Male and female, young and old, rich and poor: no one is immune to the reality of problem drinking. The facts and statistics of alcohol use disorder—one of the most common and devastating health problems in the United States—paint a troubling picture. Experts estimate there are more than 12 million people with alcohol use disorder (AUD) in the U.S. Data shows that 86 percent of all adults drink alcohol, seven percent of them have an AUD, and nearly 88,000 people die each year of illness related to AUD.
Unfortunately, the numbers are especially troubling for young people. Nearly seven million 12- to 20-year-olds are binge drinkers. Those who begin drinking alcohol before the age of 15 are four times more likely to develop an AUD than those who don’t begin drinking until the age of 21. Additionally, there are more than 50,000 cases of alcohol poisoning reported each year. Also, some 30 million people admit to driving under the influence of alcohol. In the U.S., someone dies from an alcohol-related automobile accident every thirty minutes.
The causes of AUD vary from person to person, but perhaps the best way to understand how an individual develops disordered drinking is to know the facts about how alcohol affects the brain: prolonged exposure to alcohol changes rewires our internal reward system, and over time, people who consume alcohol chronically train themselves to prioritize alcohol consumption over other activities. This creates a life out of balance. When a person prioritizes drinking over work, family, and education, it can cause serious problems – for them and for their loved ones.
Who’s at Risk?
Research identifies the following groups as at-risk for AUD:
- Men who consume more than 15 drinks a week (one standard drink is 12 ounces of beer, 8 ounces of malt liquor, 5 ounces of wine, and 1.5 ounces of liquor)
- Women who consume more than 12 drinks a week
- Anyone who consumes more than five drinks at a time, at least once a week
- People who have a parent with an AUD
- Individuals with a mental health disorder such as depression, anxiety, schizophrenia, or personality disorder
- People with adverse childhood experiences (ACEs)
It’s important to understand that not everyone who displays these behaviors will develop an alcohol use disorder. However, the statistics show that if you’re in one of the categories above, your risk of developing an AUD is significantly higher than people who do not fall into one of those categories.
AUD: Signs and Symptoms
AUD symptoms include:
- Intense cravings for alcohol
- Repeated – but failed – attempts to stop drinking
- Inability to limit intake on a given occasion
- Inability to fulfill work, family, and school responsibilities
- Withdrawal from family
- Withdrawal from social activities
- Experiencing withdrawal symptons, such as nausea, sweating, and shaking
- Drinking to avoid withdrawal symptoms
Long-term exposure to alcohol can also lead to heart disease, liver disease, cardiovascular problems, cognitive decline, and immune deficiency. In fact, there’s not a single major physiological system in the human body that long-term exposure to alcohol does not harm.
Understanding Alcohol Side Effects
When we drink alcohol, things happen that we expect, but there are also things we don’t expect. For instance, expected short-term effects include slurred speech or drowsiness. But when we consume too much alcohol at one time, bad things happen. We experience vomiting, diarrhea, upset stomach, headaches, and difficulty breathing. We experience distorted vision and hearing, impaired judgment, a decrease in perception and coordination, and a loss of red blood cells (known as anemia). In some cases, extreme intoxication can lead to unconsciousness and coma.
While the short-term alcohol side effects are perhaps more well known, what may not be well understood is the long-term lasting damage to the body that occur large amounts of alcohol are consumed on a regular basis. Whether during occasional binge-drinking episodes or through prolonged use, long-term consumption can cause high blood pressure, stroke, and other heart-related diseases, as well as nerve damage, sexual problems, vitamin B1 deficiency – which can cause amnesia, apathy and persistent disorientation. Other negative effects of long-term alcohol use include ulcers, gastritis, malnutrition, and cancers of the mouth and throat.
Alcohol and Medication
One of the more serious alcohol side effects—and unfortunately one that many people are unaware of until a serious and potentially deadly situation arises—is alcohol’s interference with many common and often vitally important medications. Whether they’re prescription, over-the-counter, or even herbal supplements, alcohol often has harmful interactions that may include nausea and vomiting, headaches, dizziness, fainting, changes in blood pressure and generalized abnormal behavior. More serious consequences of mixing alcohol and medications include internal bleeding, heart and liver damage, and impaired breathing.
The dangers of mixing alcohol and antibiotics—especially alcohol and amoxicillin—are not well known. While not a particularly dangerous pairing with certain antibiotics, alcohol does impair the drug’s efficiency, simply meaning that the body may not recover as quickly from an infection when the antibiotic is taken with alcohol. However, certain classes of antibiotics should never be taken with alcohol— tinidazole and trimethoprim-sulfamethoxazole for instance—since this can lead may lead to headache, nausea, vomiting, and rapid heart rate. Likewise, mixing of prednisone and alcohol—the former a steroid used to treat a wide variety of conditions including allergies, asthma, colitis, and migraine headaches—can potentially worsen symptoms of these various diseases and conditions and, in some cases, cause gastrointestinal bleeding.
Coping with Alcohol Withdrawal Symptoms
When a heavy drinker—whether a binge drinker or alcoholic—suddenly stops or severely reduces the amount of alcohol they consume, a wide variety of withdrawal symptoms can occur. On the mild side of the spectrum, those with an alcohol problem can expect anxiety or nervousness, depression, irritability, jumpiness or shakiness, mood swings, unclear thinking, and disturbed sleep.
However, for others, especially people with a long history of problem drinking, symptoms can be much more serious and may involve potentially life-threatening symptoms. These include seizures, delirium tremens (DTs), Wernicke encephalopathy, and Korsakoff Syndrome.
Researchers theorize these dangerous withdrawal symptoms occur because heavy and prolonged drinking suppresses neurotransmitters, the chemicals that transmit messages from the brain throughout the body. These chemicals include GABA—which produces feelings of relaxation and calm—and glutamate, which produces feelings of excitability. When the suppression of these neurotransmitters ceases, they rebound exponentially, and the brain enters a state of hyperexcitability.
Because alcohol withdrawal symptoms can escalate quickly, it’s vital to quit drinking with medical assistance, especially if you’ve been drinking for a long time. There are highly effective treatments that can ease and eliminate the symptoms of withdrawal. This is crucial if an individual with alcohol use disorder has an underlying health condition that could complicate the medical picture.
The idea of enduring the rigors of alcohol withdrawal is intimidating. But as therapists note, there hope: Indeed, millions of people around the world have successfully completed treatment, and learned to live a life without alcohol.
Treatment for Alcohol Use Disorder
The first step on the road to getting help for problem drinking often involves an AUD assessment administered by a behavioral health specialist. Assessments often include the following types of questions:
- “Can you handle more alcohol now than when you first started drinking?”
- “Do you drink heavily when you are disappointed, under pressure, or have had an argument with someone?”
- “Have you had any blackouts – i.e. lapses in memory – recently?”
- “When you’re sober, do you sometimes regret things you did or said while drinking?”
Each question is designed to evaluate the place alcohol occupies in your life and whether or not that place supports, or undermines, a healthy and fulfilling lifestyle.
If the mental health professional who administers your evaluation determines you have an AUD, they will likely recommend evidence-based treatment at a licensed and accredited treatment facility. Integrated treatment that includes therapy, counseling, lifestyle changes, and community support set the new standard of care. Treatment centers that don’t offer individualized, integrated treatment programs are less effective than those that do.
In addition, mutual-help group models such as Alcoholics Anonymous (AA) help millions of people around the world. Online-based approaches that provide access to therapy at all times of the day and night are becoming more available. Also, one-on-one outpatient counseling in a nurturing inpatient setting can help people who want to quit drinking, but for various reasons can’t commit to treatment at a specialized alcohol use disorder facility.
Regardless of what model for long-term recovery from alcohol addiction a person chooses, it’s important to ask questions of care-givers and therapists. Finding the right match for treatment leads to the best possible outcomes. Counselors and admissions staff should take measures at the onset of treatment to identify any issues that may hinder recovery. Programs should be fully licensed and accredited, and their entire staff should likewise have up-to-date training and certification. Treatment centers should also be accredited by third party organizations. These include The National Association of Treatment Providers (NATP), the Commission of Accreditation of Rehabilitation Facilities (CARF), and others.
Hope for the Future: Treatment Works
Problem drinking affects millions in the United States. The chances are you or someone you know experiences an alcohol use disorder. The good news is that today, we have more tools and knowledge at our disposal than ever before. With our new information, new techniques, and new focus on the prevalence of AUD in the U.S., we can connect with the people who need treatment the most. When they get treatment, they can start their journey to lasting, long-term recovery.