Alcohol use disorder is, tragically, a prevalent disease in the United States today. A brief look at available research indicates the following:
• 14.4 million Americans over the age of 18 or roughly 5.8% of this population have an alcohol use disorder. Alcohol use disorder tends to slant towards men, with 9.2 million men and 5.3 million women suffering from this disease.
• 26% of Americans said they binge drank in 2018.
• 88,000 people die every year of alcohol-related causes.
The good news is that there are more ways than ever that this disorder can be treated. While some people are more likely to become addicted to alcohol, a wide range of treatments have been developed that can help people recover from their addiction and lead a good and healthy life.
What Is Alcohol Addiction?
Alcohol addiction, which has been renamed “alcohol use disorder,” is defined as a problem with alcohol that creates severe problems and dependency-related issues in a person’s life. Alcohol use disorder is more than just having an occasional drink at a party or a glass of wine with dinner. It means someone who has a dependence on alcohol that makes it difficult — or impossible — to stop drinking.
The Diagnostic & Statistical Manual of Mental Disorders lists formal criteria to define an alcohol use disorder. These include answering affirmatively to the following questions or scenarios:
• Had instances of drinking more or longer than intended
• Failed at more than one effort to stop drinking
• Spent a lot of time drinking or was sick after drinking
• Had such a strong desire to drink that the ability to think of anything else was impossible
• Found that drinking or being hungover after drinking interfered with family responsibilities or home responsibilities or created problems at work or school
• Continued drinking even though drinking was causing problems with family or friends
• Cut back on previously fun, interesting or engaging activities in order to drink more
• Got into dangerous situations as a result of drinking, such as driving impaired or engaging in unsafe sexual practices, that increased the odds of being injured or killed
• Continued drinking despite the presence of increased depression or anxiety that came as a result of the drinking or if the drinking exacerbated an existing health problem
• Demonstrated an increased tolerance to alcohol resulting in the need to drink more in order to achieve the desired effect or showed that drinking the same amount of drinks had less effect than it did previously
• Showed withdrawal symptoms after no longer drinking, including trouble sleeping, sweating, or a racing heartbeat.
Under these criteria, answering yes to two to three of these questions indicated a mild alcohol use disorder, four to five meant a moderate alcohol use disorder, and six or more “yes” answers meant a severe alcohol use disorder.
Other symptoms of alcohol use disorder include:
• Feeling a constant urge to drink
• Drinking secretly
• An inability to regulate the amount of alcohol you drink
• Storing alcohol in uncommon places in order to avoid detection or increase the convenience under which you can drink
• Having alcohol negatively impact important relationships in your life
What Is Binge Drinking?
All forms of alcohol are not identical. Indeed, some people suffer from specific types of alcohol abuse. One such example is binge drinking.
According to the Centers for Disease Control, binge drinking is excessive drinking that leads to a blood alcohol concentration of higher than 0.08%. Everyone processes alcohol differently, but this roughly translates to men drinking five or more drinks in two hours or women drinking four or more drinks.
The numbers are stark: One in six adults in the United States binge drinks four times per month. Unsurprisingly, binge drinking is most popular among the 18-to-35-year-old crowd, of whom roughly 25% reported binge drinking. As you might expect, binge drinking is a behavior that is most common and popular among college-aged individuals.
Men are more likely to binge drink; this lines up with the fact that men are also more likely to have an alcohol use disorder. Binge drinking is also more common in people who live in households that make more than $75,000 every year.
Not all binge drinkers are alcoholics, and not all alcoholics are binge drinkers. However, the issue with binge drinking is that is increases people’s risk for serious physical or social complications. Binge drinkers are more likely to be injured, commit sexual assault, be involved in violence, or engage in risky sexual behavior. In the long-term, binge drinking can dramatically and negatively impact your physical health, increasing the odds of numerous chronic health conditions, certain types of cancers, and reproductive difficulties.
What Is a Functional Alcoholic?
Alcohol use disorder exists in many different forms, and it is important to realize that not all alcoholics have hit rock bottom. Many are able to drink unhealthy amounts of alcohol but still function well in society. Indeed, in many cases, friends and family are completely in the dark about their loved one’s struggles with alcohol.
These individuals are commonly known as functional alcoholics. Functional alcoholics are people who meet many of the criteria for alcohol use disorder, like a constant urge to drink and failed efforts to cut back on drinking. However, these individuals have been able to “compartmentalize” or hide their alcohol use from others.
To an extent, the term “functional alcoholic” is a misnomer. More often than not, someone who is referred to as a functional alcoholic will eventually lose their ability to function and need treatment in order to avoid the more severe consequences of their alcohol use.
Furthermore, it is important to note that the term “functional alcoholic” is a social and casual one, not a medical one. No one can be “diagnosed” as a functional alcoholic.
Who Is More Likely to Become Addicted to Alcohol?
One of the more interesting parts of alcohol use disorder — and one of the reasons it is so frightening — is that it can truly strike anyone. While there are some groups of people who are more likely than others to become addicted to alcohol, no group is immune to this potential disease. Indeed, no single, specific cause can be determined as a “sole factor” that leads to alcohol use disorder.
That being said, there are some risk factors that make a person more likely to become addicted to alcohol. These include:
• A family history of issues with alcohol. Alcohol use disorder has a genetic component and tends to run in families. Available research shows that genetics are responsible for approximately half of the risk associated with developing an alcohol use disorder.
• Other mental illnesses, including personality disorders, schizophrenia, and major depressive disorder.
• Age of first drink, with a younger age associated with an increased likelihood of alcohol addiction.
• Easy access to alcohol, including plentiful alcohol stores and cheap prices.
• High levels of stress.
• Heavy amounts of drinking among one’s peer group.
• Media and advertising that depicts heavy levels of drinking.
What Treatments Are Available for Alcohol Addiction?
Thankfully, a variety of methods have been developed in order to treat alcohol use disorder. These methods run a wide gamut, including everything from self-help books to full-blown inpatient therapy.
Many people are able to stop using alcohol on their own, either by cutting it off “cold turkey” or taking advantage of a variety of books and self-help courses that are available to assist people in stopping alcohol use. However, this is often not enough for people who have alcohol use disorder, particularly those who have been drinking for a long time or who have other underlying psychological issues that need to be addressed.
Because there are often other issues at play, counseling can be greatly effective. A counselor can review your case history, discuss the underlying issues causing you to drink, and help you identify a variety of behavioral strategies that can help you stop drinking. A counselor can also help you identify the other issues that are influencing your drinking behavior, assisting you in the important process of improving as a person and using those improvements to cease the self-destructive drinking behavior.
Depending on the person’s needs, different types of therapy may apply to an individual. These include:
• Cognitive-behavioral therapy, which focuses on the thoughts that someone has related to alcohol and the behavior that those thoughts bring. This therapy focuses on changing both the negative thought patterns and subsequent behavior.
• Marital and family therapy, which brings in some or all of the person’s family in order to focus on improving the behavior of the individual in question. If done right, this therapy will help to identify and repair underlying relationship issues, resulting in someone improving their behavior and reducing their alcohol use.
• Motivation enhancement therapy, which specifically encourages someone to view the various positive changes that will occur in their life if they reduce their drinking. In doing so, the person in question will develop a specific plan to drink less.
Likewise, support groups can help people work with others who are also struggling with alcohol use disorder. The most well-known group is Alcoholics Anonymous, which has been around for decades and follows a well-known 12-step program. However, AA’s emphasis on spirituality is not always effective for certain people. As such, there are numerous other types of support groups available. While the philosophy of these groups will vary, they all have the effect of creating a space for those with alcohol use disorder to find social support, review strategies, and help other individuals learn how to recover.
In more extreme cases, someone may need medication in order to reduce alcohol cravings. At the moment, the United States Food & Drug Administration has approved three medications designed to alter the way your body processes alcohol, thus, potentially making it easier to wean yourself away from the drug: naltrexone, acamprosate, and disulfiram. None of these medications are a guarantee of success, and all should be used in conjunction with other forms of therapy.
In more extreme cases, an individual may need inpatient therapy, which involves staying in a residential program for a set period of time. During their stay, an individual will be completely removed from society, thus, removing the ability for them to get alcohol. A person will engage in heavy individual therapy and group therapy, with the long-term goal being to develop strategies and behaviors designed to get them functioning in society again.
There are many high-quality in-patient treatment clinics throughout the country. One such example is The Granite House. Located in Derry, New Hampshire, The Granite House offers individualized treatment plans and a specific client-to-client program designed to ease someone into the treatment program and, then, back into the real world.
As you likely now understand, alcohol use disorder is a very real and prevalent disease that kills tens of thousands of people every year. Fortunately, the evidence is clear: Recovery from alcoholism is possible.