For many people, drinking alcohol is nothing more than a pleasant way to relax. However, for people with alcohol-use disorders, drinking to excess can endanger both themselves and others. If you consume alcohol to cope with difficulties or to avoid feeling bad, you’re in potentially dangerous territory. Understanding the problem is the first step to overcoming it and either cutting back to healthy levels or quitting altogether.
When does drinking become a problem?
According to the Canadian Centre on Substance Abuse and Addiction, alcohol abuse is a drinking pattern that results in significant and recurrent adverse consequences. Alcohol abusers may fail to fulfill major school, work or family obligations. They may have drinking-related legal problems, such as repeated arrests for driving while intoxicated. They may have relationship problems related to their drinking. Alcoholism, on the other hand, means people have lost reliable control of their alcohol use. Alcohol-dependent people are often unable to stop drinking once they start.
For most adults, moderate alcohol use is relatively harmless. “Moderate” meaning no more than two drinks a day for men and one for women and older people. A drink is 1.5 ounces of spirits, 5 ounces of wine or 12 ounces of beer.
What causes alcohol-related problems?
Problem drinking has multiple causes, with genetic, physiological, psychological, and social factors all playing a role. Not every individual is equally affected by each cause. These causes include:
- Psychological traits such as impulsiveness, low self-esteem and a need for approval
- Drinking to self-medicate emotional problems
- Peer pressure and socializing regularly with heavy drinkers
- Genetic factors
What are some of the issues caused by problematic alcohol use?
Heavy drinking can lead to health, relationship, workplace and related problems.
- Short-term effects include memory loss, hangovers and blackouts.
- Long-term problems associated with heavy drinking include stomach ailments, heart problems, cancer, brain damage, serious memory loss and liver cirrhosis.
- Heavy drinkers also markedly increase their chances of dying from automobile accidents, homicide and suicide.
- Alcohol abuse and alcoholism can worsen existing conditions such as depression or induce new problems such as serious memory loss, depression or anxiety, and drunk and disorderly conduct.
- Spouses and children of heavy drinkers may face family violence.
- Children may suffer physical and sexual abuse and neglect and develop psychological problems.
- Women who drink during pregnancy run a serious risk of damaging their fetuses.
- Relatives, friends and strangers can be injured or killed in alcohol-related accidents and assaults.
Denial is one of the biggest obstacles to getting help for alcohol abuse and alcoholism. The desire to drink is so strong that the mind finds many ways to rationalize drinking, even when the consequences are obvious. By keeping you from looking honestly at your behaviour and its negative effects, denial also exacerbates alcohol-related problems with work, finances, and relationships.
If you have a drinking problem, you may deny it by:
- Drastically underestimating how much you drink
- Downplaying the negative consequences of your drinking
- Complaining that family and friends are exaggerating the problem
- Blaming your drinking or drinking-related problems on others
If you find yourself rationalizing your drinking habits, lying about them or refusing to discuss the subject, take a moment to consider why you’re so defensive. If you truly believe you don’t have a problem, there should be no reason for you to cover up your drinking or make excuses.
Signs of problematic alcohol use: What do you notice in yourself, a friend or a co-worker?
It’s important to be aware of the warning signs of alcohol abuse and alcoholism and take steps to cut back if you recognize them. The Substance Abuse and Mental Health Services Administration (samsha.org) shares this list that can help you increase your awareness of how substance misuse may affect both your personal and professional life.
Physical and emotional indicators
- Tremors (e.g., shaking or twitching of hands or eyelids)
- The smell of alcohol on the breath or marijuana on clothing
- Burned fingers or lips, needle marks on arms, slurred speech or incoherence, hyperactivity, too much energy (e.g., appearing anxious)
- Lethargy, falling asleep easily
- Impaired coordination or unsteady gait (e.g., staggering, off balance)
- Wide mood swings (e.g., overactive, very talkative and then alternately withdrawn or isolative)
- Often fearful for no apparent reason Increasingly angry or defiant
- Bloodshot eyes
Social and behavioural indicators
- Uses alcohol or other substances more than intended or more frequently
- Experiences increased strain in relationships (e.g., family, professional)
- Isolates self from peers, friends and family, as well as from routine activities
- Is unsuccessful in efforts to cut down or control substance misuse
- Needs more of the substance to get the same feeling (i.e., has an increased tolerance for the substance)
- Does not maintain obligations at work, school or home because of substance misuse
- Talks regularly about getting high
- Spends a great deal of time and money trying to obtain the substance
- Misuses sick leave to recover from substance misuse
- Expends energy on denying, lying about or covering up substance misuse
- Continues misuse despite associated problems. Experiences recurrent substance-related legal problems (e.g., stopped for driving under the influence or involved in domestic incidents)
- Experiences blackouts or has difficulty remembering events that occurred while under the influence
- Has difficulty making decisions, concentrating or attending to a task and has short-term memory loss
- Has difficulty following instructions on the scene or in the office
- Needs repeated assistance with completing ordinary paperwork
When should someone seek help?
It’s not always easy to see when your alcohol intake has crossed the line from moderate or social drinking to problem drinking. The bottom line is how alcohol affects you. If your drinking is causing problems in your life, then you have a drinking problem.
- You feel guilty or ashamed about your drinking.
- You lie to others or hide your drinking habits.
- You need to drink in order to relax or feel better.
- You “black out” or forget what you did while you were drinking.
- You regularly drink more than you intend to.
- Friends or relatives express concern.
- You become annoyed when people criticize your drinking.
- You feel guilty about your drinking and think that you should cut down but find yourself unable to do so.
- You need a morning drink to steady your nerves or relieve a hangover.
Types of treatment
There are several approaches available for treating alcohol problems. No one approach is best for all individuals. The good news is that no matter how severe the problem may seem, most people with an alcohol use disorder can benefit from some form of treatment.
Behavioural Treatments. Behavioral treatments are aimed at changing drinking behaviour through counseling. They are led by health professionals and supported by studies showing they are beneficial.
Medications. Three medications are currently approved in the United States to help people stop or reduce their drinking and prevent relapse. They are prescribed by a primary care physician or other health professional and may be used alone or in combination with counselling.
Support Groups. Alcoholics Anonymous (AA) and other 12-step programs provide peer support for people quitting or cutting back on their drinking. Combined with treatment led by health professionals, mutual-support groups can offer a valuable added layer of support.
Whether you choose to go to rehab, rely on self-help programs, get therapy or take a self-directed treatment approach, support is essential. Recovering from alcohol addiction is much easier when you have people you can lean on for encouragement, comfort and guidance. Without support, it’s easy to fall back into old patterns when things get tough.
Your continued recovery depends on continuing mental health treatment, learning healthier coping strategies and making better decisions when dealing with life’s challenges. In order to stay alcohol-free for the long term, you’ll also have to face the underlying problems that led to your alcoholism or alcohol abuse in the first place.
If you are thinking about your own path to recovery, consider the following:
- Think about telling someone you trust, who understands and will support you through this effort. It is also a good idea to let those close to you know what you are going through and to tell them how they can help. Consider reaching out to a faith leader, mentor, or someone else who has helped you in the past and enlisting this person for support.
- Find new ways to manage stress, such as with exercise, stretching, deep breathing, acupuncture, massage and connections with trusted friends and family members.
- Look for local programs and providers. Groups such as Alcoholics Anonymous, Narcotics Anonymous, and Al-Anon are free of charge and offer confidential assistance several times per week.
Helping a friend or co-worker
- Express your concern directly to your friend or coworker when they are not under the influence of alcohol or other drugs. Emphasize how much you care and remind the person they are not alone.
- Offer to accompany your friend to a recovery meeting or to help find other assistance. If you have tried speaking with your coworker and they are not receptive, consider talking with your team leader or supervisor about your concerns. Chances are, your supervisor is already aware of the situation and can take the necessary steps to get the person the help they need and deserve.
- Consider arranging for a strategic intervention. This may involve several other people and should be coordinated by an experienced substance abuse professional.
- Don’t attempt to punish, threaten, bribe or preach. Avoid emotional appeals that may only increase feelings of guilt and the compulsion to drink or use other drugs.
- Don’t cover up or make excuses for the problem drinker or shield them from the realistic consequences of their behaviour.
- Don’t argue with the person when they are impaired.
- Don’t drink along with the problem drinker.
- Above all, don’t feel guilty or responsible for another’s behaviour.
The worst thing you can do is nothing. Most people who misuse substances are not able to stop without support from others. Take the first step to help yourself, a friend, or a coworker.
- Canadian Centre on Substance Abuse (2011). Alcohol and Health in Canada: A Summary of Evidence and Guidelines for Low-Risk Drinking. Retrieved October 1, 2018 from: http://www.ccdus.ca/Resource%20Library/2011-Summary-of-Evidence-and-Guidelines-for-Low-Risk%20Drinking-en.pdf
- Canadian Centre on Substance Use and Addiction. Drinking Guidelines. Retrieved October 1, 2018 from: http://www.ccdus.ca/Eng/topics/alcohol/drinking-guidelines/Pages/default.aspx
- Healthwise Staff (2017). Signs of Substance Abuse. HealthLinkBC. Retrieved October 1, 2018 from: https://www.healthlinkbc.ca/health-topics/aa52544
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