Alcohol addiction: causes, symptoms and therapy

Alcohol dependence is one of the addictive diseases and can affect anyone. The boundaries between so-called risky consumption and alcohol addiction are fluid. If alcoholism remains untreated, the probability of physical and psychological consequential damage is high. It is all the more important to recognize signs of alcohol abuse at an early stage and to take advantage of offers of help. Rapid diagnosis and therapy improve the prognosis significantly – but permanent abstinence requires excellent willpower and support from family and environment. What are the symptoms of alcoholism, and what to do if you are addicted to alcohol? You can find answers to the most important questions here.

What is alcohol addiction?

There is a fine line between moderate alcohol consumption, alcohol abuse and diagnosed alcohol dependence. Experts distinguish between low-risk, risky and harmful alcohol consumption and alcohol dependence. Alcohol consumption is considered dangerous when potentially toxic amounts of alcohol are consumed (either daily or through so-called binge drinking), but no harmful consequences or dependence have yet developed. Harmful alcohol consumption occurs when drinking has adverse effects on physical or mental health – a “hangover” alone is not enough for this. But when do you develop alcoholism? Where does alcoholism start?

The amount consumed is not necessarily decisive here, but rather the role that alcohol plays in everyday life. Specific criteria characterize an actual dependency. The consequences for physical and mental health are immense, and social life is also damaged. No wonder that alcohol addiction is usually accompanied by great suffering.

Alcohol dependence is, by definition, an addiction and can occur in all age groups, cultures and social classes. It develops and progresses insidiously, so a diagnosis is often made late. The fact that alcohol is tolerated in our latitudes also contributes to the high number of unreported cases, as does the fact that the subject of addiction is very shameful. It can currently be assumed that around 1.6 million people in Germany are struggling with alcohol addiction.

 

When is an alcohol dependent?

How much an alcoholic drink is secondary. It also doesn’t matter what kind of alcohol someone drinks – beer, wine or schnapps. Concrete signs that must be fulfilled are decisive for the diagnosis of alcohol dependence. The six main criteria of an addiction are used. If at least three of these happen within a year, you are, by definition, alcohol dependent.

The six criteria for alcohol addiction are:

1. There is a strong desire to drink alcohol.
2. There is a loss of control over the amount and frequency of alcohol consumption.
3. Tolerance develops: those affected have to constantly increase the amount of alcohol to achieve the desired effect.
4. Those affected struggle with withdrawal symptoms (such as nausea or tremors) when alcohol is not available in sufficient quantities.
5. Interests and obligations are neglected in favour of alcohol.
6. Even if there are clear consequences (e.g. job loss, separation or illness), alcohol consumption will not be avoided.

How does alcohol addiction show up?

Recognizing alcohol abuse is not easy at all because corresponding behaviours and behaviour patterns only creep in slowly. The physical deterioration of alcoholism is often preceded by a long ordeal, which those affected cleverly hide. Sooner or later, however, physical and mental alcohol dependence will draw attention to itself with clear signs.

Symptoms in women and men are very similar and affect the entire organism. Long-term alcohol abuse usually has serious health consequences. Late effects such as liver inflammation, liver cirrhosis, pancreatitis, gastrointestinal diseases, cardiovascular diseases or cancer are common. Malnutrition and an increased risk of accidents and injuries are also possible effects.

The social consequences of alcohol addiction should also not be neglected. Conflicts in the social environment and with the law, job loss and separations, loss of contact and isolation are common.

 

Alcohol addiction: symptoms and consequences at a glance

The following is an overview of the immediate symptoms and long-term consequences of alcoholism:

• Disinhibition, lightened mood, and impulsiveness increase
• Impaired vision, hearing and speech
• Perception disorders, problems with coordination
• Impaired memory (especially short-term memory)
• Gastrointestinal problems (such as vomiting, diarrhoea, appetite disorders, reflux, gastritis, and ulcers)
• malnutrition and nutrient deficiencies
• sleep disorders
• Mood swings, tendency to depression and anxiety disorders
• feelings of inferiority and guilt
• hallucinations and delusions
• Vascular changes on the skin, especially on the face (reddening of the face and nose, red eyes)
• sometimes changes in the fingernails (stripes, reddening of the crescent-shaped area or whitening of the entire nail)
• Cardiovascular diseases (e.g. vascular diseases, high blood pressure, myocardial diseases, cardiac arrhythmias )
• Inflammation of the pancreas (pancreatitis)
• Effect on the brain (brain atrophy and increased risk of dementia and Alzheimer’s )
• Elevated liver values ​​and liver damage (such as fatty liver, liver inflammation, liver cirrhosis or liver cancer )
• Increased risk of cancer (tumours in the mouth and throat, stomach cancer, colon cancer, liver cancer)
• increased risk of accidents and injuries
• psychosocial problems (loss of job or social contacts, conflicts with the law)
• Withdrawal symptoms when alcohol is unavailable (tremors, sweating, insomnia, nausea, seizures, irritability, aggression, increased suicidality)

Due to the numerous health consequences of alcohol addiction, those affected have a reduced life expectancy.

Course: Alcoholism as a process

Alcohol dependence is a gradual process with smooth transitions between normal (low-risk) alcohol consumption, risky drinking behaviour and harmful alcohol abuse through to addiction. Since the consequences of excessive consumption are usually not immediately apparent, the facade can often be maintained for a long time. Especially at the beginning of the addiction, one hardly recognizes “secret” alcoholics as outsiders.

Although the course of the addiction is, of course, different for each individual, certain stages or phases can still be identified:

• First, the amount and frequency of drinking are increased to cope better with specific situations.
• Gradually, alcohol takes on greater importance in thinking and acting.
• It’s getting harder and harder to stay in control of your drinking habits.
• Interpersonal relationships, hobbies and commitments are neglected in favour of the addictive substance.
• When no alcohol is available, withdrawal symptoms become noticeable.
• At the end of the process, the addictive behaviour usually ultimately determines the daily routine. Physical, psychological and social consequences are noticeable.

Causes: how does alcoholism develop?

There is no specific trigger for alcoholism; instead, different reasons play a role. One can, therefore, assume that the development of alcohol dependence is multifactorial. There are probably interactions between biological conditions, social and cultural factors and individual requirements.

The question of whether alcoholism is hereditary was also examined. Based on the study situation, one can assume that there is a genetic disposition. Specific imitation behaviour also plays a role when children observe critical consumer behaviour from an early age. This effect also comes into play during puberty. Stressful life experiences and trauma such as abuse, bullying or loss are also considered risk factors for the development of alcohol addiction.

Last, the social and cultural approach to alcohol has a corresponding effect. There is also an interaction between mental illness and alcohol abuse.

 

Fight alcohol addiction – with support.

Seeking help and treatment as early as possible has a positive effect on the prognosis of alcohol dependence. However, this presupposes that those affected are aware of their addiction problem. Relatives and close people play an essential role here. So, it is of little use to cover up the alcohol problem and to spread the cloak of silence over it. Confrontation with facts, support, and accompaniment in the therapy process is more effective. In addition to general practitioners or psychiatrists, contact persons are primarily addiction counselling centres.

Therapy: How is alcohol dependence treated?

Treatment options for alcohol dependency are varied and are individually tailored to the patient. There are outpatient and inpatient options. In addition to the alcohol withdrawal itself (detoxification), the treatment is based on medicinal support and psychotherapy for withdrawal treatment. Alternative approaches, such as relaxation techniques or hypnosis, are also used. If complete weaning from alcohol is not possible, the first step is to reduce alcohol consumption.

Drugs for alcohol addiction

Since physical withdrawal is usually accompanied by severe symptoms and can lead to complications, it is usually carried out in a clinic under medical supervision. This physical detoxification takes about seven to 14 days. By administering appropriate medication, physical and psychological withdrawal symptoms can be reduced to a tolerable level.

Although there is no specific remedy for alcohol addiction or even over-the-counter medication or home remedies, those affected can still be supported with medication. Active substances that reduce the desire for alcohol, such as naltrexone or baclofen, are used here. However, such tablets are by no means a substitute for withdrawal therapy.

 

Psychotherapy for alcohol dependence

In addition to physical withdrawal, psychological treatment is crucial so that those affected can learn to live without alcohol. Depending on the progression of the disease, inpatient or outpatient psychotherapy may be considered. The treatment is tailored directly to the affected person. Individual and group therapy vary, and various therapy forms are also used. These include in-depth psychological approaches, behavioural therapy, and family-oriented or systemic approaches. The treatment is supplemented by alternative methods such as relaxation techniques, mindfulness training or painting, movement and music therapy.

Alcohol dependence: prognosis

The fact that alcohol addiction is a gradual process and is accompanied by considerable shame does not always make it easy for those affected to turn to addiction counselling or seek medical help. Early diagnosis and appropriate treatment positively influence the course of the disease and the prognosis. Combating alcohol addiction without adequate therapy, however, is hardly possible.

Alcoholics without insight are at risk of long-term damage. The average life expectancy is reduced by up to twelve years if those affected do not seek help.

However, even with treatment, the recidivism rate for alcoholism is high. Only about 45 per cent of all those affected are still abstinent four years after the end of therapy. This shows that addiction – even if it seems to be overcome – accompanies people throughout their lives. Dry alcoholics make a conscious decision again and again to abstain and not to drink. Therefore, follow-up care is critical to avoid relapses. In addition to addiction counselling facilities, there are also self-help groups such as Alcoholics Anonymous.