Warning Signs of Alcoholism
Because alcohol is considered socially acceptable to consume at a legal age, it can be easy to regard all drinking as harmless. Joking about overconsumption is common, and the line between moderate consumption and problem drinking can be quickly blurred. This can make it challenging to recognize the real signs of alcohol abuse in your own life or in that of a loved one’s.
However, detecting the signs early may help you avoid developing this chronic condition or allow you to identify someone in your life who may benefit from alcohol addiction treatment.
What Are Standard Drinking Levels?
Before diving deeper into the warning signs of alcoholism, it can be helpful to clarify the measure of a standard drink. In people who are of legal age to drink alcohol, up to 1 drink daily for women or up to 2 drinks daily for men is considered moderate drinking according to the U.S. Department of Health and Human Services and U.S. Department of Agriculture’s jointly issued 2015-2020 Dietary Guidelines for Americans.1
The National Institute on Alcohol Abuse and Alcoholism considers the following amounts of alcohol equal to one standard drink in the U.S.:2,3
- 12 ounces of beer (5% alcohol).
- 5 ounces of wine (12% alcohol).
- 1.5 ounces of liquor (40% alcohol).
Further, binge drinking involves consuming a large amount of alcohol in a short period.1,4 It is considered binge drinking when a woman has 4 or more drinks, and a man has 5 or more drinks, in approximately 2 hours.1,4 Heavy alcohol use involves consuming more than 3 drinks daily for women and more than 4 drinks daily for men, or binge drinking at least 5 times in a month. 1,4
Binge and heavy drinking can raise the likelihood of developing an alcohol use disorder (AUD); however, a person doesn’t have to drink heavily to develop an AUD.1,3,4
Warning Signs of Alcohol Use Disorder
Based on the Diagnostic and Statistical Manual of Mental Disorder (DSM-5), to be diagnosed with an alcohol use disorder (AUD), a person must display at least two of 11 outlined criteria within a 12-month period.5,6 When examining your own drinking habits, ask yourself the following:5,6,7
- Do you have strong urges or cravings to drink alcohol?
- Do you have an inability to stop drinking even after it has caused problems in relationships with family members, friends, or loved ones?
- Are you unable to cut back or stop drinking alcohol, even if you really want to?
- Do you consistently struggle to complete responsibilities at home, school, or work due to alcohol?
- Have you continued to drink after it has caused or worsened a physical or psychiatric health issue?
- Have you cut back on or quit enjoyable hobbies or activities due to alcohol use?
- Have you developed a tolerance to alcohol so that the usual amount has less of an effect on you?
- Do you have difficulty controlling how much alcohol you consume or the length of time you spend drinking?
- Do you repeatedly drink alcohol in situations that are physically dangerous, such as while driving?
- Do you spend a significant amount of time getting alcohol, drinking it, or dealing with its negative effects (e.g., hangovers)?
- Are you experiencing symptoms of withdrawal when alcohol use is stopped? These symptoms can include sleep difficulties, tremors, nausea, vomiting, sweating, and/or hallucinations.
The number of criteria that are met indicate how severe the disorder is, with 2 to 3 indicating mild AUD, 4 to 5 indicating moderate AUD, and 6 or more symptoms indicating severe AUD.6,7 Keep in mind that although you may meet these criteria, only a psychiatrist or mental healthcare provider can screen and officially diagnose an AUD.
Tips to Cut Down on Drinking
If you are concerned that your drinking is problematic or is causing negative consequences, you may want to reduce your alcohol use. Drinking less may have a positive impact on your physical and mental health, improve your relationships with others, and lower your risk of developing AUD.8
There are many different tips for cutting down on drinking, but not all of these methods will help every individual. It is important to experiment and figure out which techniques work for you. Some ideas for reducing alcohol intake include:8,9
- Be aware of how much you are drinking. Keeping a tally of how many drinks you are consuming can illustrate how much you are consuming daily and weekly. It is important to be aware of the size of your drinks. For example, you may fill a glass of wine to the top and consider that to be 1 drink, but it could be more than a standard drink, depending on the size of the glass.
- Create a budget. The cost of alcohol can add up, especially if you often go out drinking. Set aside a specific dollar amount that you can spend on alcohol and stick to it. If you plan to go out, you may want to bring a limited amount of cash with you instead of a credit or debit card.
- State your intentions. You may want to drink only on certain days of the week and have a specific number of drinks on those days. It could be a good idea to set aside non-drinking days. Let your family and friends know what you are trying to do. They can offer you support in cutting back.
- Take baby steps. Scaling back your drinking a little at a time can be more attainable than cutting back a lot all at once. Setting one large goal can be discouraging. It’s often easier to reach several small goals.
- Identify hobbies that don’t involve alcohol. This is an especially helpful tip for people who have lost touch with activities that don’t involve drinking. Hiking, biking, or other exercise with friends, cooking, learning a new skill, or engaging in activities that you used to enjoy can help to occupy your time.
- Identify and manage your triggers. Stay away from certain people, places, or things that increase your desire to drink alcohol. Develop a plan to handle triggers that you can’t avoid. Social support, activities to keep you distracted, and an awareness of why you want to cut back on drinking can help you manage cravings. Finally, remind yourself that all urges do pass.
- Practice saying no. Alcohol is present in a variety of situations, and you may be presented with a drink when you don’t plan on drinking. With practice, you can become comfortable saying no right away in any situation when you don’t want to accept a drink.
While these are good places to start to cut back on drinking, not everyone will be successful in doing so. If you experience symptoms of withdrawal when not drinking or haven’t been able to cut back at all after several months, you may want to consider quitting alcohol completely.8 In these cases, seeking formal treatment can be an important step in quitting alcohol.
Ways to Get Sober
If you have tried to quit drinking and have been unsuccessful, it may be time to seek professional care. Alcohol addiction treatment involves a variety of techniques that can be used to help people work toward recovery and maintain long-term sobriety. These include:
- Detox. A supervised, medical detox is typically the starting place prior to beginning formal addiction treatment. Medical detox can help people avoid unnecessary discomfort or life-threatening complications when experiencing alcohol withdrawal. Some symptoms of withdrawal are uncomfortable while others are potentially fatal (such as seizures).3,10 Facilities provide medical supervision around the clock and medications to ensure your safety through the detox process.3,10
- Inpatient or outpatient treatment. Depending on the level of care you need, treatment may involve an inpatient or outpatient setting. Inpatient treatment involves staying at a facility for the duration of treatment and receiving 24/7 supervision and access to on-call medical staff. Outpatient treatment is less intensive than inpatient treatment and allows individuals to return home each day following recovery programming.11 Treatment lengths vary but regardless of setting, all will involve a mix of intensive counseling, behavioral therapies, medications to manage AUD, coping skills education, and often encourage self-help meeting attendance.11,12
- Behavioral therapies. Many types of therapy can be used to treat alcoholism. Some treatment facilities combine different methods for optimal effectiveness.13 Cognitive behavioral therapy, motivational enhancement therapy, and contingency management are commonly used techniques to help people get sober, identify and manage triggers and cravings, change negative behaviors, prevent relapse, and maintain their motivation to remain sober.5,10,13
- Counseling. Relationship and family counseling aim to strengthen family bonds through sessions with a spouse, partner, and other family members of the person in treatment.5 This can also help loved ones learn how to better support your recovery efforts.3
- Medications. Naltrexone, acamprosate, and disulfiram are all FDA-approved medications for the treatment of AUD.13 They aren’t addictive and can be combined with counseling and self-help meeting attendance.5,13
Does Alcoholism Treatment Work?
A variety of factors can influence how effective treatment for alcohol use disorder is, such as the severity of the diagnosis, the person’s level of motivation, the type of treatment received, types of available support, and if they have physical or psychiatric health issues in addition to an AUD.10
Studies show that approximately 33% of people who have received treatment for alcoholism show no symptoms a year after treatment.5 Even more showed significant improvement in symptoms, with follow-ups showing that up to half of people who received alcoholism treatment were able to maintain sobriety after 3 years.5,14
Studies show that treatment helps people maintain sobriety long-term as well; more than 57% of people who remained sober after 3 years continued to maintain sobriety after 16 years.14 Even if a relapse does happen, many people can reduce their drinking markedly or quit completely with additional treatment and the proper supports.15
Get Help Now
If you’re ready to seek treatment for alcoholism or would like to learn more about your options, American Addiction Centers (AAC) can help. AAC is a nationwide provider of addiction treatment centers and is dedicated to making recovery accessible to everyone in need.
As operator of AlcoholRehab.org, AAC offers a toll-free hotline so that you may speak with our admissions navigators any time of day and learn more about our approach to alcoholism treatment. With locations across the country, we’re able to provide a number of unique settings as your backdrop for recovery and are equipped to treat co-occurring disorders via an integrated approach to treatment.
If you’d like to learn more about your treatment options, facility locations and/or what treatment may involve, call us today. All calls are 100% confidential and there’s no pressure to make a decision right away. We’re here for you and are excited to discuss your path to recovery with you.
. National Institute on Alcohol Abuse and Alcoholism. (n.d.). Drinking levels defined.
. National Institute on Alcohol Abuse and Alcoholism. (n.d.). What’s a “standard” drink?
. American Psychological Association. (2018). Understanding alcohol use disorders and their treatment.
. National Institute on Alcohol Abuse and Alcoholism. (n.d.). What are the different drinking levels?
. National Institute on Alcohol Abuse and Alcoholism. (2014). Treatment for alcohol problems: Finding and getting help.
. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Publishing.
. National Institute on Alcohol Abuse and Alcoholism. (n.d.). Alcohol use disorder.
. National Institute on Alcohol Abuse and Alcoholism. (n.d.). Tips to try.
. National Health Service. (2018). Tips on cutting down.
. National Institute on Drug Abuse. (2018). Principles of drug addiction treatment: A research-based guide (Third edition).
. National Institute on Drug Abuse. (2018). Types of Treatment Programs.
. National Institute on Drug Abuse. (2018). Principles of Effective Treatment.
. National Institute on Alcohol Abuse and Alcoholism. (n.d.). Professional help.
. Moos, R.H., & Moos, B.S. (2006). Rates and predictors of relapse after natural and treated remission from alcohol use disorders. Addiction, 101(2), 212-222.
. National Institute on Alcohol Abuse and Alcoholism. (n.d.). Choose your approach.