Alcohol Use Disorder: A Common Problem
Alcoholism is one of the most common forms of substance abuse in America, and worldwide. The National Institute on Alcohol Abuse and Alcoholism has found that 6.2% of adults over the age of 18 have what is known as alcohol use disorder (AUD), also referred to as alcohol addiction, alcohol dependency, or simply alcoholism, and the American Psychiatric Association recognizes alcohol use disorder as one of the most common mental health problems affecting Americans.
Alcohol Abuse Vs. Alcohol Use Disorder
It is important to distinguish between the abuse of alcohol and alcohol use disorder (AUD) as stated by the National Institute on Alcohol Abuse and Alcoholism. While both revolve around unhealthy alcohol use, there are important features that differentiate them.
Alcohol Abuse: Consequences
People who engage in alcohol abuse or alcohol misuse have a pattern of drinking that leads to major, repeated negative consequences for their lives and their health.
professional and legal consequences
People who engage in alcohol misuse may neglect important responsibilities at work because of their alcohol consumption. They may also face legal problems if they drive after drinking too much alcohol or behave in dangerous or illegal ways after they drink alcohol.
personal and familial consequences
They may have to seek marital and family counseling to address issues that stem from their alcohol use disorder, which can affect their family members. Some people only learn that their alcohol use has negatively impacted their lives when they enter family therapy.
Heavy drinking vs. alcoholism
Still, not everyone who engages in alcohol misuse would technically qualify as having alcohol use disorder. Some people are better characterized as heavy drinkers. They may face the consequences above, but not fully fit the criteria in the Diagnostic and Statistical Manual (a reference guide used to diagnose mental disorders) for alcohol use disorder.
Alcohol Use Disorder: Symptoms
The American Psychiatric Association and the National Institute on Alcohol Abuse and Alcoholism define alcohol use disorder more specifically than the abuse of alcohol. To qualify for alcohol use disorder, one must have alcohol dependence, which includes the following features.
Inability to control consumption
People with alcohol use disorder are often unable to control how much alcohol they drink once they start drinking. They may set out to have one or two drinks, then find themselves having several. Their alcohol consumption is beyond their control.
Alcohol cravings in a person with alcohol use disorder are different from those in a heavy drinker. A heavy drinking person may be able to stop after a set number of drinks, whereas a diagnosable alcoholic may find their cravings increasing as they drink more.
Tolerance
One feature of alcohol use disorder is tolerance. Increased tolerance means that people with alcohol problems must drink more over time in order to achieve the feeling they are seeking.
People who engage in heavy drinking on a regular basis are likely to find that they need more drinks than they once did to get drunk, or just to feel normal. Their alcohol use thus increases as they try to reach the sense of ease and comfort they are seeking.
Withdrawal Symptoms
Another key diagnostic feature is that people with alcohol use disorder frequently experience withdrawal symptoms. Alcohol withdrawal can be dangerous, as it is one of few substance use disorders that can actually result in death from withdrawal symptoms.
People with prolonged problematic alcohol use can have deadly seizures if they stop drinking suddenly (what is known colloquially as “cold turkey “)without the help of treatment professionals to monitor their health and assist them through their withdrawal symptoms.
Health Risks of Heavy Drinking and Alcohol Use Disorder
In both the short and long term, heavy drinking and alcohol use disorder can lead to major health problems.
Short Term Health Risks
Drinking heavily, even once, places a person at risk of a number of negative health outcomes in the short term.
Increased risk of injury
People who consume alcohol to excess face increased risk of injury in car accidents if they drive while intoxicated. They are also at higher risk of falling due to their impaired balance, drowning, and being severely burned.
increased risk of violence
People who consume alcohol to excess also face increased risk of being a perpetrator or victim of violence. They are at higher risk of committing homicides or being victims of homicides, committing or falling victim to sexual assault, and being involved in intimate partner violence (also known as domestic abuse).
risky sexual behaviors
People who drink heavily are also more likely to engage in risky sexual behaviors, that can lead to unwanted pregnancies or infection with sexually transmitted diseases.
Long Term Health Risks
Drinking alcohol heavily on a regular basis, as is the case with most sufferers of alcohol use disorder incurs additional serious health risks over a long term period.
Cardiovascular and digestive issues
People with alcohol use disorder often deal with high blood pressure and have an increased risk of stroke. They may also suffer from heart disease. Additionally, they face problems with digestion, a result of the strain that processing alcohol puts on the stomach and the liver. Liver disease is one of the most common issues affecting people with alcohol use disorder.
Increased cancer risk
Alcohol use disorder places a person at higher risk for many cancers, including mouth, throat, and esophageal cancer. They also face higher risk of cancer of the liver, colon, and rectum, areas that are put under additional strain by alcohol use disorders.
Weakened immune system
Alcohol use disorder puts incredible strain on the immune system, making it easier for people to contract other diseases. Because the body is going through so much trouble processing the toxic substance, the immune system is less capable of responding to other threats, making the flu, the common cold, and even COVID-19 more likely to infect people with alcohol use disorder.
cognitive issues
Alcohol use disorder leads to problems with learning and with forming memories, and can eventually lead to Wernicke-Korsakoff Syndrome, better known as wet brain. This is a form of dementia that is specific to late-stage sufferers of alcohol use disorder. It causes lesions on the brain that ultimately lead to impaired coordination, hallucinations, memory loss, disorientation, and an inability to care for one’s self.
fetal alcohol syndrome
Women with alcohol use disorder who are unable to stop drinking during pregnancy face increased risk of miscarriage and stillbirth. If they carry their child to term, the baby is likely to suffer from fetal alcohol syndrome (FASD).
Babies with FASD have lower body weight, heart and kidney problems, and abnormal facial features. They may also have uncoordinated movements, hyperactivity, difficulty paying attention and retaining information, and speech and language delays. These issues may constitute an intellectual disability.
Treatment Options
Luckily, there are a range of options for people who are seeking treatment for alcohol use disorder. Turning Point of Tampa is a treatment center that incorporates elements of all of the following treatment plans. Turning Point is a great source for primary treatment for alcohol use disorder, as well as eating disorders and issues with drug abuse. Turning Point of Tampa now offers Inpatient Detox to prevent withdrawal symptoms that could be fatal. Read on to learn about some of the most popular addiction treatment programs for alcohol dependence.
The Alcoholics Anonymous Treatment Program
Alcoholics Anonymous is a group founded in 1935 in Akron, Ohio. It is a nationwide support group for people who identify as alcoholic. Although Alcoholics Anonymous does not endorse or operate treatment centers or other professional institutions, its 12 steps are an important part of the treatment process at many alcohol treatment centers.
The AA CONCEPT of Alcoholism
Alcoholics Anonymous describes alcoholism two ways: The alcoholic cannot stop drinking alcohol entirely, and/or they cannot control the amount they take once they begin drinking. Let’s take a moment to look more closely at these two features of the AA definition of alcoholism.
Inability to stop entirely
Some people may go for days or weeks without drinking, but cannot do so permanently. AA holds that this indicates that they suffer from alcohol use disorder. They may successfully string together weeks, months, or years of abstinence, but they always return eventually. If when you try to stop drinking, you cannot do so permanently, you fit the bill for AA’s definition of alcohol use disorder.
The Phenomenon of Craving
While many people feel themselves becoming intoxicated after a few drinks and feel compelled to slow down or stop drinking for the night, others cannot stop once they start. This is the second feature in the AA definition of alcoholism.
The AA Big Book describes this as “the phenomenon of craving,” an experience in which one drink inevitably leads the alcoholic drinker to crave more. A person’s drinking habits can be a clue to whether they are suffering from alcohol use disorder, as observers might note that they continue drinking alcohol even when they have promised themselves and others that they will only have one or two drinks.
How AA HELPS PEOPLE WITH alcohol use disorder
Alcoholics Anonymous uses a 12-step spiritual framework to help people with alcohol use disorder. Many other 12-step programs and support groups have sprung up following AA, including Narcotics Anonymous, Cocaine Anonymous, Overeaters Anonymous, and Sex and Love Addicts Anonymous.
The 12 Steps
The 12 steps begin by asking people with alcohol use disorder to admit that they are powerless over their alcohol dependence, and that their lives are out of control as a result.
They must then accept that a power greater than themselves can help them overcome their insanity. While many people choose some form of God as their higher power, AA is open to people of all faiths, and even to atheists. Your personal higher power can be whatever you choose-so long as it is not yourself. For many people, their higher power is the group or program of AA.
The third step constitutes making a decision to turn your life over to your higher power, whatever that may be, giving up on your own ideas of how to fix your drinking behavior and your other problems.
In the fourth step, people with alcohol use disorder conduct a moral inventory, in which they catalogue their resentments, their faults, and their moral defects, and work toward forgiving others for harm done to them in the past, while recognizing their own role in perpetuating that harm.
In the fifth step, sufferers of alcohol addiction admit the wrongs and character defects uncovered in the previous step to their higher power, themselves, and another person (often a sponsor).
In the sixth step, alcoholics become ready for their higher power to remove their character defects.
In the seventh step, sufferers of alcohol use disorder humbly ask their higher power to remove their resentments, character defects, and the shortcomings that have led to their excess alcohol consumption and unmanageable way of living.
In the eighth step, people with alcohol use disorder are asked to create a comprehensive list of those they have harmed (regardless of whether their alcohol use disorder was involved in that harm) and to become willing to amend the harm they have caused.
In the ninth step, they attempt to right the wrongs identified in the previous step, except where doing so would harm them or others.
In the tenth step, sufferers of alcohol use disorder continue to take moral inventory on a regular basis and strive to admit when they are wrong.
In the eleventh step, people with alcohol use disorder seek to improve their contact with their higher power, usually through prayer and meditation.
In the twelfth and final step, recovering alcoholics strive to carry the message of AA to alcoholics who are still suffering from alcohol use disorder and to practice the principles of AA throughout every domain of their lives. This is the stage at which many alcoholics begin sponsoring others, although some may begin to do so earlier.
Many sufferers of alcohol use disorder go through the steps multiple times during their recovery. But others may not be inclined to pursue a program based on spirituality. Luckily, there are other options for people who want help with their alcohol use disorder but do not want to follow AA’s plan of action.
The Substance Abuse and Mental Health Services Administration Treatment Program
The Substance Abuse and Mental Health Services Administration takes a more scientific view of alcoholism than AA. SAMHSA is used here to denote a variety of more science-based treatment options that differ from AA’s spiritual framework. Alcoholism treatment is not one-size fits all, and SAMHSA’s recommended programs are more aligned with the concept that alcohol use disorder is a medical condition, rather than the spiritual malady that AA conceptualizes it as.
The Mental Health Perspective on Alcoholism Treatment
People who seek treatment for alcohol use disorder and do not wish to join AA or follow the 12 steps can follow a less spiritual treatment plan that treats alcoholism as a medical condition.
SAMHSA notes that people with mental health issues often turn to alcohol use as a form of self-medication. Unfortunately, they may develop alcohol use disorder while trying to deal with other mental health issues like depression or anxiety. And alcohol use can make some mental disorders worse.
SAMHSA’s framework, as well as that of the National Institute on Alcohol Abuse and Alcoholism, looks at alcohol use disorder in the context of mental health, rather than spiritual health. Here are some of the options they suggest for people seeking help with alcohol problems or full-on alcohol use disorder.
Group therapy
While AA is often thought of as a support group and frequently includes group meetings, they are not led by licensed therapists. People with alcohol related problems may benefit from group therapy led by licensed clinicians who can guide them through clinically tested and proven therapy modalities.
These exercises can include identifying group member’s personal and shared experiences with problematic drinking, sharing techniques they use to combat alcohol cravings, and sometimes charting their alcohol intake to get a grasp on exactly how much they are using, so that they can set measurable goals for reducing their use. In outpatient rehab settings, these groups might bring in family members to share about how alcohol use disorder has affected their loved ones.
The abstinence-only approach that AA advocates for can also be intimidating to some people with alcohol problems who don’t identify alcohol use disorder as their biggest issue. They may find benefit in support groups that don’t set total abstinence as a goal, but rather a reduction in problem drinking, or in support groups that focus on other mental health issues that may be contributing to their alcohol problems.
For example, a person who has started drinking heavily in the wake of the loss of a family member may need to go to a grief support group as a brief intervention to help them get back on track. Having clinically-licensed professionals in charge of the group increases their chances of success.
Behavioral therapies
Another form of talk therapy that has proven helpful to many sufferers of alcohol use disorder is behavioral treatment. This is one of many treatment methods centered on the science of behaviorism, which identifies how people form both positive and negative habits, and how they can be broken.
Motivational enhancement therapy is one of a few behavioral therapies that are employed in alcohol counseling. Alcohol counselors work to help people build their own intrinsic motivation to stop or decrease their drinking behavior, recognizing that external consequences can have little impact on people who drink to cope with the same consequences their drinking habits have produced.
Behavioral treatments often start by identifying triggers, or stimuli that lead a person to want to drink. The treatment provider will then develop a treatment plan for decreasing the effect of these triggers.
Treatment success depends on breaking the connection between the trigger and the problematic behavior. For example, a person who drinks whenever he has a bad day at work might be taught healthier coping skills to deal with workplace stress, like exercising or doing a creative activity.
Behavioral treatments are often part of ongoing treatment following discharge from a treatment center. It’s important to recognize that behavioral treatment and AA are not mutually exclusive, but may actually work well together. The National Institute on Alcohol Abuse and Alcoholism has found that people who continue to receive therapy after they leave a treatment center have increased chances of long-term success in recovery.
