Prevalence of Alcohol Use & Misuse

Alcohol is, without question, the most commonly used and abused substance in the United States. In 2021 alone, 67% of adults reported using alcohol during the year, and 84% reported alcohol use at some point in their lives. Unfortunately, while many adults find themselves drinking responsibly, there are millions that struggle with alcoholism.

Alcohol use can quickly become a serious concern due to the risks involved with high-level alcohol consumption. Typically, alcoholism progresses through a variety of stages. First, what may otherwise be “healthy” or “normal” use becomes misuse. Alcohol misuse is using alcohol in dangerous amounts, frequencies, and situations that could cause harm to oneself or other people. It is also commonly associated with alcohol being used to “cope” with life stressors such as anxiety, work issues, and relationship conflicts. One of the most common examples of alcohol misuse is binge drinking.

Understanding Binge Drinking

Binge drinking, or drinking more than five drinks within two hours, is one of the most dangerous ways of consuming alcohol. This is due to the higher level of medical issues like alcohol toxicity (alcohol poisoning) that can occur without intention. Binge drinking is considered an unhealthy drinking pattern that about 25% of adults, or 59 million people, reported engaging in during 2021. That accounts for almost a quarter of the US adult population, including 12% of the adult population who meet the criteria for alcohol use disorder (AUD).

Binge drinking and alcohol abuse can start in the teenage years or even earlier, though adults and the elderly may pick up the habit too.

It’s important to understand that while binge drinking is a dangerous, unhealthy drinking habit, it is not the same as alcoholism or AUD. In reality, most people who binge drink are not dependent on alcohol. Still, binge drinking, especially when recurring, is an alarming drinking behavior that may be an indication of alcoholism.

With such a large portion of the country reporting using alcohol in dangerous ways, it’s important to be aware of the warning signs of alcoholism.

Recognizing The Signs Of Alcoholism

Alcohol misuse can start to occur at any age. For some, behavior patterns begin in childhood (under 18). For others, they may start in early adulthood (21-30) or later in life due to possible experiences or situations they may have encountered. There is no exact formula that can predict who will develop an AUD; however, there are higher-risk behaviors that may indicate alcohol addiction is developing.

Early Signs

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-V-TR), there are several factors that may contribute to a person’s likelihood of developing an AUD. These may include, but are not limited to, the following:

  • Immediate family history of alcohol use disorder.
  • Living in an environment with frequent alcohol use, especially in childhood.
  • Recently experiencing a traumatic event.
  • Underage drinking, primarily when occurring at early ages (under 12)

Along with risk factors, the DSM-5 includes early behaviors and symptoms that someone in the earlier stages of alcohol addiction may display. These include, but are not limited to, the following:

  • Frequently finding reasons to use alcohol, especially in settings where it may not be appropriate.
  • Frequently engaging in unhealthy drinking patterns like binge drinking.
  • Frequently using alcohol with or without people, especially if they drink more when alone.
  • Experiencing relationship conflicts with friends, family, or partners due to alcohol use.
  • Reducing or stopping other enjoyable activities or hobbies to consume alcohol instead.
  • Experiencing problems with school or work responsibilities due to alcohol use.

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Advanced Signs

As alcoholism progresses, it becomes more serious and affects more aspects of life. These can include close family relationships, legal issues, and severe health conditions like liver disease or stroke. Some advanced signs of severe alcohol addiction may include the following:

  • Alcohol-related consequences, such as being arrested for driving under the influence or losing employment due to frequently calling out of work after drinking.
  • Frequently drinking to become heavily intoxicated or drunk, often due to stressful situations.
  • Drinking during timeframes that would not be normally associated with alcohol use for the individual (e.g., drinking during the day).
  • Downplaying or attempting to hide the amount of alcohol that they consume from others.
  • Being unwilling or unable to stop or reduce their alcohol use when requested.
  • A noticeable decline in self-care, hygiene, and other activities of daily living.
  • Engaging in high-risk behaviors while intoxicated, such as physical violence, drinking and driving, or putting themselves in risky environments.
  • Being dishonest about their alcohol use to not appear to be drinking.
  • Behavior or personality changes such as irritability, impulsivity, or depression that fluctuate with or without alcohol.
  • Continued alcohol use regardless of the consequences.

While these warning signs may indicate that alcohol addiction is developing, it is still essential for anyone struggling with alcoholism to be seen by a qualified treatment professional. These professionals may include psychiatrists, addictionologists, or behavioral health therapists trained in substance use disorder treatment.

Diagnosing Alcoholism

Treatment professionals are trained to determine if an individual does or does not meet the requirements for a substance use disorder diagnosis. Typically, this is done by completing an in-depth assessment. The criteria used for these evaluations come from the DSM-V-TR and provide an assortment of behaviors and situations that help to clarify if an individual does have a substance use disorder.

For most people, a treatment professional will review the last 12 months of an individual’s life but may review their overall life experiences from childhood to adulthood to help get a more in-depth picture. During this in-depth review, the treatment professional may ask a variety of questions to help understand their patient’s alcohol use. These questions may include the following:

In the last 12 months:

  • Have you used alcohol in larger amounts or over a longer period than intended?
  • Have you experienced a persistent desire or unsuccessful efforts to cut down alcohol use?
  • Have you spent a significant amount of time obtaining alcohol, using alcohol, or recovering from its effects?
  • Have you experienced cravings or a strong desire or urge to use alcohol?
  • Have you experienced a failure to fulfill major role obligations at work, school, or home because of alcohol?
  • Have you continued to use alcohol despite having persistent or recurrent social or interpersonal problems?
  • Have you given up or reduced important social, occupational, or recreational activities because of alcohol?
  • Have you continued to use alcohol despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by alcohol?
  • Have you needed increasingly larger amounts of alcohol in order to feel its effects?
  • Have you experienced any withdrawal symptoms when stopping alcohol use?

Depending on the answers provided, an individual may meet the requirements for an alcohol use disorder diagnosis and be recommended for certain forms of treatment based on severity. Severity levels are determined by how many criteria are met. A minimum of two are required for a diagnosis, while six or more is considered “clinically severe.” When an alcohol use disorder is considered severe, it is more traditionally referred to as alcohol addiction or alcoholism.

Alcohol Use Disorder Treatment

Many types of treatment exist for alcoholism, and the co-occurring conditions frequently experienced alongside it, like depression and anxiety. Depending on the severity level and the current amount of alcohol being used, there is a possibility medical detoxification may be the first stop in the recovery journey.

Detox from alcohol will include seeing a medical practitioner for an assessment and, in many cases, will involve medication to assist detoxification (medically assisted detox). Once the detoxification process is complete, or if it’s not required, the next phase of treatment will likely be behavioral health services such as psychotherapy to begin treating any mental health conditions. Therapy is also often combined with psychoeducation on alcohol, the brain anatomy, how the recovery process works in the brain during sobriety, and developing safe strategies to remain safe during the challenges often experienced in early recovery. Learn more about the different types of alcohol treatment here.

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Be the Change Today

If you or someone you care about are struggling with some of the symptoms of alcoholism, there is a possibility that an unhealthy alcohol use pattern has begun to develop. Unfortunately, these behavior patterns can be difficult to change alone, as the disease of alcohol addiction is a serious medical condition.

Fortunately, there are many treatment programs available to assist with finding the right approaches that could work for you or your loved one. The first step to recovery is recognizing a problem, and the second is reaching out for help. If you are ready to speak with someone today, please contact a treatment provider today for more information on the next step in the journey to recovery.