What Is an Alcoholic?

Millions of Americans struggle with alcohol misuse in their day-to-day lives. In casual conversation, the words alcoholism and alcoholic are often used to describe people who misuse alcohol, but what exactly do these words mean?

First and foremost, it’s important to note the difference between alcoholism and alcohol use disorder (AUD). AUD is a medical diagnosis of alcohol dependence (previously referred to as alcohol addiction) that can be classified as mild, moderate, or severe. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) lists 11 criteria used to diagnose AUD, and the number of symptoms an individual exhibits directly correlates to the stage of AUD they are diagnosed with.

On the other hand, alcoholism is not a diagnosis but rather a colloquial term used to describe someone who exhibits symptoms of AUD or an “alcoholic” as many people say.

There are many stigmas and preconceived notions about alcoholism in the U.S. Some of the most common being that individuals with alcohol dependence don’t want to recover, are at fault for their dependence, or should be ashamed of their condition.

Keep reading for everything you need to know about alcoholism including signs and symptoms, treatment options and resources, and more.

There are many warning signs and symptoms that can indicate alcoholism and may encourage you to seek professional help. You may notice physical, mental, and behavioral symptoms in yourself or others that are associated with AUD.

Common physical symptoms include:

• Dilated pupils
• Insomnia
• Vision problems
• Nausea
• Vomiting
• Sweating
• Shakiness
• Confusion
• Loss of appetite
• Seizures
• Hallucinations
• Nightmares

Common mental/emotional symptoms include:

• Irritability
• Mood swings
• Paranoia
• Anxiety
• Depression
• Aggression
• Mental preoccupation with alcohol
• Lack of concentration
• Alcohol cravings

Common behavioral symptoms include:

• Planning one’s day around drinking
• Drinking alcohol alone
• Drunk driving
• Risky behaviors
• Increased alcohol intake/heavy drinking
• Isolation
• Missing work or school
• Drinking more frequently
• Neglecting responsibilities

Alcohol dependence presents differently in everyone, so some people may exhibit many symptoms while others may only exhibit a few.

There are three stages of alcoholism: early stage, middle stage, and late stage alcoholism. Let’s take a look at what each of these entails.

Early-stage alcoholism is typically characterized by occasional alcohol misuse and binge drinking. Alcohol misuse is any behavior around alcohol consumption that is harmful. This can include binge drinking, blackouts, drinking at inappropriate times, or drinking in dangerous situations.

Binge drinking is a common sign of early alcoholism that is defined as consuming excessive amounts of alcohol in a short period of time. To be specific, binge drinking refers to four or more drinks for women and five or more drinks for men within two hours. Binge drinking is heavily socialized between drinking games and peer pressure to drink more. Over time, it can lead to severe alcohol dependence and can cause alcohol overdose at any point in time.

Increased alcohol intake and alcohol withdrawal symptoms often demonstrate middle-stage alcoholism. People who are experiencing middle-stage alcoholism may start to increase their alcohol intake by drinking more frequently, drinking in larger amounts, drinking alone, drinking to cope with emotions or stress, or even drinking out of boredom.

This is also when you may start to notice withdrawal symptoms when you reduce your alcohol intake or try to stop drinking. Common withdrawal symptoms are nausea, vomiting, shakiness, rapid heart rate, anxiety, insomnia, and paranoia.

Late-stage alcoholism can be classified by severe alcohol dependence and health complications. People with severe alcohol dependence may spend the majority of their time thinking about drinking in addition to actually drinking. They often experience severe withdrawal symptoms, and cravings, and feel as though they cannot function without alcohol.

This is also when health problems due to alcohol misuse may become more noticeable. There are myriad health conditions caused by alcohol misuse, but some common ones include liver damage, heart damage, and an even higher risk of certain cancers.

AUD is a condition that can affect anyone. However, there are common causes and risk factors that can put individuals at an increased risk for developing alcoholism.

Common causes and risk factors for alcoholism include:

• Family history of alcohol problems
• Early exposure to alcohol
• History of trauma
• History of mental illness
• Being in your 20s or 30s
• Drinking too much regularly or binge drinking

As a disclaimer, these characteristics do not ensure that an individual will develop alcohol dependence, but they do indicate the need for increased caution surrounding alcohol intake.

Short-term and long-term alcohol misuse can both pose serious threats to your physical health. These health problems can be acute or in severe cases, irreversible.

Physical effects of alcohol misuse include:

• Fatty liver disease
• Ulcers
• Gastritis
• Liver damage
• Cirrhosis
• Alcoholic hepatitis
• Cardiomyopathy
• Arrhythmias
• Esophagus cancer
• Breast cancer
• Colorectal cancer
• Digestive cancers
• Weakened immune system
• Heart disease
• Stroke
• Weight loss
• Fatigue
• Pancreatitis
• High blood pressure
• Heartburn

In most cases, the longer an individual misuses alcohol, the more exacerbated these conditions can become. If treated promptly, it’s possible to reverse the damage of some health conditions, but others may have permanent effects.

Just like your physical health, your mental health is also greatly impacted by alcohol dependence.

Mental health effects can include:

• Impaired cognitive function
• Memory loss
• Dementia
• Impaired decision-making skills
• Exacerbated pre-existing mental health conditions
• New mental illnesses (schizophrenia, anxiety, depression, bipolar disorder)

Many people with mental illnesses use alcohol to cope with the symptoms of their condition, but this often only provides short-term relief and worsens the problem in the long run.

Aside from damaging your physical and mental health, alcoholism can also be detrimental to your social and familial life.

Many people with alcohol dependence start to isolate themselves or neglect responsibilities, which can lead to breakdowns in relationships with friends and family members.

For example, alcohol misuse can cause memory loss and confusion, leading people to forget plans, responsibilities, or other obligations. In other cases, people with alcohol dependence may skip out on plans to drink instead.

As a result, many people find that their relationships are weakened or even end due to their alcohol consumption.

Early detection of alcoholism is incredibly important for many reasons. If detected early and treated properly, there is a decreased risk of physical health consequences, alcohol overdose, worsened dependence, and other consequences such as job loss.

If you suspect you or a loved one is experiencing alcoholism, there are many online resources and assessments that can help identify symptoms and behaviors associated with alcohol dependence. These can be a great starting point and even cause for intervention.

From there, it is encouraged to seek a professional diagnosis. This can be done via a medical evaluation from a healthcare professional. Your healthcare provider will ask you questions about your alcohol use and behaviors surrounding alcohol to determine if you meet the criteria for an AUD diagnosis. They will also examine you for any health effects of alcohol misuse.

If you receive an AUD diagnosis, your doctor will also be able to tell you if your alcohol dependence is mild, moderate, or severe. Mild dependence is characterized by two to three symptoms, moderate dependence by four to five, and severe dependence by six or more.

Once you’ve received a diagnosis, or identified alcoholism signs on your own, you may choose to seek treatment and recovery options. There are many evidence-based treatment methods that have shown high levels of efficacy in people with alcohol dependence.

Many people choose to enroll in an alcohol treatment program to treat their dependence. Typically, rehab programs are either inpatient or outpatient, the former meaning individuals live in a care facility for the duration of their treatment. Outpatient treatment means individuals travel to a rehab center several times a week for treatment. Treatment programs use comprehensive treatment plans to address dependence from multiple angles.

Other common treatment options include detox services, medication-assisted treatment (MAT), counseling, and therapy. Detoxification services are often part of the recovery process and essentially help you through the withdrawal stage before treatment. As for MAT, this common treatment service uses specific medications to treat alcohol dependence by reducing withdrawal symptoms, cravings, and the effects of alcohol on the brain and body.

Counseling and therapy are also important parts of treatment as they address the mental and behavioral parts of alcohol dependence. They are often offered in both group and individual settings, depending on your needs. Behavioral therapy is particularly common as it encourages mental reframing and behavioral changes.

Outside of traditional treatment, some people choose to pursue other recovery options such as 12-step groups, alternative therapies, or sober housing.

In addition to treatment, an incredibly important part of recovery is having a support system and being familiar with local resources. This goes for the individual with alcohol dependence as well as their friends and family members.

As an individual with AUD, it’s vital to build a support system to rely on during your treatment and recovery. This can include friends, family members, or peers. Having a support system can reduce feelings of loneliness or hopelessness and provide a sense of accountability.

Some people choose to join 12-step groups such as Alcoholics Anonymous (AA, Al-Anon) or other support groups in their area.

Here are some resources for people with AUD:

• Alcoholics Anonymous
• LifeRing
• Women for Sobriety
• Secular Organizations for Sobriety

As mentioned above, it’s important for caregivers and loved ones of people with alcohol dependence to have support as well.

Here are some resources for friends and families:

• NIAAA – Caretaker Support Resources
• Al-Anon Family Groups
• Substance Abuse and Mental Health Services Administration (SAMHSA) – Resources for Families Coping with Mental and Substance Use Disorders

You may also choose to pursue family therapy through a local provider.