Overview of Alcohol Use and Abuse
Nearly one-third of all adults will meet criteria for an alcohol use disorder at some point in their lives.
Many people begin to use alcohol as a way to escape their problems or feel more relaxed.
Over the long term, alcohol abuse can cause serious health problems including liver cirrhosis, cancer, and cardiovascular disease.
Signs of alcoholism include losing interest in activities, problems at school or work, erratic behavior, and difficulties with relationships.
Alcohol withdrawal is potentially fatal and should be medically supervised.
Signs of alcohol overdose include confusion, hypothermia, pale or blue-tinged skin, loss of consciousness, and slowed breathing.
What Is Alcohol?
Ethanol, or "drinking alcohol," is the primary psychoactive or intoxicating component in all beers, wines, and various types of liquors.15 Most people consume alcohol in beverage form. It is rapidly absorbed into the bloodstream from the stomach and the small intestine.
Ethanol is produced by fermenting yeast, sugars, and starches. The alcohol content of drinks can vary widely depending on how long the mixture is allowed to ferment. As such, some guidelines have been established to define the standard drink, which can be:
- 12 ounces of beer.
- 5 ounces of wine.
- 1.5 ounces (i.e., one shot) of 80 proof distilled liquor or spirits (e.g., gin, vodka, rum, or whiskey).
- 8 ounces of malt liquor. 16
Alcohol is a central nervous system depressant. In general, brain activity slows down when under the influence of alcohol, leading to impairment of a number of physiologic processes.
A single drink of alcohol will not directly kill brain cells. But, over time, chronic alcohol consumption can harm the cerebellum - an area of the brain that, when damaged, can impair movement and coordination.17
Effects of alcohol include:
- Slowed reaction time.
- Altered speech.
- Lowered inhibitions.
- Coordination problems.
- Impaired judgment.
Signs and Symptoms of Alcoholism
- Drinking more or for longer than you originally planned.
- Trying unsuccessfully to cut back on your drinking on more than one occasion.
- Getting sick or needing a lot of time to get over the effects of drinking.
- Feeling an intense craving to have a drink.
- Drinking or recovering from drinking interferes with your ability to take care of your home or your family or has caused problems at work or school.
How Addictive Is Alcohol?
Consistent alcohol use can quickly lead to the development of alcohol dependence and, ultimately, the patterns of compulsive use associated with alcohol addiction. Some people use alcohol as a way to cope with bad feelings or life's difficulties, because alcohol offers a fast and easy way to feel good. Alcohol can even help normally shy individuals feel more comfortable in social situations.
It can be difficult to recognize whether your drinking is problematic. Generally, when you begin to crave alcohol or regularly use it to escape bad feelings or to cope with life's challenges, you may have a problem.
Causes of Addiction
Alcohol addiction can occur as the result of interconnected factors. These can include a genetic predisposition, your social environment, and your emotional health.
Addiction is fueled, in part, by both physiological and psychological dependence on alcohol.
Being physiologically dependent means that the circuitry in your brain has been altered so that you experience withdrawal symptoms when you stop drinking.
Psychological dependency occurs when you believe that you must continue to use the substance in order to function every day.
The Substance Abuse and Mental Health Services Administration (SAMHSA) defines binge drinking as having 5 or more alcoholic drinks in the same sitting at least once within a 30-day period. 19 The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines it as 5 drinks for men and 4 drinks for women in a 2-hour time span. 25
It has been estimated that more than 1 in every 6 adults binge drinks 4 times a month and that the average number of drinks consumed during a binge is 8. 20
In chronic, heavy drinkers, abruptly slowing intake or quitting alcohol altogether can lead to a range of withdrawal symptoms. How soon these symptoms appear and how severe they are will vary from person to person, depending on how much they had been drinking, on average. Symptoms of alcohol withdrawal can begin 4-12 hours following the last drink and may persist for several weeks.1, 4
Alcohol withdrawal can be fatal, and heavy drinkers attempting to quit should seriously consider medical supervision in case symptoms become severe.
Symptoms of alcohol withdrawal can include:
- Elevated blood pressure.
- Rapid and/or irregular heart rate.
Overdose can occur with alcohol, resulting in alcohol poisoning. Some of the most common signs and symptoms of alcohol poisoning include: 21,22
- Profound disorientation.
- Hypothermia (i.e., excessively low body temperature).
- Pale or blue-tinged skin.
- Vomiting. (Vomiting while unconscious or partially conscious poses an extreme choking hazard.)
- Slowed respiratory and heart rate.
Alcoholism treatment options include:
- Inpatient or residential rehab centers . You stay at the treatment facility while participating in a program that includes detoxification, group and individual therapy, and 12-step meetings.
- Outpatient rehab centers . You continue to live at home while visiting a treatment center for a few hours on certain days of the week.
- 12-step programs . You meet with others in recovery to support each other and work with a sponsor on completing a series of recovery steps. Alcoholics Anonymous is the 12-step program for alcohol addiction.
- Dual diagnosis treatment facilities . You attend a specialized treatment program that helps you overcome an addiction and a co-occurring mental health problem.
Cost and Paying for Treatment
The cost of a treatment program will depend on:
- The program type (inpatient vs. outpatient).
- How long the program is.
- Where the program is located.
- The program's features.
- What kind of insurance coverage you have.
If you have insurance. Call 1-888-319-2606 to learn more about what your insurance will cover and what your treatment options are based on your insurance.
If you don't have insurance. Contact the Substance Abuse and Mental Health Services Administration's toll-free helpline to get assistance finding a rehab program that helps those without insurance.
Rates of use. In 2015, nearly 52% of people age 12 or older reported past-month alcohol use, with almost 25% of them engaging in binge drinking at least once and 6.5% binge drinking at least 5 times in the last month. These rates represent a slight decrease in alcohol use from 2014 to 2015.10
Underage drinking. Underage drinking slightly decreased between 2014 and 2015, but rates remain high. More than 7.5 million adolescents between the age of 12 and 20 reported drinking in the previous month. More than 5 million of them binge drank at least once, and almost 1.3 million binge drank at least 5 times in the month prior to surveying.11 In 2012, at least 855,000 teenagers between the ages of 12 and 17 met criteria for an alcohol use disorder. 23
Rates of alcoholism. More than 15 million people suffered from an alcohol use disorder in 2015.11
Use among high school students. Rates of drinking among 8th, 10th, and 12th graders have shown a slow but steady decline since 2000.12 In 2015, 26% of 8th graders reported alcohol use at some point in their life, 21% reported use within the last year, and almost 10% reported use in the month before the survey.13 These rates were higher among 10th graders, with 47% reporting use at some point in their life, 42% drinking in the last year, and 21.5% drinking in the last month.13 Rates further increased among 12th graders, with 64% having tried alcohol at some point in their life, 58% indicating that they drank in the last year, and more than 35% indicating that they drank within the last month.13
Men vs. women. Rates of drinking tend to be slightly higher among men than women. Almost 109 million men report drinking at some point in their life, 89 million of them report drinking within the last year, and nearly 73 million report drinking within the last month, whereas 108 million women report use at some point in their life, 87 million report drinking within the last year, and 65 million report drinking within the last month.10
Deaths.Alcohol is the fourth-leading preventable cause of death in the United States, killing nearly 88,000 people every year.14
Automobile fatalities. In 2014 alone, 31% of driving fatalities involved an alcohol-impaired driver. That's nearly 10,000 preventable deaths in one year.14
Find Treatment for Alcohol Addiction
If you or someone you love is struggling with alcohol abuse, call 1-888-319-2606 to speak with a treatment support specialist about alcohol rehabilitation options.
. Connor JP, Haber PS, Hall WD. Alcohol use disorders. Lancet 2015 [Epub ahead of print].
. Nasqvi NH, Morgenstern J. Cognitive neuroscience approaches to understanding behavior change in alcohol use disorder treatments. Alcohol Res 2015;37:29-38.
. Jones JD, Comer SD. A review of pharmacogenetic studies of substance-related disorders. Drug Alcohol Depend 2015;1521-14.
. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th ed. Arlington, VA, American Psychiatric Publishing, 2013.
. Alcoholic neuropathy: MedlinePlus Medical Encyclopedia. Available at: https://www.nlm.nih.gov/medlineplus/ency/article/000714.htm
. National Institute on Alcohol Abuse and Alcoholism. Beyond Hangovers: Understanding alcohol's impact on your health .
. National Institute on Alcohol Abuse and Alcoholism. Alcohol and Your Health.
. National Institute on Drug Abuse. Alcohol.
. Naimi TS, Brewer RD, Mokdad A, Clark D, Serdula MK, Marks JS. Binge drinking among US adults. JAMA 2003;289(1):70-75.
. Center for Behavioral Health Statistics and Quality. (2016). Results from the 2015 National Survey on Drug Use and Health: Detailed Tables . Substance Abuse and Mental Health Services Administration, Rockville, MD.
. Center for Behavioral Health Statistics and Quality. (2016). Key substance use and mental health indicators in the United States: Results from the 2015 National Survey on Drug Use and Health (HHS Publication No. SMA 16-4984, NSDUH Series H-51).
. Johnston, L. D., O'Malley, P. M., Bachman, J. G., Schulenberg, J. E. & Miech, R. A. (2016). Monitoring the Future national survey results on drug use, 1975-2015: Volume 2, College students and adults ages 19-55 . Ann Arbor: Institute for Social Research, The University of Michigan.
. National Institute on Drug Abuse. Monitoring the Future Study: Trends in Prevalence of Various Drugs .
. National Institute on Alcohol abuse and Alcoholism. (2016). Alcohol Facts and Statistics .
. Ethyl alcohol. (2015). Encyclopaedia Britannica .
. National Institute on Alcohol Abuse and Alcoholism. What Is a Standard Drink?
. National Institute on Alcohol Abuse and Alcoholism. (2004). Alcohol's Damaging Effects on the Brain . Alcohol Alert #63.
. National Institute on Alcohol Abuse and Alcoholism. Exploring Treatment Options for Alcohol Use Disorders .
. National Institute on Alcohol Abuse and Alcoholism. Drinking Levels Defined .
. Centers for Disease Control and Prevention. (2015). Fact Sheets - Binge Drinking .
. National Institute on Alcohol Abuse and Alcoholism. (2015). Alcohol Overdose: The Dangers of Drinking Too Much .
.U.S. National Library of Medicine. (2015). Medline: Ethanol Poisoning .
. National Institute on Alcohol Abuse and Alcoholism. Alcohol Use Disorder .
. National Institutes of Health. NIH study finds alcohol use disorder on the increase . Press release, June 3, 2015.
. National Institute on Alcohol Abuse and Alcoholism. (n.d.) Drinking levels defined .
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