Alcohol Addiction and Treatment

Problematic alcohol use is a prevalent public health issue in the U.S.¹ According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), around 14 million American adults aged 18 and older have alcohol use disorder (AUD), the diagnosis for alcohol addiction.¹

No matter how bad things might seem right now, treatment helps many people recover. Research indicates that roughly 1/3 of people who are treated for alcohol use disorders have no further symptoms 1 year later, and others make significant improvements in their drinking and alcohol-related problems.¹ Evidence-based treatment, which can mean behavioral therapies and medication, has been shown to be effective for treating AUD and can help you start the path to recovery.²

What is Alcohol Addiction?

Alcohol use disorder is a chronic medical issue characterized by compulsive alcohol use despite the negative consequences.³  When AUDs develop, people become unable to control their alcohol intake and drink even when their health and overall wellbeing suffer.³

A person’s risk for developing AUD is thought to be influenced by their patterns of drinking in addition to several other factors, which can include:

• Using alcohol at an early age. Research has found that people who start drinking before age 15 are 5 times more likely to develop AUD than those who wait until they are 21 to start drinking.³
• Genetics and/or family history of alcohol problems. Genes aren’t destiny, but the interaction between genes and the environment may increase your risk. Research shows that AUD is up to 60% heritable.³ Having a close relative with AUD can increase risk by 3–4 times.⁴ Having parents who drank alcohol around you can also increase the risk.³
• Social, cultural, and other environmental factors. For example, exposure to peer pressure, thinking that alcohol will help you cope with stress, or viewing drinking and intoxication as relatively favorable cultural norms could raise the risk of developing alcohol-related problems.⁴
• Having a high level of impulsivity is usually related to more severe AUD and an earlier onset of the disease.⁴

Alcohol can affect communication pathways within the brain and alter certain types of physiological functions.⁵ For example, it can negatively impact the areas that are responsible for balance, coordination, and memory.⁵ Its impact on several key regions of the brain, including those involved with impulsivity, executive function, and reward, can ultimately reinforce continued drinking behavior and further promote the cycle of alcohol addiction.⁶

Signs of Alcohol Addiction

The American Psychiatric Association outlines several criteria for AUD in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Doctors and other treatment professionals use these criteria to diagnose alcohol use disorders. Though not intended for people to diagnose themselves, it can be helpful to understand the diagnostic criteria and signs of alcohol addiction, which include:⁴

• Using alcohol in higher quantities or more frequently than you originally intended.
• Being unable to cut down or control your alcohol use.
• Spending most of your time obtaining, using, and recovering from the effects of alcohol.
• Experiencing cravings, or intense desires for alcohol.
• Being unable to fulfill obligations at work, home, or school due to alcohol use.
• Continuing to drink alcohol despite having social or interpersonal problems that are caused or worsened by alcohol.
• Continuing to use alcohol despite knowing that you have a persistent or ongoing physical or mental health problem that is likely due to your alcohol use.
• Giving up activities you once enjoyed in order to drink alcohol.
• Drinking alcohol in situations where it is physically dangerous to do so (such as while driving or operating machinery).
• Developing tolerance, which means you need to drink increasingly more to achieve a desired level of intoxication.
• Experiencing withdrawal symptoms when you stop drinking or needing to continue drinking to relieve or avoid such symptoms.

Health Effects from Alcohol Misuse

Alcohol misuse can result in negative short- and long-term effects. The types and severity of such effects may depend on how much and how often you drink.⁷

Potential short-term effects can include:⁷

• Acute alcohol poisoning.
• Injuries resulting from falls, drownings, car accidents, etc.
• Increased risk of engaging in violent behaviors.
• Increased likelihood of risky sexual behaviors, which can increase your chances of contracting sexually transmitted diseases.

Chronic alcohol use can harm your physical and mental health. Some of the potential long-term effects include:^7,8

• Cardiovascular issues, including high blood pressure, cardiomyopathy, and increased risk of stroke.
• Liver disease.
• Digestive problems.
• Nutritional deficiencies.
• Serious neurological conditions such as Wernicke-Korsakoff Syndrome.
• Increased risk of certain cancers, including breast, mouth, throat, esophagus, voice box, liver, colon, and rectum cancer.
• Learning and memory problems, including a risk of dementia.
• Mental health problems, such as depression or anxiety.
• Alcohol use disorders, including significant physiological dependence and withdrawal risks.

What is Alcohol Withdrawal?

When someone regularly drinks, they can develop alcohol dependence, which means that their bodies have adapted to the presence of alcohol to a point that withdrawal symptoms may arise when drinking slows or stops.⁹ Withdrawal symptoms for alcohol can range in severity from mild to severe and may be life-threatening in some cases.¹⁰

According to the DSM-5, withdrawal symptoms can include:⁴

• Autonomic hyperactivity (which includes symptoms such as sweating or pulse rate greater than 100 bpm).
• Hand tremors.
• Insomnia.
• Nausea or vomiting.
• Transient visual, tactile, or auditory hallucinations or illusions (such as seeing or hearing things that aren’t there).
• Psychomotor agitation, which means repetitive and purposeless movements.
• Anxiety.
• Generalized tonic-clonic seizures – the type most people think of when they think about seizures.

Though relatively rare, some people may also be at risk of serious withdrawal complications, such as delirium tremens, which can include symptoms such as visual hallucinations, profound confusion, tachycardia (rapid heartbeat), hypertension (high blood pressure), hyperthermia (low body temperature), agitation, and diaphoresis (excessive sweating).¹¹ It can be fatal if left untreated.¹¹

Alcohol detox, and particularly medically supervised detox, can help ensure your safety and comfort and minimize withdrawal symptoms. It can also provide immediate medical care should complications arise, which is why it is safer that detoxing at home. In fact, the Substance Abuse and Mental Health Services Administration (SAMHSA) indicates that the preferred setting of care for managing alcohol withdrawal is hospitalization or another form of 24-hour medical care.¹⁰ Occasionally, one may receive sedating medications such as benzodiazepines during alcohol withdrawal in order to help mitigate any potentially uncomfortable withdrawal symptoms, and to minimize the risk of severe withdrawal issues such as seizures.^10,11

Treatment for Alcohol Addiction

Treatment for AUD can involve a combination of medications and behavioral therapies. Medications for alcohol addiction treatment may include naltrexone, acamprosate, and disulfiram.¹ You may also participate in behavioral therapies, such as cognitive-behavioral therapy (CBT), to help you make positive and healthy changes to thoughts and behaviors that contribute to AUD.¹

Depending on your unique needs, treatment for AUD can take place in different settings. Potential treatment programs can include:

• Detox, which can be the first step in the recovery process. It helps you safely and comfortably withdraw from alcohol while preparing you for continued treatment efforts.¹²
• Inpatient/residential treatment. You live onsite and receive 24/7 care. It’s usually well-suited for people with relatively severe addictions, co-occurring mental or medical health issues, less stable living environments, and fewer social supports.¹²
• Outpatient treatment. Though treatment may take place at a rehab center or other clinical setting, you’re able to return home outside of treatment hours. Outpatient treatment settings can benefit people with less severe addictions, access to transportation, supportive home environments, and good support systems.¹²
• Alcoholism recovery is a lifelong process, so most people benefit from some form of ongoing care once formal treatment ends. This can include different options, such as regular checkups with a treatment provider, counseling, or participating in mutual support groups, like Alcoholics Anonymous (AA).¹

Finding Alcohol Addiction Help

Seeking alcohol addiction help might start with consulting your healthcare provider. They can perform an evaluation and help determine the appropriate setting based on your unique needs.¹ You can also find treatment facilities around the country using SAMHSA’s FindTreatment.gov website.

Reaching out to an addiction helpline, such as the one owned and operated by American Addiction Centers (AAC), can help answer questions you may have about alcohol addiction treatment and potentially help you find treatment. If you or a loved one are struggling, AAC is here to help. Please call to speak to an admissions navigator to learn more about your rehab options.