person suffering from addiction

With the festive period fast approaching, below we discuss alcohol use and abuse, including how this typically changes between December and January. We collaborated with Dr Samantha Miller (MB CHB) to share insight into the health risks and signs someone might be struggling with alcohol, as well as giving advice on limiting alcohol consumption, drinking safety tips, and quitting tips, amongst other topics – such as offering coping techniques. Read on to find out more…

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The motivation to consume alcohol can come from various factors, including past experiences, personality factors, life circumstances and coping, social norms, and environmental factors (to name just a few), and it is often a combination of psychological and social factors that leads to the transition from occasional social alcohol consumption to problematic alcohol use and addiction.

Alcohol Abuse

Consumption of alcohol has been normalized as an integral part of celebrations and socializing. What many people don’t realize is that alcohol can be dangerous and addictive, with far-reaching harmful effects. Dr Samantha Miller shared that “alcoholism, also known as alcohol addiction, alcohol abuse, or alcohol use disorder (AUD), is the harmful use of alcohol above recommended limits. It is also characterized by the inability to stop drinking excessively, despite negative effects on a person’s social life, work, education, or health. It is typically diagnosed by a healthcare professional based on certain criteria”.

Binge drinking

The Dietary Guidelines for Americans recommends limiting alcohol intake to a maximum of 2 drinks a day for men and 1 drink per day for women. Therefore, having one drink is usually not a problem, whereas consuming excessive amounts or drinking alcohol daily may indicate an alcohol use disorder (AUD). However, heavy episodic drinking, sometimes called “binge drinking” is drinking a large amount of alcohol in a short time, and should be avoided. It is defined as drinking such that blood alcohol concentration (BAC) reaches a level of 0.08 g/dL. This usually happens after men consume 5 drinks and women consume 4 drinks over about 2 hours. Binge drinking on more than 4 days per month qualifies as heavy alcohol use.

Dr Samantha Miller added that “those who binge drink are more likely to be involved in car accidents and violent encounters, including homicide and sexual assault. It’s crucial also to understand what is meant by ‘a drink’; this equates to 12 ounces of 12% beer, 5 ounces of 12% wine, or 1.5 ounces of 40% spirit”. Heavy and binge drinking put a person at risk of developing alcohol addiction and alcohol use disorder.

Signs you might be struggling with alcohol

The medical term alcohol use disorder refers to what is commonly known as alcoholism. If you’re wondering whether you have an alcohol use disorder, ask yourself the 11 questions on our alcohol hotline page… A few examples of the questions include:

  • Do you end up drinking more or for a longer time than you intend to?
  • Do you spend a lot of time drinking or recovering from the aftereffects (e.g., hangover)?
  • Has drinking put you in unsafe situations, for example, drinking and driving or having unsafe sex?
  • Do you need more drinks than before to get the same effects?

If your answer is yes to two or more of the questions it is a cause for concern, and the more questions you answered yes to the more urgent is the need for change.

People who are addicted to alcohol may be in denial and unable accept that they have a problem. In this case, it can fall on family members and friends to spot the warning signs of problematic alcohol use or addiction and get help. If you are worried about a friend or family member, then listed below are the symptoms of alcohol use disorder:

If a person has had 2–3 of the above symptoms within the past 12 months, their alcohol use disorder is considered “mild”; 4–5 symptoms is “moderate”; and 6 or more symptoms is considered a “severe” alcohol use disorder.

Dr Samantha Miller added that the “early signs of alcohol abuse can be difficult to spot. The user may start to prioritize activities involving alcohol consumption or being unable to engage in social activities without drinking. There may be noticeable behavioral changes, such as becoming more withdrawn and secretive or changing who they spend time with. Other patterns, such as sleep, may also change”. She also added that “a person may neglect social, educational, or work commitments and have unexpected periods of absence or trouble holding down a job. If an alcohol habit is creating a financial burden, look for signs of not spending money on other things, or finding other sources of income, e.g. selling personal possessions or crime. Look out for alcohol paraphernalia, such as empty alcohol bottles or cans”.

According to Dr Samantha Miller, the physical signs of alcohol use disorder may include “alcohol withdrawal, which can manifest as mood swings, including aggression or violent outbursts, appearing agitated, shaking or seizures. There may be a noticeable weight loss due to loss of appetite or lack of funds to buy food. A person may exhibit physical neglect, e.g. poor dental and personal hygiene, as their habit takes over their life and becomes an addiction”.

Health Risks

The health risks of excessive drinking can be divided into short-term and long-term effects. Short-term effects of excessive alcohol consumption, such as binge drinking (consuming more than 4-5 drinks on one occasion), result in impaired judgement, meaning the user is more likely to engage in dangerous activities and increases the risk of accidents. In addition, excess alcohol consumption can result in alcohol poisoning, which can interfere with basic bodily functions such as breathing, placing the user at risk of choking, coma, and death.

Long-term health risks of excessive drinking include damage to most body systems, including the heart, brain, nervous system, liver, pancreas, and immune system. In addition, excessive alcohol consumption is associated with high blood pressure, stroke, liver disease, depression, dementia, and several types of cancer. More information on the short-term and long-term health effects can be found here.

Drinking can impact their personal life, relationships, school or work performance, and finances. Some people with alcohol use disorder perform illegal activities under the influence of alcohol and get into trouble with the law.

Alcohol also affects important brain functions like decision-making and impulse control, and continued excessive alcohol use can lead to changes in brain chemistry such that the person is unable to control their drinking. Heavy drinkers can develop a physical dependence on alcohol, leading to intense cravings and withdrawal symptoms when alcohol consumption is substantially reduced or stopped.

Help and Advice

Drinking Safety Tips

When it comes to drinking safety tips, Dr Samantha Miller suggests “limiting alcohol intake to one or two drinks per day is recommended, and certainly not exceeding 4–5 drinks on one occasion. If you plan on drinking more than 1–2 drinks, keeping a log of your drinks can help you know when to stop. Set a plan of how much you intend to drink and communicate this with your friends and family. Eating before and after having a drink can help to absorb the alcohol and minimize adverse effects such as clouded judgement or impaired balance. Staying hydrated can also reduce the effects of alcohol – with some people preferring to alternate an alcoholic drink with a glass of water. If you are drinking, it is important to plan how you will get home and remain with trusted people. Never try to drive when under the influence of alcohol”.

When it comes to treating a hangover, Dr Samantha Miller says that “obviously, the best way to curb a hangover is to avoid it in the first place! Limiting alcohol consumption to 1–2 drinks, or avoiding alcohol altogether, is a sure-fire way to prevent the hangover. There is no specific ‘cure’ for a hangover, but there are ways to alleviate the symptoms. Drinking plenty of water can help with dehydration and aid your body in removing the alcohol from your system – you might also consider using an oral rehydration salt to replace lost minerals. For a headache, simple analgesia such as acetaminophen may help; and for an upset stomach, an antacid may be useful. ‘Hair of the dog’ – another alcoholic drink – is not a good hangover remedy!”.

The Festive Period

During the festive period it can be useful to create a plan to keep your alcohol consumption low – Dr Samantha Miller recommends to “plan which days of the week you plan to have a drink – and stick to the plan. Share your goals with friends and family that you may be spending time with, and voice your wish to limit your alcohol consumption. You might like to avoid social activities centred around alcohol consumption and avoid spending too much time with people who drink alcohol excessively. Picking a drink you enjoy that is not alcoholic means you can still enjoy a drink with friends without the alcohol. If you tend to drink alcohol at home, avoid having alcoholic beverages in your house to avoid the temptation to drink”.

There are also additional risks when drinking alcohol in cold weather… Dr Samantha Miller explained that “drinking alcohol often makes the user feel warm; however, this is deceptive! Alcohol causes blood vessels to dilate, removing heat from the body’s core. In addition, alcohol use can result in impaired decision-making, meaning a user may stay in a cold environment longer than they would normally, placing the user at risk of hypothermia”.

During the festive period last year (December 2021 and January 2022), there were 60,500 searches for information on ‘Dry January’ across the US, with Google Trend data shows that searches are significantly increasing year on year in the States.

Quitting Help and Support

Quitting alcohol for good is achievable and sustainable with the right support. Users can quit alcohol alone; however, the aid of specialist services increases the chances of success.

Alcohol use disorder is treatable, and recovery is possible with the right help… Dr Samantha Miller suggests that “if you are worried someone is struggling with an alcohol problem, it is most important to talk with them without judgement and offer your support. In addition, it may be useful to signpost them to professional services to guide them through recovery. A primary care practitioner is often the first point of contact, as they can help with practical assistance and onward referral to specialist services”.

The Substance Abuse and Mental Health Services Administration (SAMHSA) have a national helpline that is a great resource to share with someone struggling with addiction and not feeling comfortable speaking with their doctor right away. SAMHSA also has a directory of specific treatment programs and resources for alcohol addiction. Dr Samantha Miller added that “support can be on an inpatient or outpatient basis and may include an initial detoxification stage, followed by a rehabilitation program. Techniques proven to assist in recovery from alcohol addiction include pharmacological treatment, behavioural therapy and group therapy”.

Sharing concerns about your drinking is an important step in getting the support you deserve and asking for help is essential. The good news is that however severe or longstanding an alcohol problem, most people can benefit from some form of treatment. There is a wide range of treatments for alcohol use disorder available to you – the main types of addiction treatments offered to people with alcohol use disorder include:

  • Behavioral therapies like cognitive-behavioral therapy (CBT), motivational enhancement, and marital and family counseling can help you change drinking behaviors through counseling.
  • Medications can help offset the changes caused by alcohol in your brain, reduce heavy drinking, and make it easier for you to remain sober.
  • Peer support groups like Alcoholics Anonymous and other 12-step programs help you cut back or quit drinking through support from others who have faced similar challenges.

Quitting Plan

Dr Samantha Miller says “the first stage of any plan is to identify why you might want to quit alcohol. Use this planning stage to educate yourself on the risks of continuing to drink and the benefits of quitting. It might be useful to write some of these things down to refer to later.

“Next, it is useful to identify a ‘stop date’. This allows the user time to make appropriate preparations to quit drinking. Some find it useful to involve others in this process, such as telling friends and family about the ‘stop date’. This gives a feeling of accountability, and those you choose to tell can be more aware and supportive of you. It is also useful to take this preparation time to remove all alcohol from your environment. Part of the plan should include which methods you plan to use to aid in your alcohol cessation.

“Be aware of adverse or unpleasant effects of alcohol cessation, including withdrawal, and plan strategies and support mechanisms to cope with these. For example, some find it useful to have a ‘quit buddy’ who might also stop drinking at the same time as you”. When a person who is a heavy drinker abruptly stops drinking they can suffer several symptoms which are collectively called alcohol withdrawal syndrome. The symptoms of alcohol withdrawal can start 1–3 days after the last drink and may include: fast breathing and fast heart rate; high blood pressure; dilated pupils; elevated body temperature; sweating; nausea, vomiting, diarrhea; tremors (shaking hands); seizures; agitation, irritability, disorientation; anxiety; insomnia; delusions, hallucinations, paranoia; and combativeness. Severe alcohol withdrawal syndrome frequently requires a hospital stay with intensive care to manage medical complications like seizures.

Dr Samantha Miller added that “having targets, accountability and rewards for reaching defined milestones in the alcohol cessation journey may also be part of a plan. For example, counting ‘alcohol free’ days, or putting the money you’d usually spend on alcohol into a jar for a day out or a holiday. As you continue your journey to stop drinking permanently, remind yourself of the benefits; for example, you might have more money or no longer be troubled by hangovers”.

Finally, Dr Samantha Miller shared that “for those with alcohol use disorder (AUD), specialist services may be necessary to achieve and sustain alcohol cessation. Specialist services typically implement a two-step plan of detoxification and rehabilitation. Rehabilitation involves implementing measures to reduce the likelihood of relapse and normally involves a combination of counselling, medication, and social support. This might involve individual counselling or group support, for example, alcoholics anonymous. These interventions focus on lifestyle changes to assist the patient in maintaining abstinence from alcohol”.

References

  • Centres for Disease Control and Prevention (CDC)(2019). Binge Drinking. Available at: https://www.cdc.gov/alcohol/fact-sheets/binge-drinking.htm
  • National Institute on Alcohol Abuse and Alcoholism (NIAAA). Overview of Alcohol Consumption. Available at: https://www.niaaa.nih.gov/alcohols-effects-health/overview-alcohol-consumption
  • US National Library of Medicine: Medline Plus (2014). Alcohol. Available at: https://medlineplus.gov/alcohol.html
  • National Institute on Alcohol Abuse and Alcoholism (NIAAA). Alcohol’s Effects on the Body. Available at: https://www.niaaa.nih.gov/alcohols-effects-health/alcohols-effects-body
  • National Cancer Institute (2021). Alcohol and Cancer Risk. Available at: https://www.cancer.gov/about-cancer/causes-prevention/risk/alcohol/alcohol-fact-sheet
  • NHS (2019). The Risks of Drinking Too Much. Available at: https://www.nhs.uk/live-well/alcohol-support/the-risks-of-drinking-too-much/
  • Australian Government Department for Health (2020). Alcohol. Available at: https://www.eatforhealth.gov.au/food-essentials/fat-salt-sugars-and-alcohol/alcohol
  • Drink Aware (2022). Alcoholism: signs, symptoms and treatment. Available at: https://www.drinkaware.co.uk/facts/health-effects-of-alcohol/mental-health/alcoholism
  • National Institute on Alcohol Abuse and Alcoholism (NIAAA)(2020). Understanding Alcohol Use Disorder. Available at: https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/understanding-alcohol-use-disorder
  • Drink Aware (2021). Teenage Drinking. Available at: https://www.drinkaware.co.uk/advice/underage-drinking/teenage-drinking/
  • Drink Aware (2022). Alcohol and cold weather. Available at: https://www.drinkaware.co.uk/advice/staying-safe-while-drinking/alcohol-and-cold-weather
  • Dietary Guidelines for Americans (2020). Available at: https://www.dietaryguidelines.gov/resources/2020-2025-dietary-guidelines-online-materials
  • NHS (2022). Tips on Cutting down. Available at: https://www.nhs.uk/live-well/alcohol-advice/tips-on-cutting-down-alcohol/
  • Harvard Health (2022). 11 ways to curb your drinking. Available at: https://www.health.harvard.edu/staying-healthy/11-ways-to-curb-your-drinking
  • Drink Aware (2022). How to “cure” a hangover? Symptoms, treatment and prevention. Available at: https://www.drinkaware.co.uk/facts/health-effects-of-alcohol/hangovers/hangover-cure-and-prevention/

Last updated: March 10, 2023