For many people, drinking alcohol is a pleasant way to relax. However, many people struggle with controlling their drinking at some time in their lives. More than 14 million adults ages 18 and older have alcohol use disorder (AUD), and 1 in 10 children live in a home with a parent with a drinking problem.

For people with alcohol-use disorders, excessive drinking can endanger themselves and others. If you consume alcohol to cope with difficulties or to avoid feeling bad, you’re in potentially dangerous territory. Understanding the problem is the first step to overcoming it and either cutting back to healthy levels or quitting altogether.

What’s the difference between alcohol abuse and alcoholism?

Alcohol abuse is a drinking pattern that results in significant and recurrent adverse consequences. Alcohol abusers may fail to fulfill 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. 

Alcoholism, on the other hand, means people have lost reliable control of their alcohol use. Alcohol-dependent people are often unable to stop drinking once they start.  

What is moderate use?

For most adults, moderate alcohol use is relatively harmless. “Moderate” means no more than two drinks a day for men and one for women and older adults. 

(Note: A “drink” is 1.5 ounces of spirits, 5 ounces of wine, or 12 ounces of beer).

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. These causes include:

• Psychological traits such as impulsiveness, low self-esteem and a need for approval
• Drinking to self-medicate emotional problems
• Peer pressure and socializing regularly with heavy drinkers
• Genetic factors

What are some of the issues caused by problematic alcohol use?

Heavy drinking can lead to health, relationship, workplace and related problems.

• 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.
• Alcohol abuse and alcoholism can worsen existing conditions such as depression or induce new problems such as serious memory loss, depression or anxiety, and drunk and disorderly conduct.
• Spouses and children of heavy drinkers may face family violence.
• Children may suffer physical and sexual abuse and develop psychological problems.
• Women who drink during pregnancy run a serious risk of damaging their fetuses.
• Relatives, friends, and strangers can be injured or killed in alcohol-related accidents and assaults.

The problem of denial.

Denial is one of the biggest obstacles to getting help for alcohol abuse and alcoholism. The desire to drink is so strong that the mind finds many ways to rationalize drinking, even when the consequences are apparent. By keeping you from looking honestly at your behavior and its negative effects, denial worsens alcohol-related problems with work, finances, and relationships.

If you have a drinking problem, you may deny it by:

• Drastically underestimating how much you drink.
• Downplaying the negative consequences of your drinking.
• Complaining that family and friends are exaggerating the problem.
• Blaming your drinking or drinking-related problems on others.

If you find yourself rationalizing your drinking habits, lying about them, or refusing to discuss the subject, take a moment to consider why you’re so defensive. If you genuinely believe you don’t have a problem, there should be no reason for you to cover up your drinking or make excuses.

When is it time for treatment?

The good news is that no matter how severe the problem may seem, most people with alcohol use problems can benefit from some form of treatment. Research shows that about one-third of people treated for alcohol problems have no further symptoms one year later. Many others substantially reduce their drinking and report fewer alcohol-related problems.

According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), if you answer “yes” to two or more of the following statements, you likely have an alcohol use problem.

In the past year, have you:

• Had times when you ended up drinking more or longer than you intended?
• More than once wanted to cut down or stop drinking, or tried to, but couldn’t?
• Spent a lot of time drinking? Or being sick or getting over the aftereffects?
• Experienced craving—a strong need, or urge, to drink?
• Found that drinking—or being sick from drinking—often interfered with taking care of your home or family? Or caused job troubles? Or school problems?
• Continued to drink even though it was causing trouble with your family or friends?
• Gave up or cut back on activities that were important or interesting to you or gave you pleasure so that you could drink?
• More than once gotten into situations while or after drinking that increased your chances of getting hurt (such as driving, swimming, using machinery, walking in a dangerous area, or having unsafe sex)?
• Continued to drink even though it made you feel depressed or anxious or added to another health problem? Or after having a memory blackout?
• Had to drink much more than you once did to get the effect you want? Or found that your usual number of drinks had much less effect than before?
• Found that when the effects of alcohol were wearing off, you had withdrawal symptoms, such as trouble sleeping, shakiness, irritability, anxiety, depression, restlessness, nausea, or sweating? Or sensed things that were not there?

If you have any of these symptoms, your drinking may already be a cause for concern. The more symptoms you have, the more urgent the need for change. A health professional can conduct a formal assessment. You should speak with your physician or an addictions specialist immediately.

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