What Is Alcoholism?

Alcoholism, recognized as an illness by the American Medical Association (AMA) in 1956, is a disease that alters the brain, affecting motivation and the ability to make healthy choices. Once it takes hold, it can be challenging to overcome without proper help and support.

Potential Predictors of Alcohol Use Disorders

Several factors can indicate a predisposition to alcohol use disorders:

Age of First Drink: Individuals who start drinking at a younger age are more likely to develop heavy drinking habits into adulthood.
Genetics: A family history of alcoholism can increase the risk.
Environment: Social and environmental factors can contribute to the development of alcohol dependence.

No one plans to become dependent on alcohol, but recognizing these predictors can help in understanding the risks.

The Stages of Alcoholism: Recognizing the Signs

The Jellinek Curve, created by E. Morton Jellinek in the 1950s and later revised by British psychiatrist Max Glatt, outlines the typical phases of alcoholism and recovery. It demonstrates the progression of alcohol addiction and the potential for recovery if the cycle of dependence is broken.

Stage 1: Pre-Alcoholic

Drinking to feel better about oneself, to dull pain, or to eliminate anxiety. This stage can escalate without intervention.

Stage 2: Early Alcoholic

Warning signs include blacking out, lying about drinking, drinking excessively, and obsessively thinking about drinking.

Stage 3: Middle Alcoholic

The struggle becomes apparent to those close to the individual. Symptoms include missing work, irritability, physical signs of alcohol abuse (redness in the face, weight changes, sluggishness, stomach bloating), and increased need for support.

Stage 4: Late Alcoholic

Drinking dominates life, affecting health, relationships, and livelihood. Attempts to stop drinking may result in severe withdrawal symptoms like tremors or hallucinations.

Stage 5: Recovery

The goal is to transition from detox to treatment and maintenance, practicing sober living and achieving a state of transcendence in the recovery process.

Do You Need Help? 10 Warning Signs of Alcoholism

Recognizing these symptoms can be crucial in seeking treatment:

Drinking more than intended.
Neglecting responsibilities at school, work, or home.
Continuing to drink despite negative impacts on relationships, finances, or health.
Drinking in physically hazardous situations, such as driving.
Developing a tolerance to alcohol, needing more to achieve the same effect.
Experiencing withdrawal symptoms when attempting to stop drinking.
Losing interest in once-enjoyed activities or becoming socially isolated.
Becoming dishonest, secretive, aggressive, moody, or temperamental.
Craving alcohol and drinking first thing in the morning.
Spending excessive time thinking about drinking, acquiring alcohol, and recovering from hangovers.

Physical Signs and Symptoms of Alcohol Addiction

Rapid weight changes.
Slow or staggering walk.
Difficulty sleeping or staying awake.
Unexplained bruises or marks.
Glazed or red eyes.
Cold, sweaty palms or shaking hands.
Puffy face, blushing, or paleness.
Nausea, vomiting, or excessive sweating.
Low or no energy.
Depression or anxiety.
Deterioration of personal appearance or hygiene.

Long-Term Health Problems Associated with Chronic Heavy Drinking

Cancer

Chronic heavy drinking is strongly linked to several types of cancer. Alcohol consumption can lead to the development of cancer in various parts of the body due to the conversion of ethanol to acetaldehyde, a toxic chemical that can damage DNA and proteins. Key cancers associated with alcohol use include:

Mouth and Throat Cancer: Alcohol can irritate the cells in the mouth and throat, leading to mutations that may cause cancer. The risk increases significantly for those who also use tobacco.
Esophageal Cancer: The esophagus is particularly vulnerable to the carcinogenic effects of alcohol. The risk is higher in individuals with a deficiency in enzymes that metabolize acetaldehyde.
Liver Cancer: The liver processes alcohol, and excessive consumption can lead to cirrhosis and eventually liver cancer. This is one of the most severe outcomes of chronic alcohol abuse.
Colorectal Cancer: Alcohol consumption has been linked to an increased risk of colon and rectal cancers. This risk is amplified in individuals with a family history of colorectal cancer.
Breast Cancer: Research shows a clear correlation between alcohol intake and an increased risk of breast cancer. Even low to moderate alcohol consumption can increase the risk.

Brain Damage

Long-term alcohol abuse can cause significant damage to the brain, affecting both its structure and function. The impacts include:

Difficulty Walking: Alcohol can affect the cerebellum, the part of the brain that controls movement and balance, leading to unsteady gait and coordination problems.
Blurred Vision and Slurred Speech: Alcohol disrupts the brain’s communication pathways, leading to impaired vision and speech.
Slowed Reaction Times: Chronic alcohol use can slow down neural processing, affecting reaction times and decision-making abilities.
Memory Impairment: Long-term alcohol abuse can lead to memory blackouts and permanent cognitive deficits. This includes difficulties with short-term memory and the development of alcohol-related dementia.
Dementia and Intellectual Impairments: Over time, heavy drinking can cause significant brain shrinkage and cognitive decline, leading to conditions like Wernicke-Korsakoff syndrome, a serious disorder linked to thiamine deficiency.

Cardiovascular Disease

Alcohol abuse is a major risk factor for various cardiovascular diseases:

Blood Clots: Alcohol can affect the clotting process, increasing the risk of both clot formation and bleeding.
Heart Attacks and Strokes: Heavy drinking can raise blood pressure and lead to the buildup of fatty deposits in the arteries, significantly increasing the risk of heart attacks and strokes.
Cardiomyopathy: This condition, where the heart muscle weakens and fails to pump blood efficiently, can be directly caused by chronic heavy drinking.
Heart Rhythm Abnormalities: Alcohol can disrupt the electrical signals in the heart, leading to arrhythmias, which can be life-threatening.

Cirrhosis of the Liver

Cirrhosis is the late stage of liver scarring caused by many forms of liver diseases and conditions, such as hepatitis and chronic alcoholism. Key aspects include:

Liver Scarring: Excessive alcohol consumption causes inflammation and scarring (fibrosis) of the liver tissue, disrupting its ability to function properly.
Symptoms: Common signs include fatigue, itchy skin, weight loss, nausea, jaundice (yellowing of the skin and eyes), abdominal pain, and swelling.
Complications: Advanced cirrhosis can lead to liver failure, necessitating a liver transplant for survival.

Pancreatitis

The pancreas, responsible for aiding digestion and regulating blood sugar, can be severely affected by alcohol:

Toxic Substances: Alcohol prompts the pancreas to produce toxic substances that can lead to inflammation.
Acute and Chronic Pancreatitis: This inflammation can cause acute pancreatitis (sudden, severe pain) or chronic pancreatitis (persistent inflammation leading to permanent damage).
Digestive Issues: The inflammation disrupts normal digestive processes, leading to severe abdominal pain, persistent diarrhea, and malnutrition.

Immune System Weakening

Chronic heavy drinking weakens the immune system, making the body more susceptible to infections and diseases:

Increased Susceptibility: Heavy drinkers are more prone to diseases like pneumonia and tuberculosis due to a compromised immune system.
Infection Risk: Alcohol impairs the immune cells that are crucial for fighting off infections, slowing down the body’s response to pathogens.
24-Hour Impact: Even drinking heavily on a single occasion can slow the body’s ability to fend off infections for up to 24 hours, increasing vulnerability to illnesses during this period.

Understanding these long-term health problems associated with chronic heavy drinking underscores the importance of seeking help and support for those struggling with alcohol use disorder. The consequences of continued alcohol abuse can be severe, but with the right interventions, recovery and improved health are achievable.

Symptoms of Alcohol Detox

Detox is the first step in treating alcoholism and can range from mildly annoying to severe, depending on the severity of the disorder. Early withdrawal symptoms include headaches, anxiety, nausea, irritability, and shaking.

Other withdrawal symptoms may include:

Chills.
Alcohol cravings.
Muscle cramps.
Irritability.
Palpitations.
Disorientation.
Tachycardia.
Hypertension.
Low-grade fever.
Mood changes.
Slurred speech.
Impaired gait.
Poor dexterity.
Fatigue.
Abdominal pain.
Loss of appetite.

The Most Severe Form: Delirium Tremens (DTs)

Only about 5% of patients with alcohol withdrawal progress to DTs, but it has a high mortality rate if not treated. Symptoms include:

Body tremors.
Excessive sweating.
Rapid heart rate.
Hypertension.
Fever.
Severe anxiety or agitation.
Disorientation, hallucinations, and seizures.

Seeking Help and Support

Addressing alcohol use disorder involves recognizing the signs and seeking appropriate help. Support from friends, family, and support groups like Al-Anon and Alateen can be crucial. Setting healthy boundaries and offering non-judgmental support can make a significant difference.

Helpful Resources

Al-Anon and Alateen: Support for families and friends of alcoholics.
Alcoholics Anonymous (AA): Support for individuals struggling with alcoholism.
Co-Dependents Anonymous (CoDA): Helping individuals develop healthy relationships.
National Institute on Drug Abuse (NIDA): Information on drug abuse and prevention.
Partnership for Drug-Free Kids: Resources for addressing drug and alcohol abuse in children.
Families Anonymous: Support for families dealing with substance abuse.
National Alliance on Mental Illness (NAMI): Support for individuals with mental illnesses and their families.
Nar-Anon: Support for friends and family of addicts.
Substance Abuse and Mental Health Services Administration (SAMHSA): Resources for substance abuse and mental health services.

By understanding the stages of alcoholism and recognizing the signs, individuals and their loved ones can take proactive steps towards recovery and a healthier, sober life.