Alcoholism is a disease that affects a significant percentage of the world’s population. If left untreated, it can be fatal. However, recognised treatment methods give a good prospect of a successful outcome.
What is Alcoholism?
Alcoholism is the colloquial word commonly used to describe the disease of long-term alcohol abuse and dependence. The predominant diagnostic classification is Alcohol Use Disorder (AUD).
What Constitutes Alcoholism?
In its extreme form, this means the inability to manage drinking habits. Uncontrolled drinking leads to physical dependence. Severely impaired sufferers cannot function normally without alcohol, resulting in physical, mental and social problems. If symptoms are not treated, permanent physical damage will occur, followed by death.
UK Facts and Figures
Statistics (2018/19) from the World Health Organisation (WHO) indicate that 8.7% of people in the UK were diagnosed with Alcohol Use Disorder. This is less than Russia (20.9%) or the USA (13.9%) but is still alarming – it means that 5.6 million people in the UK were in need of help. A 2021 Parliamentary report on alcohol statistics in England showed 347,761 alcohol-specific hospital admissions in 2019/20.
Up to date figures are not yet available but are likely to show increases of around 21% on the previous year, at least partly caused by the pandemic (estimate based on evidence to date).
Early warning signs of alcoholism include:
- Inability to control alcohol consumption
- Craving alcohol when not drinking
- Putting alcohol above personal responsibilities
- Feeling the need to keep drinking more
- Spending more money than affordable on alcohol.
Diagnostic Symptoms of alcoholism (Source: Diagnostic Statistical Manual of Mental Disorders, 5th Edition (DSM-5), published by the American Psychiatric Association).
Alcohol Use Disorder Criteria – DSM-5
- Alcohol is often taken in larger amounts or over a longer period than was intended.
- There is a persistent desire or unsuccessful efforts to cut down or control alcohol use.
- A great deal of time is spent in activities necessary to obtain alcohol, use alcohol, or recover from its effects.
- Craving, or a strong desire or urge to use alcohol.
- Recurrent alcohol use resulting in a failure to fulfil major role obligations at work, school, or home.
- Continued alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol.
- Important social, occupational, or recreational activities are given up or reduced because of alcohol use.
- Recurrent alcohol use in situations in which it is physically hazardous.
- Alcohol use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by alcohol.
- Tolerance, as defined by either of the following:
- A need for markedly increased amounts of alcohol to achieve intoxication or desired effect.
- A markedly diminished effect with continued use of the same amount of alcohol.
- Withdrawal, as manifested by either of the following:
- The characteristic withdrawal syndrome for alcohol
- Alcohol (or a closely related substance, such as a benzodiazepine) is taken to relieve or avoid withdrawal symptoms.
The severity of the Disease is Assessed as follows:
- Mild – Presence of 2–3 symptoms above
- Moderate – Presence of 4–5 symptoms above
- Severe – Presence of 6 or more symptoms above.
Risk Factors of Alcoholism
People may discover alcohol in their teens or turn to it in later life following a traumatic experience. The effect of alcohol is insidious, leading people unawares into potentially life-threatening behaviours. Contributing factors include:
- Relieving stress – the sedative effect of a drink to unwind after work can become regular large amounts as tolerance builds.
- Overcoming anxiety – a drink that starts as a boost to help deal with social or other situations can quickly become a dependence.
- Coping with loss or other traumas – some people turn to alcohol in times of severe emotional pain where counselling would have been a better option. The escape from reality that alcohol provides can become a dangerous obsession.
- Isolation and loneliness can sometimes lead people into solitary drinking.
- Social pressure can sometimes lead to occasional drinking getting out of control and become an unhealthy habit as tolerance increases.
Alcohol taken in large quantities damages several parts of the body, especially the liver, heart and brain. Alcohol also affects the nervous system. When heavy drinking has gone on over several years, a dependency is established and a sudden cessation is likely to cause severe withdrawal symptoms and be extremely dangerous. Symptoms will vary but withdrawal by a heavy drinker should never be attempted alone.
Without medical supervision, there is a high risk of epileptic fits, heart failure and delirium.
What Happens if Alcoholism is Left Untreated?
Alcoholism is a progressive disease. Sufferers will most likely drink more and more. There will be severe consequences for their health, their work and social life and their relationships with loved ones. The pressure of addiction on finances and a general ability to function normally will often lead people into behaviours they would previously have considered unacceptable. Family dysfunction, job loss, domestic violence and criminal behaviour such as drink-driving or petty theft often follow.
Many alcoholics dream of being able to control their drinking and spend considerable effort on trying to do so, usually without success.
Who Does it Affect?
Any person near to an alcoholic is likely to be affected. Alcoholism is known as the ‘family disease’ and it can break a family apart, but others can be affected too: work colleagues, old friends and recreational acquaintances can all be seriously upset in emotional and practical ways by the erratic behaviour of an alcoholic. Desperate family members and friends may be driven to cover up or otherwise enable the sufferer out of misplaced kindness or fear of worse consequences.
Eventually, a crisis will occur, perhaps loss of a job or a driving conviction. For many, this is the moment when they ask for help and start the process of recovery. Sadly, there will be some who are too much in denial to want to stop, despite overwhelming reasons to do so. However, for those who do want to change, there is help available.
Treatment for Alcoholism
Alcoholism treatment can be either outpatient or residential but either way, it is likely to start with a detox. Alcohol poisons the body and it takes several days for the body of a heavy or dependent drinker to get through the withdrawal stage and start normal functioning. It is essential that any detox is performed under medical supervision.
Therapy takes many forms but generally speaking, it is the process whereby a person is helped to make changes to their attitudes, beliefs and expectations which will beneficially affect their behaviour and lifestyle. For some, this will be regular counselling sessions, for others, it will be attendance at meetings of Alcoholics Anonymous, one of the most effective self-help therapies ever devised. More.
For others, it may be residential rehab. Some may do all three. Very few people manage to stop drinking with no help at all.
Residential Rehab for Alcoholism
This normally consists of three elements: detox, intensive therapy in a residential setting, and continuing care following discharge back into the community. Residential treatment can be expensive compared to other treatments, but recovery outcomes are better. It offers a therapeutic community, safe from temptations and outside stress where intensive rehabilitation takes place. The 24/7 presence of medical and therapeutic staff is another advantage.
If you need emergency mental health advice or medical support please call the NHS 24 helpline as soon as possible on 111. The advice is free and could save a life.
If you need advice on accessing inpatient rehab treatment for alcohol addiction, please call our 24-Hour helpline on 01721 728118 to arrange a free addiction assessment. We are here to help.
Can you detox from alcohol at home?
We do not advise detox at home unless nursing staff are available 24/7. Those with no other options except a home detox are strongly advised not to stop drinking abruptly but to taper off their drinking over as long a period as possible – at least two weeks. Slowly reducing the amount of alcohol, you drink is not easy and should only be done as a last resort. You should consult a GP before starting to detox. The length of tapering off needed will be relative to the amount of alcohol that you have been drinking.
What is considered excessive drinking?
A bottle of 11% wine contains 8.25 units of alcohol. The government recommends a maximum intake of 14 units per person per week. Regular intake above this level can cause physical damage and so could be said to be excessive.
Seriously excessive intake would be perhaps double the recommended level on a regular basis. Other factors such as a person’s BMI have a bearing on how alcohol affects the body. Perhaps more important that the measure of alcohol are the negative consequences that follow heavy drinking.
What health problems are associated with alcoholism?
Long-term problems and chronic diseases linked to excessive drinking include:
- High blood pressure, liver disease, heart disease, stroke, digestive problems.
- Cancer of the breast, liver, voice box and digestive tract.
- Weakening of the immune system.
- Memory problems, depression and anxiety.
Is Alcoholism Treatable?
Yes, alcoholism is very treatable. At Castle Craig Hospital we believe that complete abstinence is essential to success. We have treated thousands of patients since opening in 1988. We have no doubt that anyone can be helped to live a happy sober life, regardless of their background provided they show honesty, openness and a willingness to change.
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