Alcohol Abuse & Alcoholism

What Is Alcohol Abuse?

Alcohol abuse is a condition where you drink too much and your drinking has become disruptive in many areas of your life, but you aren’t dependent on alcohol. The Centers for Disease Control and Prevention (CDC) defines “excessive” alcohol use as drinking an average of more than two drinks per day for men and more than one drink per day for women. Even without dependence, you may have some of the symptoms of alcohol dependence, or alcoholism, which are described in the next section. You may have trouble cutting back on your drinking or quitting without help. The same resources available to people with alcoholism (counseling and self-help groups, for example) can also help people who abuse alcohol but are not dependent. Learn more about treatment in “How Is Alcohol Dependence Treated?”

Signs that you may be abusing alcohol include:

  • Trouble fulfilling responsibilities at work, school, or home
  • Drinking in dangerous situations, such as when driving or operating machinery
  • Having legal problems related to drinking, such as being arrested for driving under the influence or for alcohol-related violent behavior
  • Continuing to drink even though you know it is harming your personal relationships and health

What Is Alcohol Dependence?

Alcohol dependence, also known as alcoholism, is considered a chronic disease. If you have alcoholism, your body has become dependent on alcohol, and you lose control over your drinking—when you drink and how much. You’re aware that drinking may cause health problems and is disrupting your relationships, work life, and may be negatively impacting your finances, but you continue to drink anyway.

Some factors can increase the risk that your drinking will turn into alcoholism. These include:

  • Drinking too much over an extended period, which can lead to physical dependence on alcohol
  • Beginning drinking at an early age
  • Gender—with men more likely to become dependent on alcohol than women
  • A family history of alcoholism or alcohol abuse
  • Having depression and other mental health problems
  • Having people around you who drink heavily or abuse alcohol

How Do I Know if I’m Addicted to Alcohol?

If you worry that you may be addicted to, or dependent on, alcohol, consider the following questions. If you answer “yes” to even one of them, you may be abusing or dependent on alcohol and should seek help (learn more about treating drinking problems in “How Is Alcohol Dependence Treated?”).

  • If you’re a man, do you ever have five or more drinks in one day? Or, if you’re a woman, do you ever have four or more drinks in a day?
  • Do you have strong cravings for alcohol?
  • Do you continue to drink even though you know it is causing physical and emotional problems and conflict in your relationships?
  • Do you need a drink when you wake up in the morning?
  • Do you feel guilty about your drinking?
  • Do you think you need to cut back on how much you drink but can’t make yourself limit your intake?
  • Are you annoyed if other people criticize your drinking habits?
  • Do you experience withdrawal symptoms (nausea, sweating, shakiness, anxiety) if your stop drinking after a period of heavy drinking?

Symptoms and Effects of Alcohol Dependence

Symptoms of alcoholism, which may also occur with alcohol abuse, include:

  • Not being able to limit the amount of alcohol you drink
  • Feeling a strong need or compulsion to drink
  • Having developed a high tolerance for alcohol so that you must consume more before feeling its effects
  • Drinking-related legal problems or problems with relationships, employment, or finances
  • Drinking alone or in secret
  • Physical withdrawal symptoms when you don’t drink (such as nausea, sweating, and shaking)
  • “Blacking out” (not remembering conversations or commitments) due to drinking
  • Losing interest in activities that you once enjoyed
  • Keeping alcohol readily available by stashing it in unlikely places (such as places at home, at work, and in your car)

Alcohol dependence and abuse can cause problems in a various areas or your life, from behavior to serious health complications. The CDC estimates that from 2001-2005, there were approximately 79,000 deaths attributable to excessive drinking.

Impact on behavior:

  • Driving while intoxicated puts you at greater risk for car accidents. And being under the influence raises your risk of any type of accident.
  • Drinking may lead to poor judgment and lowered inhibitions; both can result in dangerous or regrettable situations and behaviors.
  • Drinking may contribute to conflict with family and in personal relationships.
  • Your performance at work or at school may suffer as a result of your drinking.
  • People who drink heavily may be more likely to become violent.

Impact on health:

  • Drinking raises your risk of liver disorders because drinking can cause inflammation of the liver, called alcoholic hepatitis. Over time, this inflammation can lead to scarring of the liver, also known as cirrhosis.
  • Alcohol can contribute to digestive problems by causing inflammation of the lining of the stomach and thus interfering with nutrient absorption. The pancreas may also become damaged, leading to problems with metabolism and digestion of fats, proteins, and carbohydrates.
  • You may be at greater risk of heart problems, as heavy drinking can raise your blood pressure.
  • If you have diabetes, drinking can put you at risk of dangerously low blood sugar, or hypoglycemia.
  • Men can experience erectile dysfunction as a result of excessive drinking.
  • In women, heavy drinking can interrupt menstruation.
  • Women who drink during pregnancy put their baby at risk of birth defects such as fetal alcohol syndrome, which involves both physical and mental problems.
  • Alcohol can contribute to osteoporosis, or thinning of the bones, a condition that increases your risk of fracture.
  • Excessive drinking may lead to neurological complications, such as numbness in your hands and feet, disordered thinking, dementia, and short-term memory loss.
  • You may be at an increased risk for cancer, as alcohol abuse has been linked with the development of cancers such as mouth, throat, liver, colon, and breast cancer.