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“People who drink to drown their sorrow should be told that sorrow knows how to swim.” Ann Landers1

If you or someone you love struggles with alcohol, you need to get informed - so read on and learn about: the differences between alcohol abuse and alcohol addiction, behaviors that increase or decrease your risk of addiction and what to do once you're addicted, and ready to stop!

Alcohol Abuse vs. Alcohol Addiction and Alcoholism

So do I have an alcohol abuse problem or is it alcohol addiction or alcohol dependence…and what about alcoholism? Is that worst of all?

It’s not easy to get an accurate diagnosis and sometimes, with all the different terminology in use – you can get an accurate diagnosis and still feel confused!

So to put it most simply, there are 2 basic kinds of alcohol use disorders:

  1. Alcohol abuse (problem drinking)
  1. Alcohol dependence (alcoholism and alcohol addiction mean the same thing as alcohol dependence)

Alcohol Abuse

Alcohol abuse is also sometimes known as problem drinking, and this term actually describes the situation pretty well – when your drinking starts causing you problems…you have a drinking problem (an alcohol abuse problem).

Some common signs of an alcohol abuse problem include:

  • Getting into legal troubles from your drinking (fights, alcohol fueled domestic disputes or DUIs for example)
  • Your drinking or hangovers repeatedly interfere with your ability to meet your responsibilities (at work, as a parent, at school etc.)
  • You drink in risky situations, such as when driving or using heavy machinery, when on medication that may enhance alcohol’s effects or against your doctor’s advice
  • Continuing with drinking patterns that cause you relationship problems, such as repeatedly fighting with your spouse about the way you act when drinking or about getting drunk with friends
  • Needing alcohol for stress relief

Alcoholism (Alcohol Addiction, Alcohol Dependence)

In addition to experiencing the problems of alcohol abuse, alcoholics will also:

  • Develop a tolerance (need more to get the same effects)
  • Start feeling withdrawal symptoms. After the alcohol in your body wears off you feel some or all of the following withdrawal symptoms: shakiness/trembling, anxiety and jumpiness, insomnia, irritability/depression, nausea and vomiting, sweating, headaches and loss of appetite
  • Lose control over use – drinking more or for longer than you had wanted to
  • Become unable to stop – You want to stop or cut down your use but you can’t seem to accomplish this
  • Keep drinking despite negative consequences – You keep drinking even though you know that alcohol is seriously harming your health/relationships/work or school performance/parenting or some other important facet of life
  • Become preoccupied with alcohol – You spend a lot of time, drinking, getting alcohol and recovering from drinking and you don’t engage in many activities that aren’t related to drinking
  • Drop non alcohol-related activities and relationships that used to be important2

Not all alcohol abusers become alcoholics, but abusing alcohol puts you at high risk to develop alcoholism.

What Puts You At Risk of Alcohol Addiction?

Having a family history of alcoholism increases your risk of developing the disease. Children of alcoholics are about 4 times more likely than the general population to develop an alcohol problem.3

But that being said, you still control your fate and if you choose to abstain from alcohol, you are at no risk of becoming an alcoholic, no matter how many close family members might be alcohol dependent.

Although genetics play a role, many close family members of alcoholics never develop a problem and many people without an alcoholic family member become alcoholics…so clearly environmental factors play a significant role in determining your risk for this disease.

Besides your family history (which you can’t control) other environmental and genetic factors which increase your risk of alcoholism include:

  • Regular heavy drinking – Defined as more than 15 drinks per week for men, 12 drinks per week for women and more than 5 drinks in a sitting4
  • Starting young – People who start drinking at a young age (young teenage years) are at a much higher risk to become alcoholics at some point in life than people who wait until the age of 21 to start drinking. In one study, people who started before the age of 15 were 5 times more likely to become alcohol abusers or alcoholics than people who waited until the age of 21 to start drinking5
  • Having a psychiatric disorder – People with depression, anxiety, ADHD and other disorders are at much higher risk of alcoholism and addiction than people from the general population.
  • A history of abuse – People who were physically or sexually abused as children are more likely to develop alcohol problems6
  • Cultural and social factors – If you live in a heavy drinking community you may be more likely to drink to excess yourself. Having a heavy drinking spouse or close friends may also increase your risk.

Minimizing Your Risk of Alcohol Addiction

The best thing you can do to minimize your risk of alcoholism is to drink in real moderation – or don’t drink at all (although it sometimes feels like everyone drinks, in fact almost half of all Americans, 49%, abstain completely or drink fewer than 12 alcoholic drinks per year!)6

If you choose to drink, to minimize your risk of an alcohol problem:

  1. If you are a man, drink no more than 15 drinks per week and and no more than 4 drinks in a sitting and if you are a woman, drink no more than 10 drinks per week and 3 drinks in a sitting
  2. Make sure you take days off from drinking each week, to avoid getting into a habit or developing a tolerance7

You can further reduce your risk of developing an alcohol problem by:

  • Maintaining physical and mental health
  • Getting involved in your community
  • Building and maintaining social relationships
  • Finding and engaging in something that brings purpose and meaning to your life8

I’m Addicted to Alcohol – What Do I Do?

Once addicted to alcohol, stopping for good becomes very tough.

If you’ve decided to quit drinking, you need to:

  1. Withdrawal (detox) from alcohol safely
  2. Get the support or treatment you need to maintain abstinence over time

Detox

Over time, your brain becomes very accustomed to a steady influx of alcohol, and it adapts to handle this – coming to require alcohol for ‘normal’ functioning.

If you suddenly stop drinking, because of the way your brain has changed, you can have very serious physical reactions, such as seizures, that can be fatal.

You may be able to detox without medical supervision, but you should always consult with a doctor prior to attempting a detox on your own. In many cases, you will need medical monitoring and medications during the first few days of abstinence.

Do not try this on your own. Learn more about alcohol detox, be smart, and get the help you need to be safe and comfortable during this tough initial phase.

Ongoing Treatment or Support

Alcohol addiction is considered a brain disease. By the time you develop an addiction to alcohol your brain has changed in irreversible ways, these changes make it tough for you to stay abstinent and they make it very unlikely that you will ever be able to drink in moderation again.

Learn more about how addiction changes your brain.

Once addicted...

  1. You become very susceptible to environmental cues that trigger alcohol memories and cravings. Often you won’t even know what triggers you, but something in the environment, a smell, sound or sight can trigger an unconscious memory that results in an intense craving -  as if out of nowhere
  2. Changes to the nucleus accumbens make you very motivated to engage in activities that immediately stimulate your reward systems, even at the expense of other activities that promote good long term health and wellness
  3. Brain changes in the frontal cortex diminish your ability to delay gratification and resist impulses9

So, once addicted, you’re assaulted with cravings that seem triggered almost out of thin air, you’re pushed towards activities that give you an immediate sense of reward and you become less able to resist impulses and delay gratification…no wonder quitting is so tough!

Because of all this, most people require some form of addiction treatment and long-lasting ongoing support to maintain abstinence.

Some examples of addiction treatment include:

  • Working with a psychologist, psychiatrist or addictions counselor
  • Enrolling in an outpatient addiction treatment program
  • Entering an alcohol rehab treatment program

Some examples of ongoing support include:

  • An addiction treatment aftercare program
  • Community support group participation, like AA or NA
  • Sober living housing
References
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Page last updated Feb 25, 2013

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