Alcoholism Explained: Definition, Causes & Signs


Robert Gerchalk

Robert is our health care professional reviewer of this website. He worked for many years in mental health and substance abuse facilities in Florida, as well as in home health (medical and psychiatric), and took care of people with medical and addictions problems at The Johns Hopkins Hospital in Baltimore. He has a nursing and business/technology degrees from The Johns Hopkins University.

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Alcohol Addiction: Definition, Causes, & Risk Factors

While many people associate the use of alcohol with fun and recreation, regular drinking appeals to the brain’s pleasure centers, leading the brain to associate alcohol with relaxation, euphoria and a loss of inhibitions. This can also lead to debilitating alcohol dependency and cravings. The result is alcohol use disorder (AUD). Commonly referred to as alcohol addiction or alcoholism, AUD directly affects approximately 16 million American adults and adolescents. This doesn’t even include the effects that friends and families of those with an alcohol addiction experience. These effects can be life-altering for all involved.

If not properly addressed, alcohol addiction can lead to a host of physical and emotional problems and extremely difficult life challenges. Some of the most severe problems can include brain damage and death. Fortunately, there is much you can do to alleviate alcohol addiction and reduce its potent risks.

What Is Alcohol Addiction?

As the National Institute on Alcohol Abuse and Alcoholism (NIAA) defines it, alcohol use disorder is simply, uncontrolled and problematic drinking.

More explicitly, an addiction to alcohol is a chronic illness marked by an inability to control or stop drinking alcohol despite the harm it’s posing to your health, job or school, relationships and social life.

How Does Alcohol Addiction Develop?

There isn’t just one kind of alcohol use disorder. According to the published report Classification of Alcohol Use Disorders, AUD comes in several forms. One type, alcoholism or alcohol dependence, occurs when you no longer have control over your drinking; another type, alcohol misuse, occurs when your drinking has repeated significant consequences.

How Does Alcohol Addiction Happen?

Alcohol addiction may include periods of intoxication that result from an increase in how much alcohol you have in your bloodstream. The higher this concentration, the greater your odds of experiencing negative effects.

Among the mental changes and behavioral problems alcohol intoxication can cause include:

  • Slurred speech
  • Poor coordination
  • Difficulties with memory or attention
  • Poor judgment
  • Inappropriate behavior
  • Unstable moods

While intoxicated by alcohol, you may also experience blackouts, or periods in which you can’t remember what occurred. If your blood alcohol concentration is too high, it could cause severe consequences. In extreme situations, excess alcohol intake can lead to permanent brain damage, coma or death.

What Leads to Alcohol Addiction?

Alcohol triggers the brain to release dopamine, the chemical associated with the brain’s reward system. This causes the brain to associate drinking with positive feelings, making you want to drink more. According to a 2020 study published in the Journal of Neuroscience, alcohol consumption also impacts the hormone serotonin, which is involved in key functions and factors like sleep and mood.

As your drinking increases in quantity, frequency or duration, the pleasure you experience from drinking lowers over time. You can develop a tolerance for alcohol and may experience withdrawal symptoms when you reduce or cease drinking. Eventually, you may start drinking more to stave off withdrawal symptoms, leading to a cycle that is difficult to break without professional help.

Who Does Alcohol Addiction Affect?

Alcohol Facts and Statistics by the NIAA reveals that, in 2019, 14.5 million Americans over the age of 12 had AUD. That equals just over 5% of the population and includes 9 million men and more than 5 million women.

That same year, the ratio of adolescents with AUD was 1.7%. This amounted to 414,000 youths made up of 163,000 males and 251,000 females. Note that this means, in the adolescent age group, alcohol addiction is more common among females than males. However, in the category of adults, alcoholism is more common among males than females.

Of course, alcohol addiction also negatively affects the loved ones and caregivers of the person with the alcohol addiction. Addiction to any substance can lead to relationship problems and other issues in the home.

When Does Alcohol Addiction Start?

There are several factors that can either cause alcohol addiction or increase its likelihood. These factors include:

  • Easy access to alcoholic beverages
  • Low self-confidence
  • Impulsive tendencies
  • Peer pressure
  • A craving for approval
  • Difficulty coping with emotional challenges
  • Alcohol problems running in the family
  • Low social or economic status
  • Drinking at a young age
  • Binge drinking regularly
  • Weight-loss surgery

Symptoms of Alcohol Addiction

AUD comes in severe, moderate and mild forms; in all cases, the signs and symptoms are similar. These symptoms include:

  • An uncontrollable craving for alcohol or urge to drink
  • An inability to control the amount you drink
  • Negative thinking when not under the influence of alcohol
  • Drinking alcohol in risky scenarios, such as while driving
  • Interference with activities you enjoy
  • Continuing drinking despite the problems it causes or worsens
  • Discontinuation of important activities

If you require a drink to complete the following activities, you could have AUD:

  • To get going in the morning
  • To fall asleep or even relax
  • To be social
  • To escape your emotions

Other signs include:

  • Lying to loved ones
  • Anger or desire to hurt people
  • Inability to cease thinking about drinking
  • Combining alcohol with your medications
  • Withdrawal symptoms like insomnia, nausea and seizures
  • Drinking while pregnant or looking after children

Consequences of Alcohol Addiction

Even mild cases of alcohol addiction can impact your mental and physical health significantly. Alcohol addiction frequently fosters other issues that you may have used alcohol to avoid, creating a negative, self-feeding cycle.

Over the short term, AUD can cause blackouts, hangovers and memory loss; over the long term, it can cause:

  • Heart issues
  • Stomach problems
  • Pancreatitis
  • Cirrhosis of the liver
  • High blood pressure
  • Brain damage
  • Cancer

When you drink alcohol, you’re more inclined to take perilous risks, increasing your odds of being hurt or killed by:

  • Suicide
  • Drowning
  • Auto accidents
  • Homicide

AUD has also been associated with increased risk of depression. Based on an alcohol research report, “AUD and depressive disorders are among the most prevalent psychiatric disorders and co-occur more often than expected by chance.” In fact, depression is the most common psychiatric disorder that co-occurs with AUD. Having AUD even increases your risk of developing symptoms of depression.

Drinking can lead you to develop problems with misuse, neglect, anger and violence, damaging your relationships with friends and family members as a result. It can also impair your work or school life. If you’re pregnant, alcoholism could cause a miscarriage. Your baby could also be born with fetal alcohol syndrome and have greater odds of sudden infant death syndrome (SIDS).

How Alcohol and Alcohol Addiction Affects the Brain

The damaging effects of alcohol on the brain include difficulty walking, blurred vision, slurred speech, slowed reaction times, and impaired memory. These issues are not only prevalent in the short term while under the influence of alcohol, but, over time with persistent excessive use of alcohol, they can also become long-term, chronic problems. These brain defects can occur even during periods of sobriety.

What’s more, as much as 80% of people with an alcohol addiction will develop a thiamine deficiency that leads to a debilitating condition known as Wernicke-Korsakoff Syndrome, which has both short-term and long-term effects. Short-term symptoms include muscle coordination difficulties, mental confusion and nerve paralysis affecting the movement of the eyes; long-term symptoms include severe and persistent learning and memory difficulties.

Brain damage from alcohol addiction may be caused directly by the effects of the alcohol or indirectly by poorer general health and possible liver problems associated with alcohol addiction.

Diagnosing Alcohol Addiction

An alcohol addiction diagnosis requires having two or more of the following 11 criteria over any single 12-month period:

  • Drinking more or for longer than you meant to
  • An unsuccessful attempt or enduring desire to control or reduce your drinking
  • Spending a lot of time obtaining, drinking or recovering from alcohol
  • Alcohol cravings
  • Failure to meet home, work or school obligations
  • Alcohol consumption despite the recurring or enduring personal issues it causes
  • Giving up or cutting down on important activities
  • Consuming alcohol recurrently in risky situations
  • Consuming alcohol despite an awareness of the psychological or physical problems it causes or worsens
  • Developing a tolerance for alcohol
  • Withdrawal symptoms

Whether the diagnosis is for mild, moderate or severe alcohol addiction depends on the number of these criteria that are true for you.

Alcohol Addiction Treatment

A variety of treatments for alcohol addiction exist, with the best treatment for each individual varying depending on the factors of their specific case. These include:

  • Counseling, therapy and support – Individual or group sessions for you or your loved ones
  • Behavioral therapy – A specific type of therapy focused on changing unwanted behaviors
  • Residential treatment – Enrollment in a live-in facility where you’ll undergo therapy, education and other treatments in a safe environment unexposed to potential risk factors and triggers for drinking

Medication is another option for treatment. These medications include Campral (acamprosate,) Antabuse (disulfiram,) Revia or Vivitrol, (naltrexone) or Topamax (topiramate).

All treatments have the same objective: to help a person avoid using alcohol and improve their quality of life. Unfortunately, according to the NIAA, even though proven effective treatments for alcohol addiction exist, less than 10% of those with diagnosable AUD in the past year seek such treatment.

Symptoms of Alcohol Withdrawal

If you suddenly stop or greatly reduce drinking alcohol after prolonged and/or heavy periods of drinking, you may experience certain withdrawal symptoms. These symptoms include the following:

  • Insomnia
  • Restlessness
  • Anxiety
  • Agitation
  • Abnormal, rapid breathing
  • Nausea and vomiting
  • Sweating
  • Shakes or tremors
  • Heart palpitations
  • Seizures
  • Hallucinations

These symptoms can occur anytime between several hours and days after ceasing or reducing significant alcohol use.

How Much Alcohol Is OK?

Health experts recommend that those who choose to drink alcohol do so in moderation. If you’re male, you should drink no greater than two drinks daily, and heavy drinking is considered anything more than 14 drinks in a given week or four in a given day. Females should drink no greater than one drink daily, and heavy drinking is considered anything more than seven drinks in a given week or three drinks in a given day.

One drink is equal to:

  • 12 oz. of beer
  • 8 to 9 oz. of malt liquor
  • oz. of wine
  • 1.5 oz. of distilled spirits or hard liquor such as vodka, tequila, rum or whiskey

Knowing your limits is important to maintaining a healthy and responsible balance when it comes to alcohol use. If you are prone to alcoholism due to family history or previous addictions, any alcohol use is risky and should be avoided. Those who find themselves or a loved one struggling with addiction should reach out for professional help. A qualified treatment provider can assist you in overcoming your addiction and maintaining your sobriety over the long term.