Alcohol Abuse
Alcohol Use Disorder (AUD)
About
Alcohol use disorder, which includes a level called alcoholism, is a pattern of alcohol use that involves problems controlling your drinking, preoccupation with alcohol, continuing alcohol use after it causes problems, drinking more to get the same effect, or experiencing withdrawal symptoms when you rapidly decrease or stop drinking.
Unhealthy alcohol use includes any alcohol use that puts your health or safety at risk or causes other alcohol-related problems. It also includes binge drinking which is defined as a pattern of drinking when a male consumes five or more drinks within two hours or a female has at least four drinks within two hours. Binge drinking causes significant health and safety risks.
If your pattern of drinking results in repeated distress and problems with daily life functioning, you likely have alcohol use disorder. It can range from mild to severe. If you believe you are at the beginning stages of alcohol use disorder early treatment is important because the use can increase and cause more and more severe problems in your life.
Symptoms
Alcohol use disorder can be mild, moderate or severe, based on the number of symptoms you experience.
Signs and symptoms may include:
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Being unable to limit the amount of alcohol you drink
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Wanting to limit how much you drink or being unsuccessful when trying to cut down
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Spending a lot time getting alcohol, drinking, or recovering from alcohol use
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Having urges or cravings to drink alcohol
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Alcohol interferes with obligations at school, work, family or home
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Drinking alcohol even though you know it's causing physical, social or interpersonal problems
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Giving up or reducing social and work activities and hobbies in favor of drinking
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Drinking alcohol when you know it’s not safe such as when working, operating machinery or driving. Needing to drink more to feel the effect of alcohol or noticing that your regular level of drinking has less effect
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Having withdrawal symptoms which include nausea, sweating and shaking when you don't drink, or drinking to avoid these symptoms
* Alcohol Use Disorder Can Include Periods of Alcohol Intoxication and Symptoms of Withdrawal
Alcohol intoxication is the result of increased levels of alcohol in your blood. The higher the blood alcohol level, the more intoxicated and impaired you become. Alcohol intoxication causes behavior problems and mental changes which may include inappropriate behavior, unstable moods, impaired judgment, slurred speech, impaired attention or memory, and poor coordination. You can also have periods called "blackouts," where you don't remember events. Very high blood alcohol levels can lead to coma or even death.
Alcohol withdrawal can occur when alcohol use has been heavy and prolonged and is then stopped or suddenly reduced. It can occur within several hours to four or five days later. Signs and symptoms don’t have to include all the following but may include sweating, rapid heartbeat, hand tremors, problems sleeping, nausea and vomiting, hallucinations, restlessness and agitation, anxiety, and occasionally seizures.
When to See a Doctor If you think you’re drinking too much alcohol, drinking more frequently, your drinking is causing problems, or your friends or family are concerned about your drinking, speak with a doctor. Other ways to get help include talking with a mental health professional or seeking help from a support group such as Alcoholics Anonymous or other self-help groups.
Denial is common. Many times a problem drinker may not feel like you have a problem with drinking. You might not recognize how much you drink or how many problems in your life are related to alcohol use. Listen to relatives, friends or co-workers when they speak with you about your drinking habits or if they suggest that you seek help.
If Your Loved One Needs Help
Many people with alcohol use disorder hesitate to get treatment because they don't recognize they have a problem. An intervention from loved ones can help some people recognize and accept that they need professional help. If you're concerned about someone who drinks too much, ask a professional experienced in alcohol treatment for advice on how to approach that person.
Alcohol Use Disorder Medications
In addition to AA or other self-help groups and individual counseling there are medications that can assist you to cut down your drinking or that help you remain abstinent once you stop drinking.
Disulfiram, acamprosate, and naltrexone are the most common drugs used to treat alcohol use disorder. None of these drugs provide a cure for the disorder, but they are most effective in people who participate in a Medication Assisted Treatment (MAT) program.
Disulfiram (Antabuse)
Disulfiram is a medication that treats chronic alcoholism. It is most effective in people who have already gone through detoxification or are in the initial stage of abstinence. This drug is taken once a day. Disulfiram should never be taken while intoxicated and it should not be taken for at least 12 hours after drinking alcohol. After taking disulfiram you must abstain from drinking.
Unpleasant side effects (nausea, headache, vomiting, chest pains, difficulty breathing) can occur as soon as ten minutes after drinking even a small amount of alcohol and can last for an hour or more.
Acamprosate (Campral)
Acamprosate is a medication for people in recovery who have already stopped drinking alcohol and want to avoid drinking. It works to prevent people from drinking alcohol by suppressing cravings and the urge to drink. However, it does not prevent withdrawal symptoms after people drink alcohol. It has not been shown to work in people who continue drinking alcohol, consume illicit drugs, and/or engage in prescription drug misuse and abuse. The use of acamprosate typically begins on the fifth day of abstinence, reaching full effectiveness in five to eight days. It is taken three times a day.
Naltrexone
Naltrexone blocks the euphoric effects and feelings of intoxication. This allows people with alcohol addiction to reduce their drinking behaviors enough to remain motivated to stay in treatment, avoid relapses, and take medications.
Topiramate (Topomax)
This drug is usually used to treat seizure disorders but is sometimes used “off label” for other conditions. Although not FDA approved for other treatments some practitioners use it to treat anxiety, depression and PTSD. Studies have shown a benefit to using low dose topiramate to treat alcohol use disorder. The medication may help reduce alcohol intake, reduce cravings, and assist with abstinence from alcohol.
Coping and Support Many people with alcohol problems and their family members benefit from participating in support groups to cope with the disease, prevent relapses, and maintain sobriety. These groups can be found on the internet.
Here are a few examples:
Alcoholics Anonymous (AA) is a self-help group for people recovering from alcoholism. AA offers a sober peer group and is built around 12 steps as an effective model for achieving total abstinence.
Women for Sobriety is a nonprofit organization offering a self-help group program for women who want to overcome alcoholism and other addictions. It focuses on developing coping skills related to emotional and spiritual growth, self-esteem and a healthy lifestyle.
Al-Anon and Alateen. Al-Anon is designed for people who are affected by someone else's alcoholism. Alateen groups are available for teenage children of those with alcoholism. In sharing their stories, family members gain a greater understanding of how the disease affects the entire family and helps that individual by providing a supportive and understanding environment.
Lifestyle and Home Remedies
As part of your recovery, you'll need to focus on changing your habits and making different lifestyle choices. These strategies may help.
Consider your social situation. Make it clear to your friends and family that you're not drinking alcohol. Develop a support system of friends and family who can support your recovery. You may need to distance yourself from friends and social situations that impair your recovery. Develop healthy habits. For example, good sleep, regular physical activity, managing stress more effectively and eating well all can make it easier for you to recover from alcohol use disorder. You may realize that many of your activities involved drinking. Do things that don't involve alcohol. Replace them with hobbies or activities that are not centered around alcohol.
Alternative Medicine
Avoid replacing conventional medical treatment or psychotherapy with alternative medicine. But if used in addition to your treatment plan when recovering from alcohol use disorder, these techniques may be helpful:
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Yoga. Yoga's series of postures and controlled breathing exercises may help you relax and manage stress.
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Meditation. During meditation, you focus your attention and eliminate the stream of jumbled thoughts that may be crowding your mind and causing stress.
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Acupuncture. With acupuncture, hair-thin needles are inserted under the skin. Acupuncture may help reduce anxiety and depression.