Alcohol use disorder (which includes a level that’s sometimes called alcoholism) is a pattern of alcohol use that involves problems controlling your drinking, being preoccupied with alcohol, continuing to use alcohol even when it causes problems, having to drink more to get the same effect, or having withdrawal symptoms when you rapidly decrease or stop drinking.
Unhealthy alcohol use includes any alcohol use that puts your health or safety at risk or causes other alcohol-related problems. It also includes binge drinking — a pattern of drinking where a male consumes five or more drinks within two hours or a female downs at least four drinks within two hours. Binge drinking causes significant health and safety risks.
Alcohol use disorder can be mild, moderate or severe, based on the number of symptoms you experience. Signs and symptoms may include:
- Being unable to limit the amount of alcohol you drink
- Wanting to cut down on how much you drink or making unsuccessful attempts to do so
- Spending a lot of time drinking, getting alcohol or recovering from alcohol use
- Feeling a strong craving or urge to drink alcohol
- Failing to fulfill major obligations at work, school or home due to repeated alcohol use
- Continuing to drink alcohol even though you know it’s causing physical, social or interpersonal problems
- Giving up or reducing social and work activities and hobbies
- Using alcohol in situations where it’s not safe, such as when driving or swimming
- Developing a tolerance to alcohol so you need more to feel its effect or you have a reduced effect from the same amount
- Experiencing withdrawal symptoms — such as nausea, sweating and shaking — when you don’t drink, or drinking to avoid these symptoms
Alcohol use disorder can include periods of alcohol intoxication and symptoms of withdrawal.
- Alcohol intoxication results as the amount of alcohol in your bloodstream increases. The higher the blood alcohol concentration is, the more impaired you become. Alcohol intoxication causes behavior problems and mental changes. These may include inappropriate behavior, unstable moods, impaired judgment, slurred speech, impaired attention or memory, and poor coordination. You can also have periods called “blackouts,” where you don’t remember events. Very high blood alcohol levels can lead to coma or even death.
- Alcohol withdrawal can occur when alcohol use has been heavy and prolonged and is then stopped or greatly reduced. It can occur within several hours to four or five days later. Signs and symptoms include sweating, rapid heartbeat, hand tremors, problems sleeping, nausea and vomiting, hallucinations, restlessness and agitation, anxiety, and occasionally seizures. Symptoms can be severe enough to impair your ability to function at work or in social situations.
When to see a doctor
If you feel that you sometimes drink too much alcohol, or your drinking is causing problems, or your family is concerned about your drinking, talk with your doctor. Other ways to get help include talking with a mental health professional or seeking help from a support group such as Alcoholics Anonymous or a similar type of self-help group.
Because denial is common, you may not feel like you have a problem with drinking. You might not recognize how much you drink or how many problems in your life are related to alcohol use. Listen to relatives, friends or co-workers when they ask you to examine your drinking habits or to seek help. Consider talking with someone who has had a problem drinking, but has stopped.
If your loved one needs help
Many people with alcohol use disorder hesitate to get treatment because they don’t recognize they have a problem. An intervention from loved ones can help some people recognize and accept that they need professional help. If you’re concerned about someone who drinks too much, ask a professional experienced in alcohol treatment for advice on how to approach that person.
Alcohol depresses your central nervous system. In some people, the initial reaction may be stimulation. But as you continue to drink, you become sedated.
Too much alcohol affects your speech, muscle coordination and vital centers of your brain. A heavy drinking binge may even cause a life-threatening coma or death. This is of particular concern when you’re taking certain medications that also depress the brain’s function.
Impact on your health
Drinking too much alcohol on a single occasion or over time can cause health problems, including:
- Liver disease. Heavy drinking can cause increased fat in the liver (hepatic steatosis), inflammation of the liver (alcoholic hepatitis), and over time, irreversible destruction and scarring of liver tissue (cirrhosis).
- Heart problems. Excessive drinking can lead to high blood pressure and increases your risk of an enlarged heart, heart failure or stroke. Even a single binge can cause a serious heart arrhythmia called atrial fibrillation.
- Diabetes complications. Alcohol interferes with the release of glucose from your liver and can increase the risk of low blood sugar (hypoglycemia). This is dangerous if you have diabetes and are already taking insulin to lower your blood sugar level.
- Birth defects. Alcohol use during pregnancy may cause miscarriage. It may also cause fetal alcohol syndrome, resulting in giving birth to a child who has physical and developmental problems that last a lifetime.
- Bone damage. Alcohol may interfere with the production of new bone. This bone loss can lead to thinning bones (osteoporosis) and an increased risk of fractures. Alcohol can also damage bone marrow, which makes blood cells. This can cause a low platelet count, which may result in bruising and bleeding.
- Neurological complications. Excessive drinking can affect your nervous system, causing numbness and pain in your hands and feet, disordered thinking, dementia, and short-term memory loss.
- Weakened immune system. Excessive alcohol use can make it harder for your body to resist disease, increasing your risk of various illnesses, especially pneumonia.
Early intervention can prevent alcohol-related problems in teens. If you have a teenager, be alert to signs and symptoms that may indicate a problem with alcohol:
- Loss of interest in activities and hobbies and in personal appearance
- Red eyes, slurred speech, problems with coordination and memory lapses
- Difficulties or changes in relationships with friends, such as joining a new crowd
- Declining grades and problems in school
- Frequent mood changes and defensive behavior
You can help prevent teenage alcohol use:
- Set a good example with your own alcohol use.
- Talk openly with your child, spend quality time together and become actively involved in your child’s life.
- Let your child know what behavior you expect — and what the consequences will be if he or she doesn’t follow the rules.