Alcoholism is defined as an addiction to the consumption of alcohol or alcohol dependency. There is a significant difference between having a couple of glasses of wine with dinner and not being able to control your drinking habits. But where heavy drinking turns into alcoholism is difficult to know as the progression is slow and often imperceptible.
Alcoholism makes you feel that you are unable to function without a drink and individuals experiencing this are driven by an urge to drink, even though they know it is not doing them any good. This can have a significant impact on all aspects of their lives, including work, relationships and physical and mental well being.
Given that alcohol consumption is legal in our society and also an integral part of many social activities, the government has set up guidelines about the acceptable levels of consumption in order to reduce the health risks to a low level.
The recently updated government guidelines actually now state that there is no safe level of alcohol, but that by keeping within the recommended limits you will significantly reduce the risks that alcohol consumption can bring. Originally the recommendations were different for men and women, but this has also recently changed and the number of units is now the same for men and women. The guidelines (updated in January 2016) now state that neither men nor women should drink more than 14 units of alcohol a week. 14 units are the equivalent of 6 glasses (175ml) of wine, 6 pints of beer, or 14 x 25ml glasses of spirits
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The exact cause of alcoholism is still not known but there are many factors that are thought to play a role in the development of alcoholism.
Recent research suggests that genes may have a role to play in causing a predisposition towards alcoholism. Alcoholism often seems to run in families with immediate relatives of alcoholics being up to seven times more likely to develop alcoholism.
Social and psychological factors are also thought to play a role in the development of alcoholism. People often look to alcohol to provide some relief from coping with negative feelings or circumstances that they feel unable to cope with, such as stress, anxiety or life issues. It is a way of avoiding the reality of the situation when they do not have the necessary coping mechanisms to deal with whatever the problem might be. If someone has grown up in an environment where their parents have used alcohol to avoid difficult feelings, it could be a pattern that repeats itself.
Once someone starts drinking heavily alcohol dependency can develop when the alcohol changes the chemicals in your brain. These changes increase the pleasurable feelings that alcohol gives you, making you want to drink more of it.
There are different levels of addiction and in its early stages it can be difficult to notice, but if you think you might be starting to develop a dependency, here are some questions you could ask yourself.
If you have gone beyond the initial stages of alcoholism and you are alcohol dependent, you will start to notice physical symptoms affecting you. You will find it difficult to relax and enjoy yourself without a drink and it may feel as though you can’t function properly without a drink. Drinking becomes an important or even the most important factor in your life.
If you are unable to get a drink, you could start to experience withdrawal symptoms after just a few hours. Your hands may start to tremble or you may sweat heavily and these symptoms will subside soon after you have a drink. You may also find that you get irritable and restless when you haven’t had a drink.
Alcohol abuse is a causal factor in 60 medical conditions including:
Alcohol and Cancer: Drinking alcohol regularly can increase the risk of 7 different cancers including mouth, throat, stomach, liver and breast.
When consumed, ethanol (alcohol) is converted in our bodies into a toxic chemical called acetaldehyde which is known to damage our DNA and prevents cells from repairing the damage. Alcohol also changes the levels of hormones in our bodies, which for example in the case of oestrogen, these increased levels can be a cause of breast cancer.
Alcohol, Brain Damage and Dementia: Alcohol-related brain damage or ARBD is the term used to describe a decline in cognitive abilities caused by alcohol abuse. ARBD leads to slightly different symptoms in different people and causes a range of conditions.
There is some debate as to whether alcohol abuse is a direct cause of ARBD or whether the alcoholic’s lifestyle is also a contributory factor.
Alcohol is a toxin, which can cause damage to nerve cells and blood vessels leading to brain shrinkage. However, people who are heavily dependent on alcohol also often suffer head injuries from falling over or fighting, which can contribute to alcohol-related dementia. Likewise, heavy drinkers tend to replace food with drink and don’t look after themselves which means that their bodies do not absorb vitamins as efficiently as they might otherwise do.
Alcohol and Depression: Although alcohol can provide a temporary lifting of mood, it is actually a depressant which means that it disrupts the signals between the neurotransmitters in our brain and alters our thoughts, feelings and actions.
For some people, depression came first and people turn to drinking for a temporary release but as drinking becomes regular the alcohol lowers the levels of serotonin in your brain – a chemical that helps to regulate your mood.
Using alcohol to relieve depression actually starts a vicious circle and heavy drinking when you don’t already suffer from depression can cause it.
Alcohol and Diabetes: Alcohol is a toxin and as such, when you drink alcohol your body puts all its efforts into expelling it. By doing so, this means that other processes are interrupted and it affects the production of insulin which controls blood sugar levels. By drinking alcohol to excess, you are not only reducing the effectiveness of your insulin production but also increasing your sugar intake and this can lead to diabetes.
Alcohol and Hypertension: Your heart is responsible for pumping blood around your body supplying the energy and oxygen it needs to function. Pressure is needed to achieve this and this requires effort from the heart. A normal, healthy heart can manage this at low pressure.
Alcohol contains a lot of calories and sugar and is a particularly potent source of “bad cholesterol” in your blood. This, combined with the tendency to gain weight if you drink heavily, can cause high blood pressure, meaning that your heart needs to work harder to pump the blood around your body. This puts a strain on your heart and increases your risk of stroke or heart attack.
Alcohol and Cirrhosis of the Liver: Cirrhosis of the liver is when normally healthy tissues of the liver are gradually replaced by scarred tissues. Instead of your liver having smooth tissues, it becomes lumpy and hard. This damaged tissue can eventually prevent the liver from working properly.
Drinking heavily on a regular basis almost always causes some kind of liver damage. How much and how long you drink will affect the extent of damage with your chances of developing cirrhosis increasing as your drinking is prolonged and increased.
Alcohol and Pancreatitis: Pancreatitis is a disease in which the pancreas becomes inflamed. This happens because the digestive enzymes have been activated before they are released into the small intestine and they attack the Pancreas itself. Scientists are not entirely sure how alcohol causes pancreatitis but it is thought that the alcohol interferes in some way with the cells of the pancreas, causing it to become inflamed. However it does cause it, there is definitely a clear correlation between alcohol abuse and cases of pancreatitis.
Over time, the inflammation causes scarring and damage to the pancreas which means that it does not function properly and leads to poor digestion. A lack of insulin, one of the hormones the pancreas produces, can cause diabetes.
Alcohol and Encephalopathy: Hepatic encephalopathy is a condition caused by severe liver disease. Alcoholic encephalopathy is the same condition but refers to cases of liver disease which have been caused by alcohol abuse.
The liver is responsible for removing any toxins that enter the body. If you consume large amounts of alcohol, which is a toxin, the liver is unable to cope and the toxins enter the bloodstream and reach the brain, causing a decline in brain function.
Alcoholism impacts every relationship in the alcoholic’s life – partner/spouse, friends, family and work relationships – because of how it can change an individual’s behaviour. Alcohol abuse can affect the way your brain processes information. Alcoholics will often misinterpret social cues and signals around them and react in ways that seem out of the ordinary. When you are alcohol dependent, your physical and mental well being are affected and this, in turn, can change your day to day behaviour and interactions with other people, whatever their relationship to you.
Anger – many alcoholics display anger, aggression or violence towards their friends and family, particularly when challenged about their drinking or when intoxicated. Alcoholics tend to use anger as a defence mechanism to divert attention from them.
Lying – many alcoholics will lie to their partners and friends in order to hide the true extent of their drinking.
Inability to control your emotions – Alcohol affects your ability to regulate emotions by causing a chemical reaction that slows down activity in the central nervous system (CNS). Alcoholism changes the brain to such an extent that thinking processes are clouded, emotions are all out of control leading to extremes of emotions that are out of proportion to the situation.
Physical relationships – long term alcohol abuse can be a cause of erectile dysfunction in men. Drinking can also lead to fewer inhibitions and people find that they have sex with unsuitable partners or unprotected sex which they might regret once they have sobered up.
Depression – Alcohol is a depressant and can lead to loss of interest in participating in life and the inability to connect with other people.
The treatment required for alcoholism will depend on the level of addiction. Basically, the process will be similar for anyone who is alcohol dependent, but when and where the treatment can be carried out will vary as will the withdrawal symptoms, the length of time required and the lasting effectiveness.
To ensure your best chances of success you will need to make sure that you get the right treatment for your particular circumstances – how long you have been drinking, what your current symptoms are, how much you drink and your level of dependency. Some people can manage their withdrawal at home or through support from an NHS centre, others might need to stay in a rehabilitation centre to help them through. It will be important either way, that your treatment is managed under medical supervision, as you will not know how severe your withdrawal symptoms will be until you start the detox and some withdrawal symptoms can be life-threatening.
The basic rehabilitation treatment will be as follows:
Initial assessment: You will need to have your addiction assessed to enable the professionals to create a plan for the best approach to treatment for you. Once your initial assessment has been done, a tailored treatment plan will be developed to meet your particular needs, based on your history and current circumstances.
Detox: This is the stage when you withdraw from alcohol, allowing your body to physically adapt to having no alcohol. You will suffer withdrawal symptoms at this stage and the detox may need to be medically supervised as, depending on the severity of your symptoms, this can often be life-threatening.
Counselling & psychotherapy: This will usually be a combination of group and individual therapy. The aim of counselling is to help the individual accept and recognise that they have a problem and explore ways in which this problem can be overcome. It will address any related mental health issues, identify unhelpful patterns of behaviour and help the person develop new strategies for creating lasting change.
Learning new life skills: As part of your individual rehabilitation plan, you will be given a range of tasks to complete and training in new life skills. This might include analysing your feelings in response to the treatment you have received so far and being given new ways of managing your life, such as anger management, social and communication skills, time and money management, nutrition and fitness, social and leisure activities. You will be expected to implement these new skills in your everyday life
Ongoing support: Once you have completed your initial rehabilitation programme, it will be recommended that you join a local support group. After rehab, staying sober is a lifelong process and attending support group meetings will not only provide you with the emotional support from others going through the same thing but will also help you to avoid relapse.
For someone who has become alcohol dependent, trying to cut your alcohol intake can be challenging. The severity of the withdrawal symptoms you may experience during detox and how long they might last is generally dependent on how long and how much you have been drinking. There is no set timeframe but most cases of acute withdrawal will be over within a week to ten days.
Drinking alcohol increases the levels of dopamine in your brain. When you drink regularly, your brain stops bothering to produce its own dopamine, expecting the presence of alcohol to do the job instead.
Withdrawing from alcohol when your body has become dependent on it, can cause some severe reactions, known as withdrawal symptoms, which can potentially be fatal. Severe alcoholics should only attempt alcohol withdrawal under medical supervision.
The effects of alcohol withdrawal are likely to start around 4 -6 hours after your last drink. The symptoms usually move through different stages of severity.
Tremors are the first detox symptoms that usually begin within 12 hours of the last drink. Other symptoms associated with this first stage are insomnia, anxiety, headaches, sweating, abdominal pain, vomiting, depression and fatigue.
Hallucinations start between 12 and 24 hours after the last drink, where you may see or hear things that are not actually there. These hallucinations can be auditory, visual and tactile and many people in particular report seeing and feeling bugs crawling on their skin.
Symptoms from stage one and stage two often overlap with the Stage 1 symptoms becoming more severe.
After 48 hours the person will begin to experience seizures caused by the dehydration that alcohol withdrawal causes. This stage affects the whole body, with more violent shaking than that experienced in the tremulousness stage. The individual can lose consciousness as well.
Stage four is known as delirium tremens or DTs. This phase can begin from three to four days after a person stops drinking and as long as two weeks afterwards. This is the most dangerous stage, but not everyone experiences it. It could also be fatal, so medical attention is necessary to address the symptoms. Delirium tremors/DTs can cause the individual to experience confusion, continued hallucinations, the feeling of being threatened, palpitations, seizures, fever, sweating and even stroke and heart attack.
This stage is when the withdrawal becomes a serious threat to life if the patient is not receiving medical supervision.
Detox symptoms will gradually subside as the body becomes used to managing without alcohol.
The term rehab is usually used to refer to rehabilitation centres, which are specialised treatment centres, usually requiring a stay as an in-patient. The reason lots of people finally enter rehab is often that they have failed to manage it by themselves or relapsed. This does not mean however that it is impossible to do it by yourself, some people do, but they are more likely to be those people who are less severely dependent.
There are different ways you could consider managing your own withdrawal from alcohol:
Self Help: There are so many resources available on the internet that by doing a bit of research you might be able to find a self-help technique or programme which you feel might work for you. Read books and take inspiration from other people’s success stories. Before starting any programme of self-help, you should talk to your GP as you may need medication to manage your withdrawal symptoms.
Support Groups: Lots of people have found support groups such as Alcoholics Anonymous really help them to overcome their alcohol addiction. These support groups work on the basis that people going through the same challenges, work together to support each other through mutual understanding and empathy. They are free to join and many people manage to break their addictions through support group meetings
Online Rehab: The Online Rehab is a unique rehab programme that can be done completely online and provides two different types of treatments, both of which provide one to one personalised support with qualified counsellors. One is a programme of one hour sessions, run over 28 consecutive days which can be used as an introduction to the therapeutic process and get your journey started. The other is the Recovery Support programme which can be used to support you once your recovery is well underway, often after a stay in rehab. The cost of The Online Rehab is considerably less than a stay in a residential rehabilitation centre and can be a good alternative way to a successful recovery.
You may have heard about the 12 step programme for recovery from addiction and wondered what it is. It is a set of 12 guiding principles to help people on the road to recovery. Originally established by Alcoholics Anonymous and used in many support group style recovery programmes, the original 12 steps have often been slightly adapted as they were based on religious principles. Some people find it hard to relate to the spiritual nature of these principles and in today’s AA meetings you are not expected to accept or follow these Twelve Steps in their entirety if you feel unwilling or unable to do so.
Most rehabilitation programmes will include some form of counselling after detox, which will often continue for some time after the initial detox. There are different types of counselling and the type you have will depend on your own personal preferences as well as your level of dependency.
Psychodynamic Counselling – this form of counselling usually looks at your own personal history, your relationships and anything in your past that may have led you to turn to alcohol. It will help you explore personal issues, understand why things have happened to you and help you to come to terms and accept things that might be bothering you subconsciously. Many people use alcohol as a way of covering up difficult feelings and emotions and addressing these issues can help you to recognise how you can make changes.
Cognitive Behavioural Therapy – also known as CBT, this form of therapy does not focus on things that have happened, but rather looks at the here and now. It helps people to become consciously aware of their negative patterns of behaviour which lead them to drink and provides the tools to help change those patterns of behaviour and reinforce new positive behaviours.
What should I do if I think I have a drinking problem?
Accepting you have a problem is the most important step on the road to recovery. Now you can do something about it.
Speak to one of our professional advisors on 0203 955 7700 and they will listen to your history and make some recommendations on the best course of action to help you overcome your addiction.
Nicholas Conn is a leading industry addiction expert who runs the UK’s largest addiction advisory service and is regularly featured in the national press, radio and TV. He is the founder and CEO of a drug and alcohol rehab center called Help4addiction, which was founded in 2015. He has been clean himself since 2009 and has worked in the Addiction and Rehab Industry for over a decade. Nick is dedicated to helping others recover and get treatment for drug and alcohol abuse. In 2013, he released a book ‘The Thin White’ line that is available on Amazon.
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