The definition of alcoholic within the addiction treatment community is “a person who suffers from alcoholism, a chronic disease that is compulsive and characterized by an uncontrollable emotional and physical dependence on alcohol.”
Unfortunately, the term alcoholic also has a negative connotation in the general public. Referring to someone as an ‘alcoholic’ seems to be more harmful than helpful.
As the understanding of the disease of addiction continues to grow, the connection between substance abuse and addiction is becoming more clear. Alcohol addiction typically does not happen after one drink. Instead, it is a progression of alcohol abuse, tolerance, dependence, and addiction.
This progression is all contained within the diagnosis of an alcohol use disorder (AUD). People who were previously referred to as alcoholics, and now understood to be a person who has an alcohol use disorder.
When a person is struggling with an AUD, they may not see their behaviors as a sign of alcohol abuse or addiction. Some symptoms of AUD may be more obvious to someone close to them.
A person may be struggling with alcoholism if these symptoms are present:
- storing/hiding alcohol
- drinking alone
- can’t stop drinking once they start
- having specific events or times for drinking
- being irritated if someone comments on or if alcohol isn’t available for those times
- only attending events where it is acceptable to consume alcohol
- no interest in previously enjoyed hobbies or events, especially if no alcohol is allowed
- having urges to drink
- drinking heavily to improve mood
- drinking negatively affects relationships, work, personal or otherwise
- feeling sick on days they don’t drink
Because alcoholism is a progressive disease that affects a person physically and mentally, it progresses with everyone differently. For some, the dependence happens quickly, for others, it can take years. That is why observing warning signs is important.
Common Characteristics of Alcoholics
To narrow down the list of potential warning signs of an alcoholic, the following characteristics are good indicators that a person is struggling with an alcohol use disorder:
Alcohol is negatively impacting their life. Alcohol consumption is resulting in problems with or loss of relationships or employment. A person with AUD may experience financial troubles as a result of alcohol consumption.
Out of control alcohol abuse can also result in legal troubles, court fines, or jail. Excess alcohol consumption may lead to a lack of social invitations due to unacceptable behaviors at previous events due to alcohol.
Whether lying to themselves or others, a person attempting to manage an out of control disease like alcoholism tends to downplay how much alcohol negatively impacts their lives. They may make up excuses why they didn’t get invited, or people have left their life.
Someone with an alcohol addiction may try to hide how often they drink, or how much they consume while they are drinking. They may make attempts to minimize how much their alcohol addiction impacts all areas of their life.
An alcoholic will experience withdrawal symptoms if they are not drinking. These withdrawal symptoms can range from uncomfortable (shakes, nausea) to unbearable (vomiting, seizures).
Additionally, the person is likely to be unable to manage, stop or reduce alcohol consumption.
A person may appear obsessed with alcohol when they have a severe AUD. Nearly everything they do centers around alcohol; wondering when they can drink, if they can drink where they are going, and if they can get away with drinking in places they aren’t supposed to.
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The fixation on alcohol may appear strange to someone who isn’t dependent on alcohol. A person struggling with alcoholism is likely to become irritated or agitated if they are not able to drink.
Levels of Alcoholism
According to information from the National Institute on Alcohol Abuse and Alcoholism (NIAAA), there are five (sub)types of alcoholics. These labels are purely informational and are used to help medical and addiction specialists to help those with alcohol use disorder.
The criteria for these categories are based mostly on drinking behaviors and the age of the person diagnosed with AUD:
- Young Antisocial (21%) – People in this subtype meet the criteria for having an antisocial personality disorder, typically begin drinking around age fifteen.
- Intermediate Familial (19%) – These individuals began drinking at approximately seventeen and typically have family members who have alcoholism.
- Young Adult (32%) – This group tends to exhibit compulsive drinking behaviors around twenty. They tend to binge drink a couple days a week, instead of drinking every day
- Functional (19%) – Average individuals in this group tend to have more education, relationship stability, and higher income than others with AUD. Primarily binge drinking nearly every other day.
- Chronic Severe (9%) – Primarily males, probable polysubstance abuse, significantly higher divorce rate.
As people with AUD get older, if they continue to abuse alcohol, they tend to progress through these stages. The younger a person is when they start drinking, the more ‘at risk’ they are for developing chronic severe AUD.
Types Of Alcohol Drinkers
According to the Department of Health in England, research has shown that different people drink for different reasons, and could be categorized into nine different subsets.
The subsets are as follows:
- Depressed Drinker – Self-medicating or uses alcohol for comfort
- Re-Bonding Drinker – Uses alcohol to connect with others, very busy person
- Macho Drinker – Alcohol provides false confidence, asserts masculinity, shows status
- Conformist Drinker – Strong community within the bar
- Hedonistic Drinker – Drinks to lower inhibitions
- Boredom Drinker – Drinks to avoid the lack of people or relationship
- De-Stress Drinker – Drinks alcohol to relax
- Community Drinker – Uses alcohol in excess to build a community network
- Border Dependent – A combination of any above-mentioned alcohol abuse characteristics
Understanding why a person drinks is very important to the treatment of AUD. Being able to explore the history of an individual receiving substance abuse treatment can help create an individualized treatment plan unique to their circumstances.
Different Drinking Levels
The Department of Health and Human Services has posted criteria that identifies different levels of drinking that are considered moderate, heavy, binge drinking.
Moderate alcohol consumption is drinking one drink per day for women and two drinks per day for men. Drinking more than this on a daily basis indicates a potential alcohol use disorder.
Binge drinking raises the amount of alcohol in the blood to .08 percent, commonly referred to as blood alcohol concentration, or BAC. This typically occurs when an adult consumes approximately four to five drinks within two hours.
The Substance Abuse and Mental Health Services Administration (SAMHSA) and the NIAAA define heavy drinking as binge drinking more than five times in a month and more than three to four drinks per day, respectively.
Diagnosing An Alcohol Use Disorder
The criteria for an alcohol use disorder is outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).
There are a number of criteria for diagnosing an AUD, which are:
- Consuming more alcohol or drinking for longer periods of time than intended
- Being unable to control or reduce the amount of alcohol being consumed, even when a person wants to stop drinking
- Significant amounts of time are spent getting, drinking, or recovering from alcohol
- Cravings for alcohol
- Alcohol use causing disruptions to home, work, or school
- Continuing to drink alcohol despite the negative impact on relationships and responsibilities
- Previously enjoyed activities are being replaced by alcohol, or events where alcohol use is allowed
- Using alcohol in dangerous or hazardous situations
- Failure to stop drinking alcohol despite the development of health or mental health issues due to alcohol use
- Needing to drink more alcohol to feel the same effect (tolerance)
- Experiencing withdrawal symptoms in the absence of alcohol
When diagnosing an AUD, there must be a descriptor based on how many criteria the person meets:
- 2-3 symptoms is considered a mild AUD.
- 4-5 symptoms are considered moderate AUD.
- 6 or more symptoms meet the criteria for a severe AUD
Alcohol Abuse And Genetics
There are many factors that contribute to developing an AUD. Research shows a strong link between a family history of substance abuse and developing an alcohol abuse issue.
Alcohol addiction is complicated and cannot be blamed on one specific factor, it can only raise the risk associated with alcohol addiction if family members have a history of addiction as well.
In 2018, over eighty-five percent of adult Americans admitted to drinking at some point, with over half stating they had drank within the last 30 days.
Over a quarter of all American adults admitted to binge drinking in the previous thirty day period. Nearly seven percent of Americans reported binge drinking more than five times in the last month.
About 5.8 percent of adults met the criteria for an AUD diagnosis, which is roughly more than 14 million people.
More than 400,000 children from ages twelve to seventeen reported that they consumed enough alcohol to meet the diagnostic symptoms of an AUD.
Underage drinking happens with about 30 percent of all people under the age of 21 revealing that they have consumed alcohol, with many of those experiences happening in the last month.
Alcohol abuse is pervasive, and it affects all age groups. It is important to understand that the younger a person is when first exposed to alcohol, the more likely they are to develop an AUD.
Alcohol is a progressive disease, and often a person with AUD may not realize that the disease needs to be treated and managed, but that sobriety is an option.
Risks Associated With Alcohol Addiction
Some of the long- and short-term social, physical, mental health issues associated with alcohol addiction include:
- relationship issues
- failure to maintain responsibilities
- domestic violence
- problems with law enforcement/legal system
- loss of employment
- financial hardships
- diseases of the eye (Alcoholic Eyes)
- heart issues such as alcoholic cardiomyopathy
- liver disease
- erectile dysfunction
- alcoholic polyneuropathy
- immune system problems
- memory impairments
- unable to remember events while drunk (blackouts)
- Wernicke-Korsakoff Syndrome (alcoholic dementia)
- mood disorders (major depressive disorder, bipolar disorder, etc.)
- anxiety disorder (social phobia, generalized anxiety, panic disorder)
Drinking excessive amounts of alcohol can cause too much alcohol to accumulate in the body, usually a result of binge drinking across multiple hours. The result is alcohol poisoning, which can be fatal.
If a person is drinking in excess, and the begin to exhibit the following symptoms, get them emergency medical treatment as soon as possible:
- slow or irregular breathing
- severe confusion
- unable to wake them
- pale or bluish skin
If someone is showing these signs, letting them sleep off the alcohol, or giving them a cup of coffee is not a guaranteed solution, and can actually be dangerous. The best thing to do is to get them medical attention.
Alcohol poisoning is extremely dangerous and can lead to death if medical attention is not sought.
Below are some statistics of the deaths linked to alcohol poisoning:
- The National Highway Traffic Safety Administration revealed that one person dies every fifty minutes as a result of alcohol-impaired-driving
- Twenty-nine percent of all fatalities in vehicles were alcohol-related, which equals a total of 10,511 people died in car crashes due to alcohol
- Over 1,000 children died as a result of drunk driving in 2018
- About six people die every day due to alcohol poisoning, and most of them are men
- Just under 100,000 people die every year in the United States due to excessive alcohol consumption
- It is estimated that one in every ten deaths is alcohol-related
If a loved one is showing symptoms of an AUD, but has not accepted that they need treatment, an intervention may be an option.
A group of family and friends of the person abusing alcohol is gathered and usually led by an addiction specialist or counselor. This group will face the person struggling with addiction and attempt to explain why the person needs to seek addiction treatment.
This process usually involves giving very clear examples of how alcohol has negatively affected their relationship, and how their relationship will change if the person does not seek treatment.
Detoxing From Alcohol
It is extremely important to attend a medically supervised detoxification as part of the treatment for alcohol addiction. Withdrawal from alcohol can be dangerous and even fatal in some cases.
A person going through alcohol withdrawal can experience seizures, tachycardia, intense anxiety, headaches, and insomnia. A number of symptoms can arise while detoxing from alcohol.
Medically supervised detox allows for medical staff to observe the person 24 hours a day, prescribing medications to treat or ease withdrawal symptoms as they come up.
Some of the more severe cases of alcohol withdrawal lead to delirium tremens, hallucinations, delusions, and aggression. Medically supervised detox can monitor these symptoms and provide treatment as needed.
During medically supervised detoxification as part of a treatment plan for AUD, a person could be prescribed any number of medications to help ease the alcohol withdrawal symptoms. Benzodiazepines, barbiturates, anticonvulsants, antipsychotics or antidepressants.
These medications work quickly to help manage withdrawal. Having medical personnel available during alcohol detox could certainly save a life. This is why it is strongly suggested that a person who is addicted to alcohol attending a treatment program with supervised detox.
Treatment Options for AUD
There are a number of treatment options for AUD, and depending on the level of addiction and the desired intensity of the treatment.
There are groups that utilize a 12-step program, like Alcoholics Anonymous (AA), that allow anonymity and no one forces attendance. These groups are peer-based and typically led by a person who has a history of alcohol abuse and addiction.
Outpatient substance abuse treatment is scheduled treatment at a clinic or facility. A person struggling with addiction can receive therapy and addiction counseling but still be able to go home afterward.
Intensive outpatient alcohol abuse treatment is a little more in-depth. The person is required to attend so many hours per day and days per week. These types of programs are helpful to those who have responsibilities and need to return home at the end of each day.
Partial hospitalization programs are similar to an intensive outpatient program, but it typically takes place at a hospital in a behavioral health/addiction treatment unit. These are similar to a day program, and a person has to attend several days and several hours per week, but still go home.
Inpatient substance abuse treatment allows a person to reside in a unit, usually within a hospital. These inpatient programs are intended to be structured and help a person become sober and explore the reasons behind their addiction.
Residential alcohol addiction treatment is a live-in type facility, usually a stand-alone facility. These locations offer addiction treatment services as well as extra amenities, such as a chef, yoga, meditation, horseback riding, outdoor activities, and more.
Once a person completes rehab, it is important to have a plan going forward, to make all attempts to avoid relapse.
Rehab facilities typically sit down with the person who is completing treatment and create an aftercare plan for the person. This plan outlines what a person should do in order to maintain sobriety and what to do if they are feeling like they may relapse.
Getting Treatment for AUD
When trying to seek treatment for an alcohol use disorder, it is important to understand the nature of the addiction, and what type of treatment is best suited for you or your loved one.
Having help and support while starting this journey is very important. Contact our addiction specialists today and let them help navigate you through this process.
Addiction Resource aims to provide only the most current, accurate information in regards to addiction and addiction treatment, which means we only reference the most credible sources available.
These include peer-reviewed journals, government entities and academic institutions, and leaders in addiction healthcare and advocacy. Learn more about how we safeguard our content by viewing our editorial policy.
- Baldwin Research Institute - Definition of Alcoholism and Alcoholic
- Centers for Disease Control and Prevention - Alcohol Use and Your Health
- Journal of Studies on Alcohol - Styles of drinking and types of drinkers
- National Highway Traffic Safety Administration - Alcohol Impaired Driving
- National Institute on Alcohol Abuse and Alcoholism - Drinking Levels Defined
- National Institute on Alcohol Abuse and Alcoholism - Alcohol Use Disorder
- National Institute on Alcohol Abuse and Alcoholism - Alcohol Facts and Statistics
- Substance Abuse and Mental Health Services Administration - Detoxification and Substance Abuse Treatment
- WebMD - Are You a High-Functioning Alcoholic?