In England there an estimated 587,780 dependant drinkers. Only 18% are receiving treatment (https://alcoholchange.org.uk/). In 2018/19 there were 358,000 admissions to hospital due to drinking alcohol. Men and women aged 55 to 64 had the highest proportions usually drinking over 14 units in a week (https://digital.nhs.uk/). Although drinking alcohol is part of many people’s lives, but how do we know when we’ve crossed the line and alcohol becomes an addiction?
About alcohol usage
How does it make you feel?
When consumed in moderation, alcohol can cause relaxation and happiness, but when consumed in excess and misused, it can lead to addiction and illness. Alcohol addiction, if untreated, will likely worsen and can even be life-threatening.
Signs and symptoms of alcoholism (alcohol dependence)
Alcoholism is the most severe form of problem drinking. Alcoholism involves all the symptoms of alcohol misuse, but it also involves another element: physical dependence on alcohol. If you rely on alcohol to function or feel physically compelled to drink, you may suffer from alcoholism.
Tolerance: The 1st major warning sign of alcoholism
Do you have to drink a lot more than you used to in order to get buzzed or to feel relaxed? Can you drink more than other people without getting drunk? These are signs of tolerance, which can be an early warning sign of alcoholism. Tolerance means that, over time, you need more and more alcohol to feel the same effects.
Withdrawal: The 2nd major warning sign
Do you need a drink to steady the shakes in the morning? Drinking to relieve or avoid withdrawal symptoms is a sign of alcoholism and a huge red flag. When you drink heavily, your body gets used to the alcohol and experiences withdrawal symptoms if it’s taken away.
Drinking alcohol causes a wide range of physical and mental health problems, either because of binge drinking or from regularly drinking more than 14 units per week.
Binge drinking can lead to injuries from falls, accidents or assaults. Drinking above the low risk guidelines on a regular basis can cause illnesses such as depression, high blood pressure, stroke, liver disease, cancers of the throat, mouth, breast and liver.
There are short-term risks like injuries and accidents which can happen because of being drunk. Head injuries in particular can be life-threatening. Other short-term risks such as alcohol poisoning are also dangerous.
Long-term risks come from regularly drinking alcohol over the low risk guideline over a long time. Then the risks of getting different diseases increase and can lead to illnesses, such as cancer, stroke, heart disease, liver disease, and damage to your brain and nervous system. Over time, the brain and body can become dependent on receiving a steady dose of the alcohol, even while the alcohol is destroying vital bodily systems. This physical dependence is a sign of addiction.
Long-term effects include damage to the brain, body and its organs. This can take years to develop and can lead to a wide range of serious health problems, like cancers, that you may not realise are due to alcohol, and can have adverse effects on those around you, family members, work colleagues and financial difficulty.
Also, those who suffer from a mental health disorders such as anxiety, depression, or bipolar disorder are also particularly at risk, because alcohol may be used to self-medicate. Co-existing alcohol misuse (or any addiction) and a mental health disorder is known as Dual Diagnosis.
Do you have a drinking problem?
It’s not always easy to tell when your alcohol intake has crossed the line from moderate or social drinking to problem drinking. Drinking is so common in many cultures and the effects vary so widely from person to person, it’s not always easy to figure out if you have a drinking problem. But if you consume alcohol to cope with difficulties or to avoid feeling bad, you’re in potentially dangerous territory.
You may have a drinking problem if you:
- Feel guilty or ashamed about your drinking
- Lie to others or hide your drinking habits
- Need to drink to relax or feel better
- “Black out” or forget what you did while you were drinking
- Regularly drink more than you intended to
The bottom line is how alcohol affects you. If your drinking is causing problems in your life, then you have a drinking problem.
Repeatedly neglecting your responsibilities at home, work, or school because of your drinking. For example, performing poorly at work, missing or failing classes, neglecting your kids, or not fulfilling commitments because you’re hung over.
Using alcohol in situations where it’s physically dangerous, such as drinking and driving, operating machinery while intoxicated, or mixing alcohol with prescription medication against clinical advice.
Experiencing repeated legal problems on account of your drinking. For example, getting arrested for driving under the influence or for drunk and disorderly conduct.
Continuing to drink even though your alcohol use is causing problems in your relationships. Getting drunk with your friends for example, even though you know this may upset your partner, or fighting with your family because they dislike how you act when you drink.
Drinking as a way to relax or de-stress. Many drinking problems start when people use alcohol to self-soothe and relieve stress (otherwise known as self-medicating). Getting drunk after every stressful day, for example, or reaching for a bottle every time you have an argument with a loved one or work colleague.
Withdrawal from alcohol dependence is unpleasant, but it is different to a hangover. Hangovers are very common but the science behind them is not well understood. Short-term effects of alcohol metabolism, effects on the balance of chemicals in the nervous system, irritation of the stomach lining, dehydration and general inflammation may all be part of a hangover, as well headaches, nausea, dry mouth, abdominal pain, irritability and tiredness.
However, withdrawal is different and complex, and is more to do with adaptation of the brain and body to alcohol use and then upset to the ‘new balance’ of chemical states when alcohol is withdrawn. Sometimes, significant or frequent binge-drinking may not just lead to a hangover but also some features of withdrawal like tremors and sweating.
Damage to nerve cells from prolonged alcohol misuse can also lead to what is commonly referred to as ‘the shakes’ and may be accompanied by confusion, profuse sweating and severe nausea, resulting in an inability to maintain proper fluid levels within the body. Dehydration can compounds other withdrawal symptoms include:
- Anxiety or jumpiness
- Shakiness or trembling
- Nausea and vomiting
- Loss of appetite
In severe cases, withdrawal from alcohol can result in confusion, delirium and hallucinations, and even seizures. This type of withdrawal is dangerous and is called delirium tremens or “DTs”. It can potentially be fatal and this is why people who are dependent long-term on alcohol should never stop drinking suddenly on their own and a medically-led detox is safest.
Our programme model is tailored to the individual’s needs. Our detox varies depending on whether the substance is a lone problem or is accompanied by misuse of other substances, the amount the patient is using, and if there any underlying mental health issues. The internal audits of the BONDS treatment protocols of many years have shown that approximately 70% of patients with alcohol or substance misuse also have an underlying mental health disorder. This combination of addiction and a mental health disorder is called Dual Diagnosis.