Alcohol Abuse and Addiction

Edmund Murphy
Dr. Samantha Miller
Written by Edmund Murphy on 24 August 2021
Medically reviewed by Dr. Samantha Miller on 15 April 2024

Addiction to alcohol, also known as alcoholism or alcohol use disorder (AUD), is one of the most common forms of substance abuse in the Western world. Since alcohol is legal and most of the time can be enjoyed socially with few adverse effects, the signs of addiction can be difficult to identify.

Key takeaways:
  • More than 65 million Americans report binge drinking or heavy drinking in a one-month period, which is more than 40% of those who drink alcohol
Alcohol Abuse and Addiction

Understanding alcohol addiction

Alcohol is a legal beverage consumed in many forms, most commonly wine, beer, and spirits. In low doses, alcohol can lower anxiety and inhibitions, promoting a relaxed state. It acts as a depressant in larger quantities and can cause loss of motor function, slurred speech, and short-term memory loss.

According to the National Survey on Drug Use and Health (NSDUH), in 2019, over 60% of Americans admitted to having drunk alcohol in the past year, though most would not say they had an alcohol problem. It is possible to consume alcohol without being an alcoholic; however, if your life is negatively affected by alcohol, you may have an alcohol use disorder (AUD) or addiction.

What is an alcoholic?

There is a high possibility that you have come across the terms alcoholic and alcoholism at some point. These terms are widely used to describe someone who has an alcohol use problem and for most people, it is considered the correct terminology for alcohol addiction. However, medical professionals and addiction specialists have been moving away from this term for years. 

The reason for this is that these terms simplify alcohol use into very basic terms. In reality, alcohol use and misuse exist on a broad spectrum and there is a vast difference between someone with no alcohol problems and someone with severe alcohol addiction. the term "alcoholism" could be applied to someone who drinks yet experiences no negative impact on their life as easily as it could to someone who is addicted. This does not help to identify alcohol use disorders (AUD) and can mean people with real problems believe they are fine.

Another reason "alcoholic" is not the preferred terminology is that it carries many societal connotations and baggage. These terms underplay alcohol abuse as being part of a wider mental health condition, one that can be treated and managed. Pejorative terms like alcoholic suggest a moral shortcoming that can lead people to not believe they have a mental illness

For these reasons, most professionals now prefer the terms "alcohol misuse", "unhealthy alcohol use", or "alcohol use disorder" to describe the varying levels of alcohol abuse.

alcoholism symptoms

Alcohol use disorder (AUD) encompasses various harmful drinking behaviors, including alcohol abuse, alcohol dependence, and alcohol addiction (alcoholism). Warning signs of alcohol use disorder are related to patterns of drinking, the continuance of alcohol consumption despite negative consequences, and the presence of withdrawal symptoms.

The consumption of an increasing volume of alcohol, particularly if more alcohol is consumed than was intended, or if the individual finds it difficult or impossible to stop drinking, may indicate a problem. Often those with alcohol use disorder develop a tolerance to alcohol, requiring more and more to have the same effects.

Other symptoms of alcoholism may include:

  • Alcohol-related accidents
  • Saying or doing things that hurt others or yourself
  • Mood swings
  • Impaired ability to work
  • Depression or anxiety

Another indicator is if there is an intense craving for alcohol, and a large proportion of time is spent on obtaining alcohol, drinking it, and recovering from a drinking session.

The presence of withdrawal symptoms, if alcohol is not consumed, is also an indicator of alcohol use disorder.

What causes alcohol addiction?

In most cases, a person's likelihood of developing an alcohol use disorder is directly related to their drinking habits, such as frequency of drinking and volume of alcohol consumed. Research also shows that psychological, biological, and social aspects also play a part in an individual’s predisposition to developing an alcohol use disorder. 

Some of the contributing factors to developing an AUD are:

  • Genetics 
  • A family history of alcoholism
  • Parental drinking habits
  • Exposure to trauma in childhood
  • Drinking alcohol in adolescence
  • Mental health issues such as depression and anxiety
  • Psychiatric disorders such as bipolar disorder and antisocial personality disorder.

The exact relationships between other conditions and the development of a disorder are unclear. It is unknown whether these conditions increase the risk of AUD or if they are more likely to develop due to excessive alcohol consumption.

Related blog: What Stages of Drunk Are There?

Alcoholism facts

The below statistics have been collected from the National Institute on Alcohol Abuse and Alcoholism (NIAAA).

General alcohol abuse statistics

  • Over 14.5 million people aged 12 and over struggle with an alcohol use disorder in the United States
  • Less than 10% of those receive treatment or attend rehabilitation centers
  • More than 65 million Americans report binge drinking or heavy drinking in a one-month period, which is more than 40% of those who drink alcohol
  • In 2018, there were 10,511 alcohol-impaired driving fatalities, totaling 29% of all traffic fatalities for the year 
  • Teen alcohol use kills 4,700 people each year, more than all illegal drugs combined.

Alcohol abuse statistics for women

  • According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), more than 5.3 million women aged 18 and older have an alcohol use disorder
  • Approximately half of women of childbearing age drink, and 18% of women in this group binge drink (drinking on average five drinks per binge)
  • More than 45% of all adult women report drinking alcohol in the last month, and 12% of these report binge drinking
  • Alcohol addiction in women has increased by 83.7% between 2002 and 2013, according to a 2017 study sponsored by the NIAAA
  • “High-risk” drinking in women, defined as more than three drinks in a day or more than seven in a week, is on the rise, with an increase of 58% between 2001 and 2011 according to the 2017 study by the NIAAA
  • Experts estimate that approximately 40,000 babies may be born with a fetal alcohol spectrum disorder (FASD) in the United States each year, and up to 8,000 of those with fetal alcohol syndrome (FAS)

Related blog: Canada Reduces Alcohol Consumption Recommendations

Alcohol abuse statistics for men

  • Nearly 60% of adult men report drinking alcohol in the last month; with 23% of them reporting binge drinking five or more times per month
  • Men are twice as likely to binge drink as women
  • Approximately 8.4% of men met the criteria for alcohol dependence in the last year
  • Men are nearly twice as likely as women to drink-drive and be involved in fatal motor vehicle traffic accidents while under the influence of alcohol
  • Men are more likely than women to die by suicide while under the influence of alcohol
  • Male-dominated professions and businesses often have higher rates of alcohol-related problems than female-led ones

Related: Living with an alcoholic

Immediate effects of alcohol

Alcohol is a depressant that affects the central nervous system, causing mental and physical faculties to slow down and become impaired.

This means that alcohol consumed in small doses (1–2 units) can reduce anxiety and stress and make the consumer feel relaxed. For this reason, alcohol is often consumed in social situations where it may reduce anxiety, negate worries about others’ opinions, and boost confidence.

While the early effects of alcohol use are usually fairly mild for most people, prolonged use can cause more severe symptoms. The culture of alcohol consumption in Western countries has also made it difficult to identify the difference between casual use and abuse. The most common differentiator is that abuse typically in a negative impact on one's life, such as:

  • Financial difficulty
  • Relationship problems
  • Illness or physical harm
  • Issues with work
  • Trouble focusing without alcohol
  • Psychological damage

Read here to find out more about the short and long-term effects of alcohol on physical and mental health.

Beer abuse

Beer comes in many forms, ranging from lagers to ales, and is usually made from a combination of barley, hops, yeast, and water. Unlike other alcoholic drinks, it tends to have a lower alcohol content by volume (ABV), ranging from 1.8% to 11%. The most common beers on the market fall between 4 and 6 percent, with the average adult being intoxicated (over the legal driving limit) after 3 to 5 beers.

Beer consumption has long been associated with social activities; it’s served widely at sporting events and cinemas and is a “go-to” alcoholic drink for social activities such as happy hours. It is also associated with drinking games on college campuses and amongst teenagers and is often the first type of alcoholic drink a young person will consume.  

Beer has become even more mainstream in recent years with the increased popularity of microbreweries and craft beers. Craft beer producers are increasingly introducing new flavors and strengths of beers, and while the innovation has added more options for beer lovers, it does pose some risks. Craft beers have a higher ABV on average and can be as strong as 12%, meaning fans of craft beer can quickly build up a tolerance to alcohol, a characteristic warning sign of alcohol addiction.

Related: How long does alcohol stay in your system?

Wine abuse

Wine is traditionally produced by fermenting grapes but can also be made with other fruits. The most common varieties are red and white, depending on the grape used, and have different flavors depending on the level of fermentation, the region of the world it comes from and the type of grape used.

Wine is often viewed in society as a classy or sophisticated drink, with some varieties being very expensive. It is also a mainstay of fine dining and dinner parties, as well as being a collector’s item for connoisseurs. This can make it difficult to identify when someone has an issue with wine consumption. Wine also has reported health benefits that make it a more defensible drink for people with alcohol use disorders. 

As with all types of AUDs, the warning signs with wine are the same, even though the socially acceptable nature of it can make it appear less hazardous. If you or someone you care about shows signs of alcohol addiction with wine, such as excessive drinking or as a means of coping with depressive feelings, then there may be an issue.

You can find out more about the different types of alcohol here.

Liquor abuse

Liquor, also known as hard alcohol or spirits, includes vodka, gin, whisky, tequila, rum, and a myriad of other beverages. The ABV of liquor is considerably higher than that of beer or wine, typically ranging from 38–60% and reaching as high as 80 or 90%. Due to its high alcohol content, liquor is often consumed in smaller measures, around 1.5 oz for a single measure (25mL in the UK). Liquor is most commonly consumed in one of two ways; either on its own (“neat”) or mixed with a carbonated beverage (a “mixer”).

Grain liquor, such as Everclear, is sometimes referred to as ETOH. You can find out more about ETOH and what it is here.

Carbonation speeds up the rate of absorption of alcohol into the bloodstream, often causing faster intoxication. When consumed in single measures or shots, liquor is rapid and easy to drink, which can quickly lead to a pattern of alcohol abuse.

Related blog: Tips For Dry January 2023

Binge drinking

The term “binge drinking” refers to the consumption of five or more alcoholic drinks in a short time period (e.g. within 2 hours) on at least one occasion in a week. Binge drinking is most commonly associated with a regular pattern of alcohol use on specific days, such as Friday or Saturday nights.

It may not be considered an issue if the individual does not drink the rest of the week, however even occasional binge drinking can lead to harm, and in many cases, prolonged periods of binge drinking can lead to alcohol dependence.

Read here to learn more about binge drinking and its impact on health.

High-functioning alcoholics

While the effects of alcohol abuse are prominent for most people, some may not realize they have a problem. So-called “high-functioning” alcoholics are able to consume damaging levels of alcohol without it impeding their personal or professional lives.   

As the damaging nature of alcohol misuse does not affect high-functioning alcoholics in the same way, many do not realize they have an issue until it is too late, for example, if they start having withdrawal symptoms after short periods of not drinking. A New York Times article estimated that almost half of alcoholics may be high-functioning and that many high-profile professionals, such as doctors or professors, make up a significant portion of this figure.

Read here to learn more about functioning alcoholics.

Alcohol induced blackouts

Blackouts caused by alcohol are gaps in an individual's memory that occur during intoxication. These blackouts occur when a person has consumed enough alcohol to block the communication between short-term and long-term memory in the hippocampus. This creates a gap in the person's memory of the night before as the short-term information is discarded before it can be stored in long-term memory. 

There are two types of blackout caused by alcohol, fragmentary blackout and en bloc blackouts. Fragmentary blackouts are more common, where an individual will experience periods of memory separated by no memory at all. These are the more common form of memory blackout when intoxicated by alcohol.

En bloc blackouts are extended periods of complete amnesia, where the person will have no memory at all for hours at a time. These are the most hazardous forms of blackout and are similar to taking high doses of GHB.

Research suggests that alcohol-related blackouts occur when blood alcohol concentration (BAC) reaches 0.16%, the same point where impulse control, coordination, judgment, and decision-making are also impaired. These blackouts are more likely to occur when alcohol enters the bloodstream quickly and is more likely in those who take anti-anxiety and sleep medication

Blackouts are different from passing out, where the intoxicated person loses consciousness, but are no less dangerous. Blackouts have been linked to serious violent and sexual assaults (notably against women) and the crimes are rarely solved as there is no recollection of the event.

Mixing alcohol and other drugs

Combining alcohol and other substances is both common and dangerous. Alcohol is a central nervous system (CNS) depressant and combined with other drugs, can have wide-ranging effects. For example, mixing cocaine and alcohol promotes the production of a substance called cocaethylene in the liver, which produces feelings of euphoria.

Related blog: Mixing Xanax And Alcohol

This toxic combination increases the risk of myocardial infarction, stroke, and liver damage and is thought to be the most commonly fatal two-drug combination. Combining alcohol with opiates such as heroin can boost the depressant qualities of both, which can lead to respiratory depression, hypoxia, coma, and death. 

Addiction to one substance increases the risk of becoming addicted to others, especially if taken in conjunction with each other to produce different highs. As alcohol is so widely available, the likelihood of combining it with other substances is high.

Related: National alcohol addiction helplines

Alcohol addiction treatment

Accessing help and thinking about recovering from alcohol addiction is a daunting prospect; however, it need not be faced alone. In fact, many alcoholics trying to combat their addiction alone are not successful.

There are many ways to get the help you need, through professional organizations and support groups, as well as alcohol addiction treatment and rehabilitation centers. The latter provides the best chance of a full recovery, owing to the professional attention addiction treatment centers can provide.

Options for alcohol treatment include:

Contact an addiction treatment center today to find your ideal center and begin the road to recovery.

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Activity History - Last updated: 15 April 2024, Published date:


Dr. Samantha Miller is a practicing NHS doctor based in Glasgow, UK, who regularly contributes as a medical reviewer for mental health and addiction.

Activity History - Medically Reviewed on 01 June 2021 and last checked on 15 April 2024

Medically reviewed by
Dr. Samantha Miller


Dr. Samantha Miller


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