What Is Alcoholism?

Alcoholism is a term used to describe moderate to severealcohol use disorder (AUD). Alcohol use disorder is a chronic brain disease in which a person loses the ability to stop or control alcohol use despite negative consequences. With chronic alcohol misuse, changes occur in the brain that worsen the AUD and the likelihood ofrelapse.

AUD can be mild, moderate, or severe, representing the various stages of alcohol misuse and addiction. The stages of alcoholism are typically grouped into three levels of severity:

• Early alcohol misuse
• Problematic alcohol use
• Severe alcohol use disorder

The Stages Of Alcoholism

People who are at risk for AUD may begin exhibiting behaviors that can lead to greater consequences. Mental health providers use eleven criteria from theDiagnostic and Statistical Manual of Mental Disorders (5^th edition) (DSM-5) to identify and diagnose different levels of alcohol use disorder. These criteria include:

• Drinking more alcohol than intended or for a longer period than intended on a regular basis.
• Having an ongoing desire to stop or reduce drinking but being unable to.
• Spending increasing amounts of time in activities obtaining, drinking, or recovering from alcohol.
• Having alcohol cravings.
• The chronic use of alcohol results in a failure to fulfill duties at home, work, or school.
• Having persistent or recurrent relational or social problems that are caused or worsened by alcohol use.
• Giving up previously important social, occupational, or recreational activities due to alcohol use.
• Repeatedly drinking alcohol in physically dangerous situations.
• Using alcohol despite knowing it causes or worsens recurrent physical or psychological problems.
• Developing atolerance to alcohol.
• Experiencingalcohol withdrawal symptoms with reduction or cessation of alcohol.

Experiencing two or more of these symptoms could mean that you have an alcohol use disorder, but only a professional can give a diagnosis. Whether you may have early alcohol misuse, problematic alcohol use, or a severe alcohol use disorder, evidence-based therapies are available and can be prescribed through addiction specialists.

You cantake our alcohol assessment today to help determine if you should seek professional guidance.

Stage One: Early Alcohol Misuse

The early alcohol misuse stage covers a wide range of drinking patterns, including occasional irresponsible use, excessive drinking, or a diagnosable mild AUD.

Using alcohol to chase pleasurable feelings, as a coping mechanism forstress, or to blunt other negative feelings often increases a person’s discomfort when not drinking, thus providing further motivation to drink.

The DSM-5 identifies a mild alcohol use disorder as one that meets between two to three symptoms listed in the eleven criteria. For some, this can begin with excessive alcohol use.

The CDC defines and divides excessive alcohol use into two categories that are differentiated for men and women:

• Binge drinking in women is four or more drinks on a single occasion but is defined as five or more drinks for men.
• Heavy drinking for women is eight or more drinks in a week; for men, it is 15 or more drinks in a week.

The beginning of alcohol misuse could start with occasional excessive drinking, but even these episodes can cause brain changes. Chronic alcohol use cancompromise brain function, making it difficult for a person to control their misuse and lead to chronic misuse.

Different levels of drinking may affect people differently. You may notice your loved one going out to party and drinking more than they used to or beginning to use increasing amounts of alcohol. Early misuse may transition from your loved one grabbing a drink immediately after work to having 3-4 drinks every day after work to escape from stress until bedtime. For others, misuse of alcohol could coincide with misuse of medications or otherdrugs or using them in dangerous situations.

Stage Two: Problematic Alcohol Use

Problematic alcohol use could be any alcohol use that causes or worsens problems in a person’s life. It may be diagnosable as a moderate alcohol use disorder; the DSM-5 defines moderate AUD as having four to five of the eleven symptoms listed.

At this stage, a person is experiencing multiple problems or dangers in their life due to alcohol misuse. People with moderate AUD often benefit frominpatient residential programs or more intensive treatment options.

People who are at the problematic stage of alcohol misuse may begin to have problems at work, home, or school because of their alcohol use. Perhaps your loved one has begun to show up late to work more frequently because the morninghangovers make it difficult to wake up on time. Maybe you’ve started skipping classes or pushing off studying and homework to go out and drink, or your drinking interferes with your ability to finish schoolwork. For another person, they may know their hypertension is worsened by their drinking, putting them at risk for heart disease and other serious conditions, but they choose to drink anyway.

Often, a person with problematic alcohol use will experience a few of these types of situations. It is important to think about how alcohol misuse may or may not be affecting all aspects of your life, and whether there are serious consequences for your alcohol use.

Stage Three: Severe Alcohol Use Disorder

Severe alcohol use disorder is any AUD in which a person might meet six or more of the criteria listed in DSM-5. At this level of alcohol misuse, a person is at high risk for both short- and long-term adverse health effects.

A person with severe alcohol use disorder is likely experiencing difficulty functioning in multiple areas of life. Even if they want to quit, it often feels impossible. So, to ease the stress of attempting, they may use alcohol to cope and forget. Your loved one mayblackout from drinking, drink during all waking hours, or make decisions that value alcohol over the people they love most.

This level of alcohol use disorder is extremely disruptive to families, relationships, and work environments. People with violent tendencies may become dangerous, and others may lose their jobs. It can be a significant strain on the patient and their loved ones when AUD develops at this level.

Severe AUD may sometimes be referred to as addiction. A person who is addicted to alcohol often experiences life in three main phases, all centered around alcohol use:

• Binge/intoxication stage, in which a person is actively drinking and experiencing the rewarding effects of their alcohol use.
• Negative affect/withdrawal stage, in which a person stops drinking for any reason and may be experiencing withdrawal symptoms, negative emotions, increased stress, and then drinks to escape the bad feelings.
• Preoccupation/anticipation stage, in which a person actively seeks out sources of alcohol after a period of abstinence, often becoming completely preoccupied with it.

It is often dangerous and nearly impossible for a person with severe AUD to recover on their own. Alcohol withdrawal syndrome can produce life-threatening symptoms, but safe,medical detox can be done in a treatment facility. Professional, evidence-basedtreatments for alcohol use disorder are available — you just have to ask for help.

Predictors Of Alcohol Use Disorders

There are several risk factors that can help a person predict their likelihood of developing AUD. How often, how much, and in which situations a person drinks can affect the development of addiction. Some risk factors for alcohol use disorder and addiction include:

• Age of first drink(s)— People who begin drinking before the age of 15 were three times more likely to develop AUD than people who wait until 21 or older.
• Genetics and family health history— Certaingenes that make addiction more likely can be passed on through families. Additionally, growing up in an environment where alcohol misuse is normal can encourage unhealthy habits that contribute to AUD.
• Mental health conditions—Mental disorders or a history of trauma are known to increase the risk of developing AUD. These includedepression,PTSD, andattention deficit disorder.

Though there are known risk factors, sometimes people with multiple factors do not develop AUD, and others with few factors do. Always drinking responsibly or avoiding drinking can greatly increase your chances of a healthy future.

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Long-Term Health Problems Associated With Chronic Heavy Drinking

Sustained alcohol misuse can lead to serious long-term health complications. If untreated, many of these conditions can contribute to early death for those struggling with severe AUD. Health conditions associated with long-term alcohol misuse include:

• Heart problems (such as stroke, high blood pressure, weakening of the heart muscle, and arrhythmias)
• Liver disease (such as fatty liver, hepatitis, fibrosis, cirrhosis)
• Pancreatitis
• Brain changes (such as disruptions in the movement circuits and mood and behavior circuits)
• Cancer (such as esophageal, liver, breast, and colorectal cancer)
• Weakening of the immune system

It is never too late to stop drinking. Even if you have developed some of these or other consequences of chronic alcohol misuse, treatment is available and can benefit your future health.

Alcohol Use Disorder Outlook And Treatment

If you or a loved one are struggling with alcohol use disorder, there are a variety ofalcohol addiction treatments that have helped people find their road to recovery.

Alcohol use disorder treatment often begins with supervised medical detox, then can progress through inpatient andoutpatient programs toaftercare services. Like other chronic diseases, AUD can be successfully managed, allowing you to live a full and healthy life despite your disorder.

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Start Your Recovery Journey Today

Though general paths to recovery have been paved, addiction specialists know the importance of individualized treatment plans. Alcohol use disorder does not have to define your life.

Call and speak to a treatment provider today and find a treatment program to guide you back to the person you want to be. Calls are always free and confidential. Healing is possible; you only need to take the first step.