Alcoholism, or AUD (Alcohol Abuse Disorder)

One of the most common disorders that can be known to create health issues, break up families, and all around disrupt someone’s life is as known as Alcoholism, or AUD (Alcohol Abuse Disorder). Alcoholism is an intense form of alcohol addiction in which an individual is unable to control their consumption and desire of alcohol. People who struggle with alcohol addiction also may begin to feel as if they cannot go about their daily lives without drinking to feel fulfilled.

They may feel the desire to drink more, are not aware of their drinking limit, and allow the alcohol consumption to interfere with their daily lives. There can be many reasons as to why someone may want a drink; they may want to relieve stress or have fun at a social event, but for alcoholics it can become much deeper than that. Carol Galbicsek from the organization Alcohol Rehab Guide explains alcoholism when she states, “Individuals struggling with alcoholism often feel as though they cannot function normally without alcohol. This can lead to a wide range of issues and impact professional goals, personal matters, relationships and overall health. Over time, the serious side effects of consistent alcohol abuse can worsen and produce damaging complications” (Galbicsek, 2018). Intense cases of AUD can also include, “more than once wanted to cut down or stop drinking but couldn’t, continuing to drink although it causes trouble with family or friends, giving up on activities that were important or interesting, more than once gotten into situations while or after drinking that increased chances of getting hurt, and continuing to drink even though it was [making one] feel depressed or anxious or adding to another health problem” (Alcohol Use Disorder).

The concept of alcohol addiction is something that has become heavily spoken about in the nineteenth century, but has been an illness to people for many years before that. In 1784, a man named Benjamin Rush was the first to claim that individuals could have an alcohol addiction. He described alcohol addiction as an “uncontrollable, overwhelming and irresistible desire to consume alcohol (Mann, Hermann, Heinz, 2000). Delirium tremens, or, alcohol withdrawal, was then acknowledged by Sutton and Pearson in 1813. The alcohol withdrawal is where the symptoms of alcohol addiction truly began. In the article, One Hundred Years of Alcoholism: The Twentieth Century, it’s stated that, “It was in the wake of the failure of prohibition that the current concept of alcoholism was formed, and the worldwide shock about the cruelty and inhumanity of Nazi politics may have promoted the modern disease concept with its focus on individual therapy and its emphasis that alcohol addiction is a disease just like any other physical or mental malady” (Man Hermann, Heinz, 2000). Finally alcoholism begins to be known as a disorder or illness as explained, “In Germany, the modern disease concept of alcoholism was promoted by Feuerlein (1967, 1996) and others who emphasized that alcohol-dependent patients should have the same entitlement to medical treatment as other patients. It was not until 1968 that a German federal court formally confirmed full insurance coverage of alcoholism-related medical treatment costs, although alcoholism had already been considered a disease since 1915” (Mann, Hermann, Heinz, 2000).

In 2018 the Talbot Recovery Program listed statistics that state, “More than 15 million people struggle with an alcohol use disorder in the United States, but less than eight percent of those receive treatment” (2018 Alcoholism Statistics You Need to Know, 2018). Not only are many people experiencing the struggles of this disorder, but they may also be getting worse due to lack of treatment. This is a large number of people who struggle with AUD and it may only be increasing.

People should to learn about and try to understand that alcohol addiction is an incredibly difficult disorder to deal with. Stigmas on alcoholism tend to paint a bad picture of the addict, instead of pointing out that there is an individual who is in need of help. Although in alcoholism it is commonly believed that maintaining abstinence is the only solution, time and dedication may ensure that forms of group and behavioral therapy are incredibly effective treatments

There are a copious amount of factors that can contribute to an individual resulting in alcoholism. The American Psychological Association explains this when they state, “Problem drinking has multiple causes, with genetic, physiological, psychological, and social factors all playing a role” (Understanding Alcohol Use Disorders and Their Treatment, 2019). Of course, as we grow into adulthood, we are capable of making our own decisions. We have learned and had experiences which should have made us able to make choices that are beneficial for ourselves. However, sometimes life can become so difficult at times that alcohol may be the only solution for people that obtain one or more of the causes of alcoholism.

Environmental factors can include going out with a group of friends who may peer pressure you to drink with them and/or having a lot of alcohol available at home to drink. It has been explained by Carol Galbicsek from Alcohol Rehab Guide that living close to retail stores that sale alcohol can also lead to alcoholism, as stated, “In recent years, studies have explored a possible connection between your environment and risk of AUD. For example, many researchers have examined whether or not a person’s proximity to alcohol retail stores or bars affect their chances of alcoholism. People who live closer to alcohol establishments are said to have a more positive outlook on drinking and are more likely to participate in the activity” (Galbicsek,2018).

Psychological factors are also important factors that play a role in many alcoholism cases, if not all of them. High stress, depression, anxiety, and bipolar disorder are examples of the psychological factors that can play a role in Alcohol Use Disorder. When an individual experiences depression, it’s very complicated for them to help to cope with their emotions or their pain, so they turn to alcohol for help. Alcohol can serve to be a temporary relief, but as soon as the feeling wears off, they begin to feel the pain again. The depressed person can then continue to rely on the alcohol to numb the pain, which will result in drinking more and more alcohol. This where the nonstop cycle of drinking begins and the presence of addiction. Stressful environment can influence drinking alcohol, as alcohol (for most people) helps to calm the nerves and reduce anxiety. People who may be in school taking difficult classes, who are working long hours at strenuous jobs, who are struggling with money, or face stressful demands and expectations from their family are all people who may be susceptible to alcoholism. All of these people may experience high levels of stress and/or anxiety and conclude to drinking alcohol as a way to temporarily be relieved of their strong emotions.

Lastly, a significant probable cause for Alcohol Use Disorder includes genetics or a family history of someone with AUD. A family history of someone with Alcohol Use Disorder is the first characteristic that can increase one’s risk of alcoholism. This may either mean that there is an addictive trait that someone has inherited from one of their parents, or that they have been raised by a parent who heavily drank alcohol. The physiological connection that separates people who can stop drinking and people who feel the need to keep going. Galbicsek explains this when she states, “While some individuals can limit the amount of alcohol they consume, others feel a strong impulse to keep going. For some, alcohol gives off feelings of pleasure, encouraging the brain to repeat the behavior... There are also certain chemicals in the brain that can make you more susceptible to alcohol abuse. For instance, scientists have indicated that alcohol dependence may be associated with up to 51 genes in various chromosome regions. If these genes are passed down through generations, family members are much more prone to developing drinking problems”, (Galbicsek, 2018).

In many cases, alcoholism has been known to be passed down in the family. If a parent has had issues with the abuse of alcohol substance, then there is a probably chance that the child will inherit the same alcohol addiction. There is not a specific gene that is passed down that can cause alcoholism, however, there is a genetic link in which can be passed down through behavioral traits. Of course this does not mean that everyone who grows up with an alcoholic parent will also become an alcoholic, it only implies that it is more probable for them to become one based on behavioral traits that may be passed down from parent to child. The American Addiction Sources Resource explains that, “Having a family member with a diagnosis of a substance use disorder increases the risk that one will be diagnosed with an alcohol use disorder (or any substance use disorder). The closer the relation, the greater the risk. For instance, having a first-degree relative like a parent or sibling who has a diagnosis of an alcohol use disorder is a more salient risk factor than having a more distant relative, such as a cousin, diagnosed with the disorder” (What Are the Causes of Alcoholism & Alcohol Abuse,2018).

The Addiction Center states that, “Genetic makeup only accounts for half of the alcoholic equation. There are also countless environmental factors (work, stress, relationships) that may lead to alcoholism” (Alcohol Addiction and Genetics, 2018). With the probability of inheriting alcohol addiction from a parent, most people would believe that there is a specific genetic trait that is passed down onto the next generation. However, there is not. There is not a specific genetic trait passed down that necessarily refers to alcoholism, but there are behavioral traits or addictive traits that may be passed down and inherited. There are many personality characteristics that may heighten the risk of becoming addicted to alcohol. Galbicsek mentions that, “… scientists have indicated that alcohol dependence may be associated with up to 51 genes in various chromosome regions. If these genes are passed down through generations, family members are much more prone to developing drinking problems” (Galbicsek, 2018).

As previously mentioned, if you grew up around family members who struggled with alcohol addiction, then you are more susceptible to suffer with Alcohol Use Disorder. We have begun to understand that there are characteristic traits that may be passed down through genetics that make people more susceptible to the addiction of alcohol. Family history that includes childhood abuse and mental illness also creates the probability for AUD. If a child is raised in a home where a lot of domestic violence occurs or if they are raised by parents who suffer with substance abuse, they are likely to begin drinking alcohol and become addicted. Growing up around someone who drinks substantial amount of alcohol can de-stigmatize it to the point where the individual may start drinking it themselves very often.

Experimenting with alcohol at a young age may increase the risk of a person becoming addicted. If an individual begins to regularly drink alcohol then they will develop a high tolerance for it. Over time it will take much more of the alcohol to get them “buzzed” or drunk. Alcohol Rehab Guide implies this when they state, “Experimenting with alcohol at a young age can lead to problems later on in life, especially in your 20s and 30s. This is especially true when adolescents engage in frequent binge drinking. While drinking early on can increase the likelihood of alcohol abuse, alcoholism can affect anyone at any age” (Galbicsek, 2018).

As statistics have demonstrated, men are more likely to develop an alcohol addiction than women are. 7.4% of males in the United States suffer with AUD, while 5.4% of women suffer from AUD. Alcohol.org demonstrates reasons that men are more susceptible to alcoholism when they state, “Men develop alcohol dependency at a much greater rate than women do. In fact, up to half all men in American have alcohol-related problems of one form or another. The reasons for this profound difference aren't entirely clear. One theory holds that men have a naturally greater tendency to take risks. This leads to more experimentation with drugs and alcohol during youth. For some men, this experimentation evolves into full-blown addiction. Another possibility is that men’s higher tolerance to alcohol lead to generally more consumption, and that even a little more consumption heightens the risk of becoming dependent” (Specific Groups More Likely to Have a Drinking Problem, 2018).

Any person who experiences high levels of stress is more probable to rely on alcohol as a stress relief. Anxiety is a mental illness in which a person is unable to control the stress or apprehension that they may feel. Many of the time, alcohol is used to de-stress and to relax, these reasons being beneficial to someone who suffers with anxiety. American Addiction Centers Resource gives an explanation: “Alcohol and some anti-anxiety medications act on the GABA receptors in the brain, calming rapid firing between neurons and allowing the individual to relax. The medications that offer this benefit, like benzodiazepines, are only prescribed for as-needed or short-term use because they can become addictive. When a person who struggles with anxiety disorder begins drinking and experiences this calmness, they may begin abusing alcohol to feel more relaxed. All forms of anxiety disorder, including panic disorder, post-traumatic stress disorder, and social anxiety disorder, increase the likelihood of developing AUD as a reaction to untreated anxiety. Additionally, people who stop drinking may experience panic and insomnia as withdrawal symptoms” (Treating Alcoholism and Co-Occurring Disorders, 2018).

Individuals who experience depression are very likely to drink alcohol in order to help with their emotions, and this can only result in AUD. A person who is depressed may be drinking alcohol to numb their pain or to have fun rather than feeling their pain. As soon as the alcohol wears off, they begin to feel their sadness or their pain so they may often drink more and more of the alcohol. Drinking more of the alcohol to help with their unwanted emotions can then lead to an addiction. The American Addiction Centers Resource explains the relation between depression and alcoholism when they state, “Close to one-third of people who have major depression exhibit signs of problem drinking. Typically, depression appears first; then, the individual will begin drinking to experience pleasure, feel less guilty or sad, or improve their self-esteem. These effects from alcohol may occur for a short time, but they do not last. Since alcohol is a depressant, people who drink too much are more likely to make their depression worse” (Treating Alcoholism and Co-Occurring Disorders, 2018). People who have bipolar disorder may also become addicted to alcohol due to the same factors that someone with depression might (as people with bipolar disorder often face the same depressive emotions as someone suffering with depression).

There are an incredible amount of treatments to help with AUD. Some of these treatments include: detoxing, attending Alcoholics Anonymous meetings, attending group therapy, visiting your healthcare professional, visiting a psychologist, medication, and attending recovery program. While there are many types of treatments to help with Alcohol Use Disorder, few have demonstrated to be more effective. Behavioral therapy and group therapy are forms of treatment that have shown to be most effective. Alcoholics Anonymous meetings, getting committed into recovery programs, and seeking counsel from a psychologist are examples of these types of therapy.

There are medications that are used to help treat alcoholism; some of these medications are known as Disulfiram, Acamprosate, and Naltrexone. These medications help in “managing the disorder, achieve recovery, and prevent relapse” (American Addiction Center, 2018). Although there are these designated medications to treat alcoholism, in many cases they have shown to not be as effective as other methods of treatment.

A great example of behavioral therapy would occur when an individual suffering with alcoholism makes regular visit to a psychologist. The psychologist will help the individual identify the cause of the drinking, learn different ways to cope with the issue, and “provide the skills and tools needed to achieve and prolong abstinence from alcohol” (American Addiction Center, 2018). Psychologists have many different useful techniques as mentioned by the American Psychological Association: “… psychologists can help people address psychological issues involved in their problem drinking. A number of these therapies, including cognitive-behavioral coping skills treatment and motivational enhancement therapy, were developed by psychologists. Additional therapies include 12-Step facilitation approaches that assist those with drinking problems in using self-help programs such as Alcoholics Anonymous (AA). These therapies can help people boost their motivation to stop drinking, identify circumstances that trigger drinking, learn new methods to cope with high-risk drinking situations, and develop social support systems within their own communities… One analysis of cognitive-behavioral approaches, for instance, found that 58 percent of patients receiving cognitive-behavioral treatment fared better than those in comparison groups… Many individuals with alcohol problems suffer from other mental health conditions, such as severe anxiety and depression, at the same time. Psychologists can also diagnose and treat these "co-occurring" psychological conditions. Further, a psychologist may play an important role in coordinating the services a drinker in treatment receives from various health professionals” ((Understanding Alcohol Use Disorders and Their Treatment, 2019).

Group therapy can also be incredibly beneficial when it involves other alcoholics and their experiences, or when it involves the individual’s family and/or loved ones. Examples of how group therapy has been beneficial to the treatment of alcoholism is demonstrated by the American Psychological Association when stated, “Psychologists can also provide marital, family, and group therapies, which often are helpful for repairing interpersonal relationships and for resolving problem drinking over the long term. Family relationships influence drinking behavior, and these relationships often change during an individual's recovery. The psychologist can help the drinker and significant others navigate these complex transitions, help families understand problem drinking and learn how to support family members in recovery…” (Understanding Alcohol Use Disorders and Their Treatment, 2019).

If we know someone who we may think is suffering with an alcohol addiction, we should reach out and help them. Alcohol Use Disorder is not a choice that one decides to have; it is a difficult disorder that someone experiences and suffers with. It is not impossible to treat or help someone who is experiencing alcohol addiction, so we must reach out to our loved ones and help them take the steps to recovery.

References

1. “Understanding Alcohol Use Disorders and Their Treatment.” American Psychological Association, American Psychological Association, 2018, www.apa.org/helpcenter/alcohol-disorders.
2. “2018 Alcoholism Statistics You Need to Know.” Talbott Recovery, 23 Feb. 2019, talbottcampus.com/alcoholism-statistics/.
3. Galbicsek, Carol. “Alcoholism Causes and Risk Factors.” Alcohol Rehab Guide, Delphi Behavioral Health Group, 10 Dec. 2018, www.alcoholrehabguide.org/alcohol/causes/.
4. “Alcohol Use Disorder.” National Institute on Alcohol Abuse and Alcoholism, U.S. Department of Health and Human Services, www.niaaa.nih.gov/alcohol-health/overview-alcohol- consumption/alcohol-use-disorders
5. Mann, Karl, et al. “ONE HUNDRED YEARS OF ALCOHOLISM: THE TWENTIETH CENTURY.” OUP Academic, Oxford University Press, 1 Jan. 2000, academic.oup.com/alcalc/article/35/1/10/142396.
6. “Alcoholism Statistics & Information on Group Demographics.” Statistics & Information on Alcoholism & Addiction Treatment Help, Alcohol.org, 2018, www.alcohol.org/statistics-information/.
7. “Which Medications Can Help in the Fight to Treat Alcoholism?” Alcohol.org, An American Addiction Centers Resource, 2019, www.alcohol.org/alcoholism/treatment-medications/.
8. “Are Specific Groups of People More Likely to Have Drinking Problems?” Specific Groups More Likely to Have a Drinking Problem, Alcohol.org, 2018, www.alcohol.org/faq/who- is-most-prone-to-alcoholism/.
9. Galbicsek, Carol. “Treating Alcoholism.” Alcohol Rehab Guide, 2018, www.alcoholrehabguide.org/treatment/.
10. Crane, Marisa. “Is Alcoholism Hereditary or Genetic?” American Addiction Centers, American Addiction Center, 2019, americanaddictioncenters.org/alcoholism-treatment/symptoms- and-signs/hereditary-or-genetic.
11. “How to Treat Alcoholism While Addressing Co-Occurring Disorders.” Alcohol.org, An American Addiction Centers Resource, 2018, www.alcohol.org/co-occurring-disorder/.

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