Alcohol Abuse and Alcoholism


Drinking alcohol is woven into the social fabric of our culture, and indeed many people enjoy the social and cultural connection of sharing a drink together. However, because drinking is so common in our society, realizing you or a loved one has a drinking problem can be a challenge. The consequences of alcohol abuse are serious. Alcohol abuse causes extensive damage to your health, your loved ones, and society. It results in thousands of innocent deaths each year, and exacerbates situations involving violent crimes and domestic violence. Learn about alcoholism signs and symptoms, what you can do, and how you can help a loved one.

What is alcohol abuse?

Social drinking is common and popular is many cultures all over the world. In several cultures, for example, a glass of wine or beer with a meal is common practice. Celebrations are often punctuated with a glass of champagne or other celebratory cocktail. And in many jobs, going out for drinks after work or entertaining clients with alcohol is the norm.

The difference between social drinking and alcohol abuse is when alcohol becomes your focus. You might only want to attend social events that involve alcohol, or you can’t enjoy yourself. Getting to the bar, or making a drink after coming home from work becomes more important than connecting with friends or family. Alcohol might be your way to avoid painful feelings or troubled relationships. And you might resort to dangerous behavior, like driving while drunk or even increased violent behavior. Increased dependence on alcohol leads to alcoholism, where you are physically dependant on alcohol and have lost control of the amount you drink.

Myths about alcohol abuse

Myth: Alcoholics have no will power. If they were stronger they could just stop drinking.

Fact: Alcoholism affects brain chemistry, which causes you to feel compelled to drink alcohol. Usually you can only stop drinking if you receive continuing help and treatment.

Myth: I can’t have a drinking problem. I have control over it because I only drink on the weekends.

Fact: When you abstain from drinking for a certain period of time and then consume a large quantity of alcohol in a very small span of time, this is called binge drinking. It is a common symptom of alcohol abuse.

Myth: I can’t be an alcoholic. I only drink wine or beer.

Fact: While hard liquor is more concentrated, wine or beer will have the same effect. You will just be drinking more of the wine or beer.

Myth: Drinking is not a “real” addiction like drug abuse.

Fact: Alcohol is a drug, and alcohol abuse is every bit as real as drug abuse. Alcohol addiction has serious long term health and legal consequences, and withdrawal can be deadly.

Causes of alcohol abuse

Why can one person drink responsibly, while another drinks to the point of losing their health, their family and their job? There is no one simple reason. Alcohol abuse and addiction is due to many factors. What’s more, since drinking is so common in our society, problem drinking can be hard to identify. Do you drink to share enjoyment or share a connection with others? If drinking is the only way you feel comfortable connecting to others, or you drink to mask depression, grief, anxiety or loneliness, you are at risk for alcohol abuse. Some other risk factors include:

Family history of alcoholism. While the interplay between genetics and environment is not entirely clear, if you have a family history of addiction, you are at higher risk for abusing alcohol.

History of mental illness.Alcohol abuse can worsen mental illness or even create new symptoms. See dual diagnosis for more information on mental illness and alcohol abuse.

Peer pressure. If people around you drink heavily, it’s hard to resist. If you are a teenager, you might feel you won’t be accepted. If drinking is common practice for work celebrations or entertaining clients, you might feel pressure to conform.

Stressful situations or a big life change. If you have a major change or a stressful situation in your life, without other coping skills, you might turn to alcohol to help you get through.

Signs & symptoms of alcoholism

How can I tell if I or a loved one has problems with drinking?

Although different people may use alcohol at different levels, the basic pattern is the same. Drinking becomes more and more important than anything else, including job, friends and family. Alcohol starts to increasingly affect you physically and emotionally, often impairing judgment to a dangerous level.

How serious is the drinking problem?

Alcohol abusers, or problem drinkers, are people who drink too much on a regular basis. The alcohol use is self-destructive or can present a danger to others, but they still demonstrate some ability to set limits and establish some measure of control over their drinking. While some people are able to maintain this pattern for a long amount of time, alcohol abusers are at risk for progressing to alcoholism. This might happen in response to a large stressful event, such as retirement or losing a job. Or it might gradually progress as tolerance to alcohol increases.

When alcohol abuse progresses to alcoholism, also called alcohol addiction or alcohol dependence, alcohol becomes essential to function. Alcoholic symptoms include a physical dependence on alcohol, and inability to stop despite severe physical and psychological consequences. Some alcoholics can hold down a job or appear to be functioning on the surface, but the drinking inevitably leads to impaired job performance and troubled relationships.

The National Institute on Alcohol Abuse and Alcoholism provides a screening questionnaire for assessing the differences between alcohol abuse and alcoholic dependence. Remember, though, the bottom line is how alcohol affects you. If it is affecting your relationships, job, or health, yet you can’t seem to stop yourself, than the problem is serious.

Physical signs of alcohol abuse and alcoholism:

  • While intoxicated: slurred speech, dizziness, clumsiness or unsteadiness
  • Blackouts, when you drink so much you pass out
  • Weight loss
  • Unexplained sore or upset stomach
  • Redness in the face or cheeks
  • Numbness or tingling in hands and feet
  • Tolerance and withdrawal symptoms
  • The more alcohol you drink, the more your body depends on it. You need more and more alcohol to have the same effect, called tolerance. If you drink heavily, you will have withdrawal symptoms if you stop drinking. Do you need a drink to steady the shakes in the morning? You’ve built up a tolerance for alcohol. Other withdrawal symptoms include sweating, shaking, nausea and vomiting, confusion, and in severe cases seizures and hallucinations. These symptoms can be medically dangerous. Talk to a medical professional if you are a heavy drinker and want to quit.
  • Mental signs of alcohol abuse and alcoholism
  • Unable to control drinking: “just one drink” rapidly leads to more
  • Drinking leads to dangerous situations like driving drunk, walking in an unsafe area
  • Increased irritability, agitation and anger, lowered threshold for violence
  • Avoiding activities that do not involve the opportunity to drink
  • Excessive weeping and emotional displays
  • Unexplained absences and sick days from work, or difficulty making commitments
  • Oversleeping or difficulty sleeping

Alcohol abuse in special populations

Teenagers. Teenagers notoriously like their privacy, are often irritable and cranky, and like to sleep in. How can you tell if your teen has an alcohol problem? Look for marked changes in behavior, appearance and health. Is your teen suddenly having trouble in school? Does he or she seem more and more isolated, or have a new group of friends? Your teen might have an unusually hard time getting up or appear sick regularly in the morning. If you have alcohol in the home, do the levels decrease faster than they should? Is the alcohol watered down?

Older adults. Alcohol abuse is challenging to detect in older adults. Increased alcohol use might happen as an older adult retires, loses a loved one, or has to move. Older adults are more sensitive to the effects of alcohol as their metabolism changes. Since older adults often do much of their drinking at home, problems functioning often go undetected. Clumsiness, unsteadiness or confusion might be attributed to the natural aging process.

Effects of alcohol abuse

What makes alcohol problems so challenging to face? Similar to drug abuse, alcohol abuse doesn’t only affect the health, finances and stability of the person drinking. It reaches family, friends, colleagues-- and even the community. What’s more, the strong denial and rationalization of the person using alcohol makes it extremely difficult to get help, and can make concerned family members feel like they are the problem. Long-term alcohol use can cause serious health complications, affecting virtually every organ in your body. These effects include:

  • Liver inflammation, which can lead to cirrhosis, a serious, irreversible liver condition
  • Increased risk of heart disease, stroke and cancer
  • Stomach problems and nutritional deficiencies
  • Neurological problems such as confusion, numbness and trouble with memory
  • Birth defects
  • Erectile dysfunction

Staying addicted: denial and rationalization

One of the most powerful effects of alcohol abuse and addiction is denial. The urge to drink is so strong that the mind finds many ways to rationalize more drinking. Someone abusing alcohol may drastically underestimate how much they are drinking, how much it is costing them, and how much time it takes away from their family and work. Denial is so powerful that an alcoholic often sincerely believes that there is no problem. They may lash out at concerned family members, so convincingly that family members might feel like they are exaggerating and overstating the problem.

This denial and rationalization can lead to increased problems with work, finances and relationships. The person abusing alcohol may blame an “unfair boss’ for losing her job, or a ‘nagging wife’ for why he is increasingly going out with friends to the bar. While work and relationship stresses happen to everyone, an overall pattern of deterioration and blaming others may be a sign of trouble.

Effects of alcohol abuse on the family

Sadly, alcohol abuse and addiction doesn’t only affect the person abusing alcohol. It affects friends, family and the entire society. Child abuse and neglect is much more common when there is alcohol abuse in the family. The abuser may neglect a child’s basic needs due to drinking. Lack of impulse control can lead to increased physical and emotional abuse. Alcohol abuse by a pregnant woman affects the developing baby’s health. Domestic violence also happens more frequently. Abusing alcohol leads to higher risk of injuries and death to self and others in car accidents.

Family stress

If you have someone you love who drinks too much, it is an enormous emotional strain. You might feel obligated to cover for the alcoholic, cutting back from work to deal with the problems that come up from the drinking— or working more to make financial ends meet. You might not be able to see friends and engage in hobbies, as coping with the abuse takes more and more time. The shame of alcoholism in the family stops many family members from asking for help, instead pretending nothing is wrong. The emotional toll can be overwhelming. Children are especially sensitive.

When a loved one has a problem with alcohol

You may not immediately realize that someone you love has an alcohol problem. It may have started slowly, and your loved one might also have tried to hide the extent of the drinking from you. You might have gotten so used to the drinking that coping with it seems almost normal. It might actually feel normal if there was an alcoholic in the family growing up. The realization that there is something seriously wrong might be too painful to admit. Don’t be ashamed, and you are not alone. Alcoholism affects millions of families, from every socioeconomic status, race and culture. There is help and support available.

What the person abusing alcohol might say if you confront them about their usage

“I can get sober any time I want to. I’ve done it lots of times”. The key to recovery is staying sober, not constantly cycling through the process. Even if the alcoholic is able to resist for a little while, usually the cravings are too strong to resist during times of stress.


“Why do you exaggerate so much? I hardly drink at all!” Remember denial is a key part of alcoholism. The person abusing alcohol might actually believe they are not using as much as they are.


“It’s your fault. If you wouldn’t stress me out so much, maybe I wouldn’t need to drink as often” It is never your fault that someone drinks too much. Even if they are feeling stressed, there are other coping skills they can choose to use.

Understanding what is involved in recovery

You cannot force someone you love to stop abusing alcohol. As much as you may want to, and as hard as it is seeing the effects, you cannot make someone stop drinking. The final choice is up to them. The right support can help you make positive choices for yourself, and balance encouraging your loved one to get help without losing yourself in the process.

Don’t expect your loved one to be able to quit and stay sober without outside help. Your loved one will need help, support and new coping skills so that he or she will be able to resist cravings in a society where drinking is often glamorized. What’s more, if your loved one has crossed the line from alcohol abuse to alcoholism, she or he has built up a tolerance to alcohol. Withdrawal symptoms can be unpleasant, painful, and even deadly.


Recovery will be an ongoing process. Someone who abused alcohol will not magically be a different person once sober. Alcohol use may have been masking painful feelings that will bubble up to the surface. It also takes time for the body and brain to recover from the effects of alcohol. Learning new coping skills and how to apply them in stressful situations is an ongoing process.


Finding support for yourself

A good place to start looking for support is through local support groups. Al-Anon is a free peer support group for families coping with alcoholism. Listening to others with the same challenges can be a tremendous source of comfort and support. Other sources of help and support include trusted friends, a therapist, or a pastor or rabbi.

Keeping your family safe

Dealing with a loved one’s alcohol abuse can be emotionally draining and exhausting. But when the family is threatened with immediate violence, it’s time for immediate action. Alcohol abuse can lower inhibitions and increase the possibility of violence. Drinking may also become so important that activities like caring for a child fall by the wayside, increasing the chance of child neglect. Visit Domestic Violence and Abuse and Child Abuse and Neglect for more information on hotlines and how to get help if you or children are being abused.

Starting Down the Road to Recovery

If you are abusing alcohol, even admitting that you may have a problem is a huge step. It takes tremendous strength and courage to admit that you are having trouble. Much as you may want to, don’t try to quit alone. Without the right support, it is very easy to rationalize just one more drink, especially since alcohol is everywhere in our society. The road to sobriety is rewarding but challenging. If you take the time to build a support network and learn your triggers for drinking, you will greatly reduce the risk of relapse.