Alcohol has played a potent role in shaping societal norms and behaviours. Today, it is one of the most widely embraced recreational substances, yet paradoxically, it holds the distinction of being one of the most destructive. This stems from its addiction potential and its involvement in numerous fatal accidents and criminal activities worldwide. Specifically, ethanol, a type of alcohol, is the primary component in alcoholic drinks, constituting the substance consumed during drinking sessions. It’s crucial to note that other alcohol types are toxic to humans.

When individuals engage in regular, prolonged alcohol consumption, they become susceptible to developing addiction and various associated health issues. Addiction is accurately described as a disorder of the brain’s reward system. It involves compulsively engaging in specific rewarding behaviours, such as alcohol consumption, despite the negative consequences. While addiction and dependence are distinct, they are frequently connected, with alcohol addiction almost always accompanied by dependence.

Alcohol addiction is a widespread and highly detrimental phenomenon, impacting millions globally and contributing to numerous deaths and an immeasurable social cost.

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Examples of alcohol addiction

The term alcohol addiction is used interchangeably with other phrases.

1. Alcoholism: Commonly used by the general public, this term more accurately describes repeated consumption of alcohol over time, leading to physical and mental health issues. Essentially, alcoholism is equal to compulsive alcohol consumption, despite its detrimental effects, indicative of alcohol addiction.

2. Alcohol dependence syndrome: According to the World Health Organisation’s International Classification of Diseases, this is characterised by a chronic craving for drinks containing alcohol, an inability to control drinking, and a pathological pattern of alcohol use causing serious impairment in social or occupational functioning. Genetic, psychosocial, and environmental factors contribute to its development.

3. Alcohol Use Disorder (AUD): In 2013, the American Psychiatric Association’s DSM-5 reclassified both alcohol dependence and abuse under this umbrella term. It encompasses 11 symptoms, with the presence of at least two indicating an alcohol use disorder, further classified as mild, moderate, or severe.

Distinguishing abuse and dependence

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While alcohol abuse once had a specific definition, it now encompasses a broad spectrum of unhealthy drinking behaviours. This includes binge drinking, dangerous intoxication levels, alcohol addiction, and alcohol dependence in non-medical contexts.

Alcohol dependence is a more precisely defined term denoting physical or psychological dependence on alcohol. It occurs when prolonged and substantial alcohol consumption leads the brain and body to adapt to certain alcohol levels, necessitating these levels for proper functioning. Withdrawal symptoms manifest upon sudden cessation.

The motivations behind alcohol addiction

The human proclivity to indulge in alcohol consumption traces back to prehistoric times, a bias driven by the allure of its intoxicating effects. From ancient rituals to contemporary celebrations, alcohol has played a primary role in culture. Its ability to elevate mood, induce euphoria, reduce anxiety, and enhance sociability has made it a companion in various personal contexts over history.
Alcohol has been a part of countless rituals and ceremonies, deeply ingrained in cultural practices and rites of passage.
However, alcohol extends beyond the positive. For some individuals, alcohol becomes a double-edged sword, offering not only moments of joy but also an avenue for negative coping mechanisms. People turn to alcohol as a means of escaping the harsh realities of daily life, dealing with chronic pain or mental health issues, or even combating the monotony of existence.

Regrettably, for a subset of individuals, the casual consumption of alcohol morphs into a more sinister thing. Over time, a percentage of those who turn to alcohol for solace find themselves addicted. The development of a compulsion to drink, whether by cravings or psychological dependencies, can lead to a cycle of uncontrollable alcohol consumption. In such cases, individuals find themselves trapped in an inescapable loop.

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What causes alcohol addiction?

Understanding the complexity of psychology reveals that alcohol addiction’s origins are diverse. While numerous factors contribute to addiction development, the certainty remains that repeated alcohol consumption over time is the exclusive precursor to alcohol addiction.

Here are some key factors that contribute to the development of alcohol addiction:

  • Genetics: Genetic factors play a significant role in susceptibility to alcohol addiction. Individuals with a family history of alcoholism are more likely to develop the disorder themselves, suggesting a genetic predisposition. Specific genes related to alcohol metabolism and brain function may contribute to an increased risk.#
  • Biochemical factors: Alcohol affects the brain’s neurotransmitters, such as dopamine and serotonin, in pleasure and mood regulation. Chronic alcohol use can lead to changes in the brain’s chemistry, making individuals more prone to dependence.
  • Social and Environmental Factors: Environmental influences, including family, peer pressure, and cultural norms, can contribute to the development of alcohol addiction. Exposure to a culture that normalises heavy drinking or experiencing stressors in the environment may increase the likelihood of alcohol misuse.
  • Early exposure: Individuals who start drinking at an early age may be more susceptible to developing alcohol addiction. Early alcohol exposure can impact brain development and increase the risk of developing a dependency.
  • Personality traits: Certain personality traits, such as impulsivity, risk-taking behaviour, and sensation-seeking, may contribute to the development of alcohol addiction. Individuals with these traits may be more likely to engage in risky drinking behaviours.
  • Neurobiological factors: Alcohol directly impacts the brain’s reward system and can lead to changes in neural pathways. Over time, the brain may become dependent on alcohol to release neurotransmitters associated with pleasure.
  • Physical dependence: With continued and heavy alcohol use, physical dependence can develop. The body may adapt to the presence of alcohol, and withdrawal symptoms may occur when a person tries to quit or cut down on drinking, making it challenging to break the cycle of addiction.

It’s important to note that not everyone who drinks alcohol will develop an addiction, and the interplay of these factors can vary from person to person. If you or someone you know is struggling with alcohol addiction, seeking professional help is crucial for a comprehensive and personalised approach to recovery.

The psychology of addiction

Each individual’s path to addiction is unique, driven by unique motives. Psychotherapy plays a role in addiction treatment, requiring different approaches to individual patients.

Stress

Stress significantly contributes to alcohol abuse and addiction. Despite alcohol’s initial stress-alleviating effects, it compounds stress in the long run. Physiologically, alcohol induces effects that heighten stress susceptibility once intoxication’s pleasurable qualities wane. Additionally, being under alcohol influence increases the risk of professional and legal issues, amplifying stress levels. The cyclical reliance on alcohol as a stress coping mechanism can lead to alcohol abuse disorder, a highly stressful condition in itself.

Tolerance

Tolerance, where the body adapts to substance levels, necessitating increased amounts for the same effects, plays a crucial role in alcohol addiction. As tolerance builds, individuals consume more alcohol to achieve the desired effects, fostering dependence and addiction.

Co-occurring disorders

Alcohol significantly contributes to various mental health issues, causing neurological damage and fostering disorders. Simultaneously, pre-existing mental health issues may drive individuals to self-medicate with alcohol, exacerbating the risk of developing alcohol addiction. Dual diagnosis approaches are essential for effective treatment.

Signs and symptoms of alcohol addiction

The signs and symptoms of alcohol addiction can vary in severity, but they generally include both physical and behavioural indicators. If you or someone you know is experiencing these signs, seeking professional help is important.

Common signs and symptoms of alcohol addiction include:

Physical symptoms of alcohol addiction:

Tolerance to alcohol
Withdrawal symptoms
Increased tolerance
Liver damage (e.g., cirrhosis)
Pancreatitis
Gastritis
Cardiovascular problems
Neurological issues (e.g., neuropathy)
Gastrointestinal problems
Sexual dysfunction
Weakened immune system

Physical symptoms of alcohol addiction:

Tolerance to alcohol
Withdrawal symptoms
Increased tolerance
Liver damage (e.g., cirrhosis)
Pancreatitis
Gastritis
Cardiovascular problems
Neurological issues (e.g., neuropathy)
Gastrointestinal problems
Sexual dysfunction
Weakened immune system

Complications of alcohol addiction

Complications arising from alcohol addiction are multifaceted, influenced by an individual’s overall quality of life, living conditions, and the specific nature of their substance abuse. Alcohol addiction can give rise to a range of adverse effects, impacting both physical and mental well-being. Here is an expanded exploration of the potential complications associated with alcohol addiction:

Mental illness:

  • Alcohol abuse is closely linked to mental health disorders such as depression, anxiety, and an increased risk of suicide.
  • Chronic alcohol use can exacerbate pre-existing mental health conditions or precipitate the onset of new psychiatric disorders.

 

Wernicke–Korsakoff Syndrome:

  • Resulting from thiamine (vitamin B1) deficiency often seen in chronic alcoholics.
  • Manifests as confusion, memory loss, and impaired coordination.

 

 

Irregular Heartbeat (Arrhythmias):

  • Alcohol can disrupt the electrical signals in the heart, leading to irregular heart rhythms.
  • Prolonged alcohol abuse increases the risk of atrial fibrillation and other cardiac complications.

 

 

Cirrhosis of the Liver:

  • Chronic alcohol consumption is a leading cause of liver cirrhosis, characterised by scarring of the liver tissue.
  • Cirrhosis can progress to liver failure, with potentially life-threatening consequences.

 

Foetal Alcohol Spectrum Disorder (FASD):

  • Pregnant women who consume alcohol risk foetal exposure, leading to a spectrum of developmental disorders known as FASD.
  • This can result in the child’s physical, behavioural, and cognitive impairments.

 

Accidents and injuries:

  • Impaired coordination and judgement under the influence of alcohol contribute to an increased likelihood of accidents and injuries.
  • Alcohol-related accidents may occur both in the short term and as part of a long-term pattern of risky behaviours.

 

Alcohol addiction withdrawal symptoms

Withdrawal from alcohol can be a challenging and potentially dangerous process. The severity and duration of withdrawal symptoms can vary based on the level of alcohol dependence and individual differences.

Common withdrawal symptoms include:

  • Tremors (Shakes)
  • Nausea and Vomiting
  • Sweating and Clammy Skin
  • Anxiety and agitation
  • Insomnia
  • Hallucinations
  • Seizures
  • Delirium Tremens (DTs)
  • Depression
  • Irritability and mood swings

It’s important to note that alcohol withdrawal can be life-threatening, especially in severe cases. Medically supervised alcohol detox is often recommended to manage withdrawal symptoms and ensure the safety of individuals undergoing the process. Seeking professional help from healthcare providers or addiction specialists is crucial to navigating withdrawal safely and initiating the path to recovery.

Dangers of alcohol and multi-drug interactions

Individuals who abuse alcohol often engage in risky behaviour by combining it with other drugs, resulting in potentially dangerous interactions. Alcohol compounds the sedative effects of central nervous system depressants, opioids, non-benzodiazepines, barbiturates, benzodiazepines, antipsychotics, and sedative antihistamines. Furthermore, combining alcohol with cocaine leads to the formation of the more toxic cocaethylene, and cannabis amplifies THC levels. It’s important to note that dangerous interactions can also occur with certain antibiotics.

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Alcohol addiction in teens

Despite legal restrictions, alcohol use and abuse are prevalent among teenagers, often viewed as a rite of passage. While most engage in recreational drinking, a small proportion develop alcohol use disorders. Factors contributing to teen alcohol addiction include:

  • Abuse or trauma.
  • Mental health issues.
  • Proximity to alcohol-friendly environments.
  • Peer influence.
  • Substance abuse.
  • Boredom.
  • Low self-esteem.

Alcohol addiction and pregnancy

Consuming alcohol above low quantities during pregnancy poses risks of foetal alcohol spectrum disorders (FASDs), including low birth weight, reduced height, intellectual deficits, sensory issues, behavioural difficulties, and abnormal appearance. Foetal alcohol syndrome (FAS) represents the severe end of FASDs, involving growth deficiency, central nervous system damage, distinctive facial features, and potential alcohol dependence at birth.

Alcohol addiction among older adults often goes unnoticed due to societal misconceptions and the belief that substance abuse is a young adult phenomenon. Risk factors include medical conditions, medication interactions, life changes (retirement, bereavement), loneliness, and mental health issues. Alcohol worsens age-related health problems and increases susceptibility to falls and accidents.

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Diagnosis of alcohol addiction

Accurate diagnosis of alcohol addiction is challenging, given patients’ reluctance to admit their struggles. Medical professionals assess addiction by considering criteria such as alcohol tolerance, withdrawal symptoms, unsuccessful attempts to quit, time spent acquiring alcohol, reduced involvement in recreational activities, continued alcohol use despite awareness of its harm, and physical/psychological issues resulting from drinking.

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Treatment for alcohol addiction

Alcohol rehab, short for rehabilitation, is a structured and supportive program designed to help people overcome their addiction to alcohol. It’s a place where individuals with alcohol-related issues receive professional help and guidance to break free from the cycle of alcohol dependence.

In alcohol rehab, individuals typically undergo a process that includes detoxification, therapy, and counselling.
Various treatment modalities exist for alcohol addiction, ranging from medical detoxification to behavioural therapies.

  • Detox: A crucial first step involves eliminating alcohol from the body, potentially leading to withdrawal symptoms. Medical supervision during detox is essential, as severe withdrawal can be life-threatening.
  • Medications: Several medications assist in alcohol addiction treatment. Disulfiram discourages drinking by causing unpleasant reactions, while naltrexone and acamprosate reduce cravings. Baclofen, off-label, also shows promise.
  • Behavioural therapies: Behavioural therapies for alcohol addiction include Cognitive-Behavioural Therapy (CBT) to change destructive behaviours, Motivational Enhancement Therapy (MET) for motivation, and Contingency Management (CM) offering sobriety incentives. Dialectical Behaviour Therapy (DBT), which combines cognitive-behavioural techniques with mindfulness and acceptance strategies to regulate emotions and improve coping, is effective, too.
  • Therapy and Counseling: Rehab involves various forms of therapy, including individual and group sessions. These sessions aim to address the root causes of alcohol addiction, develop coping mechanisms, and provide support for maintaining sobriety.
  • Support Groups: Participating in groups like Alcoholics Anonymous (AA) fosters community and shared experiences, aiding recovery.
  • Inpatient and outpatient programmes: Inpatient programmes provide intensive, 24/7 treatment, while outpatient programmes offer flexibility for those with strong social support.
  • Aftercare: Ongoing support is crucial post-treatment, encompassing counselling, support groups, and continued medical monitoring.

Challenges in treatment

Effective treatment faces challenges influenced by patient motivation, support systems, co-occurring disorders, and therapy access. The chronic nature of addiction, reflected in high relapse rates, emphasises the need for sustained, comprehensive, and long-term treatment strategies.

Alcohol addiction prevention

Prevention efforts aim to reduce alcohol addiction incidence, with strategies including public awareness campaigns, policy initiatives (taxation, restricting availability), school-based programs, and fostering supportive communities. Public health interventions emphasise addressing social determinants, reducing stigma, and promoting mental health.

Understanding the risk factors associated with alcohol addiction is crucial for prevention and early intervention. These factors vary across individuals but may include a family history of alcoholism, genetic predisposition, environmental influences, traumatic experiences, and mental health conditions.

If you or someone you know is struggling with alcohol addiction, seek help. Reach out to healthcare professionals, such as therapists or addiction specialists, for a comprehensive assessment and guidance on appropriate treatment options.

 

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FAQs

Is alcoholism a disease?
Yes, alcoholism is recognised as a disease by major health organisations. It is a chronic, relapsing disorder characterised by compulsive alcohol use, loss of control over intake, and a negative emotional state when not using.
What is an alcoholic?
An alcoholic is an individual who has developed a physical and psychological dependence on alcohol, leading to compulsive and harmful drinking behaviour. It is a term often used to describe someone with alcohol use disorder.
Is binge drinking alcoholism?
Binge drinking is a pattern of drinking that raises blood alcohol concentration to 0.08% or above. While not synonymous with alcoholism, frequent binge drinking can be a risk factor for developing alcohol use disorder.
Can I die from alcoholism?
Yes, severe alcoholism can lead to life-threatening health complications, including liver disease, cardiovascular issues, and increased susceptibility to accidents and injuries.
Why do some people become addicted to alcohol while others don’t?
A combination of genetic, environmental, and psychological factors influences the development of alcohol addiction. While genetics may predispose some individuals, environmental factors and personal choices contribute significantly to the risk.
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