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Alcoholism

Alcoholism in its truest definition, is defined as a chronic, progressive, potentially fatal disorder marked by the excessive, compulsive drinking of alcohol, leading to psychological and physical dependence or addiction.

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What you need to know
about Alcoholism

Alcoholism (also referred to as Alcohol Use Disorder; AUD), in its truest definition, is defined as a chronic, progressive, potentially fatal disorder marked by the excessive, compulsive drinking of alcohol, leading to psychological and physical dependence or addiction. Alcoholism is characterized by the inability to control alcoholic drinking, impairment of the ability to socialize and work, the tendency to drink alone and engage in violent or aggressive behavior, neglect of one’s physical appearance and proper nutrition, succumbing to alcohol-related illnesses (such as hepatitis or cirrhosis of the liver), and experiencing moderate to severe withdrawal symptoms (such as anxiety, irritability, nausea, tremors, insomnia, and confusion) upon detoxification. According to current statistics, approximately 17% of men and 8% of women will be dependent on alcohol within their lifetime. More than 15 million people currently struggle with alcoholism in the United States, but less than 8% actually receive treatment. Alcohol abuse is the third highest cause of death in the U.S., resulting in over 88,000 deaths per year – on average, those who died had their lifespan shortened by thirty years.

Additional signs that one may be suffering from alcoholism also include:

  • Using alcohol in larger amounts or for a longer period of time than originally intended
  • Being unable to reduce the amount and frequency of drinking, despite a desire to do so
  • Spending a lot of time obtaining, consuming, and recovering from the effects of alcohol
  • Frequent cravings, or a strong desire to use alcohol
  • Being unable to fulfill major obligations at work, home, or school due to the use of alcohol
  • Continuing to abuse alcohol despite negative interpersonal or social problems that result from its continued use
  • Giving up previously enjoyed social, occupational, or recreational activities because of alcohol use
  • Using alcohol in physically dangerous situations (such as driving or operating machinery)
  • Continuing to abuse alcohol despite the presence of a psychological or physical problem that is probably due to alcohol use
  • Having a tolerance (i.e. needing to drink increasingly large or more frequent amounts of alcohol to achieve desired effect)
  • Developing symptoms of withdrawal when efforts are made to stop using alcohol

According to the latest scientific research, both genetic and environmental mechanisms play a role in the development of alcoholism within an individual.

  • Genes are the physical essence of who we are as individuals. Different cultural backgrounds vary in gene makeup – some of these genes affect how alcohol is metabolized within the body, thereby affecting a person’s potential for developing alcoholism
  • Severe trauma suffered during childhood plays a major role in whether or not a person develops alcoholism within their lifetime
  • Evidence suggests that genetically predisposed individuals begin to drink at much earlier ages, when compared to people that are not alcoholics
  • Alcohol is used as a coping mechanism for individuals that suffer from co-occuring mental disorders such as bipolar, PTSD, depression, and a variety of anxiety disorders
  • The lack of a harmonious family environment or positive peer groups have been determined to be significant contributors in the development of alcoholism

What Causes Alcoholism

The true cause of alcoholism is complex and includes a variety of factors.  As you learned above, genetics, mental disorders, and environment all play a role in whether a person becomes an alcoholic, or not.

Although there is no known cure for alcoholism, it is a disease that with proper treatment and attention, it can be managed with success.  Alcoholics cannot stop – willpower is not part of the equation for a true alcoholic.  It is unrealistic to believe that a person can just stop the cycle of alcoholism with their mind – detoxing and eventually stopping the pattern of alcohol abuse requires medication and monitoring by doctors in a controlled medical environment, as severe seizures and risk of potential death can result should an alcoholic stop drinking abruptly.  While The Bridges of San Diego does not currently offer detoxification services, we can certainly refer patients to a variety of licensed facilities in their general area.

Following the detoxification process, most alcoholics require inpatient care in a controlled facility for 1-3 months, then transition into our Intensive Outpatient Program where they can continue to hone the skills they have learned to manage the disease, including the various triggers that can spur a relapse.

​A healthy diet, regular exercise and exposure to nature, creating distance from individuals and places that encourage or stimulate the urge to drink alcohol, getting adequate rest, and keeping track of ones moods are critical for recovering alcoholics.  The most important virtue one must master in the fight against alcoholism is knowing when it is time to seek help from others.

What are the Stages of Alcoholism?

Alcoholism exists on a continuum, or in other words, a continuous non-spatial whole or extent or succession in which no part or portion is distinct or distinguishable from adjacent parts. Alcohol abuse is a progressive disease and there are various stages throughout the cycle.

  • Non-Use/Abstinence – No current alcohol/drug use.
  • Experimental Use – This is when a person tries a substance, usually due to pressure by their peers or out of sheer curiosity. Studies show that when the younger a person is when they initiate use, the more likely it is that it will become a problematic addiction in the future.
  • Recreational Use – The majority of the population that does consume alcohol, falls within this category. Recreational use is when a person consumes alcohol occasionally and without excess.

 

Stages of Alcoholism:

According to some of the latest data, 10-17% of the population that progress beyond the realm of recreational use to early stage alcoholism, may notice a marked improvement in alcohol tolerance, drinking to calm their nerves after work or during stressful situations. At this stage, the individual may encounter occasional lapses in memory and recall, especially following periods of heavy consumption. Irritation also becomes evident should a family member or friend comment on their use of alcohol. Often irritation morphs into a feeling of denial and an overall disagreement of the assessment, resulting in the justification or downplaying of their actions.
Alcohol intake increase with more and more frequency. Consistent daily or weekly intake becomes a normal pattern. Real consequences begin to surface at this stage - from conflicts with family members, attendance problems with work, severe hangovers, DUI's and other negative encounters with law enforcement. Individuals in this stage begin to develop defensive behaviors when encountered by family and friends, and their concern for your developing alcoholism. As one approaches the tail end of the Middle Stage, alcohol intake becomes compulsive and physically necessary - the ability to regulate use becomes greatly diminished. As consequences mount and one finally begins to accept the negative outcomes related to their drinking, a person often attempts to cease drinking on their own, or seek professional help in a clinical environment. Family interventions have shown to be highly successful during this stage - it is critical that an intervention occur before the disease progresses into the Late Stage.
For individuals that have escalated to the late stages of alcoholism, clear and evident consequences are clear for all to see. Health problems, the ability to hold down a job, the ability to foster and interact with spouses, friends, and family are reduced and unhealthy, serious legal issues, etc. However, despite these problems, the user continues to drink in spite of the fact.

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As with all drugs, the symptoms of abuse almost always present themselves through behavior first, eventually leading to the path of physical and physiological damage.

The following are some behaviors that may indicate alcohol abuse:

  • Hiding and stashing alcohol
  • Drinking in seclusion
  • Needing to drink in order to feel “normal”​
  • “Blacking out” (not remembering actions, conversations, or commitments)
  • Promiscuous and sexually reckless
  • Legal problems such as DUI, Domestic Violence, Car accidents, etc.
  • Physical and verbal aggression
  • Risk prone behavior
  • Excessive talking
  • Exhibiting poor judgment
  • Drinking large quantities quickly (i.e. “pounding”)

Once an individual begins to lose control, alcohol will begin to affect their mental and emotional states. This can be seen with symptoms like:​

  • Sensations of being powerful and invincible
  • Extreme depression
  • Visual and auditory hallucinations
  • Huge surges in elation
  • Feelings of paranoia
  • Lacking alertness
  • Increases in anxiety
  • Wildly vacillating moods
  • Disconnection with reality
  • Increasing feelings of entitlement
  • Intensely irritable and constantly annoyed


With chronic use, all drugs eventually take a physical toll on the body. The following are both short term and long term physical effects that alcohol can have on an individual:

 

  • Heart palpitations
  • Hyperactivity
  • Headache
  • Liver Disease
  • Blurred vision
  • Insomnia
  • Numbness
  • Dizziness
  • Itchy and/or dry skin
  • Flushing
  • Dry mouth
  • Rapid heartbeat
  • Yellow skin
  • Abnormal heart rhythm
  • High blood pressure
  • Profuse sweating
  • Constipation or Diarrhea
  • Low blood pressure
  • Twitching and tremors
  • Rapid breathing
  • Nausea
  • Elevated body temperature

The Different Levels of Drinking

The following thresholds are determined by the National Institute on Alcohol Abuse and Alcoholism:​

  • Moderate alcohol consumption: 1 drink per day for women; 2 drinks per day for men.
  • Heavy drinking: 5+ drinks on the same occasion, at least once during the month
  • Low risk for developing an Alcohol Use Disorder: no more than 3 drinks on any one day and no more than 7 drinks in a week for women; no more than 4 drinks on any one day and no more than 14 drinks in a week for men.
  • Binge drinking: 4 drinks for women within a two-hour period; 5 drinks for men within the same timeframe.

Subjectivity is certainly applicable when it comes to alcohol… “a drink” for one person, may be completely different for another.  When it comes to the wide variety of alcoholic beverages available at your local bar, the amount of alcohol you are consuming is determined by the type of alcohol you have selected.  A 12oz. beer for example contains the same amount of alcohol as 1.5oz of 80 proof whiskey.

Below are comparisons of the different types of alcohol, and their equivalencies:

  • Beer/wine cooler – 12 ounces
  • Malt liquor – 8-9 ounces
  • Table wine – 5 ounces
  • Fortified wine (port, brandy) – 3-4 ounces
  • Cordial liqueur – 2-3 ounces
  • Brandy –1.5 ounces 
  • Hard Liquor (80-proof whiskey, tequila, etc.) – 1.5 ounces

​

The Scientific Criteria for
Determining Alcoholism

If you feel that a friend, family member, or even yourself may have a problem with alcoholism, there are some questions you can ask that will help to clarify the process of diagnosis. According to the American Psychiatric Association, anyone meeting any 2 of the 11 criteria within a single 12 month timeframe, would be diagnosed with alcoholism.

The number of criteria met, determines the severity of the disease:

  • Alcohol is consumed in progressively increasing amounts or over a longer period of time than was originally intended
  • There is a persistent desire to reduce alcohol use, however, attempts are unsuccessful 
  • Significant time is dedicated to acquiring alcohol, using alcohol, or recovering from its effects
  • Powerful cravings or an uncontrollable sensation to use alcohol
  • Continued, recurring failure when it comes to keeping obligations and sustaining acceptable levels of performance with work, school, and family life
  • Increasing interpersonal or social problems as a result of continued alcohol use
  • Things that were important such as social, occupational, or recreational activities are reduced or abandoned due to the use of alcohol
  • Continuing to consume alcohol on a recurring basis, in potentially hazardous or life threatening situations
  • Experiencing persistent or recurring physical or psychological problems despite the knowledge that continued usage is exacerbating the aforementioned problems
  • Progressive increases in tolerance
  • Experiencing withdrawal symptoms such as uncontrollable shaking, depression, fatigue, hyper-anxiety, body temperature fluctuations, and extreme nausea following episodes of drinking.

If you have met any two of the criteria listed above, know that with professional help, you can win in the fight against alcoholism.  It takes courage to stand in the face of something that is larger than you, something that you cannot fight alone.  Make that bold move in your life to finally deal with the alcohol that is poisoning you from the inside out.  Our caring, compassionate, and highly experienced staff are here for you, every step of the way.  You are not alone!  The programs at The Bridges of San Diego change lives – give us a call right now and see just how beautiful your life can be.