Alcohol
What Is Alcohol?
Alcohol, also known as ethanol, directly impacts the central nervous system as a depressant. It’s produced by fermenting grains, fruits, or other sugar sources. Consuming small amounts of alcohol may create feelings of relaxation and sociability. However, excessive drinking can lead to intoxication, resulting in lethargy, unconsciousness, coma, or even death.
Chronic, heavy alcohol use can lead to alcohol addiction, also known as alcoholism or alcohol use disorder. It involves intense cravings, loss of control, and withdrawal symptoms when trying to quit, even when it causes serious problems.
As one of the most widely consumed recreational drugs, alcohol plays a significant role in many people’s lives. The 2023 National Survey on Drug Use and Health, revealed that more people over 12 in the United States consumed alcohol in the past year than any other drug or tobacco product. Additionally, alcohol use disorder remains the most prevalent type of substance use disorder in the country.
Health Effects of Excessive Alcohol Use
Drinking too much alcohol can seriously harm your physical, mental, cognitive, and social well-being.
Immediate Health Effects
- Consuming alcohol excessively, especially during binge drinking, often results in various harmful health conditions. These risks include:
- Injuries such as motor vehicle crashes, falls, drownings, and burns.
- Acts of violence, including homicide, suicide, sexual assault, and intimate partner violence.
- Alcohol poisoning, a life-threatening emergency caused by high blood alcohol levels.
- Risky sexual behaviors, like unprotected sex or having multiple partners, which can result in unintended pregnancies or sexually transmitted diseases, including HIV.
- Miscarriage, stillbirth, or fetal alcohol spectrum disorders (FASDs) in pregnant women.
- Alcohol withdrawal symptoms, ranging from anxiety, insomnia, and restlessness to severe symptoms like fever, tremors, seizures, hallucinations, and mental confusion.
Long-Term Health Effects
Over time, drinking too much alcohol can lead to chronic diseases and other serious health issues, including:
- High blood pressure, heart disease, stroke, liver disease, and digestive problems.
- A weakened immune system, which increases the chances of getting sick.
- Learning and memory issues, including dementia and poor academic performance.
- Mental health problems such as depression and anxiety.
- Social problems, including lost productivity, family issues, and unemployment.
- Alcohol use disorder (AUD), also known as Alcoholism or Alcohol Addiction.
- An increased risk of cancers, including those of the breast, mouth, throat, esophagus, liver, and colon.
Understanding Alcohol Use Disorder
What is Alcohol Use Disorder?
Alcohol use disorder (AUD) is a medical condition where individuals continue to drink alcohol despite negative consequences. Alcohol use disorder (AUD) can be mild, moderate, or severe, but it is not synonymous with alcohol abuse, dependence, or addiction. While these terms are often used interchangeably, AUD encompasses a broader range of drinking behaviors and symptoms, from occasional misuse to more severe forms of addiction.
In 2023, approximately 28.9 million people ages 12 and older were diagnosed with AUD in the United States, including 16.8 million males and 12.0 million females.
Is Alcohol Use Disorder a Disease?
Yes, AUD is a chronic disease that alters the brain’s reward and control centers, making it difficult for a person to control or stop drinking. Both relapse and recovery are possible with AUD. It’s not a matter of willpower or character; rather, it’s a complex medical condition that requires medical treatment.
As a person misuses alcohol regularly, they need more to achieve the same level of satisfaction. This habitual drinking can cause significant problems in their life, affecting their family, friends, and responsibilities. Over time, changes in the brain take away the ability to choose to stop drinking, even if it means losing everything they care about.
Is Alcohol Use Disorder Inherited?
Research suggests that genetics account for about half of the risk for developing alcohol use disorder. Multiple genes can either increase or decrease a person’s risk of developing AUD. For example, some individuals of Asian descent carry a gene variant that affects how they metabolize alcohol, causing symptoms like flushing, nausea, and a rapid heartbeat when they drink. Those who experience these effects may avoid alcohol, which can protect them from developing an alcohol use disorder.
However, genetics alone do not determine whether someone will develop AUD. Psychological, social, and environmental factors play a significant role. Traits such as impulsiveness, low self-esteem, and a need for approval can lead to inappropriate drinking. Some people may also drink to cope with emotional problems. Factors such as peer pressure, easy access to alcohol, poverty, and experiences of physical or sexual abuse can also increase the likelihood of developing an alcohol use disorder.
How Do Doctors Diagnose Alcohol Use Disorder?
AUD typically develops gradually. It often starts with experimental use and over time progresses into a regular need, even when it negatively impacts health and safety. While a self-test can provide some insights, a formal diagnosis should be made by a healthcare provider.
What is the Best Way to Stop Drinking Alcohol?
Alcohol withdrawal symptoms occur when heavy or prolonged alcohol use is suddenly reduced or stopped. Symptoms can begin as early as six hours after the last drink and may include tremors, anxiety, insomnia, restlessness, and nausea. In cases of mild alcohol dependence, symptoms may subside without treatment after a few days.
More severe withdrawal symptoms occur in approximately 10% of individuals and include a low-grade fever, rapid breathing, tremors, and profuse sweating. Seizures can happen in more than 5% of untreated cases. Delirium tremens (DTs) is another severe complication, characterized by hallucinations, mental confusion, and disorientation. The mortality rate among patients with DTs ranges from 5% to 25%.
Avoid attempting to stop drinking alcohol without medical supervision, especially if you have a history of heavy drinking or severe symptoms. Alcohol withdrawal can be life-threatening if not managed properly. Outpatient alcohol withdrawal management by trained professionals is a safe, effective, and convenient way to stop drinking.
How is Alcohol Use Disorder Treated?
The most effective alcohol use disorder treatment tailors care to each individual’s needs, addressing substance use, medical, mental, and social health. This holistic approach ensures comprehensive care, leading to lasting positive outcomes.
For many people with AUD, a combination of medication, counseling, and mutual support groups is highly beneficial. This comprehensive approach helps manage cravings, develop healthier coping mechanisms, and sustain long-term recovery.
FDA Approved Medications for Treating Alcohol Use Disorder
- Naltrexone: Blocks the brain receptors involved in craving alcohol or the rewarding effects of drinking. It can be taken as a daily pill or as a monthly injection (Vivitrol).
- Acamprosate: Helps maintain abstinence by alleviating some negative symptoms of prolonged abstinence. It is taken as 2 pills three times per day.
- Disulfiram: Causes unpleasant symptoms, such as nausea and flushing, when alcohol is consumed. This helps deter individuals from drinking.
Combining Medications
Not everyone will respond to a single medication. Combining different medications that utilize various therapeutic mechanisms may be necessary for those who do not respond well to monotherapy. Clinical judgment, weighing risks and benefits, is crucial in a shared decision-making approach to treatment.
Behavioral Interventions for Alcohol Use Disorder
Behavioral interventions for Alcohol Use Disorder (AUD) are counseling strategies aimed at helping individuals change their drinking behaviors and develop healthier coping mechanisms. These interventions are crucial components of treatment and can be tailored to meet the unique needs of each person.
Key therapies include Cognitive-Behavioral Therapy (CBT), which teaches coping skills to manage triggers, and Motivational Enhancement Therapy, which builds motivation and confidence to change drinking habits. Mindfulness-based interventions help individuals focus on the present, choosing responses rather than reacting impulsively. These therapies also help develop skills to avoid relapse triggers.
Mutual Support Groups
Mutual support groups provide a community of individuals facing similar challenges, offering encouragement and shared experiences. Examples include:
- Alcoholics Anonymous (AA): A 12-step program where members share experiences and support each other in maintaining sobriety.
- SMART Recovery: Focuses on self-empowerment and teaches tools to manage addictive behaviors through cognitive-behavioral techniques.
- Women for Sobriety (WFS): A support group specifically for women, emphasizing emotional and spiritual growth.
- Celebrate Recovery: A Christian-based program that integrates faith with the 12-step principles to address addiction and related issues.
- Secular Organizations for Sobriety (SOS): Offers a non-religious alternative to traditional 12-step programs, focusing on personal responsibility and self-reliance.
Recovery is Possible
Grasping the complexity of alcohol use disorder (AUD) is crucial for successful treatment and recovery. With millions affected, a comprehensive approach—incorporating medications, behavioral interventions, and mutual support groups—provides a clear path to recovery. This journey requires ongoing care, dedication, and a personalized combination of resources to meet individual needs.
REFERENCES
- Substance Abuse and Mental Health Services Administration. (2024). Key substance use and mental health indicators in the United States: Results from the 2023 National Survey on Drug Use and Health (HHS Publication No. PEP24-07-021, NSDUH Series H-59). Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/data/report/2023-nsduh-annual-national-report
- National Institute on Alcohol Abuse and Alcoholism. (2024). Alcohol’s Effects on Health Research-based information on drinking and its impact. Retrieved from https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/understanding-alcohol-use-disorder
- Trevisan, L. A., Boutros, N., Petrakis, I. L., & Krystal, J. H. (1998). Complications of alcohol withdrawal: pathophysiological insights. Alcohol health and research world, 22(1), 61–66. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6761825/
- Stokłosa, I., Więckiewicz, G., Stokłosa, M., Piegza, M., Pudlo, R., & Gorczyca, P. (2023). Medications for the Treatment of Alcohol Dependence-Current State of Knowledge and Future Perspectives from a Public Health Perspective. International journal of environmental research and public health, 20(3), 1870. Retrieved from https://doi.org/10.3390/ijerph20031870
- Witkiewitz, K., Litten, R. Z., & Leggio, L. (2019). Advances in the science and treatment of alcohol use disorder. Science advances, 5(9), eaax4043. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6760932/
2023 National Survey on Drug Use and Health: Alcohol Use in the United States
Any Alcohol Use in the Last Month
In the past month, 47.5% of people aged 12 or older in the United States reported using alcohol (about 134.7 million people). The highest percentage was among adults aged 26 or older (51.9% or 116.1 million people), followed by young adults aged 18 to 25 (49.6% or 16.9 million people), and adolescents aged 12 to 17 (6.9% or 1.8 million people).
Binge Alcohol Use in the Last Month
Binge alcohol use in the past month was reported by 21.7% of people aged 12 or older (approximately 61.4 million people). The highest percentage was among young adults aged 18 to 25 (28.7% or 9.8 million people), followed by adults aged 26 or older (22.7% or 50.6 million people), and adolescents aged 12 to 17 (3.9% or 1.0 million people). Binge drinking is defined as consuming five or more drinks (for males) or four or more drinks (for females) on the same occasion on at least one day in the past 30 days.
Heavy Alcohol Use in the Last Month
Heavy alcohol use in the past month was reported by 5.8% of people aged 12 or older (about 16.4 million people). The highest percentage was among young adults aged 18 to 25 (6.9% or 2.4 million people), followed by adults aged 26 or older (6.2% or 13.9 million people), and adolescents aged 12 to 17 (0.5% or 141,000 people). Heavy alcohol use is defined as binge drinking on the same occasion on five or more days in the past 30 days.
Underage Alcohol Use in the Last Month
Among people aged 12 to 20, 14.6% (or 5.6 million people) reported alcohol use in the past month. Binge alcohol use was reported by 8.6% (or 3.3 million people) and heavy alcohol use by 1.7% (or 663,000 people).
Behavioral Therapies For Alcohol Use Disorder include:
Cognitive-Behavioral Therapy (CBT)
CBT can take place one-on-one with a therapist or in small groups. This form of therapy is focused on identifying the feelings and situations (called “cues”) that lead to heavy drinking and managing stress that can lead to relapse.
The goal is to change the thought processes that lead to alcohol misuse and to develop the skills necessary to cope with everyday situations that might trigger problem drinking.
Motivational Enhancement Therapy
Motivational enhancement therapy is conducted over a short period of time to build and strengthen motivation to change drinking behavior. It helps patients weigh treatment pros and cons, create a change plan, build confidence, and develop necessary skills.
Contingency Management
Contingency management uses tangible rewards to reinforce positive behaviors like abstinence or regular attendance. Patients receive rewards for meeting specific, measurable treatment goals.
Behavioral Couples and Family Counseling
Behavioral couples and family counseling involves partners and family members in the treatment process. This approach focuses on repairing and improving family relationships by incorporating positive activities, communication skills training, and identifying relapse triggers.
Brief Interventions
Brief interventions consist of a few short, one-on-one counseling sessions. During these sessions, the physician or counselor provides information about the individual’s drinking pattern and potential risks. Together, they set goals and discuss strategies for making positive changes.
12-Step Facilitation Therapy
12-Step Facilitation Therapy is used to engage patients in 12-step-based mutual help groups, like AA, alongside professional outpatient treatment. The counselor works with the patient to encourage, review, and reinforce their participation in AA. This structured process may include reading assignments, journaling, and setting weekly participation goals.
Mindfulness-Based Relapse Prevention (MBRP)
MBRP combines CBT skill-building techniques with mindfulness practices. This approach encourages flexible responses to physical and emotional triggers, rather than automatic “autopilot” reactions that lead to drinking.
Struggling with an Alcohol Use Disorder?
If you or a loved one is struggling with an alcohol use disorder, call Solstice Health & Wellness to schedule an appointment, or to learn more about addiction recovery services, contact us.
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