What is an alcoholic? How to treat alcoholism

Alcoholism, now known as alcohol use disorder, is a condition in which a person has a desire or physical need to consume alcohol, even though it has a negative impact on their life.

In the past, a person with this condition was referred to as an “alcoholic.” However, this is increasingly seen as an unhelpful and negative label. Health professionals now say that a person has an alcohol use disorder (AUD).

According to the National Institute of Health (NIH), in 2015, 15.1 million American adults (6.2 percent of the population) had an alcohol use problem.

According to the World Health Organization (WHO), globally, 3.3 million deaths every year result from the harmful use of alcohol.

Definition

Alcoholic slumped next to glass of alcohol.
Alcohol abuse disorder refers to a long-term addiction to alcohol.

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) describes alcohol use disorder as “problem drinking that becomes severe.”

A person with this condition does not know when or how to stop drinking. They spend a lot of time thinking about alcohol, and they cannot control how much they consume, even if it is causing serious problems at home, work, and financially.

Alcohol abuse can be used to talk about excessive or inappropriate consumption of alcohol, but not necessarily dependence.

Moderate alcohol consumption does not generally cause any psychological or physical harm. However, if who enjoy social drinking increase their consumption or regularly consume more than is recommended, AUD may eventually develop.

Young person drinking alcohol in park.
Causes and risk factors include peer pressure, drinking from a young age, and depression.

Alcohol dependence can take from a few years to several decades to develop. For some people who are particularly vulnerable, it can happen within months.

Over time, regular alcohol consumption can disrupt the balance of:

gamma-aminobutyric acid (GABA) in the brain

glutamate

GABA controls impulsiveness and glutamate stimulates the nervous system.

Dopamine levels in the brain rise after consuming alcohol. Dopamine levels may make the drinking experience more gratifying.

Over the long- or medium-term, excessive drinking can significantly alter the levels of these brain chemicals. This causes the body to crave alcohol in order to feel good and avoid feeling bad.

Possible risk factors

Some risk factors may also be linked to excessive drinking.

Genes: Some specific genetic factors may make some people more likely to develop an addiction to alcohol and other substances. There may be a family history.

The age of the first alcoholic drink: A study has suggested that people who start drinking alcohol before the age of 15 years may be more likely to have problems with alcohol later in life.

Easy access: There appears to be a correlation between easy access to alcohol — such as cheap prices — and alcohol abuse and alcohol-related deaths. One study registered a significant drop in alcohol-related deaths after one state raised alcohol taxes. The effect was found to be nearly two to four times that of other prevention strategies, such as school programs or media campaigns.

Stress: Some stress hormones are linked to alcohol abuse. If stress and anxiety levels are high, a person may consume alcohol in an attempt to blank out the upheaval.

Peer drinking: People whose friends drink regularly or excessively are more likely to drink too much. This can eventually lead to alcohol-related problems.

Low self-esteem: Those with low self-esteem who have alcohol readily available are more likely to consume too much.

Depression: People with depression may deliberately or unwittingly use alcohol as a means of self-treatment. On the other hand, consuming too much alcohol may increase the risk of depression, rather than reducing it.

Media and advertising: In some countries, alcohol is portrayed as a glamorous, worldly, and cool activity. Alcohol advertising and media coverage of it may increase the risk by conveying the message that excessive drinking is acceptable.

How the body processes (metabolizes) alcohol: People who need comparatively more alcohol to achieve an effect have a higher risk of eventually developing health problems related to alcohol.

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