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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.
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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.
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.
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:
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:
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:
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.
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:
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.
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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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.
Travis Pantiel, LMHC, MCAP
Travis Pantiel is a Licensed Mental Health Counselor and a National Board-Certified Counselor with specialized expertise in the co-occurring disorder treatment field.
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