Alcohol Addiction/ Alcohol Dependence: Definition, Causes, Symptoms, Effects, and Treatment.

Alcohol addiction, which is commonly called alcoholism, refers to the compulsive and prolonged use of alcohol, despite the adverse effects. According to the 2022 National Survey on Drug Use and Health (NSDUH), 29.5 million people ages 12 and older (10.5% in this age group) had AUD in the past year. Lack of control over alcohol consumption, increased tolerance, and withdrawal symptoms are unique characteristics of alcohol addiction. Alcohol dependence refers to the body’s physical reliance on alcohol. 

Biological factors such as genetic predisposition and gender, environmental factors such as access and exposure, psychological factors such as personality traits, and social influences such as culture are the causes of alcohol addiction and dependence.

The symptoms of alcohol addiction and alcohol dependence include inability to stop or reduce alcohol consumption despite attempts, attempts to stop or reduce alcohol consumption lead to withdrawal symptoms, social and psychological withdrawal, tolerance, neglecting responsibilities, spending a lot of time getting and using alcohol, as well as recovering from its effects, etc.

The common treatment methods used by experts for alcohol addiction and dependence are detoxification, behavioral therapies, medication-assisted therapy, and support groups.

What is Alcohol Addiction and Alcohol Dependence?

Alcohol is among the most commonly used substances in the United States, with over 174 million people aged 12 or older (over 62% of the age category) reporting alcohol use in the previous year, according to the 2021 National Survey on Drug Use and Health. This level of alcohol use significantly increases the risk of individuals becoming addicted or dependent on alcohol.

Alcohol addiction and alcohol dependence are connected, but they are not the same things. Alcohol addiction or alcoholism is a state of chronic and compulsive consumption of alcohol, despite the negative consequences caused. Individuals who are addicted to alcohol have no control over their drinking habits, leading to needing more alcohol for the same effect (known as tolerance). Trying to stop or cut down on alcohol consumption leads to the experience of withdrawal symptoms for affected individuals.

Alcohol dependence refers to a state of physical reliance on alcohol by the body. It is typically a result of the use of alcohol as a means of escape or a way to cope with diverse issues, such as stress. Tolerance and withdrawal symptoms are also key characteristics of alcohol dependence.

How Do Alcohol Addiction Impact Brain Function?

Alcohol addiction involves changes to how the brain functions. Consistent drinking of alcohol can lead to the shrinkage of the hippocampus. According to a study by the University of Oxford, researchers followed participants for 30 years, tracking their drinking patterns and brain health. Participants in the study who drank 4 or more drinks a day had almost 6 times the risk of hippocampus shrinkage compared to nondrinkers.

Regular and excessive consumption of alcohol by individuals also causes adaptation in the brain, resulting in the reduction of dopamine production. Lower dopamine production leads to a diminished response to alcohol, hence increasing quantities of alcohol are required to achieve the level of effects individuals want. When this happens, individuals have developed a tolerance of alcohol.

The disruption of the balance of the central nervous system’s neurotransmitters by regular consumption of alcohol leads to the body adapting to the presence of alcohol over time. Hence, it begins to depend on it to function normally.

Suddenly stopping or reducing alcohol consumption will require the brain to readjust to its absence, bringing about withdrawal symptoms. Withdrawal symptoms typically cause intense physical and psychological discomfort such as anxiety, nausea, seizures, etc. Hence, individuals often return to alcohol consumption to escape or gain relief from such symptoms. The cycle continues until an intervention is made.

What are the Symptoms of Alcohol Addiction?

Alcohol addiction presents a wide range of symptoms, ranging from mild to severe. Recognizing these symptoms makes early detection of alcohol addiction possible, hence reducing its disruption in the lives of individuals and enhancing the chances of recovery. Some of the most common symptoms are:

• Loss of control over the consumption of alcohol
• Strong desire or urge to consume alcohol
• Tolerance, with high quantities required to achieve the same effects
• Experience of withdrawal symptoms following attempts to stop or reduce alcohol consumption
• Alcohol consumption despite negative consequences
• Significant shift in priorities with individuals focusing on getting and consuming alcohol
• Neglecting key responsibilities, either at home or work
• Failing relationships
• Social withdrawal, with individuals losing interest in activities they used to enjoy
• Hiding the consumption of alcohol
• Increased anxiety or depression
• Irritability
• Agitation
• Mood swings
• Difficulties with memory
• Organ (Liver, pancreas, gastrointestinal, heart, and kidney) problems

What are the Causes of Alcohol Addiction?

The causes of alcohol addiction include mental health disorder, family history, and other environmental factors such as peer pressure and societal/cultural beliefs. Data from Statista shows that as of 2022, roughly 25 percent of U.S. adults with a serious mental illness reported alcohol dependency or abuse within the past year. This statistic depicts the percentage of adults in the United States with alcohol dependence or abuse as of 2022, sorted by level of mental illness. The factors include:

1. Genetic Predisposition and Family History

Some genes, such as alcohol dehydrogenase 1B (ADH1B), CHRM2, have been found to be associated with alcohol addiction and dependence. They are involved in the regulation of neurotransmitters associated with pleasure and reward, hence influencing how an individual responds to alcohol. Therefore, individuals who have a family history of alcohol addiction and dependence are more likely to develop alcohol addiction and dependence themselves. This, however, does not imply they will certainly end up addicted to or dependent on alcohol.

2. Environmental Factors

Individuals who have friends or family members who consume alcohol regularly or excessively are more likely to develop the same pattern of alcohol consumption. This risk is particularly higher for younger people, who are often under the pressure of being accepted or fitting in. Another important environmental factor that contributes to alcohol addiction and dependence is the culture of individuals. Environments or societies where heavy consumption of alcohol tends to be celebrated pose a higher risk of alcohol addiction and dependence to individuals.

3. Co-occurring Mental Health Disorders

The relationship between alcohol addiction and dependence and mental health disorders is complex and deep. Individuals battling mental health issues like depression will most likely end up self-medicating, such as taking alcohol to gain relief from symptoms. The relief is typically temporary, hence they continue to consume alcohol. Sadly, this often leads to worse depressive symptoms because alcohol is a depressant. The more they try to use alcohol to cope with mental health symptoms, the higher the risk of alcohol addiction and dependence.

4. Stress and Traumatic Events

Overwhelming negative emotions are usually associated with traumatic events, as well as chronic stress. Individuals experiencing such negative emotions, distressing memories, or stressful life situations are likely to turn to alcohol as a means of escape or relief. This increases the risk of alcohol addiction and dependence.

5. Early Exposure to Alcohol Consumption

Individuals who are exposed to alcohol consumption early in life have a high risk of developing addiction to and dependence on alcohol. For instance, individuals who are exposed around adolescence, a period during which the brain undergoes critical development, are more vulnerable because alcohol is capable of interfering with the adolescent process.

Note: for alcohol addiction and dependence to happen, more than one of the risk factors above typically comes into play. For instance, an individual with a genetic predisposition to alcohol addiction gets exposed early to alcohol consumption.

What are the Effects of Alcohol Addiction?

The effects of alcohol addiction include short term effects such as euphoria, head pain, slurred speech, nausea and vomiting and long term effects such as weakened immune system, changes in appetite, changes in weight, and insomnia. In complicated situations, alcohol addiction can lead to death. Alcohol consumption contributes to 3 million deaths each year globally as well as to the disabilities and poor health of millions of people. Overall, harmful use of alcohol is responsible for 5.1% of the global burden of disease.

Short-term Effects of Alcohol Addiction

• Euphoria
• Lowered inhibitions
• Slurred speech
• Loss of coordination
• Head pain
• Gaps in memory or loss of consciousness
• Nausea and vomiting

Long-term effects of Alcohol Addiction

• Weakened immune system
• Changes in appetite
• Change in weight
• Changes in libido
• Insomnia
• Memory and concentration problems

What are the Health Complications of Alcohol Addiction?

Diverse health complications are associated with alcohol consumption. The most common complications are:

• Liver disease (fibrosis and cirrhosis)
• Pancreatitis
• Gastrointestinal inflammation and bleeding
• Gastroesophageal reflux disease
• Diabetes
• Respiratory complications
• Increased blood pressure
• Stroke
• Brain damage
• Cancer

According to the National Institute on Alcohol Abuse and Alcoholism, the increasing rate of morbidity and mortality associated with alcohol consumption makes screening patients for heavy drinking and recommending evidence-based treatment important.

How is Alcohol Addiction Treated?

Alcohol addiction is treated using a combination of different approaches which include detoxification, behavioral therapies, medication assisted treatments, and support groups. For alcohol addiction, experts typically seek to address the social, physical, and psychological aspects of the condition to ensure effectiveness and reduced risk of relapse. According to the 2022 National Survey on Drug Use and Health (NSDUH), 2.2 million people ages 12 and older who had alcohol use disorder (AUD) in the past year (7.6% of people with past-year AUD in this age group) received alcohol use treatment in the past year. Some effective treatment methods popular among addiction treatment professionals are:

1. Detoxification

Detoxification is usually the first step in addiction treatment, especially with severe alcohol addiction. It refers to the safe management of the physical withdrawal symptoms experienced by individuals when alcohol consumption is stopped suddenly. It is typically conducted under strict medical supervision, ensuring individuals are safe and as comfortable as possible. It helps to reduce the risk of relapse by alleviating the effects of withdrawal symptoms. Sometimes, experts may reduce alcohol consumption gradually if they consider it best for an individual.

2. Behavioral therapies

Addiction treatment specialists use various behavioral therapies in the treatment of alcohol addiction and dependence. They are aimed at changing the thought patterns, beliefs, and ultimately the behaviors associated with the use of alcohol in individuals. Negative or unhealthy thoughts and beliefs are reengineered to help individuals understand their addiction and embrace their roles in changing it. Individuals are also taught healthy coping mechanisms for stress and other issues.

Motivational EInterviewing, cognitive-behavioral therapy (CBT), and contingency management are popular and effective behavioral therapies used by experts for alcohol addiction and treatment.

3. Medication Assisted Treatments

To manage cravings, alleviate withdrawal symptoms, and ultimately reduce the risk of relapse, addiction experts often prescribe medications as part of the alcohol addiction and dependence treatment. Acamprosate, naltrexone, and disulfiram are examples of popular medications experts use to treat alcohol addiction and dependence.

4. Support Groups and Peer support

Alcoholics Anonymous (AA) is a popular support group individuals with alcohol addiction issues join. Such groups are designed to provide a conducive and supportive environment, ideal for sharing experiences, learning from others on a similar path, and receiving encouragement. Such support is important for addiction recovery, because of its lonely and overwhelming nature.

Note: Alcohol addiction treatment must be comprehensive, hence it typically involves a combination of programs administered in an inpatient or outpatient setting. Individuals with serious alcohol addiction and dependence live in a rehab facility in order to receive intensive care and support. This is known as inpatient treatment. On the other hand, less severe cases often involve visiting a rehab center for scheduled meetings while living at home and doing other important things. This is outpatient treatment.

What are the Recovery Pathways and Strategies for Alcohol addiction and dependence?

For a full recovery from alcohol addiction, some pathways and strategies are necessary. They include:

1. Commitment to Sobriety: the journey of recovery must start with individuals making a decision to achieve and maintain sobriety. The path is not easy and there will most likely be setbacks. Hence, it is imperative to have a strong determination to abstain from alcohol consumption as well as embrace the need for changes.
2. Get professional help: addiction recovery is very challenging. It is very hard or simply impossible to do it yourself. Experts in this field understand the mechanisms of addiction and have evidence-based interventions designed according to the needs of individuals. They offer structured treatment programs for comprehensive treatment and an easier recovery journey through the alleviation of withdrawal symptoms.
3. Participate in support groups: individuals on recovery need extensive support. Family members and friends are often very helpful here. However, participating in support groups provides unique experiences because people there understand how it actually feels because they feel similar things.
4. Develop healthy coping mechanisms: having healthy coping mechanisms such as exercises helps reduce the risk of turning to alcohol and ultimately reduce the risk of addiction and dependence.
5. Prioritize self-care activities: activities such as getting enough sleep, eating a balanced diet, and practicing mindfulness are important self-care routines that help to keep your emotions balanced.

Despite the similarities that often exist in the recovery journey of individuals, the journey of each person is different. Therefore, what works for one will not necessarily be effective for another. Hence, find the pathways and strategies that are suitable for your needs.

How can Alcohol Use Disorder be Prevented?

Preventing alcohol use disorders involves being aware of the risk factors and its enormous effects on every aspect of individuals’ lives. Individuals must try to reduce or avoid these risk factors that contribute to alcohol addiction and dependence.

For instance, the National Institute on Alcohol Abuse and Alcoholism advised that men should not take more than two drinks per day and women should not have more than one drink per day. Individuals with a family history of alcoholism are expected to be more careful, hence should take lesser quantities if they can’t avoid alcohol entirely.

Also, individuals must learn healthy coping mechanisms for stress and challenges, to reduce the risk of turning to alcohol for escape. If you ever see yourself displaying some symptoms of alcohol use disorder, get help immediately. The earlier you get intervention, the better.

What are the risks and complications of combining alcohol and fentanyl, and how can they be addressed in treatment?

Combining alcohol and fentanyl poses severe risks and complications due to their synergistic depressant effects on the central nervous system. This combination can lead to profound respiratory depression, unconsciousness, and fatal overdose. Both substances enhance each other’s sedative effects, increasing the risk of life-threatening respiratory failure. In treatment, it is essential to address both addictions concurrently, using comprehensive medical supervision during detoxification to manage withdrawal symptoms safely. Integrated therapy approaches, including medication-assisted treatment (MAT), behavioral therapy, and continuous monitoring, are critical to prevent relapse and support long-term recovery.

How does alcohol addiction affect mental health, and what integrated treatment approaches are recommended?

Alcohol addiction significantly impacts mental health, often exacerbating conditions such as depression, anxiety, and bipolar disorder. Chronic alcohol use can alter brain chemistry, leading to mood swings, cognitive impairments, and increased risk of psychiatric disorders. Integrated treatment approaches are recommended to address both alcohol addiction and co-occurring mental health issues. These approaches include a combination of medication-assisted treatment (MAT) to manage withdrawal and cravings, cognitive-behavioral therapy (CBT) to address negative thought patterns and behaviors, and holistic therapies such as mindfulness and stress management to support overall mental well-being.

What is a Safe Level of Alcohol Consumption?

Individuals wary of alcohol addiction and dependence often want to know the level of drinking considered safe. Two drinks daily is considered safe for men, while women shouldn’t take more than one daily. However, pregnant women or women trying to be pregnant, people taking certain medications, and people with some medical conditions are all advised to completely abstain from alcohol consumption.

Does Alcohol Addiction and dependence Treatment Work?

The treatment of alcohol has a great success rate. For instance, about half of the people who entered the drug and alcohol treatment system in England from 2019 to 2020 completed treatment and were free from dependence, according to the data published by Public Health England. According to the Butler Center for Research, up to 68% of people who enter detox before treatment recover from alcohol addiction and dependence.