An alcoholic is generally defined as someone who has alcohol use disorder. Very broadly, you may be an alcoholic if you regularly encounter issues related to alcohol and have difficulty controlling how much you drink despite these issues.
Definition of an Alcoholic
In a modern medical context, alcoholic is a fairly non-specific term that is rarely used.
Alcoholic is a colloquial descriptor referring to an individual who struggles with alcohol. Generally speaking, an alcoholic is someone who suffers from alcohol use disorder (AUD), commonly just called an alcohol addiction or alcoholism.
Key Facts About Alcoholism
Some key facts related to alcoholism in the United States include the following:
- Over 85.6 percent of people 18 and older report drinking alcohol at least once in their lifetime, and 25.8 percent report engaging in binge drinking at least once in the past month, according to a 2019 survey.
- That same survey found 414,000 adolescents ages 12 to 17 and an estimated 14.5 million people over 12 had AUD, which is a massive number considering the population of the United States is estimated to be about 335.5 million.
- Despite being legal for adults to purchase in most parts of the United States, alcohol has significant abuse and addiction potential, even when compared to many illegal or otherwise more tightly regulated substances.
- It is very difficult to overcome AUD on your own, but only a small percentage of people seek help for AUD from addiction treatment professionals. Many more people seek care for issues caused by heavy alcohol use rather than getting help to stop their drinking.
Understanding Alcohol Use Disorder
Key to understanding AUD is knowing that alcohol addiction is about more than just willpower or an individual drinking more than they should. Alcohol can cause long-lasting changes to the brain, with repeated use essentially “rewiring” the brain to consider having alcohol in one’s system as your “normal” state and then causing a variety of unpleasant symptoms when alcohol isn’t in your system.
AUD ranges in severity, from mild to severe. It can trap a person in the difficult position of needing to drink to feel like they are able to function while they still experience the various negative effects associated with alcohol use. They will also experience strong cravings to use alcohol, further complicating their ability to stop drinking, even if they’re willing to go through the withdrawal process and try addiction recovery treatments.
What Are the Symptoms of Being an Alcoholic?
In addition to a person often being under the influence of alcohol, a person is generally considered to be an alcoholic, more specifically to have AUD, if they experience strong cravings to drink alcohol, frequently lose control around alcohol, are unable to stop drinking once they’ve begun, and are in a negative emotional state when not drinking or drunk.
Alcoholics generally suffer from withdrawal when they stop drinking alcohol, which is the result of the physical dependence alcohol can cause. Common symptoms associated with alcohol withdrawal include the following:
- Anxiety or nervousness
- Mood swings
- Difficulty thinking clearly
- Nightmares and other sleep problems
- Jumpiness or shakiness
Sometimes, alcohol withdrawal can cause more severe symptoms that may require emergency medical care, such as if one experiences delirium tremens, which is characterized by various sudden and severe mental or nervous system changes. It may also cause seizures.
This is why it is best to quit alcohol with the help of addiction treatment experts. With the right assistance, a person can avoid these more serious symptoms, ensuring they get through the withdrawal process safely and successfully.
On a more basic level, if drinking is causing you distress and harm but you are unable to stop despite this, you likely have AUD and might consider yourself an alcoholic. This relationship with alcohol isn’t healthy. It warrants talking to a professional about how to get help regaining control and improving both your mental and physical health.
What Causes People to Become Alcoholics?
Many factors can contribute to a person developing problems with alcohol. Known contributors to AUD include the following:
- Drinking at an early age
- Genetics and a family history of alcohol-related issues
- Mental health conditions
- Traumatic events, such as childhood abuse
A person without these problems can still develop issues with alcohol. If an otherwise healthy person engages in binge drinking and heavy alcohol use, they may develop AUD.
Alcohol can cause physical dependence, described earlier, which can make stopping drinking much more difficult and lead to further issues related to alcohol use. If you have developed a physical dependence on alcohol due to long-term, heavy drinking, you shouldn’t stop drinking suddenly. You need medical assistance and supervision.
How to Diagnose AUD
AUD is primarily diagnosed by a person answering “yes” to two or more questions from a list. These questions are as follows:
In the past year, have you done any of the following?
- Drank more or for longer than you intended
- Failed to cut down or stop drinking despite a desire to do so
- Experienced compulsions to drink
- Dedicated a significant amount of time to drinking or recovering from drinking
- Continued drinking even when it had negative life effects
- Kept drinking even when it interfered with work or school
- Gave up previously important activities to drink instead
- Been in dangerous situations while drinking
- Continued drinking despite physical or mental health issues
- Experienced tolerance to alcohol
- Had withdrawal symptoms when you stopped drinking or reduced the amount you drink
You can’t diagnose yourself with AUD; only a medical professional can do that. However, if you look at this list and realize you meet the criteria for AUD, you should definitely talk to a professional about getting diagnosed.
Even if you don’t fit the definition of AUD, you should still talk with a treatment professional if alcohol has caused you significant issues and you feel you can’t stop on your own or could use help from a professional to stop or reduce your drinking. This is a sign that alcohol is a problem for you, and you could use support in this area.
Levels of Drinking
When discussing alcohol use, it’s important to understand what level of drinking is considered moderate versus what level of drinking you should consider unhealthy. These levels are usually considered as follows:
Moderate drinking is defined as drinking 2 or less drinks per day for men and 1 or less drinks per day for women. These recommendations seem to be for cisgender people, and transgender individuals should generally use the recommendations for their assigned sex as birth or, preferably, just talk to a doctor about the level of alcohol use considered normal for their biology.
Importantly, a “normal” level of drinking is highly dependent on the individual. If alcohol is doing harm, even at low levels, a person should not be drinking as much as they are. Some individuals, such as those who are pregnant, have certain health issues, or are on certain medications, should not drink at all.
It’s possible that even drinking at these levels that are defined as moderate can be a problem for some people. Consider how your alcohol use affects your life rather than using only these definitions.
Definitions for heavy drinking vary slightly depending on the organization referenced. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) states that heavy drinking is 4 or more drinks per day for men and 3 or more drinks per day for women, or 14 drinks per week for men and 7 drinks per week for women. The Substance Abuse and Mental Health Services Administration (SAMHSA) defines heavy drinking as binge drinking on 5 or more days in the past month.
Heavy drinking is unhealthy and can signal AUD, although a person can engage in heavy drinking even if they don’t have AUD. Repeatedly and intentionally engaging in heavy drinking is more likely to signal an issue than accidentally or occasionally engaging in heavy drinking, but heavy drinking of any kind can still affect your health.
Per NIAAA, binge drinking is any pattern of drinking that causes a blood alcohol concentration level of 0.08 percent or higher. For context, this is the same BAC level that many states set as their legal limit for driving and similar activities.
For the typical adult, this means drinking between 4 and 5 drinks in 2 hours, although the specifics can vary significantly depending on the individual’s body.
Abstinence, in the context of alcohol and drug use, means to abstain from a substance altogether. For alcohol, this would mean avoiding drinking.
For people in recovery, it is usually recommended that they avoid drinking at any level and don’t engage in any type of consumption intended to get them drunk.
For some people, abstinence even means avoiding certain food items, like sauces, that may contain trace amounts of alcohol, but this level of avoidance usually isn’t necessary unless you’re on specific medications or trying to avoid alcohol for religious reasons. Most of these food items aren’t going to meaningfully cause intoxication unless eaten in much higher portions than normal.
Warning Signs That You Might Be an Alcoholic
If you think you might fit the definition of AUD as described earlier, you might be an alcoholic and should seek help. Common warning signs to look out for include the following:
- Other people note your drinking levels or try to tell you to reduce your level of drinking.
- You are unable or unwilling to control or reduce your drinking.
- You experience financial complications as a result of heavy alcohol use.
- There is a deterioration of your quality of life, such as experiencing health or relationship problems, as the result of alcohol use.
Very simply, if alcohol use is semi-regularly causing you issues of any kind, you likely have some level of a problem. At the very least, you should talk to an addiction treatment professional about what you’ve been experiencing and if there’s anything that may help you achieve a healthier relationship with alcohol.
Are the Effects of Heavy Alcohol Use Reversible?
Heavy alcohol use is also associated with an increased risk of injury, and an injury will obviously not be reversed just because someone stops drinking.
Generally, sustained abstinence from alcohol can partially or completely reverse the health impact it has on an individual. In virtually all cases, a person will at least experience significant improvements in their health if they had previously struggled with heavy drinking and they stop drinking.
With that said, some potential health effects of heavy alcohol use are very serious and not easily reversed. For example, heavy alcohol use can lead to Wernicke-Korsakoff syndrome, which can cause brain damage that worsens over time. Cessation of alcohol use can help stop this condition from worsening, but some of the symptoms can be permanent, and others may take a long time to recover from.
Heavy alcohol use can also be a significant cancer risk. If it develops, cancer will require treatment beyond stopping use of alcohol.
Treatment Options for Alcohol Use Disorder
When seeking to recover from problems with alcohol, it’s important to work with a treatment professional to plan out your recovery and to understand the treatment options likely to help you best. Some treatments commonly used to help people struggling with alcohol use include the following:
Detoxing from alcohol is the process of allowing your body to fully process the alcohol already in its system and avoiding consuming any alcohol as it adjusts to that absence. This can be difficult as it means you will likely experience withdrawal, which can sometimes be severe.
In rare cases, alcohol withdrawal can be life-threatening, so again, it’s important to get medical supervision for this process if you have been drinking for a long time or at high levels. Addiction treatment professionals can provide you with evidence-based care to make this process safer and easier, especially if you undergo detox at a specialized facility.
Several medications can be used to help at varying stages of the addiction treatment process, including these:
These medications can be used to reduce cravings for alcohol as well as withdrawal symptoms. They can also trigger unpleasant reactions if alcohol is consumed, discouraging alcohol use and reducing the likelihood of relapse. Some medications counteract the effects of alcohol.
In addition, some medications may be prescribed to deal with specific symptoms of withdrawal or co-occurring disorders.
Therapy & Counseling
Any addiction treatment plan will include at least some element of therapy or counseling. In therapy sessions, you’ll identify triggers that make you want to drink, and you’ll learn healthier ways to deal with these triggers.
Therapy can also improve your overall mental health and address any co-occurring mental health issues. This is key to enjoying life more fully, even beyond how this can help you recover from alcohol addiction.
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- Wernicke-Korsakoff Syndrome. (January 2022). National Library of Medicine.
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