How Do You Know If You are Addicted to Alcohol?

For thousands of years, people have enjoyed alcoholic beverages. Alcohol consumption—to a moderate level, of course—has also been recommended for health reasons, such as to lower the risk of heart disease.
But alcohol use can also be harmful. For instance, harmful alcohol use results in three million deaths a year around the globe. Some of these deaths are related to diseases associated with alcohol use, while others are related to injuries and car crashes: Every 50 minutes, an American dies in an accident involving a drunk driver.

Intoxication and withdrawal

So, how do you know if you are using alcohol for harmless enjoyment and its potential health benefits, or if you are using it in a harmful way? One sign is that you get drunk often. Alcohol intoxication (i.e. drunkenness) increases the risk of injuries and accidents. According to the DSM-5, the diagnostic manual of the American Psychiatric Association, the criteria for alcohol intoxication include psychological or behavioral changes (e.g., mood swings, aggression, inappropriate sexual behaviors) that develop during or soon after drinking, and one of the following symptoms: Lack of coordination, unsteady walk, repetitive to-and-fro eye movements, slurred speech, attention or memory problems, and sleepiness or unresponsiveness (i.e. stupor).

Another sign of alcohol problems is that you can not cut down or stop drinking. Specifically, if you stop drinking alcohol, you will experience unpleasant physical and psychological reactions. These reactions are called withdrawal symptoms.

The nature of the withdrawal symptoms depends on the specific drug. In the case of alcohol, withdrawal is characterized by at least two of the following symptoms developing few hours or days after you reduce your alcohol consumption: Nervous system hyperactivity (excessive sweating, fast heartbeat), anxiety, agitation, hand tremor, short-lived hallucinations, sleeplessness, seizures, and nausea or vomiting.
These symptoms usually last less than a week but are more likely to be severe in those who have been drinking heavily and for a long time.

alcohol use disorder

Alcohol use disorder

Withdrawal symptoms are one of the key signs of problematic alcohol use or alcohol addiction. In the DSM-5, the diagnostic label for this condition is alcohol use disorder. Aside from withdrawal, the criteria for alcohol use disorder include two or more of the following:

• Drinking more or for longer than intended
• Wanting but failing to reduce alcohol use
• Spending considerable time in getting alcohol, using it, or recovering from its effects.
• Craving
• Failing to meet obligations (e.g., at work)
• Continuing to drink in spite of its negative effects on one’s personal and social life
• Not participating in important activities (e.g., social outings) because of drinking
• Continuing to drink even after learning that it has worsened a health condition
• Drinking in dangerous situations (e.g., swimming after drinking heavily)
• Tolerance (i.e. needing to drink more to get the same desirable effects as before).

Many individuals with alcohol use disorder have a dual diagnosis, meaning they have other psychological disorders aside from their alcohol problem. According to an article in Lancet Psychiatry, these psychological disorders often include anxiety, mood, thought disorders, and other substance-related conditions.

A variety of treatments exist for alcohol use disorder and co-occurring conditions. Of course, before seeking treatment, the first step is to recognize one has an alcohol problem.
So, if you are concerned about your drinking habits, ask yourself:
• How often do I get drunk?
• Can I stop drinking without experiencing withdrawal symptoms?
• Do I meet any other criteria for alcohol use disorder?

Provided by Dr. Anthony Mele. Dr. Mele has provided psychological treatment and executive leadership in a wide range of settings including inpatient and residential drug and alcohol treatment centers and outpatient specialty clinics. Harbor Psychiatry & Mental Health provides outpatient treatment and mental health services to help Orange County, Ca communities with the treatment of substance use disorders.

References
1. https://www.who.int/news-room/fact-sheets/detail/alcohol
2. https://www.cdc.gov/motorvehiclesafety/impaired_driving/index.html
3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7006178