Do You Have a Drinking Problem?
While it may be obvious to those around you, knowing (or admitting) you, in fact, have a drinking problem can feel like an overwhelming admission of failure. How did you go from the person who could enjoy a few drinks socially to reaching a point when you don’t know when or how to stop? Once alcohol use reaches a point of dependency, it’s what’s known as Alcohol Use Disorder (AUD), a brain disorder that can cause lasting changes if not stopped in its tracks.
According to a 2019 national survey by the Substance Abuse and Mental Health Services Administration (SAMHSA), 14.1 million adults ages 18 and older identified as having an alcohol use disorder (AUD). At its worst, too much alcohol can cause severe health problems, says psychotherapist Michael S. Levy, Ph.D. author of Take Control of Your Drinking. “These include high blood pressure, stroke, liver disease, heart disease, and digestive problems,” he says. “It can also impact learning and memory and cause poor judgement.”
While studies show there are several risk factors—namely, genetic, psychological, and environmental—for developing an AUD, the reality is, anyone can fall victim. Yet, the good news is that no matter how severe the problem, evidence-based treatment with behavioral therapy from a mental health professional, support groups, and potentially medication can help people with AUD achieve and maintain recovery. Admitting to yourself there’s a problem is an important step, say Dr. Levy. But first, you need to be aware of all the warning signs. Here, how to tell when it’s time to get help.
Your Tolerance Is Higher Than All Your Friends
The reality is, the more you drink, the more your body builds up a natural tolerance, which means you’ll require more alcohol to feel the effects. “Take an honest look at the number of drinks you consume each week,” says Steven L. Flamm, M.D., chief of the hepatology program and professor of medicine at Northwestern Feinberg School of Medicine. The National Institutes of Health (NIH) characterizes excessive drinking as binging four or more drinks at a time for women or five or more drinks for men within a few hours or consuming eight or more drinks a week for women or 14 or more drinks a week for men.
You Always Close Down the Bar
On any given night out, it’s anyone’s guess (especially yours) just how many cocktails you’ll order, or worse, what your behavior will be like once the alcohol takes hold. “For example, a person may decide to go out for a couple of drinks and instead stays out for many hours, drinks way too much, and doesn’t remember parts of the evening due to drinking too much (having a black out); and there is a pattern of this taking place,” Dr. Levy says.
You Need to Drink in the Morning
If you need to start your day with a glass of vino or can’t control your cravings to the point that you have to have a drink, chances are you might be alcohol-dependent, characterized by excessive drinking, continued use despite problems, and an inability to control consumption. Because there’s no food there to soak up morning alcohol, the alcohol passes from the stomach right into the small intestine, where it gets absorbed into the bloodstream, and the effects of drinking, such as impaired thinking and body movements, are intensified.
Bad Experiences Don't Deter You From Drinking
If you’ve suffered harmful consequences as a result of your alcohol consumption—a DUI, health problems, relationships issues, job-related problems, or are spending so much money on alcohol that financial problems occur—yet you still continue to drink, this could be a sign of an AUD, Dr. Levy says. “An AUD usually develops over time as a person engages in heavy and chronic drinking,” Dr. Flamm says. “This can ultimately lead to chemical changes in the brain that increase the pleasurable feelings obtained from drinking alcohol,” he says.
You Can’t Stop
If repeated attempts to quit drinking fail, this is likely a red flag for alcohol dependence. “Clinical signs of dependence include being unable to stop drinking despite wanting to stop along with repeated unsuccessful efforts to stop,” Dr. Levy says. Going “cold turkey” can be dangerous, though, especially for people who have developed a dependence, so getting help is key. An estimated 95,000 people die from alcohol-related causes annually, making alcohol the third-leading preventable cause of death in the United States, reports the CDC.
You Experience Withdrawal if You Skip a Drink
Withdrawal happens when a person who has been drinking too much alcohol suddenly stops drinking. According to the NIH, alcohol withdrawal symptoms usually occur within eight hours after the last drink but can occur days later. Symptoms usually peak by 24 to 72 hours but may go on for weeks. “Withdrawal can include anxiety and tremors, high blood pressure, seizures, rapid heart rate, increased sweating, delirium, nausea and vomiting, headache, inability to sleep, mental agitation and confusion, and auditory, visual, and tactile hallucinations,” Dr. Levy says.
You Are Not Alone
Reaching out for help is the best possible thing you could do for yourself—and those around you. “If you believe that you are drinking too much or that you may have a drinking problem it’s important to consult medical professionals to address both the behavioral and physical problems,” Dr. Flamm says. Start with your primary care physician who will often ask you a series of questions and run bloodwork to determine if alcohol consumption has impacted your body. Remember, the first step is the hardest. You got this.
Understanding the Risks for AUD: Frontiers in Neuroscience. (2018.) “The Risk Factors of the Alcohol Use Disorders—Through Review of Its Comorbidities.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5958183/
Signs of AUD: MedlinePlus. (n.d.) “Alcohol Use Disorder (AUD).” https://medlineplus.gov/alcoholusedisorderaud.html
All About AUD: The National Institute on Alcohol Abuse and Alcoholism (NIAAA). (2020.) “Understanding Alcohol Use Disorder.” https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/understanding-alcohol-use-disorder