What is Alcohol Abuse and how to treat Alcoholism
Alcoholism treatment, or alcohol use disorder, is a chronic and sometimes-progressive medical condition that involves the compulsive consumption of alcohol. Such maladaptive patterns of drinking can lead to several serious social, familial, and physical consequences.
What is Alcoholism?
The National Institute on Alcohol Abuse and Alcoholism (NIAAA) describes alcohol use disorder (AUD) as a chronic brain disease characterized by compulsive drinking, loss of control over the use of alcohol, and the experience of negative emotions when not using alcohol.1 In many instances, the terms alcoholism and AUD are used somewhat interchangeably.
Some of the signs, symptoms, and behavioral changes used to make a diagnosis of an AUD include:2
- Cravings or strong urges to drink.
- A persistent desire but an inability to stop drinking.
- Recurrent drinking in dangerous situations, such as driving a car.
- Giving up on once-important social, occupational, or recreational activities because of alcohol use.
- Alcohol tolerance or the need for increasing amounts to achieve a desired level of intoxication.
- Experiencing physical withdrawal symptoms, such as nausea, tremors, or seizures after stopping drinking.
In 2018, an estimated 14.4 million Americans over the age of 18 had AUD.3 In addition, around 401,000 youth, ages 12 to 17, also met the criteria to be diagnosed with AUD.3
What is Binge Drinking?
In 2018, more than a quarter of people above the age of 18 in the U.S. were estimated to have engaged in binge drinking within the past month.3 An estimated 2 in 5 young adults between the ages of 18 and 25 binge drink.4
The NIAAA defines binge drinking as any episode of drinking that causes a blood alcohol level of 0.08% or higher.3 To reach this, women typically have to consume 4 or more drinks in 2 hours, whereas men have to drink at least 5 drinks in the same time span.3
Episodic binge drinking, while potentially problematic, does not necessarily mean that an individual meets criteria for AUD.3 However, should this pattern of drinking become more frequent or consistent, it can place a person at higher risk for developing an AUD.3
What are the causes of Alcoholism?
Many may wonder what causes alcoholism to develop, but there is no simple answer to this question. The development of AUD is thought to be influenced by a mixture of multiple factors, including genetics and environment.
Past studies have supported a potential link between a genetic vulnerability to depression and AUD development.5 Others have suggested a heritable component to drinking at a young age and a subsequent higher risk of developing AUD.6 In addition, experiencing early childhood trauma could increase the risk of developing alcoholism.7
Other factors involved in the development of an AUD are still being explored. The Substance Abuse and Mental Health Services Administration notes that a person’s home environment could affect their risk of becoming an
For example, if someone is raised in a household with inadequate parental supervision, they may have easier access to alcohol.8 The community environment can also affect a person’s risk for AUD.8 If a community doesn’t strongly enforce laws prohibiting the sale of alcohol to minors, then minors can easily obtain and use alcohol.8 The home environment can also serve as a protective factor. For instance, should a person be raised with strong parental involvement, including their support and proper supervision, then the likelihood of that person developing a drinking problem during adolescence may be much lower.8
Signs of Alcohol use disorder
A diagnosis of alcohol use disorder may be given to people with problematic patterns of drinking behavior that have a significant negative impact on their day-to-day lives. There are many signs and symptoms of AUD, several of which we mentioned earlier.
Healthcare professionals including physicians, psychologists, and other qualified behavioral health practitioners may make an AUD diagnosis based on the presence of these signs and symptoms. Should should a person meet at least 2 of the following diagnostic criteria within a 12-month period, they may have AUD:2
- Drinking more alcohol than you originally intended to or drinking more frequently than you had planned.
- Experiencing cravings to use alcohol.
- Experiencing signs of physical withdrawal when alcohol is withheld.
- Giving up things that you previously enjoyed, such as sports and hobbies, to consume alcohol.
- Spending a great deal of time and money acquiring, using, and recovering from using alcohol.
- The inability to fulfill roles at work, school, or home because of alcohol use.
- Tolerance to alcohol, which means that a person has to keep drinking more and more to feel the effects of alcohol.
- Unsuccessful attempts to cut back or stop using alcohol.
- Using alcohol even if it makes a mental or physical problem worse.
- Using alcohol even though it causes family or other interpersonal conflicts.
- Using alcohol when it is dangerous to do so, such as drinking and driving.
For most people, detox is the first step in alcoholism treatment. For people with significant levels of physiological alcohol dependence, attempts to abruptly stop drinking alone could prove dangerous, as serious complications, including withdrawal seizures, may occur.9 A supervised medical detox period may be needed to keep a person safe and comfortable throughout withdrawal.
If you or someone you know is currently attempting to quit using alcohol, help is only a phone call away. At Alcohol Intervention Service (AIS) we can answer questions you have and share more information about our treatment options. Give us a call today at (888) 972-8513 for help with alcoholism treatment and advise.
For people at high risk of severe withdrawal, several days of inpatient treatment—either in a hospital based setting or longer-term rehabilitation facility able to medically manage acute alcohol withdrawal—may be needed to stabilize a person in early recovery. After successful withdrawal management through medical detox, a period of more comprehensive rehabilitation may begin. The various treatment settings for different alcohol recovery programs include:10
- Residential treatment, which can be a short-term program lasting a few months, or a long-term program lasting up to a year or more. Residential treatment typically follows inpatient treatment and is appropriate for those who previously attended an inpatient and/or outpatient program, but who need continued supervision to maintain sobriety.
- Outpatient treatment, where a person comes to treatment for a few hours at a time, 2 to 3 times per week, but can continue living at home. This type of treatment may be the first stage of treatment for someone with a less severe AUD. However, it might be the second stage of treatment for someone who has completed treatment in an inpatient facility.
Whether alcoholism treatment is provided on an inpatient or outpatient basis, many substance use treatment programs will employ a combination of several treatment approaches. Some of the different types of treatment may include:11, 12, 13
- Behavioral therapy, including cognitive-behavioral therapy (CBT) and motivational enhancement. Both of these approaches focus on helping a person with AUD think differently about the disorder. Motivational enhancement is focused on getting a person to engage with their treatment and overcoming barriers to changing behaviors. CBT focuses on identifying maladaptive behaviors and developing new coping skills to better maintain sobriety and avoid relapse.
- Family therapy, including helping a family set boundaries and behaviors, which can enhance recovery for the family member with AUD.
- Treatment for dual diagnosis or co-occurring disorders, which involves an integrated treatment strategy for both AUD and a mental health issue, such as depression or anxiety. The treatment of both conditions helps to sustain recovery from both disorders.
- 12-step or other mutual support group meetings, such as Alcoholics Anonymous (AA) which emphasizes recognition of AUD and ongoing support and recovery.
Some people with AUD benefit from the use of medication-assisted treatment, which may help to support a person in recovery by minimizing cravings and decreasing the risk of relapse to problematic drinking. In combination with behavioral therapies, there are several drugs used for this purpose, including:14
- Campral, also known as acamprosate, acts on the GABA and glutamate neurotransmitter systems. Campral helps to control the insomnia, anxiety, and restlessness that often accompany alcohol withdrawal. It can help people maintain longer-term recovery, especially in those people who are severely alcohol dependent.
- Disulfiram (Antabuse) deters drinking in patients highly motivated to quit. If a person takes disulfiram and then uses alcohol, the result is flushing, nausea, and heart palpitations.
- Naltrexone, which acts on the opioid receptors in the brain to block the reward of drinking and potentially reduce cravings for alcohol. An extended-release form (Vivitrol) only has to be administered by injection once a month.
- Topiramate is sometimes used off-label to help decrease continued drinking behavior in recovering individuals.