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Alcoholism and Addiction
Ethyl alcohol is the intoxicating agent found in beer, wine and liquor. It is produced by fermentation of yeast, sugars, and starches that occur in fruits like grapes and grains like barley and wheat.
Of the many substances that can be addictive, alcohol is the most commonly abused. Cognitive functions that control reasoning, rational thinking and judgment are impaired when a person is inebriated, and that damage can become chronic in long-term heavy drinkers. Women are more sensitive to its effects than men.
According to the National Council on Alcoholism and Drug Dependence (NCADD), 17.6 million people, or one in every 12 adults, suffer from alcoholism and alcohol abuse. More than half of all adults have a family history of alcoholism, and over seven million children live in a household where at least one parent has a problem with alcohol abuse and alcoholism. Moreover, alcohol remains the most abused drug among youths, even more than tobacco and illicit drugs, despite the fact that drinking under the age of 21 years is illegal.
What is Alcoholism?
Alcoholism or alcohol dependence is characterized by physical and mental craving for alcohol. It generally starts as alcohol abuse wherein people develop unhealthy or detrimental drinking habits like heavy drinking every day or binge drinking on any occasion.
Heavy drinking is defined as:
- For women: consuming more than 1 drink per day on average.
- For men: consuming more than 2 drinks per day on average.
Binge drinking, on the other hand, is defined as consuming
- For women: 4 or more drinks during a single occasion.
- For men: 5 or more drinks during a single occasion.
Binge drinking is the most common form of excessive alcohol consumption, especially among teens and college youths who often have drinking competitions with peers to show-off their tolerance levels and drink to lower inhibitions, have fun and fit in with their peers. It is estimated that those between the age of 12 to 20 years drink 11 percent of the total alcohol consumed in the United States and more than 90 percent of this alcohol is consumed during bouts of binge drinking.
Alcohol abuse and addiction is dangerous for youths, and for adults as well, impairing their ability to think rationally. As addicts, they become incapable of controlling their craving for alcohol, despite the damage being done to their health as well as the havoc it creates in their personal, social and professional lives. Excessive use raises the risk for disease and is the third leading lifestyle-related cause of death, responsible for approximately 88,000 deaths every year.
Why is Alcohol Addictive?
People become addicted to alcohol because of the way it affects the levels of dopamine in the rewards system of the brain.
Alcohol is a small, simple molecule, which allows it to interact with many neurotransmitter systems in the brain. One of the paradoxes about alcohol is that it can be either a stimulant or a depressant, depending on the neurotransmitters that it is affecting at a particular time. Studies have found that alcohol is a stimulant when it acts on the dopamine or norepinephrine neurotransmitters, but it is a depressant when it acts on inhibitory GABA neurotransmitters. The size of the alcohol molecule allows it to unlock many different receptors in the brain, while larger, more complex molecules – such as those in opiate drugs or amphetamines – seem to only act on a single neurotransmitter system.
Variables such as how much alcohol has been consumed, and how long it has been since the last drink, affect the biphasic response, determining whether the alcohol acts mainly as a stimulant or a depressant in the central nervous system. When blood alcohol content is rising, the stimulant properties appear to be dominant; when it starts to drop, the depressant properties are usually stronger.
This interaction between alcohol and neurotransmitters induces several reactions including feelings of euphoria, satisfaction, drowsiness and relaxation. Alcohol increases the amount of dopamine in the brain’s reward system, which is why it so often leads to alcoholism. It also triggers the release of norepinephrine and adrenaline, acting as a stimulant. The epinephrine and norepinephrin increase the pulse rate and blood pressure in people who have been drinking.
Alcohol acts as a central nervous system depressant when it acts on the GABA system. At this point, a drinker begins to lose control over his or her body, causing loss of coordination and poor balance. The heart rate is slowed, causing dizziness and drowsiness.
People drink for many reasons, including seeking the physical reactions that help them escape from stress and the problems in their lives. This is the reason why individuals who are going through a rough phase – due to grades in school or college, issues related to relationships or finances, professional or family problems, or other difficulties – are vulnerable to alcohol abuse and possible dependence or addiction.
There is a correlation between alcoholism and the release of natural opioids or endorphins (neurotransmitters) in areas of the brain that produce feelings of pleasure and reward. People whose brains release more endorphins in response to alcohol may get more gratification from drinking and are likely to drink more and become alcoholics.
Some people are genetically more vulnerable to addiction. Research suggests that while about half the risk of addiction is due to poor coping skills, the other half can be attributed to a genetic predisposition to addiction. This seems to be related to the number of D2 dopamine receptors that a person has, which is partly a function of genetics. Imaging studies found evidence to support the theory that people with fewer D2 receptors are more likely to become addicted than people with greater numbers of D2 receptors.
Another recent theory for alcohol dependence is that long term alcohol abuse leads to higher levels of acetate, a by-product of alcohol metabolism. The brains of these heavy drinkers adapt, and develop the ability to use acetate for energy, while people who are not heavy drinkers rely on glucose (the simplest form of carbohydrate) as fuel for normal brain functioning. In fact, heavy drinkers are able to use this alternate source of energy twice as fast as light drinkers. This extra energy source makes them even more addicted to alcohol.
Signs of Alcoholism
The alcohol dependence symptoms might appear differently in each person. However, there are a few common signs that someone might be abusing alcohol or forming a dependence on the substance. The most significant signs of dependence are tolerance and withdrawal. Tolerance is when a person requires larger quantities of alcohol to feel the same effect. Alcohol withdrawal occurs when a person’s body is dependent upon the substance and stops drinking. Alcohol withdrawal symptoms include headaches, nausea, irritability, shaking or trembling, anxiety, sweating, insomnia, depression, and fatigue.
Alcohol detox can be dangerous, which is why a person should go through a medically monitored alcohol addiction treatment program, such as the one at DTRC. Alcohol detox symptoms are similar to that of withdrawal. However, alcohol detox can lead to serious and life-threatening health complications, such as seizures and delirium tremens.
Other symptoms of alcoholism include a loss of control and an inability to stop drinking, even when a person has the desire to do so. An alcoholic will also often drink throughout the day and despite knowledge of the negative consequences of his or her actions. Drinking becomes a compulsion that is stronger than a person’s will power. Another sign a person has a problem is when he or she no longer enjoys or engages in favorite activities and hobbies.
Who is at Risk of Alcohol Addiction?
Although anyone may take up drinking as a regular habit, the risk of alcohol dependence increases in:
- Men who have 15 or more drinks in a week
- Women who have 12 or more drinks in a week
- Individuals who have five or more drinks per occasion at least once a week
- Young adults who feel peer pressure
- People suffering from depression, bipolar disorder, anxiety disorders or schizophrenia
- Individuals who have easy access to alcohol
- People with low self-esteem
- Youths and adults having problems with relationships
- People leading a stressful lifestyle
- Individuals who live in a family where alcohol use is common
What are the Adverse Effects of Alcohol Abuse?
Binge drinking can have immediate effects on parts of the brain that control movement, speech, judgment, and memory, thereby causing difficulty in walking, slurred speech, blackouts, memory lapses, and impulsive behavior. These hangover symptoms usually subside after eight to twelve hours.
However, heavy or binge drinking over a period of time are related to a number of serious physical, mental and behavioral problems including:
- Heart problems such as cardiomyopathy (weakening of the heart muscle), arrhythmias (irregular heart beat), stroke and high blood pressure
- Liver problems such as fatty liver, hepatitis, fibrosis and cirrhosis (irreversible scarring of the liver)
- Gastric problems such as inflammation of the stomach lining and ulcers
- Pancreatitis, dangerous inflammation of the blood vessels in the pancreas that prevents proper digestion
- Cancer of the mouth, esophagus, throat, liver or breast
- Weakened immunity, increasing susceptibility to infections and diseases like pneumonia and tuberculosis
- Polyneuropathy, damage to multiple nerves causing weakness, numbness and burning pain
- Wernicke–Korsakoff Syndrome, due to severe deficiency of Vitamin B1 (thiamine), resulting in symptoms like mental confusion, memory problems, paralysis of the nerves that move the eyes, difficulty in walking and poor muscle coordination
- Negative emotional responses like aggression, irritability, anxiety and depression
- Chronic fatigue, sleep disturbances and mood swings
Apart from these effects, drinking also creates serious problems for the families of people with alcoholism. Cognitive functions that control reasoning, rational thinking and judgment are impaired when a person is inebriated, and that damage can become chronic in long-term heavy drinkers. In addition, some alcohol abusers develop aggressive tendencies. Domestic violence, sexual assaults, relationship break-ups, accidents and lack of productivity at work are among the devastating outcomes of alcoholism.
Rehabilitation for Alcoholism
Rehabilitation for alcoholism may be a step taken by the family or by the alcoholic, hoping to break the destructive patterns of behavior that accompany alcohol addiction. However, it is important to know that the road to recovery is not an easy one. Despite determination and unwavering efforts to quit drinking, relapses are likely to occur. Nevertheless, a comprehensive rehabilitation program can make the recovery process easy and successful.
A holistic treatment program for alcohol addiction aims to:
- Free the addict from alcohol dependence or reduce his dependence
- Enable the addict to maximize his physical, mental and social abilities
- Allow the addict to achieve full social integration
- Reduce the morbidity caused by, or associated with alcoholism
A customized addiction treatment program that restores the cognitive abilities, and addresses not just the addiction but also its underlying psychological cause or causes, is the most effective approach in treating addiction.
Drug Treatment Rehab Center
Drug Treatment and Rehab Centers (DTRC) offers services that help people recover from addictions to alcohol and other drugs. Patients are screened and treated for all underlying and co-occurring conditions in order to reduce the risk of relapse. Through customized programming that combines individual and group psychotherapy and complementary alternative therapeutic activities such as yoga, meditation, art therapy, equine therapy, and music therapy, the programs at DTRC provide balanced, holistic treatment for the person, not the disorder. Call our Admissions team at (415) 366-6922 to learn more.