Alcoholism and alcohol use disorder (AUD) was a major concern for almost 15 million people ages 12 and older in the United States in 2019, according to the National Survey on Drug Use and Health (NSDUH). Sadly, only about 7% of those people received any treatment for their alcohol abuse in the previous year.
What makes it so hard for someone to stop abusing alcohol? Why don’t more people seek treatment? What causes people to drink to excess in the first place? Addiction is a powerful biological concern and chronic condition. Unfortunately, for too long people have viewed addiction as a moral failing connected to a lack of willpower. The reality is that addiction changes the brain, disrupts a person’s thinking, and makes it very difficult for them to stop abusing alcohol.
What Causes Addiction?
Addiction is a complex issue that can be caused by multiple factors, including genetics, environment, past experiences, and mental health. Since everyone is unique, they may share similar experiences or family ties and not develop a drinking problem, while someone else in similar circumstances will.
Scientists believe that genetics play a significant role in a person’s risk of developing an addiction to alcohol. For instance, having the A1 allele of the dopamine receptor gene DRD2 may be linked to an elevated likelihood of alcohol addiction. Researchers believe that alcoholism has a 55% chance of being inherited along family lines.
The environmental influences that can lead to alcoholism include peer pressure, poor parental supervision, parental drug use, or even living in a poor neighborhood. Negative and traumatic experiences, particularly in childhood, may also increase a person’s odds of developing an addiction to alcohol. Examples of experiences that may impact a person’s physical and mental health and increase future problems with alcohol include:
- Physical abuse
- Sexual abuse
- Verbal abuse
- Physical or emotional neglect
- Witnessing violence
- Having a family member with a mental illness
- Having an incarcerated family member
- Having a family member who is addicted to drugs or alcohol
- Parental separation or divorce
These types of trauma can result in post-traumatic stress disorder (PTSD), and research has shown strong links between PTSD and addiction. Finally, there is also often a connection between other mental health issues and alcohol addiction. This is known as a co-occurring disorder or dual diagnosis. The addition of a mental health issue makes achieving sobriety that much more challenging.
How Does Alcohol Change the Brain?
Alcohol, like many drugs, can take over a person’s brain, making it harder to stop drinking even when the person knows they should. Over time, chronic alcohol use can destroy parts of the brain that are necessary for survival. This process starts when alcohol blocks communication between brain cells. Alcohol stops these chemical signals from reaching neurons in the brain, resulting in the most common signs of intoxication, including slurred speech and slowed reflexes.
Over time, alcohol abuse can cause lasting damage to the brain. Neurotoxicity occurs when neurons burn out from the over-reaction of neurotransmitters from months or years of drinking. This causes damage between the pathways of the brain, causing slower reactions, thinking, and cognitive processing. Alcohol abuse can also damage brain matter. Heavy drinking actually causes the brain to physically shrink, reducing the volume of gray matter, or cell bodies, that the brain contains.
The obvious signs of alcohol’s effect on the brain include issues with attention, problem solving, impulsivity, and spatial processing. But heavy drinking can also alter other operations of the brain, including decreased fluency, learning, processing speed, and working memory. The parts of the brain that handle higher functions like problem solving and impulse control are especially susceptible to damage from heavy drinking for a long period.
When someone drinks heavily for a long period of time, the brain adapts further to the presence of alcohol in the body. As a result, neurotransmitters become over-activated by the brain when the person stops drinking, resulting in dangerous symptoms of withdrawal. Withdrawal is not only painful but can also cause additional brain cell damage.
What Happens to Your Body Because of Alcohol?
Excessive drinking significantly impacts the brain but is also seriously detrimental to the human body. For instance, long-term alcohol abuse can affect the heart, causing cardiomyopathy, or an enlarged, inefficient heart muscle, arrhythmia, higher blood pressure, an increased risk of stroke, and a heightened likelihood of bleeding.
The digestive system also suffers from heavy drinking. The problems start in the mouth, with damage possible in the salivary glands, gums, tongue, and teeth. Alcohol abuse has also been linked to esophageal or stomach ulcers. Finally, because of the increased blood pressure associated with alcohol addiction, the esophagus’ blood vessels can become enlarged and potentially even rupture.
Perhaps the most well-known complications of alcoholism are liver damage and pancreatitis. Cirrhosis of the liver occurs when that organ is scarred because of the chronic inflammation from excessive drinking. When this happens, vital functions of the liver, such as fighting infection and cleaning the blood, can slow or stop. Alcohol can also cause fatty liver, fibrosis, and alcoholic hepatitis. Pancreatitis occurs when the pancreas becomes inflamed and can result in diabetes and other endocrine disorders, autodigestion, or a spilling of digestive enzymes into the abdomen, or permanent organ damage.
Finally, alcoholism can damage a person’s immune system, making them more likely to become sick from viruses.
How Do I Stop Drinking?
If you suspect that you may have an issue with alcohol abuse, the first step is to determine how much you actually drink. Does one drink turn into four? Do you find it hard to stop drinking once you start? Answers to questions like these can provide insight into whether you are struggling to control your drinking.
It is also important that you examine why you drink. Are you trying to numb emotional pain or avoid stressful situations? Are you struggling to face challenges and using alcohol to manage your emotions? The reasons behind your drinking can provide insight into healthier ways to cope with stress. Depending on what you find, you may need to seek additional help from a mental health or addiction treatment professional.
If you determine that your current level of alcohol use is dangerous or unhealthy, you may decide to take steps to limit your drinking. Involving friends, family, and loved ones can be helpful to keep yourself on track to stop or limit your drinking. You may even want to seek out a community of others, such as a 12-step program like Alcoholics Anonymous, for added support.
Other suggestions for cutting back or eliminating alcohol include:
- Find alternative activities. Use healthy new activities to fill the time that you previously spent drinking.
- Avoid triggers. Certain places, activities, or even people can trigger your desire to drink. Try to avoid these triggers as much as possible.
- Plan to handle urges. If you know that you won’t be able to avoid a certain trigger, you should develop a plan to manage the urges or emotions that may result to avoid the temptation to drink.
- Know what to say. Having a prepared statement for when someone offers you a drink can help you handle any potential awkwardness that you may feel in that moment.
- Prioritize wellness. Try engaging in healthy activities, including healthy eating and exercise, to help manage your emotions and boost your motivation.
As you start to make progress, you may want to consider enrolling in a professional addiction treatment program to further strengthen your sobriety.
Alcohol Treatment Programs
There are many options for the treatment of alcoholism, and no one treatment will work for everyone. It is important for you to understand and evaluate your options and consider different treatment methods. Typically, a combination of several different therapeutic techniques can be helpful.
Therapeutic techniques for alcohol addiction include behavioral therapy, medication, and peer support groups. One of the most effective and popular choices for behavioral therapy is cognitive behavioral therapy or CBT. A talk therapy approach used to treat many different kinds of substance use disorders, CBT helps you identify negative thoughts and actions that may be contributing to your addiction. CBT helps you overcome addiction by:
- Improving self-control
- Recognizing situations in which you are most likely to drink
- Avoiding trigging circumstances, if possible
- Developing coping strategies that will help you when you are faced with situations that trigger cravings
- Coping with other problems and behaviors that may lead to your substance abuse
A therapist using CBT will ask you to examine the thoughts, feelings, and circumstances that may have contributed to your drinking. This type of functional analysis helps you to identify circumstances where you may have problems coping with life stress, emotions, or trauma. CBT also teaches you skills to manage difficult situations that may arise in your life. This includes learning that feelings of distress are natural and can be dealt with without alcohol.
Additionally, there may be medications available that can help you overcome an addiction to alcohol. The first medication approved for AUD was disulfiram, which causes a person to get sick if they drink by altering the way the body breaks down alcohol.
Another prescription that has proven helpful for individuals managing alcohol addiction is naltrexone. This medication allows a person to still drink and get drunk but eliminates the pleasurable feelings associated with drinking.
An additional medication, known as acamprosate, aids people with the symptoms of alcohol withdrawal that can linger for months after their last drink. These symptoms can include insomnia, anxiety, restlessness, and sadness.
Medication may not be appropriate for everyone and is not a substitute for addiction treatment. But for people who qualify, medication can help support behavioral therapy and peer support.
The final component of overcoming alcohol addiction involves the assistance of a support group of your peers. The most well-known is Alcoholics Anonymous (AA), but there are other 12-step programs as well. All offer you support from other people who are working to quit or cut back on their own drinking.
One of the key components you’ll need to maintain your sobriety is the ability to recognize the warning signs of relapse. These include any return to the thinking patterns that were previously associated with your alcohol addiction. Other warning signs include engaging in self-defeating behaviors or seeking out situations with alcohol or people that use alcohol. Irrational or irresponsible thinking or behavior may also indicate the possibility of a relapse.
Other signs to be aware of are:
- A change in attitude or behavior. This includes skipping or stopping your recovery program or stopping the new healthy habits that you have developed in rehab.
- Elevated stress. Any events that significantly increase your level of stress can put you at risk of relapse.
- A loss of control or judgment. When you begin to make irrational choices or unhealthy decisions, you need to refocus your sobriety efforts.
- Withdrawing socially. If you stop attending your support meetings or otherwise disengages socially, you could be close to drinking again.
Addiction is preventable and treatable, but it is important to remember that achieving sobriety is an ongoing process. You may experience setbacks, and relapse is part of the process. You should remember that alcoholism is a chronic disease, like high blood pressure or diabetes. When people living with those conditions have a flare up, it is not viewed as a failure, but rather a sign they need to reevaluate their current treatment and try something new. The same is true with alcoholism. Changing the habit of addiction is hard, and it takes time and persistence.
At Bridges of Hope, we take a comprehensive and integrated approach to addressing substance use and mental health disorders. Find out how our therapeutically proven, evidence-based clinical treatment helps people in Indiana recover from alcohol addiction.