April is Alcohol Awareness Month. This year, the National Council on Alcoholism and Drug Dependence (NCADD) is turning their attention to early intervention with their theme “For the Health of It: Early Education on Alcoholism and Addiction.”

This theme aims to stop problems that stem from addiction through education and awareness that eliminates the possibility of addiction in the first place. Alcohol addiction is a complex issue that affects all aspects of a person’s life – physical, mental, emotional, and social.

Physical

Over 17.6 million adults in the U.S. suffer from alcohol dependence, and many millions more engage in risky behavior like binge drinking. Alcohol is a highly addictive depressant that is absorbed into the bloodstream from the stomach. It is processed by the liver and kidneys. The rate of alcohol processing is highly dependent on the individual. Alcohol affects motor function and control, slowing down reflexes, speech, and muscle coordination.

Alcohol works as a diuretic in the body, and the after-effects of overconsumption are most likely due to the fact that dehydration concentrates alcohol’s effects in the body. Headache, nausea, and fatigue occur when the lack of water in the body taxes the body’s ability to function. Hangover headaches in particular are due to dehydration. Without water, the brain shrinks in the skull, and the headache is caused by the stretching membranes that attach the brain to the skull.

People who are taking pain medications run the risk of overdose and severe health consequences if they combine their prescription pain meds with alcohol and for this reason should never consume any amount of alcohol. There is no safe amount; even one glass of wine can cause dangerous side effects.

Due to genetic, psychological, biological, and social factors, overconsumption of alcohol can lead to addiction. While it is true that not everyone who drinks to excess will become alcoholics, for some, even one drink can start the process of addiction. Alcohol changes the neurology of the brain, altering its balance and changing the chemistry. In some people, these changes make it much more difficult for them to stop drinking. People who have a family history of alcoholism are more susceptible to addiction, and research indicates that there is a genetic link to addiction.

Mental

Alcohol addiction has a strong mental component as well. Alcoholics may remember their first drink with pleasure. Maybe they had a bonding moment or it was a celebration of a success. Some people use alcohol to unwind from a difficult job or as a stress reliever for issues at home. The amygdala controls memory and emotion, and as a drinker continues to associate drinking with positive emotions and memories, the behavior becomes more ingrained.

This is especially true if the person drinking has stress in other areas of life. Alcohol also physically affects the hypothalamus, the area in the brain that regulates stress. Many say they drink to relieve stress, but the brain then becomes dependent on this type of stress relief. Because withdrawal from alcohol can cause stress, the brain sends powerful signals to urge the person to continue drinking.

Drinking then also becomes associated with pleasurable feelings, and humans are evolutionarily programmed to seek pleasurable experiences. Many drinkers will say they drink to escape, but after a while it becomes harder and harder to control the impulsivity of knee-jerk drinking.

Emotional

For many alcoholics, the depressing effects of alcohol are what they seek. They may have experienced trauma in their lives, and alcohol can dampen any feelings associated with that trauma. After a while, the drinker needs more and more alcohol to put aside the traumatic event, and “drinking to forget” becomes an addiction.

Social

Drinking is a social event, in general. There may be wine at dinner or cocktails at a party or an event. Backyard barbecues, baseball games, concerts: alcohol is present in most of these venues. The act of drinking is a social event, but when a person becomes an alcoholic, this may take on a new meaning. When the rest of the group stops at one or two drinks, the alcoholic will continue drinking until they pass out. Waking up remorseful and embarrassed the next morning, they may decide to have a few drinks before heading out with friends, and the behavior becomes hidden.

Friends of alcoholics may have a hard time accepting that there is a problem, and when they do, their reactions could be extreme. Some will disappear, and some may try to help. Regardless, the social nature of the drinking has changed and colored the relationships surrounding the addicted person.

The signs of alcohol addiction are as follows:

  • Tolerance: If a drinker needs to drink more to get the same effect, this is a risk factor for addiction. Conversely, someone who has been drinking for years and can suddenly get the same effect after one or two drinks may be experiencing the beginning stages of liver failure.
  • Neglecting responsibilities: Not all alcoholics miss work or neglect their families, but this is a key sign. If a person is calling in sick more frequently or missing family functions, they may be struggling with addiction. On the other hand, some alcoholics are able to continue with their daily activities. These functioning alcoholics may be harder to convince to seek treatment as they don’t see themselves as a stereotypical alcoholic.
  • Continued drinking despite difficulties: Drinking after a DUI or other legal trouble related to alcohol or using money to buy alcohol instead of paying bills or caring for themselves is an indication of trouble and addiction. Addicts may keep drinking even though it is harming relationships with friends and family.
  • Inability to stop or loss of control: When a person wants to stop but physically cannot, or if they feel like they have no control over their drinking, they may be addicted.

Alcohol withdrawal

Withdrawal from alcohol can be a very painful and dangerous experience. Typically, withdrawal symptoms start within a couple hours of the last drink and can include:

  • Shaking
  • Headache
  • Cravings for alcohol
  • Irritability
  • Nausea
  • Pain in the muscles
  • Chills
  • Anxiety

An extreme form of withdrawal called delirium tremens (DTs) can be particularly dangerous. These withdrawal symptoms are caused when heavy drinkers stop suddenly. All of the neurotransmitters suppressed by the alcohol spring back, resulting in hypersensitivity. Seizures, convulsions, and hallucinations can occur.

Proper medical attention and care during the withdrawal period can ease symptoms and make the process less painful, but withdrawal from an addictive substance is not easy and requires support. There are a number of things that can make the process easier.

  • Using meditation in addition to counseling
  • Taking prescription medication to ease withdrawal symptoms
  • Getting support from people who have experience in withdrawal (e.g., Alcoholics Anonymous)
  • Resting and eating a healthy diet
  • Replacing drinking with a positive behavior (e.g. art, exercise, etc)
  • Recognizing that it will be difficult but it is possible
  • Journaling to process the experience

Addiction and withdrawal can be a painful process, physically, mentally, emotionally, and socially. For more support and information on alcohol addiction visit NCADD’s informative site.

Image by John Ott via Flickr

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