Alcohol is a legal and largely socially acceptable drug. There is very much a ‘drinking culture’ in large parts of the UK but excess drinking can be a serious problem – not only for the people involved but for society as a whole.
According to the charity Alcohol Change UK, 24% of adults in England and Scotland regularly drink over the Chief Medical Officer’s low-risk guidelines and 27% of drinkers in Great Britain binge drink on their heaviest drinking days. Additionally, there are estimated to be more than 600,000 dependent drinkers in England alone.
It’s easy to downplay or deny that there might be a problem in the midst of this drinking culture – and denial frequently goes hand in hand with serious drinking problems. So how do you know if you have a problem with alcohol?
What is Alcohol Use Disorder?
It’s worth noting that drinking any amount of alcohol can be harmful. The low-risk guidelines say that to keep health risks from alcohol to a low level it is safest not to drink more than 14 units a week on a regular basis. It does not say there is any ‘safe’ amount, however. The official advice adds that if you have even one or two heavy drinking episodes a week, you increase your risks of death from long-term illness and from accidents and injuries. The risk of developing a range of health problems, including cancers of the mouth, throat and breast, also increases the more you drink on a regular basis.
Unhealthy alcohol use can include any kind of drinking that either causes harm or puts you at risk, but this is not necessarily the same as an alcohol use disorder (AUD). Alcohol use disorder is a problematic pattern of alcohol use leading to “significant impairment or distress”, which can include the condition commonly known as full-blown alcohol addiction or alcoholism. The British Medical Journal (BMJ) says alcohol use disorder is defined as clinically significant impairment or psychosocial stress in the previous 12 months.
Signs and Symptoms of Alcohol Use Disorder
Alcohol use disorder can be mild, moderate or severe. Different people may experience different physical, behavioural, and psychological symptoms but there are some common signs of alcoholism and other types of AUD, including:
- Drinking more – more regularly and/or in higher quantities
- Regularly being intoxicated
- Needing to drink more for the same effect
- Having no ‘off switch’, drinking more than you intended
- Continuing to drink despite harmful consequences
- Feeling a strong craving or urge to drink alcohol
- Ill effects when you do not drink (withdrawal symptoms)
- Feeling anxious about getting alcohol
- Avoiding situations where you cannot drink
- Drinking in inappropriate circumstances (in charge of children, driving etc)
- Planning your social life/activities around drinking
- Being unable to quit or cut down if you want to
This is not an exhaustive list but if any of the above apply to you, you might have an alcohol problem up to and including an alcohol use disorder.
Risk Factors for Alcohol Use Disorder
Anyone can develop a problem with alcohol, including alcohol use disorder. The more frequently and more heavily you drink, the more likely you are to become dependent or develop an alcohol use disorder, as well as increasing the risks of harm through illness, injury and poor decision-making. Alcoholism can affect people of any age, sex or social class but there are some known risk factors.
- Drinking at an early age – one national survey in the US found that people who began drinking before age 15 were more than 5 times as likely to report having AUD in the previous year compared to those who waited until age 21 or later to begin drinking.
- Genetics – while it is not fully understood, numerous studies have suggested there is a link between addiction and genetics, meaning alcohol misuse can run in the family. There is often an overlap with environmental factors, with people from a heavy-drinking household being more likely to drink themselves.
- Mental health issues – there is often a complex relationship between mental health and alcohol misuse, with each affecting the other to various degrees. Psychiatric conditions including schizophrenia, major depressive disorder (MDD) and personality disorders are all known to be common co-morbidities (meaning they occur at the same time) with alcohol use disorder.
How is Alcohol Use Disorder Diagnosed?
Alcohol use disorder can be diagnosed by healthcare professionals and if you are worried about your drinking, your first stop will often be your GP. They may use the Alcohol Use Disorders Identification Test (AUDIT), a widely used screening test that has been developed by the World Health Organisation (WHO) and modified for use in the UK. It asks a number of questions about your alcohol consumption and habits and can help determine if you have a problem with alcohol.
Treatment Options for Alcohol Addiction
When it comes to treatment for alcoholism, there are a number of options available. Counselling can help people to explore the root causes of their drinking and change the way they think and behave around alcohol. This may be available through support groups, local drug and alcohol services or comprehensive recovery programmes in private alcohol rehab.
People who are physically and psychologically dependent on alcohol may need detoxification, with monitoring, support and medication to help with withdrawal symptoms. The most common medicine for this is chlordiazepoxide (Librium). Medicine can also help to reduce cravings for alcohol, with the most commonly used for this being acamprosate and naltrexone.
Tips for Reducing Alcohol Use
If you are looking at reducing alcohol consumption, there are a number of things you can try. It can help to set a plan and a budget for any drinking you do, with drink-free days throughout the week. Swap to smaller sizes and lower-strength drinks. Let supportive friends and family know that you are trying to cut down and ask them not to encourage you to drink. If you are having trouble with any or all of these things, you might want to consider seeking further help – call us today on 0800 470 0382.