a link between numerous genetic traits that can contribute to an alcohol use disorder. Some people are simply genetically predisposed to developing the problem. These genetic traits appear to make some people physiologically prone to becoming dependent on alcohol.
People who are in proximity to areas in which alcohol is consumed or sold are often more prone to developing alcohol use disorder. The effects of advertising, particularly on younger people, have been shown to be a cause of alcohol use disorder.
The economic conditions of one’s environment can also contribute to problem drinking. It is interesting to note that studies have shown that economically affluent areas are more prone to alcohol abuse than areas of lower income.
Culture, religion, and family all play a role in the causes of alcohol use disorder. Some cultures tend to encourage drinking—even heavy drinking, and this type of alcohol abuse can easily lead to alcohol dependence.
On the other hand, there are cultures and religions which discourage or forbid consuming alcoholic beverages and this obviously reduces the risk. Individual family attitudes toward drinking can also complicate one’s chances of developing alcohol use disorder.
Depression, anxiety, and mental illness are all causes of alcohol dependence. Alcohol can work as a form of self-medication for these types of psychological issues. The more people rely on alcohol to treat the symptoms of psychological problems, the more likely they will develop alcohol use disorder.
It is crucial to bear in mind that any combination of these causes greatly increases the chance of developing a drinking problem. Each will compound the pressures which lead to an alcohol use disorder.
Alcohol Use Disorder Risk Factors
In addition to the direct causes, there are some risk factors that also contribute to the development of alcohol use disorder.
While these factors do not in themselves directly lead to alcohol use disorder, living with one or more of these risk factors presents the danger of developing the problem.
Drinking steadily over time: While many people begin drinking while in their teens, continuing to drink steadily and heavily over long periods of time will inevitably lead to tolerance of alcohol and this can lead to alcohol dependence.
People who begin drinking at an early age are more likely to become problem drinkers.
This is not simply a matter of genetics. A family history of drinking and heavy drinking creates the presumption that heavy drinking is acceptable.
Physical and emotional trauma can lead to excessive drinking. This, in turn, can lead to an alcohol use disorder.
Doctors have found a link between bariatric surgery and the development of alcohol use disorder. Bariatric surgery has also been linked to relapse from recovery.
Social and cultural risks
Living with a person who drinks heavily or being close to people who abuse alcohol can pose a risk for some people. The influence of advertising and mass media also present risks, especially to younger people.
How does it Impact your health?
The dangers to your health from alcohol use disorder are many, and some of these dangers are devastating. Drinking alcohol even on a single occasion can pose health risks. Heavy drinking associated with alcohol use disorder impacts your health in some specific ways:
- Alcohol interferes with your brain and central nervous system. Over time, alcohol can disrupt the brain’s pathways causing mood and behavior changes. This can lead to an inability to concentrate and think and cause coordination problems.
- Cardiomyopathy- A condition in which the heart muscle stretches and droops.
- Arrhythmia- irregular heart-beat.
- High blood pressure.
Alcohol is processed primarily in the liver. With excessive alcohol consumption, the liver becomes damaged.
- Fatty liver, or steatosis.
- Alcoholic hepatitis.
Alcohol will cause the pancreas to build up to toxic substances which will, in turn, lead to pancreatitis. This is a dangerous inflammation and swelling of the pancreas.
Excessive alcohol consumption of the type associated with alcohol use disorder has also been linked to several forms of cancer.
Which Medicines can Treat Alcohol Use Disorder?
While alcohol use disorder is best treated through a combination of individual and group counseling following some specific programs, there are medications that can assist in the treatment of the disorder. Some of these medications have been in use for many years, while others have come into use following more recent medical studies.
Also called “Antabuse,” this medication causes people to become nauseated and intensely sick if they try to drink while taking the drug. The belief was that people would be less likely to drink if consuming alcohol made them sick.
Disulfiram has been shown to be effective in some people, but others simply stop taking it precisely because it makes them sick.
Naltrexone will inhibit the pleasurable feelings one gets from drinking alcohol. While you will become intoxicated if you drink while taking Naltrexone, you will not experience the feelings associated with being intoxicated.
This medication also tends to inhibit cravings for alcohol. Studies have shown that Naltrexone works best in people who have been able to stop drinking for at least a few days.
This medication eases the withdrawal symptoms from alcohol. It helps alleviate the anxiety, insomnia, depression, and restlessness people often experience while detoxing from alcohol.
The drug works by re-establishing a balance in the brain chemistry which becomes destabilized from heavy drinking. Like Naltrexone, Campral works best in people who have already stopped drinking for a short time.
In addition to medications prescribed specifically for alcohol detox and treatment, other medications are used to prevent seizures, depression, and anxiety. These may include anticonvulsants and antidepressants.
What are the Treatments for Alcohol Use Disorder?
Because there has been so much research in the field of addiction treatment, there are now an array of scientifically tested treatments available for alcohol use disorder.
All of these treatments are designed to meet specific needs. There is no one treatment for everyone who struggles with alcohol use disorder.
Some of the more prominent treatment programs include:
Cognitive Behavior Therapy (CBT)
This treatment modality helps identify feelings and situations which lead to alcohol abuse in the first place. People learn coping skills which replace the tendency to abuse alcohol in order to deal with issues and situations. CBT generally includes group therapy and individual counseling.
Motivational Interviewing Therapy (MI)
MI is a form of intervention which helps people become motivated to change destructive behaviors such as alcohol abuse. It is sometimes employed as a preliminary intervention toward other forms of therapy.
Dialectical Behavioral Therapy (DBT)
Dialectical Behavioral Therapy provides people with new skills for managing painful emotions and situations. Patients gain skills in managing conflicts and other uncomfortable situations. DBT focuses on four crucial areas: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness.
Traumatic Incident Reduction Therapy (TIR)
TIR primarily focuses on reducing stress related to past traumatic events and experiences. It involves re-introducing these events and experiences in a safe environment so that patients can gain control over their feelings and associations with these experiences. By gaining control of their feelings and emotions in relation to the trauma, patients become able to alleviate many of the underlying causes of their alcohol use disorder.
In addition to these therapies and treatment programs, treatment centers also include programs designed to prevent relapse into alcohol use disorder. Many treatment programs also provide treatment for other co-occurring mental health issues.
Wrapping things up
Alcohol use disorder is a serious medical condition. Excessive drinking has a devastating impact on your physical and mental health, it impacts your family and your professional life, and it can eventually be fatal.
The causes of alcohol use disorder are complex, and there are numerous risk factors for developing the condition.
However, alcohol use disorder is now well-understood by medical science. We are far from the old models of understanding that only saw excessive drinking in terms of alcoholism. Alcohol use disorder is now a recognized medical condition.
There are a number of treatments available for alcohol use disorder, and the pain and discomfort of detox can be alleviated with medications. These treatments are based on sound medical science and are proven effective for long-term recovery.