Alcoholism: Understanding Alcohol Addiction
All excess is ill, but drunkenness is of the worst sort. It spoils health, dismounts the mind, and unmans men.
Is Alcohol a Drug?
Yes, alcohol is a drug. Like any other drug, the alcohol contained in alcoholic beverages (ethanol) has physiological effects on the body when ingested and can even interact with other drugs and medications. Many of the effects of alcohol on the body and brain are pleasurable and are what we experience when we feel a “buzz”. These short-term effects include stress relief, anxiety reduction, and lowered inhibitions.
Alcohol effects the brain generally by suppressing excitatory nerve pathways, which is why alcohol is considered a depressant. Specific areas of the brain, however, are triggered by alcohol to release naturally-occurring opioids that result in the pleasurable feelings associated with drinking. When alcohol is consumed regularly, the long-term effects of alcohol on the brain include contracted and destroyed brain tissue (wet brain) which result in problems with cognition and memory and behavioral changes.
What is Alcoholism?
Alcoholism is an addiction to alcohol that medical experts now refer to as alcohol use disorder. Typically, a person that is physically dependent on alcohol to the point that abruptly stopping drinking would produce withdrawal is what is considered an alcoholic. Alcoholism is a disease in that it is characterized by an abnormal physical reaction to alcohol and occurrence is predicted by genetic, social, and psychological factors.
Critics of the disease-concept of alcoholism and addiction claim that because it is a consequence of choice, it cannot be a disease. Diabetes, however, has a similar element of choice. Just like not everyone who consumes too much sugar develops diabetes, not everyone who drinks too much becomes an alcoholic.
What Are the Signs and Symptoms of Alcoholism?
There are many signs that a person may be an alcoholic, but they vary depending on how far their addiction has progressed. The most obvious sign of an alcohol problem is alcohol withdrawal symptoms. Alcohol withdrawal is a condition experienced by alcohol dependent drinkers when they stop drinking. Symptoms can occur within several hours to several days after the last drink, but the alcohol withdrawal timeline varies depending on drinking patterns.
Symptoms of Alcohol Withdrawal Include:
- rapid heart rate
- sweating
- tremors (shakiness)
- insomnia
- nausea
- vomiting
- hallucinations
- restlessness
- anxiety
- agitation
- seizures
Another sign of alcoholism is frequent alcohol poisoning, which is characterized by serious symptoms of drinking too much alcohol. Heavy binge drinking large amounts of short periods can often result in alcohol poisoning. Signs and symptoms of alcohol poisoning include:
- Confusion
- Vomiting
- Seizures
- Slow breathing (less than eight breaths a minute)
- Irregular breathing (a gap of more than 10 seconds between breaths)
- Blue-tinged skin or pale skin
- Low body temperature (hypothermia)
- Passing out (unconsciousness) and can’t be awakened
Symptoms of chronic alcoholism can manifest as a myriad of complex medical problems. Chronic alcoholism can cause:
- Liver diseases like alcoholic hepatitis and cirrhosis – this is often produces noticeably yellow eyes and yellow skin, a condition called jaundice
- Digestive problems like ulcers, gastritis, and pancreatitis
- Heart problems like high blood pressure, cardiomyopathy, and arrythmia
- Diabetes complications
- Vitamin B1 deficiency which can cause problems with eye movement
- Damage to bones resulting in osteoporosis and low platelet count, which can cause bleeding problems
- Zinc deficiency
- Weakened immune system resulting in increased susceptibility to pneumonia
- Increased risk of mouth, throat, liver, esophagus, colon, and breast cancers
- Dementia and other neurological diseases
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Who Is At Risk of Developing Alcoholism?
“How does one become an alcoholic?” is a question that medical professionals have been trying to answer for decades. We know now that many mental health conditions increase the occurrence of alcoholism. This is called co-occurrence and is treated in specialized programs called dual-diagnosis treatment programs.
There are a lot of other factors that influence whether somebody becomes an alcoholic. There are biological factors like the quantity of endorphins released in the orbitofrontal cortex when alcohol is consumed. There are genetic factors: having a parent who is an alcoholic increases your chances of developing the disease. There are social factors like how common alcohol use is in your household or group of friends. And there are psychological factors like low self-esteem or the co-occurrence of PTSD, as is common in the military community and among veterans.
As of 2019, the National Survey on Drug Use and Health found that 14.5 million people in America ages 12 and older (5.3 percent of this population) struggled with alcoholism. This number was made up of 9 million men and 5.5 million women. Of those struggling with alcoholism, only 6.9 percent of the men and 7.9 percent of the women over age 18 received any sort of substance abuse treatment.
Commonly co-occurring mental health conditions:
Alcoholism and anxiety
Alcoholism with bipolar disorder
Alcoholism and depression
Alcoholism and PTSD
Alcoholism and schizophrenia
“Can alcoholism be cured?” is a question that will produce different answers depending on who you ask. Members of Alcoholics Anonymous, the largest fellowship for alcoholism recovery in the world, believe that alcoholism is a disease made up of a physical allergy, a mental obsession, and a spiritual malady that cannot be cured. Many experts in the field of addiction also believe that alcoholism is best treated as a chronic illness, for which there is no cure but there is treatment that can lead to long-term recovery. What this means is that an alcoholic can recover and stop drinking if treated properly, but they will never be able to drink “like a normal person”.
The most effective treatment for alcoholism includes a medically stabilized alcohol detox, followed by residential inpatient addiction treatment, and eventually aftercare programs like intensive outpatient therapy, alcohol counseling, 12-step fellowship, and individual therapy. During the detoxification, medical professionals monitor a patient for dangerous symptoms like seizures and delirium tremens and provide alcohol detox medications like Librium, Ativan, Clonidine, Zofran, and anti-convulsants. During residential addiction treatment, patients continue to receive medical monitoring and begin to undergo comprehensive therapy to address any underlying issues.
Doctors may prescribe medications to prevent alcohol relapse like Antabuse, Acamprosate, and Vivitrol once a patient has begun to recover. Many recovering alcoholics go on to live happy, productive, and alcohol-free lives but they must first take the step to reach out and get help.
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