Alcoholism and Alcohol Abuse
Recognizing the Signs and Symptoms of a Drinking Problem
It’s not always easy to see when your alcohol intake has crossed the line from moderate or social drinking to problem drinking. But if you consume alcohol to cope with difficulties or to avoid feeling bad, you’re in potentially dangerous territory. Drinking problems can sneak up on you, so it’s important to be aware of the warning signs of alcohol abuse and alcoholism and take steps to cut back if you recognize them. Understanding the problem is the first step to overcoming it and either cutting back to healthy levels or quitting altogether.
Do you have a drinking problem?
Since drinking is so common in many cultures and the effects vary so widely from person to person, it’s not always easy to figure out where the line is between social drinking and problem drinking. You may have a drinking problem if you:
- Feel guilty or ashamed about your drinking.
- Lie to others or hide your drinking habits.
- Have friends or family members who are worried about your drinking.
- Need to drink in order to relax or feel better.
- “Black out” or forget what you did while you were drinking.
- Regularly drink more than you intended to.
The bottom line is how alcohol affects you. If your drinking is causing problems in your life, then you have a drinking problem.
Identifying problem drinking
The following quiz can help you identify how much you’re drinking and whether your alcohol intake could be causing problems in your life. A drink is equal to 12oz. of beer, 5oz. of wine, or a standard shot (1.5 oz.) of liquor.
Interpreting the score:
1 to 7: Your drinking level is likely safe unless you have a medical condition or are taking a medication that is adversely affected by alcohol, or you are pregnant.
8 or more: Could indicate harmful or hazardous drinking.
13 or more for women: Could indicate alcohol dependence.
15 or more for men: Could indicate alcohol dependence.
This questionnaire is not intended to replace professional diagnosis.
Source: AUDIT (World Health Organization)
Risk factors for drinking problems and alcoholism
Risk factors for developing problems with alcohol arise from many interconnected factors, including your genetics, how you were raised, your social environment, and your emotional health. Some racial groups, such as American Indians and Native Alaskans, are more at risk than others of developing drinking problems or alcohol addiction. People who have a family history of alcoholism or who associate closely with heavy drinkers are more likely to develop drinking problems. Finally, those who suffer from a mental health problem such as anxiety, depression, or bipolar disorder are also particularly at risk, because alcohol is often used to self-medicate.
The path from alcohol abuse to alcoholism
Not all alcohol abusers become full-blown alcoholics, but it is a big risk factor. Sometimes alcoholism develops suddenly in response to a stressful change, such as a breakup, retirement, or another loss. Other times, it gradually creeps up on you as your tolerance to alcohol increases. If you’re a binge drinker or you drink every day, the risks of developing alcoholism are greater.
Signs and symptoms of alcohol abuse or problem drinking
Substance abuse experts make a distinction between alcohol abuse and alcoholism (also called alcohol dependence). Unlike alcoholics, alcohol abusers have some ability to set limits on their drinking. However, their alcohol use is still self-destructive and dangerous to themselves or others.
Common signs and symptoms include:
Repeatedly neglecting your responsibilities at home, work, or school because of your drinking. For example, performing poorly at work, flunking classes, neglecting your kids, or skipping out on commitments because you’re hung over.
Using alcohol in situations where it’s physically dangerous, such as drinking and driving, operating machinery while intoxicated, or mixing alcohol with prescription medication against doctor’s orders.
Experiencing repeated legal problems on account of your drinking. For example, getting arrested for driving under the influence or for drunk and disorderly conduct.
Continuing to drink even though your alcohol use is causing problems in your relationships. Getting drunk with your buddies, for example, even though you know your wife will be very upset, or fighting with your family because they dislike how you act when you drink.
Drinking as a way to relax or de-stress. Many drinking problems start when people use alcohol to self-soothe and relieve stress. Getting drunk after every stressful day, for example, or reaching for a bottle every time you have an argument with your spouse or boss.
Signs and symptoms of alcoholism (alcohol dependence)
Alcoholism is the most severe form of problem drinking. Alcoholism involves all the symptoms of alcohol abuse, but it also involves another element: physical dependence on alcohol. If you rely on alcohol to function or feel physically compelled to drink, you’re an alcoholic.
Tolerance: The 1st major warning sign of alcoholism
Do you have to drink a lot more than you used to in order to get buzzed or to feel relaxed? Can you drink more than other people without getting drunk? These are signs of tolerance, which can be an early warning sign of alcoholism. Tolerance means that, over time, you need more and more alcohol to feel the same effects.
Withdrawal: The 2nd major warning sign
Do you need a drink to steady the shakes in the morning? Drinking to relieve or avoid withdrawal symptoms is a sign of alcoholism and a huge red flag. When you drink heavily, your body gets used to the alcohol and experiences withdrawal symptoms if it’s taken away.
Withdrawal symptoms include:
- Anxiety or jumpiness
- Shakiness or trembling
- Nausea and vomiting
- Loss of appetite
In severe cases, withdrawal from alcohol can also involve hallucinations, confusion, seizures, fever, and agitation. These symptoms can be dangerous, so talk to your doctor if you are a heavy drinker and want to quit.
Other signs and symptoms of alcoholism
You’ve lost control over your drinking. You often drink more alcohol than you wanted to, for longer than you intended, or despite telling yourself you wouldn’t.
You want to quit drinking, but you can’t. You have a persistent desire to cut down or stop your alcohol use, but your efforts to quit have been unsuccessful.
You have given up other activities because of alcohol. You’re spending less time on activities that used to be important to you (hanging out with family and friends, going to the gym, pursuing your hobbies) because of your alcohol use.
Alcohol takes up a great deal of your energy and focus. You spend a lot of time drinking, thinking about it, or recovering from its effects. You have few if any interests or social involvements that don’t revolve around drinking.
You drink even though you know it’s causing problems. For example, you recognize that your alcohol use is damaging your marriage, making your depression worse, or causing health problems, but you continue to drink anyway.
Drinking problems and denial
Denial is one of the biggest obstacles to getting help for alcohol abuse and alcoholism. The desire to drink is so strong that the mind finds many ways to rationalize drinking, even when the consequences are obvious. By keeping you from looking honestly at your behavior and its negative effects, denial also exacerbates alcohol-related problems with work, finances, and relationships.
If you have a drinking problem, you may deny it by:
- Drastically underestimating how much you drink
- Downplaying the negative consequences of your drinking
- Complaining that family and friends are exaggerating the problem
- Blaming your drinking or drinking-related problems on others
For example, you may blame an ‘unfair boss’ for trouble at work or a ‘nagging wife’ for your marital issues, rather than look at how your drinking is contributing to the problem. While work, relationship, and financial stresses happen to everyone, an overall pattern of deterioration and blaming others may be a sign of trouble.
If you find yourself rationalizing your drinking habits, lying about them, or refusing to discuss the subject, take a moment to consider why you’re so defensive. If you truly believe you don’t have a problem, there should be no reason for you to cover up your drinking or make excuses.
|Five myths about alcoholism and alcohol abuse|
Myth: I can stop drinking anytime I want to.
Fact: Maybe you can; more likely, you can’t. Either way, it’s just an excuse to keep drinking. The truth is, you don’t want to stop. Telling yourself you can quit makes you feel in control, despite all evidence to the contrary and no matter the damage it’s doing.
Myth: My drinking is my problem. I’m the one it hurts, so no one has the right to tell me to stop.
Fact: It’s true that the decision to quit drinking is up to you. But you are deceiving yourself if you think that your drinking hurts no one else but you. Alcoholism affects everyone around you—especially the people closest to you. Your problem is their problem.
Myth: I don’t drink every day OR I only drink wine or beer, so I can’t be an alcoholic.
Fact: Alcoholism is NOT defined by what you drink, when you drink it, or even how much you drink. It’s the EFFECTS of your drinking that define a problem. If your drinking is causing problems in your home or work life, you have a drinking problem—whether you drink daily or only on the weekends, down shots of tequila or stick to wine, drink three bottles of beers a day or three bottles of whiskey.
Myth: I’m not an alcoholic because I have a job and I’m doing okay.
Fact: You don’t have to be homeless and drinking out of a brown paper bag to be an alcoholic. Many alcoholics are able to hold down jobs, get through school, and provide for their families. Some are even able to excel. But just because you’re a high-functioning alcoholic doesn’t mean you’re not putting yourself or others in danger. Over time, the effects will catch up with you.
Myth: Drinking is not a “real” addiction like drug abuse.
Fact: Alcohol is a drug, and alcoholism is every bit as damaging as drug addiction. Alcohol addiction causes changes in the body and brain, and long-term alcohol abuse can have devastating effects on your health, your career, and your relationships. Alcoholics go through physical withdrawal when they stop drinking, just like drug users do when they quit.
Effects of alcoholism and alcohol abuse
Alcoholism and alcohol abuse can affect all aspects of your life. Long-term alcohol use can cause serious health complications, affecting virtually every organ in your body, including your brain. Problem drinking can also damage your emotional stability, finances, career, and your ability to build and sustain satisfying relationships. Alcoholism and alcohol abuse can also have an impact on your family, friends and the people you work with.
The effects of alcohol abuse on the people you love
Despite the potentially lethal damage that heavy drinking does to the body—including cancer, heart problems, and liver disease—the social consequences can be just as devastating. Alcoholics and alcohol abusers are much more likely to get divorced, have problems with domestic violence, struggle with unemployment, and live in poverty.
But even if you’re able to succeed at work or hold your marriage together, you can’t escape the effects that alcoholism and alcohol abuse has on your personal relationships. Drinking problems put an enormous strain on the people closest to you.
Often, family members and close friends feel obligated to cover for the person with the drinking problem. So they take on the burden of cleaning up your messes, lying for you, or working more to make ends meet. Pretending that nothing is wrong and hiding away all of their fears and resentments can take an enormous toll. Children are especially sensitive and can suffer long-lasting emotional trauma when a parent or caretaker is an alcoholic or heavy drinker.
If you’re ready to admit you have a drinking problem, you’ve already taken the first step. It takes tremendous strength and courage to face alcohol abuse and alcoholism head on. Reaching out for support is the second step.
Whether you choose to go to rehab, rely on self-help programs, get therapy, or take a self-directed treatment approach, support is essential. Recovering from alcohol addiction is much easier when you have people you can lean on for encouragement, comfort, and guidance. Without support, it’s easy to fall back into old patterns when things get tough.
Your continued recovery depends on continuing mental health treatment, learning healthier coping strategies, and making better decisions when dealing with life’s challenges. In order to stay alcohol-free for the long term, you’ll also have to face the underlying problems that led to your alcoholism or alcohol abuse in the first place.
Those problems could be depression, an inability to manage stress, an unresolved trauma from your childhood, or any number of mental health issues. Such problems may become more prominent when you’re no longer using alcohol to cover them up. But you will be in a healthier position to finally address them and seek the help you need.
Helping a loved one
If someone you love has a drinking problem, you may be struggling with a number of painful emotions, including shame, fear, anger, and self-blame. The problem may be so overwhelming that it seems easier to ignore it and pretend that nothing is wrong. But in the long run denying it will be more damaging to you, other family members, and the person with the drinking problem.
8 things not to do
- Don't attempt to punish, threaten, bribe, or preach.
- Don't try to be a martyr. Avoid emotional appeals that may only increase feelings of guilt and the compulsion to drink or use other drugs.
- Don't cover up or make excuses for the problem drinker or shield them from the realistic consequences of their behavior.
- Don't take over their responsibilities, leaving them with no sense of importance or dignity.
- Don't hide or dump bottles or shelter them from situations where alcohol is present.
- Don't argue with the person when they are impaired.
- Don't drink along with the problem drinker.
- Above all, don't feel guilty or responsible for another's behavior.
Source: National Clearinghouse for Alcohol & Drug Information
Dealing with a loved one’s alcohol problem can be an emotional rollercoaster. It’s vital that you take care of yourself and get the support you need. It’s also important to have people you can talk honestly and openly with about what you’re going through.
A good place to start is by joining a group such as Al-Anon, a free peer support group for families coping with alcoholism. Listening to others with the same challenges can be a tremendous source of comfort and support. You can also turn to trusted friends, a therapist, or people in your faith community.
You cannot force someone you love to stop abusing alcohol. As much as you may want to, and as hard as it is to watch, you cannot make someone stop drinking. The choice is up to them.
Don’t expect the person to stop drinking and stay sober without help. Your loved one will need treatment, support, and new coping skills to overcome a serious drinking problem.
Recovery is an ongoing process. Recovery is a bumpy road, requiring time and patience. An alcoholic will not magically become a different person once sober. And the problems that led to the alcohol abuse in the first place will have to be faced.
Admitting that there’s a serious problem can be painful for the whole family, not just the alcohol abuser. But don’t be ashamed. You’re not alone. Alcoholism and alcohol abuse affects millions of families, from every social class, race, and culture. But there is help and support available for both you and your loved one.
When your teen has a drinking problem
Discovering your child is drinking can generate fear, confusion, and anger in parents. It’s important to remain calm when confronting your teen, and only do so when everyone is sober. Explain your concerns and make it clear that your concern comes from a place of love. It’s important that your teen feels you are supportive.
Five steps parents can take:
- Lay down rules and consequences: Your teen should understand that drinking alcohol comes with specific consequences. But don’t make hollow threats or set rules that you cannot enforce. Make sure your spouse agrees with the rules and is prepared to enforce them.
- Monitor your teen’s activity: Know where your teen goes and who they hang out with. Remove or lock away alcohol from your home and routinely check potential hiding places for alcohol—in backpacks, under the bed, between clothes in a drawer, for example. Explain to your teen that this lack of privacy is a consequence of having been caught using alcohol.
- Encourage other interests and social activities. Expose your teen to healthy hobbies and activities, such as team sports, Scouts, and afterschool clubs.
- Talk to your child about underlying issues. Drinking can be the result of other problems. Is your child having trouble fitting in? Has there been a recent major change, like a move or divorce, which is causing stress?
- Get outside help: You don’t have to go it alone. Teenagers often rebel against their parents but if they hear the same information from a different authority figure, they may be more inclined to listen. Try seeking help from a sports coach, family doctor, therapist, or counselor.
Finding the right alcohol addiction treatment
Many effective alcohol treatment options are available, including rehab programs. However, professional help isn’t the only way to overcome the problem and get better. There are also plenty of things you can do to help yourself stop drinking, achieve lasting recovery, and regain control of your life. Read Overcoming Alcohol Addiction.
Resources and references
Signs and symptoms of alcohol abuse and alcoholism
Rethinking Drinking – Interactive website with tools to help you check your drinking pattern, identify signs and symptoms of a problem, and get tools to cut back. (National Institute on Alcohol Abuse and Alcoholism)
Signs and Symptoms – Covers the common signs and symptoms of alcohol abuse. (National Council on Alcoholism and Drug Dependence)
Effects of alcohol abuse
Alcohol's Damaging Effects on the Brain – Reviews the effects of alcohol on the brain, including blackouts, memory lapses, and other types of brain damage. (National Institute on Alcohol Abuse and Alcoholism)
Alcohol: A Women's Health Issue – Explores drinking in women, including health issues and problem drinking. (National Institute on Alcohol Abuse and Alcoholism)
Helping someone with a drinking problem
Helping an Adult Family Member or Friend with a Drug or Alcohol Problem – Learn about actions you can take, how to bring up your concerns, and how to deal with emergencies. (Partnership for Drug-Free Kids)
Intervention eBook: What to Do If Your Child Is Drinking or Using Drugs (PDF) – Practical advice for parents on how to talk to and help a child with an addiction. (Partnership for Drug-Free Kids)
How to Talk to an Older Person Who Has a Problem with Alcohol or Other Medications (PDF) – How to identify the signs and symptoms of problem drinking in older adults and express your concerns. (Hazelden)
Coping with an Alcoholic Parent – Article for teenagers and adolescents on dealing with the problem of an alcoholic parent and how to get support. (Nemours Foundation)
Family Disease – Alcohol abuse and alcoholism affects the whole family, which is why recovery from addiction is a family affair. (National Council on Alcoholism and Drug Dependence)
Support groups for problem drinkers
Most of these organizations have worldwide chapters:
Secular Organizations for Sobriety – SOS is a similar organization to AA but without the religious affiliation. (Secular Organizations for Sobriety)
Women for Sobriety – A non-profit organization dedicated to helping women overcome alcoholism and other addictions. (Women for Sobriety, Inc.)
Alcoholics Anonymous – Learn more about AA, including the 12 steps, and find a support meeting in your area. (Alcoholics Anonymous)
SMART Recovery – Self-Management and Recovery Training (SMART) is a program that aims to achieve abstinence from alcohol through self-empowerment and self-directed change. (SMART Recovery)
Support for family members of alcoholics
Al-Anon and Alateen – Screening questionnaire for problem drinking based on World Health Organization study. (Auditscreen.org)
References for this article
AUDIT (Alcohol Use Disorders Identification Test) – Support group for friends and families of problem drinkers. Based on the twelve-step Alcoholics Anonymous program. (al-anon.alateen.org)
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