What Is Alcohol Abuse?
In the United States, alcohol is the most commonly used and misused substance. It can be addictive.1,14 Not everyone who consumes alcohol will become addicted, but there are certain people who may be more susceptible to addiction.2
The effects alcohol has can vary between people, and there are factors that influence those effects, including age, health status, family history, and how much and how often one drinks.2 It should be noted that alcohol addiction and abuse are not the same. Addiction is a chronic disease that involves uncontrolled, continued substance pursuit and use despite any harmful consequences.3-6 Individuals who suffer from alcohol addiction are often diagnosed with an alcohol use disorder (AUD), and they may also have developed a dependency on alcohol.
Dependence is a state where the body requires the presence of a substance such as alcohol just to function normally. Without it, the individual will experience severe, possibly life-threatening, withdrawal symptoms.5,6 Dependence on alcohol is often experienced in tandem with addiction.6
Those who abuse or misuse alcohol are not necessarily addicted to or dependent on alcohol. An individual can misuse alcohol without drinking on a consistent basis. For example, an individual who abuses alcohol may only drink once a week. However, when that individual drinks, they may put themselves in risky situations or drink enough to cause problems, such as alcohol poisoning.2
Common Methods of Alcohol Abuse
Binge Drinking and Heavy Drinking
- Binge drinking is excessive drinking that is defined as 5 or more drinks in 2 hours for a man and 4 or more drinks for a woman. Most people who are binge drinkers are not identified as alcohol dependent.
- One in 6 US adults report binge drinking approximately 4 times each month, and binge drinking occurs most commonly among adults aged 18-34. Binge drinking can lead to numerous health problems, including alcohol poisoning, car accidents, violence, sexually transmitted diseases, cancer (including breast, mouth, liver, and colon), and memory and learning problems.15
Pregnant Women and Alcohol
- Alcohol can present various dangers during pregnancy, and there is no known level of use that is considered safe. All types of alcohol are dangerous.
- Drinking while pregnant is dangerous because the alcohol is passed on to the baby and can cause miscarriage; stillbirth; and numerous physical, behavioral, and intellectual development issues, including low body weight, poor coordination, hyperactive behavior, poor memory, learning disabilities, poor judgment skills, visions or hearing problems.16
Teen Alcohol Use
- Many teenagers misuse alcohol due to the accessibility of the substance and peer pressure. In fact, alcohol tops the list of drugs used by teenagers, per the National Institute on Drug Abuse. In fact, more than 8% of 8th graders, 18% of 10th graders, and 30% of 12th graders were current alcohol drinkers in 2018.11
- Teenagers who misuse alcohol may exhibit signs including low energy, having alcohol paraphernalia, concentration problems, problems with coordination, mood swings, changing social circles, declining academic performance, behavioral issues/rebelling, smelling of alcohol.12,13
- Teens who use alcohol are at an increased risk in a number of ways. Teens who drink may be sexually active and participate in unprotected sex more often than teens who do not consume alcohol.13 These teens are also at an increased risk of becoming a victim of rape or assault.
- They may also get injured or die in car crashes involving alcohol.13 Not only can alcohol abuse alter how a teen acts, it can also have adverse effects on the adolescent brain.
- Studies show that brain development continues past the teenage years. Alcohol abuse during the brain’s formative years can negatively impact how the brain develops and can also lead to learning problems and increase the risk of developing an alcohol use disorder in the future.12
Signs and Health Effects of Regular Alcohol Use
Binge drinking and excessive use of alcohol has a wide range of consequences, from nausea and headaches from a hangover to severe liver problems from chronic drinking. In the short-term, drinking too much can be very dangerous, sometimes deadly. Effects may include:2,5,7
- Slurred speech.
- Impaired judgment.
- Trouble concentrating.
- Memory loss.
- Problems breathing.
Risk of significant personal harm or long-term health problems are increased with chronic alcohol consumption. People who use excessive amounts of alcohol are at higher risk of:2,5,7
- Mouth, esophageal, throat, liver, and breast cancer.
- Raised risk of heart problems, such as cardiomyopathy.
- Brain damage.
- Weakened immune system.
- Liver disease.
- Violence or self-harm.
- Accidents, such as vehicle collisions.
Identifying Alcohol Use Disorders
Abuse of alcohol has the potential to lead to an alcohol use disorder (AUD). An AUD is a chronic disease in the brain that is defined by the compulsive use of alcohol,, an inability to control how much you drink, and negative feelings when you are not drinking.17 Signs that may indicate an alcohol use disorder include the following:5,17
- Neglecting personal/family responsibilities.
- Declining academic or professional performance.
- Conflicts with loved ones.
- Preoccupation with drinking and cravings.
- Inability to control drinking.
- Failing in attempts to stop drinking.
- Needing increasing amounts of alcohol to feel its effects.
- Getting drunk when it could be hazardous, such as before driving.
- Going through withdrawal when not drinking.
When has drinking progressed to alcoholism?
Combining Alcohol with Other Drugs
AUD often occurs in the presence of another substance use disorder. In 2017, 16% of individuals entering treatment for substance use used alcohol alone vs. 37% entering treatment for AUD along with a co-occurring substance use disorder.18 Many people combine alcohol use with prescription or illicit drugs. This can have dangerous and possibly even deadly consequences. Learn more about combining alcohol with drugs here:
Consuming with Illicit Drugs
Mixing with Prescription Drugs
Individuals who wish to overcome problems with alcohol use or who suspect they may have alcohol use disorder have a number of options.
According to the National Survey on Drug Use and Health (NSDUH), more than 2.4 million people age 12 or older received substance use treatment in 2017 for alcohol use alone.8 Many of the individuals who are treated for alcoholism and alcohol abuse often seek outside help from treatment centers and therapy sessions.
Alcohol treatment centers are designed to help individuals who are addicted or who abuse alcohol in a number of ways. Some treatment centers require an individual to stay at the center for a specific amount of time while others offer outpatient treatment. Many centers offer both long- and short-term treatment options.3
During treatment, individuals go through detoxification. Detoxification is the set of interventions used to keep a person safe as they readjust to a lack of alcohol in the body.9,10 Medical detox is extremely important for
someone dependent on alcohol because withdrawal can cause delirium and potentially life-threatening seizures, along with other very serious symptoms.2,9,10
Treatment with therapy and possibly medication should follow detox.10 Treatment centers are designed to provide support in the form of individual therapy, as well as group therapy and educational classes on drug addiction. During therapy sessions, patients can explore their reasons behind their excess alcohol consumption, as well as what they can do to overcome their abusive behavior.3
Inpatient treatment allows patients to receive care in a structured, controlled environment.3 With housing, medical care, and various forms of therapy, inpatient treatment can be best for those who do not have an effective home support system or are dealing with a more severe form of alcohol abuse.3
Outpatient treatment is also an option for many alcoholics. Outpatient treatment centers are designed to provide recovering alcoholics with a place to explore their destructive behavior. Many outpatient treatment centers provide anonymous group meetings, as well as other programs to help recovering individuals overcome their issues.3 With outpatient treatment, individuals are not placed in a controlled environment so it is important that people who use outpatient treatment have a strong system to rely on outside of treatment.
- Substance Abuse and Mental Health Services Administration. (n.d.). Alcohol Misuse.
- National Institute on Alcohol Abuse and Alcoholism. (n.d.). Overview of Alcohol Consumption.
- National Institute on Drug Abuse. (2019). DrugFacts: Treatment Approaches for Drug Addiction.
- National Institute on Drug Abuse. (2018). Drugs, Brains, and Behavior: The Science of Addiction: Drug Misuse and Addiction.
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
- National Institute on Drug Abuse. (2018). Principles of Drug Addiction Treatment; A Research-Based Guide (Third Edition): Is there a difference between physical dependence and addiction.
- National Institute on Alcohol Abuse and Alcoholism. (n.d.). Alcohol’s Effects on the Body.
- Substance Abuse and Mental Health Services Administration. (2018). Results from the 2017 National Survey on Drug Use and Health: Detailed Tables.
- Substance Abuse and Mental Health Services Administration. (2015). TIP 45: Detoxification and Substance Abuse Treatment.
- National Institute on Drug Abuse. (2017). Frequently Asked Questions.
- National Institute on Drug Abuse. (2019). Monitoring the Future Study: Trends in Prevalence of Various Drugs.
- National Institute on Drug Abuse for Teens. (2019). Alcohol.
- Centers for Disease Control and Prevention. (2018). Fact Sheets-Underage Drinking.
- Substance Abuse and Mental Health Services Administration. (2019). Reports and Detailed Tables From the 2018 National Survey on Drug Use and Health (NSDUH).
- Centers for Disease Control and Prevention. (2018). Fact Sheets-Binge Drinking.
- Centers for Disease Control and Prevention. (2018). Alcohol Use in Pregnancy.
- National Institute on Alcohol Abuse and Alcoholism. (n.d.). Alcohol Use Disorder.
- Substance Abuse and Mental Health Services Administration. (2018). National Survey of Substance Abuse Treatment Services (N-SSATS): 2017: Data on Substance Abuse Treatment Facilities.