What is Alcohol Dependancy?
Alcohol is a staple of many cultures, with British society being no exception. For centuries, people in Britain have enjoyed alcohol at social gatherings, including sports events and celebrations of various kinds. The availability of this substance is widespread, and this fact, alongside societal approval, has made it easier to access alcoholic drinks than any other drug. However, the immediate accessibility of alcohol creates an additional level of difficulty for individuals recovering from alcohol dependence.
Experts use the term “alcohol dependence” both medically and psychiatrically. It refers to a situation where an individual develops physical or psychological dependence on a substance. This dependence occurs when brain chemistry adapts at the cellular level to the consistent use of alcohol. In other words, it functions normally only when certain levels of alcohol are present. When you stop the alcohol intake suddenly, it can result in withdrawal syndrome characterised by many unpleasant symptoms, some of which are incredibly dangerous.
Although some medical professionals have claimed that the word “alcohol dependence” sounds old-fashioned, others think differently, hence its continued currency in healthcare settings besides various alternative names.
The History of Alcohol Dependence
Despite the problem persisting in modern times, we can recognise cases of alcohol dependence throughout the course of human history. Even our ancestors knew about the dangers of drinking excessively, with contemporary authors describing alcohol withdrawal symptoms.
Naming this condition is not as clear-cut today, with experts opting not to utilise terms such as “alcoholism”. Though it may sound antiquated, the term has multiple meanings. It’s an umbrella term for both alcohol addiction and various related disorders. Granted, the general public often describes the condition using this term. However, medical professionals distinguish between various conditions and behaviours that are associated with long-term alcohol abuse.
One term experts use to diagnose this condition is “alcohol dependence”. It was adopted due to the current understanding that we need to look at alcohol as an external factor within the broader context of biological, psychological, and environmental interactions. In other words, this condition requires a multifaceted treatment strategy, distinct from approaches often used for other established diseases.
Alcohol dependence: Naming conventions
When we use the term “alcohol dependence”, we’re specifically referring to a process where an individual’s system starts to rely on the presence of alcohol in order to function normally in their everyday activities. This process is closely related to alcohol addiction, though the two are quite distinct from one another. Alcohol addiction is primarily a psychological phenomenon. It results from a disorder of the “reward system” the human brain implements when the individual consumes alcohol repeatedly.
Other terms related to alcohol dependence, with slight variation regarding how they manifest and operate, include “alcohol use disorder”, “alcoholism” (as previously mentioned), and “alcohol abuse”. The first two terms refer to a pattern of repeated consumption, one that ultimately results in physical and/or mental health issues. Alcohol abuse, on the other hand, refers to a whole range of unhealthy behaviours linked to beverage intake, involving binge drinking. However, the presence of alcohol dependence or addiction isn’t a requirement during this particular type of behaviour.
Psychological alcohol dependence
Somewhat vague, but nevertheless real and dangerous, psychological alcohol dependence is an issue where individuals develop an unhealthy reliance upon alcohol on a psychological level. In other words, they develop an obsessive desire for alcohol consumption, and their entire cognitive process is affected when there’s no alcohol in their system.
Considering this is a psychological issue, the underlying symptoms that indicate its presence will also be of a psychological nature. Some physical symptoms of withdrawal are definitely possible, but the indicators for this type of dependence will still be predominantly psychological and, more specifically, behavioural.
Physical alcohol dependence
When the human body adjusts to the presence of alcohol, it creates a new equilibrium, i.e., a basic level of “normalcy”. Therefore, when the alcohol is completely absent, symptoms that have a physical impact on you can manifest. More than a few of these symptoms can be fatal. This type of reliance on alcohol is a physiological phenomenon called physical dependence.
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The Psychological and Neurological Mechanisms
of Alcohol Dependence
The psychological mechanism behind addiction is yet to be completely understood, but experts recognise it as a disruption of the aforementioned brain’s reward system. Repeated engagement in certain behaviours conditions this system to reinforce them. Furthermore, the brain induces negative feelings when said behaviours are not pursued. For instance, individuals who often consume alcohol may find solace and psychological support in its consumption. The constant reemergence of that subjective feeling can lead users to continue consuming alcohol in order to avoid the discomfort of withdrawal.
On a neurological level, alcohol works by suppressing the activity of the central nervous system (CNS) through its enhancement of the neurotransmitter GABA (gamma-aminobutyric acid). Persistent alcohol consumption prompts adjustments in GABA activity within the CNS. That will result in abnormal function if alcohol intake is suddenly ceased. Given the crucial role of the CNS in the human body, such abnormal functioning can have severe consequences, potentially leading to fatal outcomes.
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What are the Causes and Types of Alcohol Dependence?
Every instance of addiction is distinct. Experts do not fully grasp the factors that contribute to it, although we understand that both environmental and genetic influences can play a vital role in its development. One indisputable fact is that alcohol dependence emerges from consistent consumption, and its development can be greatly reduced, even discontinued, when the individual abstains from further substance intake.
Experts contend that there is an entire spectrum of alcohol abuse. It ranges from occasional binge drinking to severe alcoholism, which encompasses both forms of dependence. For instance, there are specific alcohol consumers (the experts have dubbed them “functional alcoholics”) who manage to maintain relatively productive and successful lives. These individuals still grapple with serious alcohol use disorders, but they continue to hold steady jobs, engage in social interaction with their local communities, etc. At the other end of this spectrum, certain alcohol consumers are unable to function effectively. To use a colloquial term, their entire lives are quite literally consumed by alcoholism.
What are the Stages of Alcohol Dependence?
Classifying the levels of substance dependence is crucial in how we apply specific types of treatment. Considering we’ve known about the dangers of alcohol abuse for many millennia now, we have a vast pool of knowledge as a resource that we can use in classifying the severity of these forms of behaviours. Furthermore, experts in different medical and scientific fields have invested hundreds of thousands of hours researching alcohol dependence over the past few centuries.
Some difficulties do arise when researching and classifying this issue, partially because these systems can vary wildly, and because each individual case of substance abuse is unique. With that in mind, there is really no single, universally accepted classification. But if we’re talking in general terms, a rough estimate would produce three major stages:
- Early
- Middle
- Late
Early alcoholism
Early alcoholism comes about when you shift from being a recreational drinker to feeling the urge to consume alcohol specifically. You might feel a desire to drink more either because you seek the same effects as from your previous intake or because you wish to increase the intensity of those effects. This stage is also the first one where individuals feel the severity of withdrawal symptoms (as well as the first stage where withdrawal symptoms are even present, overall).
Mid-stage alcoholism
Mid-stage alcoholism already displays some alarming traits, such as an increased level of drinking to the point where it overtakes other activities. At this stage, the individual will display self-destructive behaviour, especially in social settings, manifesting as an inability to work or study, and increased problems with friends, romantic partners, family, etc. Physically, the person has reached a stage of constantly craving alcohol, experiencing mood swings more frequently, and facing increasingly severe withdrawal symptoms with each episode. The number of blackouts also increases at this stage.
Late stage alcoholism
Finally, when discussing late-stage alcoholism, we have to stress how serious it truly is. Once you reach this point, alcohol becomes the dominant force in your everyday life. It will reach a point where you’ll consume the substance nearly every waking hour. Socially, your life will suffer extreme consequences, with many individuals outright cutting themselves off from their friends and loved ones. The isolation will only fuel the already severe levels of alcohol intake. The human body, at this stage, can suffer from a variety of life-threatening disorders, including liver cirrhosis. Fatalities are very much possible, to the point where even withdrawal symptoms will become extremely severe, but also potentially deadly.
Four Features of Alcohol Dependence
Certain common traits permeate every case of alcohol dependence. While we need to remember the uniqueness of each individual case of substance abuse, we must also be mindful of every pattern that indicates addictive behaviour. The four most common features, manifesting in nearly every person suffering from this condition, include cravings, loss of control, physical dependence, and tolerance.
- Cravings
Cravings are fairly easy to understand. When you drink to excess for a long time, your body feels a strong desire to continue drinking once that intake is paused. - Loss of control
Next, there’s the loss of control; when an individual who is dependent on alcohol starts to drink, they have an extremely hard time stopping themselves. - Withdrawal symptoms
The third stage is a manifestation of stage two, through withdrawal symptoms like sweating, shakiness, shivering, or nausea. - Tolerance
The fourth feature is tolerance; your body will eventually get used to a certain amount of alcohol intake, and you won’t feel the desired effects like you did in the early stages of consumption. As such, you’ll feel the need to consume even more, precisely so you can replicate that feeling.
Who is Most at Risk of Alcohol Dependence Syndrome?
Broadly speaking, regular alcohol intake will always carry a risk of developing dependence, even with individuals who have no prior experience with addictive behaviour. Naturally, we should point out that certain individuals will always be more susceptible to the condition than others.
Here is a brief list of the most common risk factors:
- Concurrent mental health conditions
- Going through traumatic events
- Drinking during the early stages of your life
- Specific life or work-related challenge
- Shyness and low self-esteem
- Stress and anxiety (and other similar states of mind
- Working or spending long periods of time in an environment with immediate and open access to alcohol
- Living near facilities that trade, serve, or promote a lifestyle revolving around drinking
- Direct or indirect exposure to drinking (or other forms of substance abuse) at an extremely early age
- Having extra funds available for buying alcohol
- Continuously being exposed to advertisements related to alcohol
What are the Common Traits in Alcohol-Dependent People?
Despite each individual case of dependence being unique, experts have noticed a vast number of commonalities across different cases. The following is a list of the most common personality traits that individuals with alcohol dependence display:
- Isolation
- Notable reduction of patience
- Extreme sensitivity
- A sharp drop-off in self-esteem
- Acting deceitful
- Acting impulsive
- Manipulative behaviour
- Heavily increased propensity for risk-taking
- Defensiveness
- Preoccupation with how society perceives them
Statistics on Alcohol Dependence
Before proceeding, it’s important to highlight some of the most crucial statistics regarding alcohol dependence in the UK:
- In early 2024, 72% of adults drank alcohol at least once on a weekly basis
- From 2021 to 2022, there were 342,795 hospital admissions where alcohol acted as the primary factor
- In England alone, in 2023, 7,423 deaths were linked specifically to alcohol consumption
- Men are three times more likely to die as a result of alcohol-related issues
- Some 35% of adults drink at a level which indicates an increased risk of harm (roughly 14 units per week for men and 7 for women
The Effects of Alcohol Dependence on the Family and Society
Addiction, in general, is a detriment to family life. Members are forced to experience how their loved ones deteriorate and suffer from the destructive behaviour they often exhibit, all as a result of over-consuming an addictive substance.
In terms of family break-ups in the UK, alcohol is one of the highest factors contributing to the issue. That includes a cost to the NHS of up to £3.5 billion per year. These expenses don’t even account for the vast cost to police and social welfare services, which cannot be quantified accurately, but is undoubtedly vast. Experts estimate that the total cost of alcohol to the country’s GDP is more than £27 billion per year.
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High-functioning Alcoholics in Society at Large
Certain individuals might have no issue leading normal lives despite the severity of their alcohol dependence. The term experts use to describe this phenomenon, as we’ve outlined earlier, is “high-functioning alcoholism”.
According to some estimates, around 20% of individuals dependent on alcohol can fall under the high-functioning category. Due to their appearance and demeanour, these individuals often don’t fit the stereotype of someone struggling with addiction. Therefore, the alcohol problems they suffer from can be hard to identify without more direct inspection. Nevertheless, they face significant health risks, and their descent into low-function alcoholism is highly likely.
Common Warning Signs of Alcohol Dependence
As an individual who drinks often, you might not be able to assess your level of dependence on alcohol. However, there are multiple warning signs that appear before major problems become evident. Certain indicators include:
- An immediate desire to have an alcoholic drink upon waking
- Alcohol-induced anxiety and depression due to changes in the brain’s structure
- Organising daily activities with alcohol as a priority
- Worrying about securing the next alcoholic beverage
- An overwhelming urge to consume alcohol
Notable Physical Symptoms of Alcohol Withdrawal
Experts claim that physical alcohol dependence can be identified by observing specific, visible symptoms that appear when the alcohol consumption stops. The following list contains a few of the common symptoms of withdrawal:
- Seizures (which can be life-threatening)
- Hand tremors (colloquially known as “the shakes”)
- Excessive sweating
- Depression
- Heightened anxiety
- Challenges with sleeping (which may escalate to severe insomnia)
- Visual hallucinations
- Delirium tremens
The Long-Term Serious Health Effects of Alcohol Dependency
We cannot understate how severe long-term alcohol abuse can be for the human body. Some of the effects it has, both physically and mentally, on the drinker can be fatal. Of these effects, the most devastating ones are:
- Stroke
- Heart disease
- Pancreatitis
- Liver-related illnesses, such as cirrhosis
- Various forms of cancer, including those of the liver, intestines, mouth, and breast
Diagnosis of Alcohol Dependence
Diagnosing this form of dependence comes with its own set of difficulties. One of the most common ones involves the patient being uncooperative. In the UK, specialists in alcohol dependence utilise various types of screening questionnaires. These tools can help identify and classify what type of alcohol use disorder the individual is suffering from. One commonly used type is the Alcohol Use Disorders Identification Test or the AUDI. Another is the Fast Alcohol Screening Test or FAST. Both of these may be given by any general practitioner.
Another popular method involves blood testing. This can help identify long-term substance abuse, as well as pinpoint what particular damage was done to the body as a result of excessive alcohol intake. Some of the common tests carried out by experts include ALT (alanine aminotransferase), bilirubin, GGT (gamma-glutamyl transferase), and MCV (mean cell volume).
Alcohol Dependence Treatment
With the advances in modern technology and extensive research, experts have become highly skilled when it comes to treating alcohol dependence. In fact, across the UK, you can find multiple treatment facilities that apply the latest methods of treatment, taking every detail into consideration throughout your ordeal.
A period of reduced alcohol intake will ensue, which is an optimal time to implement proper addiction treatment. The sooner this treatment is applied to the patient, the better.
The treatment process can be facilitated through proper medication prescription. Broadly speaking, there are two phases that make up this process:
Detox, coupled with withdrawal
During this phase, medical professionals monitor the patient for safety and, if necessary, administer appropriate medication
- Therapy
Experts will help you understand what caused the addiction and determine the best approach for handling it.
Getting the Necessary Help
Do you recognise any of the previously mentioned symptoms? If so, we encourage you to contact your GP and discuss what you need to do next. In addition, we highly recommend reaching out to a licensed addiction specialist. Discuss your condition with each individual expert openly and in detail. They will provide the most effective form of treatment, tailor-made for your particular level of alcohol dependence.
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