Am I An Alcoholic?

Am I an alcoholic?  If you are seriously asking this question, the reality is that, at the very least, you will have a problem with drinking. Alcohol addiction, also known as alcoholism, is an Alcohol Use Disorder (AUD) and is a world apart from drinking heavily on occasion. You can even be mildly alcohol dependent but not necessarily be an alcoholic.

Here we look at the characteristics, signs and symptoms that define alcoholism as a chronic alcohol use disorder, the possible implications of being a sufferer and how you can get help if you are an alcoholic.

What Makes You an Alcoholic?

An alcoholic is someone who suffers from alcohol addiction/alcoholism, which is a chronic and progressive disorder of the brain. Alcoholism is characterised by a preoccupation with alcohol, excessive drinking, frequent loss of control of the amount of alcohol consumed and the continuation of drinking despite mounting negative consequences.

As a medically recognised disorder, there are various stages of alcoholism. At best, a person can still function, hold down a job and maintain some form of relations with their family (functioning alcoholic). At worst, being an alcoholic can be debilitating, all-consuming and life-threatening.

Alcoholism classed, as a substance abuse disorder in the Diagnostic and Statistical Manual of Mental Health Disorders (DSM-5), is clinically considered both a physical disease (of the brain) and a mental health disorder. Someone who has a drinking problem suffers from an overwhelming compulsion to drink alcohol and has very little control over their intake and actions while intoxicated.

Once sober, an alcoholic will still find it very difficult to control their impulsiveness around alcohol, and this is why alcoholism is also characterised by repeated relapse.

How Do I Tell If I Am an Alcoholic?

To be diagnosed with an alcoholic, you would need to meet at least two of the following clinical criteria within the same 12 month period: (1)

• Drinking more alcohol or for longer than you intended
• Being unable to reduce, moderate or stop alcohol despite a desire to do so.
• Spending a lot of time obtaining, using, and recovering from the effects of alcohol.
• You have cravings or a strong overwhelming desire for alcohol.
• Being unable to fulfil important obligations and commitments at home, work or school because of alcohol consumption
• Continuing to abuse alcohol despite negative consequences to your social, personal and work life.
• Losing interest in recreational activities or hobbies because of alcohol
• Using alcohol in physically dangerous situations (such as driving or operating machinery).
• Continuing to abuse alcohol despite the presence of harm to your physical or mental wellbeing.
• Developing a tolerance to alcohol (i.e. needing to drink increasingly large or more frequent amounts to achieve the desired effect).
• Developing symptoms of alcohol withdrawal when efforts are made to stop drinking.

Rehab guide can further simplify these criteria to:

1. Once you start drinking you lose control of the amount you drink and the consequences that follow
2. When you are trying not to drink, the obsession (constant thinking or overwhelming desire) to drink always take you back to alcohol
3. You suffer negative consequences as a direct result of your drinking yet are still unable to stop or moderate your intake

Identifying with these statements indicates that you are probably an alcoholic and should seek a professional diagnosis and help for your condition. The earlier alcoholism is treated, the less harm is endured by the sufferer and inflicted on their loved ones.

What Being an Alcoholic Means

If you are an alcoholic, you have two choices:

1. Continue drinking, sustaining more damage to your mental and physical health, personal relationships, finances and social life. In which case, alcoholism will lead to an early death
2. Seek help and treatment for alcoholism so that you can get and stay sober and rebuild your life

Being an alcoholic does mean that you suffer from a lifetime health condition and disorder of the brain. However, being an alcoholic is not your fault; neither is it a choice. What you do have a choice in is whether you access treatment or not.

Alcoholism can be successfully treated using a combination of evidence-based medical and therapeutic treatments.

Does Being an Alcoholic Mean I have To Stop Drinking Forever?

If you are an alcoholic, then complete abstinence is the only proven way to maintain recovery from this disorder.

Studies conducted on the brain chemistry of drug addicts and alcoholics found that for such people who are affected by addiction, their brain releases high amounts of dopamine in response to consuming alcohol or a drug. Dopamine is a neurotransmitter that regulates the brain’s reward centre and emotional responses to a stimulus (3)

In alcoholics and drug addicts, the effect of drugs and alcohol is so great that the brain re-prioritises what is most important. In a person who isn’t affected by addiction, their priority’s will be food, shelter and survival. An individual affected by addiction, alcohol or drugs is placed above these by the brain.

Dr George Koob, director of NIH’s National Institute on Alcohol Abuse and Alcoholism, said. “The brain changes with addiction, and it takes a good deal of work to get it back to its normal state. The more drugs or alcohol you’ve taken, the more disruptive it is to the brain.” (2)

As a chronic disorder of the brain, alcoholism cannot be cured, but it can be successfully treated, and abstinence can then be maintained.

A period of sobriety will do little to repair the damage caused by alcohol to the brain’s prefrontal cortex. Even if you stop drinking alcohol, damage caused to the brain’s pleasure/reward system will not be repaired. For an alcoholic, taking a drink after sobriety means reactivating the brain’s memory and dopamine response. Unfortunately, more often than not, they quickly find themselves right back where they left their drinking and worse.

For an alcoholic, life without alcohol can be unfathomable, just as going without food or water is to a person with a healthy brain. This is why treatment and relapse prevention is so important. Alcohol literally hijacks an alcoholic brain. (3)

Will I Always Be an Alcoholic?

There is a well known saying in Alcoholics Anonymous “Once alcoholic, always alcoholic”. (5)Like a person with Type 1 diabetes, even though their condition can be effectively managed through daily treatment, they have diabetes does not change. The same applies to alcoholism. For an alcoholic to manage their condition and the symptoms to be kept at bay, the sufferer must abstain from alcohol daily and undergo extensive behavioural therapy. (4)

Recovery Rates For Alcoholics

Sadly, relapse rates for alcoholics are high. It is estimated by the National Institute on Drug Abuse (NIDA) that 40-60% of individuals who suffer from an addiction problem relapse. While relapse doesn’t need to be the end of the world providing the individual can quickly access support and treatment.

Substance misuse disorders have a similar relapse rate to that of other chronic health conditions such as Asthma, Hypertension (high blood pressure) and Diabetes Type 1 (4)

Source: NIDA

You can reduce your chances of an alcoholic relapse by undergoing an alcohol detox and alcohol treatment programme, one that treats you as a whole person and is tailored to your individual treatment needs.

Life Without Alcohol

If you are an alcoholic and not in recovery, chances are you cannot imagine a life without alcohol in it. That’s because alcohol to an alcoholic IS their life.

Some alcoholics manage to get sober but do nothing else to change their behaviours. This can lead to a very painful existence with an extremely high chance of relapse – also referred to as being a dry drunk.

For an alcoholic to remain sober on a long term permanent basis, recovery and life have to have meaning and be enjoyable.

If you are currently drinking and suffer from alcohol withdrawal symptoms when you do not drink, then you will need to undergo an alcohol detox to ensure you can stop drinking safely and successfully.

Once sober, it is medically recommended that an alcoholic undergoes rehabilitation. For you, this could mean a stay in residential alcohol rehab or accessing support through your local community alcohol services and GP.

Behavioural-based therapies have been proven to help individuals recover from alcoholism as have behaviour modification programmes. However, the key to living sober is learning and taking on new ways of thinking and actions conducive to recovery.

Asking For Help

If you can identify yourself as an alcoholic, you must ask for help. Alcoholism only ever gets progressively worse over time without treatment. With treatment, you can live a life free from alcohol and become the person you have always wanted to be and know in your heart that you can be.

You will need to – Accept that you suffer from an illness that is not going to go away magically. Accept that you will need help to overcome your dysfunctional relationship with alcohol. Accept you cannot beat alcoholism with the same brain that manifests the condition.

If you would like to discuss your condition in confidence and receive free advice on what steps you can take to get well, Rehab Guide is here to help. Call us now on 02072052845 to find out more about our alcohol detox and rehabilitation treatment programmes. You can recover from alcoholism, and it starts with asking for professional help.

Sources and references:

1.  American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). American Psychiatric Publishing; 490-491.
2. https://newsinhealth.nih.gov/2015/10/biology-addiction
3. https://www.health.harvard.edu/newsletter_article/how-addiction-hijacks-the-brain
4. https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery
5. Alcoholics Anonymous Big Book