Alcoholism is both a physical and mental illness, which causes people to drink alcohol despite it resulting in negative consequences. It affects hundreds of thousands of people in the UK, and millions more around the world. Although not a curable illness, it can be effectively treated and managed with a programme of detoxification and rehabilitation.
It can be difficult to tell the difference between alcoholism, alcohol abuse, and alcohol dependence, with many people unable to correctly distinguish between them. The main difference between the three is in the effect each has on daily life.
Alcohol is considered safe in moderation, but when occasional use becomes more common and begins to interfere with everyday life, it is typically classed as abuse. The UK Government’s guidelines on alcohol consumption states that no more than fourteen units of alcohol should be consumed by adult men and women each week; which means that consuming a large amount at one time (binge drinking), may still be considered abuse, without it being a regular occurrence.
It is also possible to become dependent on alcohol without actually having an addiction. When alcohol dependence develops, your body will begin to crave it when its effects wear off. You may start to notice withdrawal symptoms and will feel the need to drink more than before now that you have built up a tolerance.
By the time an alcohol addiction develops you will have formed a deep physical and psychological need for it. You will also continue to drink, even when knowing that doing so will cause harmful consequences for you and those around you.
Over 7.5 million people in the UK show signs of alcohol dependence, according to NHS figures. For them, drinking alcohol is an important, or maybe the most important, part of their day, with many feeling unable to function properly without it.
The effects of alcohol abuse are detrimental to physical health as well as mental health and can lead to many different illnesses.
You are likely to experience problems with sleep, and in the event you drink to solve the issue, your quality of sleep will be poor. This will result in you feeling constantly tired and sluggish.
Since alcohol contains what are commonly referred to as ’empty calories’, you may notice your weight starting to creep up. Moreover, if you are getting most of your calories from alcohol, you are unlikely to be getting the nutrients your body needs, which could also have a negative impact on your health and wellbeing.
As alcohol abuse progresses from dependency to addiction, your need for alcohol will become increasingly overwhelming. You may start to spend more and more of your time drinking or thinking about drinking, leaving little time for anyone or anything else. This can affect your ability to take care of responsibilities at home and work, and can have a negative impact on your relationships with family members, friends, and work colleagues.
As is the case with all addictions, you will find that your finances will begin to suffer. Spending an increasing amount of money funding your habit while also struggling to perform at work will affect with your ability to earn an income, landing you in financial difficulty.
It can be difficult to recognise the start of a drinking problem, because you may not have realised that your drinking habits have changed, until a family member or friend mentions changes in your behaviour or personality.
Alcohol dependency is different for different people. Although many sufferers share things in common, their relationships with alcohol might at first seem to be nothing alike. This can make it difficult for people to identify themselves as alcohol dependent, even as drinking has an increasingly more damaging effect on their relationships, health, and enjoyment of life.
Though alcohol dependency may come in various guises, the chemistry at the heart of it is the same for everyone. When problematic drinking habits continue over a period of time, it leads to long-term electrical changes in the brain, which causes the compulsive attitude towards alcohol that characterises alcoholism. The brain is essentially being hijacked by chemicals, which steer the mind’s attention towards finding and consuming more alcohol.
Alcohol dependency is not a failure of will or lack of strength of character, as was believed for many years. However, progress in science over the last few decades has shown us that alcoholism is rooted in both biology and behaviour, making it a ‘bio-behavioural disorder’. Biology and behaviour are two sides of the same coin, and alcohol dependency cannot be treated by just focusing on one side alone.
Physical dependence can soon follow, as abstinence begins to cause withdrawal symptoms such as shaking, feeling sick and feeling tired without reason.
Even before withdrawal, heavy and prolonged drinking can cause several physical symptoms because of large amounts of alcohol on the body.
Alcoholism is not something that happens overnight though. It is a process that involves a number of stages:
Genetics make up about 50% of the risk for alcohol dependence, but they by no means tell the whole story. Genetic history is often hard to distinguish, but if parents are regular heavy drinkers, or they drink to reduce stress and depression, it is likely that their children will grow up believing that these behaviours are normal and possibly harmless. But environmental influence doesn’t come only from the home; peer pressure from friends, colleagues and partners can also encourage new and difficult patterns of drinking which can lead to dependency or co-dependency.
Stress and Difficult Life Events
For others, dependency comes after a prolonged period of difficulty in their life. Drinking might appear to be a good method of coping in these situations, and sufferers will often start as a ‘stop-gap’, just to tide them over until conditions improve. Nevertheless, as drinking begins to impact relationships and responsibilities, and hangovers exacerbate the very stress the drinking sought to avoid, the difficulties can increase, encouraging yet more drinking and leading to a vicious cycle.
Individuals who are alcohol dependant have higher rates of psychiatric disorders than the rest of the population, including depression, anxiety, post-traumatic stress disorder, and psychosis. For these people, alcohol might be a DIY solution to their disorder, and at first might be effective at keeping the symptoms under control. Nonetheless, in time, these problems will only intensify as a result of alcohol abuse.
Denial and how it protects alcoholism
Denial is common among those suffering with alcoholism. Your loved ones may have tried to discuss the problem with you, but you were unable to see things as clearly as them. Denial is one of the body’s defence mechanisms and is employed by the brain to protect you from a harsh reality. It can be useful for a short period but if it continues, can end up causing harm.
Denial can be an obstacle to recovery because it can prevent you from seeing the truth of your situation. If you are practicing denial, you can continue with your addictive behaviour without consequence or responsibility for your actions. If it is strong enough, it can be projected to your family members and friends, who will then also be convinced that your problem is either not as bad as it seems or is something else entirely.
Heavy alcohol use can lead to damage in certain areas of the brain and is known as alcohol-related brain damage, or ARBD. Scientists know that brain function can be affected by prolonged alcohol abuse; its structure and physical shape can also be altered, leading to serious problems.
ARBD is responsible for mood, memory, and learning problems as well as changes in personality. Some of the symptoms of ARBD are similar to those of Alzheimer’s disease.
Alcohol abuse during pregnancy is also responsible for problems such as foetal alcohol syndrome, or foetal alcohol spectrum disorder (FASD), the name given for all types of problems occurring in babies born to mothers who have abused alcohol while pregnant. FASD can cause both mental and physical problems.
While it is known that alcohol crosses the placenta during pregnancy, it is not known if there is any safe level of alcohol consumption during pregnancy. Current UK guidelines recommend that pregnant women avoid it completely.
We do know that alcohol abuse during pregnancy leads to birth defects that include distinctive facial features such as a thin upper lip, small eyes, and a smaller-than-average head. It can also result in problems with internal organs, mainly the heart, kidneys, and liver.