alcohol addiction

How to Stop Drinking Alcohol

How to Stop Drinking Alcohol

In 2015, the National Survey on Drug Use and Health (NSDUH) found that 87 percent of American adults drank alcohol at least once in their lifetime, and about 70 percent reported that they drank at least once in the past year. Over half of adults in the US drink at least once per month. None of these patterns of alcohol consumption are necessarily troublesome, as they are well within the guidelines for moderate drinking. However, the NSDUH also found that close to 27 percent of Americans binge drank at least once in the past month, 7 percent drank heavily, and around 16 million people in the United States struggle with alcohol use disorder (AUD).

Part of the reason so many people in the US struggle with drinking is that few understand what a standard drink is and how much alcohol is considered moderate. Basic serving sizes include:

  • 12 ounces of beer, or about one bottle

  • 5 ounces of wine, or about one small glass

  • 1.5 ounces of hard liquor, or about one shot

For example, a pint of beer is more than one serving because it is 15 ounces. Many servings of wine in restaurants or bars, especially white wine, are more than five ounces. Often, bars put more than a shot of liquor in cocktails. This can lead to drinking too much by accident. However, even when a person understands basic serving sizes, they may not understand how many servings are too many. Drinking more than moderately increases the risk of alcohol dependence and addiction.

Binge Drinking, Heavy Drinking, Alcohol Abuse, and the Consequences

The Centers for Disease Control and Prevention (CDC) defines binge drinking as:

  • For men: five or more servings of alcohol in a two-hour period

  • For women: four or more servings in a two-hour period

The CDC lists heavy drinking as:

  • For men: 15 servings of alcohol per week, or more than two per day

  • For women: 7 servings per week, or more than one per day

The definitions change based on gender because of differences in body mass, body composition, and hormones. These can all affect how the body metabolizes alcohol.

People who drink heavily tend to drink consistently, rarely bingeing, but still struggling with alcohol dependence because they feel like they need to drink a lot to feel normal. People who binge drink2, however, put themselves at risk of alcohol poisoning, and they may develop an addiction if they drink to reduce the effects of a hangover the next day.

Alcohol use disorder, a form of alcohol addiction, begins with compulsive behaviors around alcohol, leading to a loss of control. People who struggle with AUD are more likely to binge drink regularly and drink consistently, combining risks from both binge drinking and heavy drinking.

Defining Alcohol Use Disorder

The latest version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) lists the criteria a physician will use to determine if you struggle with AUD. The manual requires at least two of the listed symptoms that cause distress or harm for at least one year.

  1. There have been several times when you drank more than you intended or for longer than you intended.

  2. You spend a lot of time drinking, and/or feeling sick the next day because of drinking.

  3. You tried to stop drinking more than once, but you were unable to do so.

  4. You experienced cravings for alcohol.

  5. Drinking or being sick from drinking interfered with work, family responsibilities, school, or social engagements.

  6. You continued to drink despite consequences at work, at school, with family, etc.

  7. You cut back on hobbies or activities that were important to you, so you could drink instead.

  8. You continued to drink despite changes to mood, especially depression or anxiety, or drinking too much began to affect your physical health. You suffered more than one memory blackout.

  9. You drank even though being drunk increased your changes of getting hurt, such as drinking before driving.

  10. You continue to drink even though you feel like you need to drink more to achieve the original effects.

  11. You experienced withdrawal, including physical symptoms, when you did not drink.

According to the DSM-5, the number of symptoms can indicate how severe the addiction is.

  • Mild AUD is 2-3 symptoms from the list.

  • Moderate AUD is diagnosed with the presence of 4-5 symptoms.

  • Severe AUD is diagnosed if the person displays six or more symptoms.

If your physician gives you a questionnaire with this list, or you read the list and worry about your own drinking habits, you may struggle with AUD or another form of problem drinking. Fortunately, there are many ways to treat this condition. The foundation of any addiction treatment starts with medically supervised detox, which is very important for alcohol abuse since alcohol withdrawal can be life-threatening. Then, an evidence-based rehabilitation program can help you change compulsive behaviors.

How Detox and Rehabilitation Can Help

The National Institute on Drug Abuse (NIDA) maintains a list of Principles of Effective Treatment, which states basic information about overcoming addiction with help from professionals. While the list states that no single form of treatment is appropriate for everyone, there are basic steps that anyone struggling with addiction, including to alcohol, can benefit from.

  • Detox: This is the first step in overcoming addiction. Detox is designed to end the body’s physical dependence on an intoxicating substance like alcohol, which can reduce physical distress and cravings on a long-term basis. If you see that you can feel normal and healthy without abusing drugs or alcohol, then you are more likely to stay sober.

    Again, alcohol requires medical oversight during detox because some withdrawal symptoms are life-threatening. These include seizures and hallucinations. During detox, your physician will evaluate you to determine if these symptoms are a risk and may prescribe medications like Valium to help taper your body off alcohol. Benzodiazepines like Valium work on a similar area of the brain as alcohol.

  • Rehabilitation: The purpose of rehabilitation, whether inpatient or outpatient, is to help you change your behaviors when you feel stressed, run into triggers, or experience cravings. Most of this behavioral retraining involves therapy, mostly in the form of group therapy. Inpatient treatment and intensive outpatient treatment will also involve individual therapy. Types of therapy applied to addiction treatment include Cognitive Behavioral Therapy, Motivational Enhancement Therapy, family counseling, 12-Step programs, and brief interventions. NIDA recommends remaining in a rehabilitation program for at last 90 days, or three months, to make sure that behavioral changes stick; this reduces the risk of relapse.

  • Support groups: In the 1930s, Alcoholics Anonymous pioneered the idea of a support group for people working to end their addiction to alcohol. Since then, these support groups have been the foundation of many alcohol and drug addiction treatment programs. During and after rehabilitation, support groups can help you receive emotional support and learn how others deal with stress while avoiding alcohol.

  • Maintenance medication: It is rare for a doctor to prescribe maintenance medication for alcohol use disorder, but sometimes, a person relapses so often that reducing cravings for alcohol will help them stay sober for longer. Naltrexone and acamprosate are the primary drugs prescribed to maintain sobriety after overcoming AUD because these two substances have been shown to reduce cravings for many people.

    Disulfiram was one of the first maintenance medications. If a person relapsed and drank alcohol while on disulfiram, they would feel very sick. The point of the drug was to create a mental association between alcohol and illness, but the substance is rarely used anymore since it causes more distress than it relieves.

  • Aftercare: Once you complete detox and rehabilitation, you should find ways to get emotional support to remain sober. In addition to support from family and friends, attending mutual support groups, going to an individual therapist, and/or finding complementary medical practices like meditation, yoga, and nutritional supplements can help you stay on track.

Alcohol use disorder can feel overwhelming, but there are many approaches to treatment that have been proven to work. If you worry about your drinking or a loved one’s drinking, ask for help from a physician, therapist, or addiction specialist.

Is It Problem Drinking or Alcoholism? Take Our Assessment Test and Find Out

It is a common issue: People who are struggling with alcoholism often don’t recognize that there’s a problem. Most of the time, those who engage in abuse of alcohol don’t have the tools or ability to notice when drinking has gotten out of control. However, the question eventually arises: “Am I drinking too much?” or “Am I an alcoholic?”

It can help these individuals to have a guide or questionnaire to review, carefully considering the answers to each question. In using this guide, a person can then approach a medical or addiction treatment professional for a formal diagnosis and plan for recovery. The following includes a questionnaire that can serve as just that kind of guide.

Recognizing the Problem

A general way of looking at all the following questions is to seriously consider whether the individual has control over how drinking affects daily life, including relationships, mental and physical health, and activities. As explained by an article on addiction from the University of Rochester, people who become addicted to alcohol or other substances have trouble changing their behavior when it comes to seeking pleasure.

Because of this trouble, it may be difficult for individuals to recognize when alcoholism has become a problem. Using a questionnaire like the one below can help people who are trying to determine whether alcohol has become a problem for themselves or a loved one.

Self-Evaluation Questionnaire

The following questionnaire is based on the factors used to diagnose substance use disorders, as defined by the Diagnostic and Statistical Manual of Substance Use Disorders, also known as the DSM-5. This list of behavioral symptoms has been compiled and fine-tuned by psychiatrists, psychologists, and addiction treatment specialists to give medical professionals a standard by which to diagnose substance use disorders like alcoholism.

When going through the questions, note how many receive a “yes” answer:

  • 2-3: A mild substance use disorder could be diagnosed.

  • 4-5: This indicates a moderate substance use disorder.

  • 6 or more: Addiction or another type of severe substance use disorder is likely.

If only a few answers are “yes,” this doesn’t mean there isn’t a problem. Continued alcohol abuse by those with a mild alcohol use disorder can lead to more severe symptoms and a later diagnosis of alcoholism. Any potential substance use disorder should be taken seriously.

Do I regularly drink more than I plan to?

Many people can casually drink at a party, having one or two drinks over a few hours and then stopping. However, people struggling with alcohol abuse or alcoholism might find they’ve lost track of how many drinks they’ve had. They may also find that they’ve been drinking for several hours without realizing it – much longer than they might have intended.

Alcoholism results in a loss of control over drinking. If a person finds that the amount of alcohol consumed on a regular basis is more than the individual intended to consume, the answer to this question is “yes.”

Have I been unsuccessful at quitting before?

As explained by the American Society of Addiction Medicine, substance use disorders like alcoholism are chronic conditions which, like other chronic medical conditions such as asthma and diabetes, often result in relapse. This means that people who are struggling with alcohol use disorders may attempt to quit using alcohol and ultimately end up relapsing to alcohol use one or more times.

It is important to note that continued relapse can present a danger to the individual. Not only can alcohol withdrawal itself result in dangerous symptoms, but relapsing to alcohol use can lead to circumstances where overdose – drinking amounts of alcohol that put the person’s health or even life at risk – is more likely to occur. This is because a person’s tolerance for alcohol quickly drops after quitting use; however, when the person returns to use, drinking the large amounts that were consumed before quitting can result in overdose, or alcohol poisoning, where it didn’t previously.

Has my drinking interfered in my personal relationships?

Substance abuse can often become a sticking point in relationships. As described by the American Association for Marriage and Family Therapy, when the amount of alcohol that a person is consuming becomes a concern to loved ones, challenges can arise that include:

  • Arguments

  • Loss of intimacy

  • Betrayal of trust

  • Not living up to expectations

The real hallmark, however, is not just that these things are happening, but that the individual struggling with alcohol abuse cannot stop drinking regardless of potential negative relationship consequences.

Another effect of alcoholism on relationships is that the person may have a change in social relationships as a result of drinking. Often, the person will begin to gravitate more toward friends who encourage or participate in the individual’s drinking, and away from those who are critical of the person’s behavior. This can be a self-destructive change, decreasing the person’s motivation to stop consuming alcohol.

Do I spend a lot of time seeking opportunities to drink, drinking, or dealing with hangovers?

People with alcohol use disorders tend to have excessive focus on drinking and on getting alcohol or dealing with the aftereffects of a binge. In fact, this focus may seem to arise at inappropriate times, such as first thing in the morning, or at times when drinking can create a risk or interfere with other important activities. The person may also seem to be thinking about or participating in drinking far more often than seems healthy to outsiders.

On top of this, the individual spends a lot of time recovering from bouts of drinking. Hangovers are a common occurrence, and they may even lead the person to continue drinking to prevent them. In any case, a person who is struggling with alcoholism may find that much more time is lost during the day and night due to drinking and its effects.

Does drinking or the aftereffects of drinking keep me from my responsibilities?

Because of the inordinate amount of time spent drinking and dealing with hangovers, a person who is struggling with alcoholism is often unable to keep up with responsibilities at home, work, or school. Perhaps the individual often calls in sick to work because of hangovers. Alternatively, the person may spend too much time drinking with friends and miss homework or work assignments. Drinking may take over time at home, resulting in housework left undone or bills left unpaid.

These responsibilities don’t go away, and consequences can include disciplinary actions at school or work, a lost job, poor grades, or other external consequences. It also may result in financial difficulties or an unhealthy living environment, which can also contribute to relationship issues. If, in the face of all of this, the individual still cannot stop drinking, alcoholism is likely an issue.

Do I prefer drinking over other activities I used to enjoy?

Similar to the above, a person who has become dependent on drinking may stop participating in enjoyable activities or hobbies. An avid athlete may give up sports to spend more time at the bar. A parent may miss a child’s performances or games due to drinking bouts or hangovers.

Taking inventory of how the individual’s time was spent before alcohol use and comparing it to how time is spent now can help to determine whether alcoholism has become a factor. This can appear to be a change in personality and preferences – behaviors that can be a strong indicator that alcoholism is present.

Is my drinking causing health problems, and do I keep doing it anyway?

Long-term effects of alcohol abuse can cause physical and psychological health issues other than alcoholism itself. Physical conditions are caused by alcohol toxicity and the ways alcohol affects how body systems function. Negative effects on the brain, such as those described by the National Institute on Alcohol Abuse and Alcoholism, have to do with brain damage and alcohol’s effects on brain chemistry. Resulting mental and physical health problems include:

  • Heart disease, heart attack, or stroke

  • Digestive issues or conditions, including some cancers

  • Liver damage, scarring, cirrhosis, and failure

  • Brain damage, cognitive issues, or memory loss

  • Depression or other mood disorders

  • Worsening anxiety

A person who has been drinking large amounts of alcohol regularly and is seeing these issues develop may find excuses to keep from connecting the problems to the alcohol use. On the other hand, the person may simply ignore the connection. However, if physical and emotional issues are known to be connected to drinking and the person still cannot control alcohol use, alcoholism could be the reason.

Do I drink in risky situations?

As mentioned above, people with alcohol use disorders often spend more time drinking than is appropriate, and this may involve drinking in situations where it can be dangerous. This includes drinking before driving, when using dangerous machinery, or before participating in a risky sport or activity. Drinking in risky situations can include sexual encounters too; in fact, a study from the Journal of Studies in Alcohol and Drugs demonstrated that level of intoxication was the sole motivating factor in sexual risk-taking for female college students.

Alcohol consumption relaxes a person’s usual inhibitions, making it more likely that the person will participate in activities that would normally be avoided. The result can be injury, illness, or even death as a result of drinking alcohol and taking undue risks on a regular basis.

Have the effects of drinking alcohol diminished over time, or is more alcohol required to have the same effect as before?

Regular and heavy substance abuse over time can result in a condition called tolerance, as described by the University of Rochester, where the effects of alcohol do not seem to be as strong as they were when the person first started drinking. This may manifest as the person needing to have more alcohol to feel the same euphoric effects that used to occur with just one or two drinks.

Tolerance means that alcohol use has begun to disrupt the brain’s chemical pathways, a sign that the brain is beginning to become dependent on the presence of alcohol for those pathways to function. This, in turn, is a precursor to alcoholism, and it can continue to occur to a degree after alcoholism has developed.

Do I have cravings or urges to drink alcohol?

Many of the above behaviors follow a key symptom of alcoholism: cravings. When the person is not engaging in alcohol use, urges to drink may become uncontrollable, leading the person to seek out an opportunity to drink. Sometimes, these cravings may be triggered by certain situations, such as stress or being with people who encourage heavy drinking. Whether the triggers are positive or negative, they result in an uncontrollable urge to drink.

Cravings are also the strongest contributor to relapse when the person tries to stop drinking. Often, cravings that arise from unrecognized triggers are most likely to keep the person from being able to maintain long-term sobriety.

If I stop drinking, do I experience uncomfortable physical and mental symptoms?

Cravings are not the only symptom of alcohol withdrawal – a syndrome described by American Family Physician. Other symptoms include:

  • Trembling

  • Changes in sleep patterns

  • Stomach upset, nausea, or diarrhea

  • Headache and body aches

  • Inability to focus

  • Anxiety

  • Heart palpitations

  • Delirium

  • Seizures

The longer a person has been drinking heavily, the more severe these withdrawal symptoms can be if the person tries to stop drinking. The most severe withdrawal symptom is called delirium tremens, a condition that can result in confusion, delirium, fever, seizures, coma, and death.

These symptoms feel like a hangover, but they can be much worse. If the individual feels these symptoms whenever an attempt is made to quit drinking, alcoholism is incredibly likely. Treatment should be sought immediately to prevent the potential for severe symptoms to occur. Individuals should not attempt to quit drinking on their own as the symptoms of alcohol withdrawal can be life-threatening; medical assistance is required.

Getting Help

If this questionnaire has unveiled the possibility that even a mild alcohol use disorder is present, it is important for the individual to seek out a treatment professional for a thorough diagnosis and assistance in managing the disorder. Because the risk of a more severe disorder can lead to any or all of the risks described above, professional assistance is mandatory. Getting help early can prevent the individual from experiencing severe consequences of drinking or disrupting the lives of loved ones.

Research-based, individualized treatment is most likely to help the person manage this chronic condition and minimize the potential for relapse in the future, as emphasized by the National Institute on Drug Abuse. The result can be a return to a more productive, healthy life and a future free from the disruption that alcoholism can cause.

☎️ Fountain Hills Recovery is here to help. Contact us confidentially to discuss your treatment options. 1.800.715.2004 or visitwww.fountainhillsrecovery.com.