For many people, drinking alcohol is nothing more than a pleasant way to relax. However, people with alcohol use disorders drink to excess, endangering both themselves and others. This question-and-answer fact sheet explains alcohol problems and how psychologists can help people recover.
When does drinking become a problem?
For most adults, moderate alcohol use — no more than two drinks a day for men and one for women and older people — is relatively harmless. (A “drink” means 1.5 ounces of spirits, 5 ounces of wine, or 12 ounces of beer, all of which contain 0.5 ounces of alcohol.)
Moderate use, however, lies at one end of a range that moves through alcohol abuse to alcohol dependence:
- 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.
- People with alcoholism — technically known as alcohol dependence — have lost reliable control of their alcohol use. It doesn’t matter what kind of alcohol someone drinks or even how much: alcohol-dependent people are often unable to stop drinking once they start. Alcohol dependence is characterized by tolerance (the need to drink more to achieve the same “high”) and withdrawal symptoms if drinking is suddenly stopped. Withdrawal symptoms may include nausea, sweating, restlessness, irritability, tremors, hallucinations, and convulsions.
Although severe alcohol problems get the most public attention, even mild to moderate problems cause substantial damage to individuals, their families, and the community.
According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), 1 in 13 American adults is an alcohol abuser or alcoholic at any given time. A 1997 government survey revealed that drinking problems are also common among younger Americans. For example, almost 5 million youths aged 12 to 20 engage in binge drinking, which involves females consuming at least four drinks on a single occasion and males at least five.
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. For some alcohol abusers, psychological traits such as impulsiveness, low self-esteem, and a need for approval prompt inappropriate drinking. Some individuals drink to cope with or “medicate” emotional problems. Social and environmental factors such as peer pressure and the easy availability of alcohol can play key roles. Poverty and physical or sexual abuse increase the odds of developing alcohol dependence.
Genetic factors make some people especially vulnerable to alcohol dependence. Contrary to myth, being able to “hold your liquor” means you’re probably more at risk–not less–for alcohol problems. Yet a family history of alcohol problems doesn’t mean that the children of those with alcohol problems will automatically grow up to have the same problems–nor does the absence of family drinking problems necessarily protect children from developing these problems.
Once people begin drinking excessively, the problem can perpetuate itself. Heavy drinking can cause physiological changes that make more drinking the only way to avoid discomfort. Individuals with alcohol dependence may drink partly to reduce or avoid withdrawal symptoms.
How do alcohol problems affect people?
While some research suggests that small amounts of alcohol may have beneficial cardiovascular effects, there is widespread agreement that heavier drinking can lead to health problems. In fact, 100,000 Americans die from alcohol-related causes each year. 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. Although men are much more likely than women to develop alcoholism, women’s health suffers more, even at lower levels of consumption.
Drinking problems also have a very negative impact on mental health. Alcohol abuse and alcoholism can worsen existing conditions such as depression or induce new problems such as serious memory loss, depression, or anxiety.
Alcohol problems don’t just hurt the drinker. According to NIAAA, more than half of Americans have at least one close relative with a drinking problem. Spouses and children of heavy drinkers are more likely to face family violence; children are more likely to suffer physical and sexual abuse and neglect and to develop psychological problems. Women who drink during pregnancy run a serious risk of damaging their fetuses. Relatives and friends can be killed or injured in alcohol-related accidents and assaults.