Alcohol Addictions: Signs, Dangers and Recovery

What is Alcohol Really?

Alcohol is a legal, controlled substance that lowers anxiety and inhibitions. It also has a broad range of side effects, from loss of coordination to slurred speech. Not everyone who drinks is an alcoholic, but anyone whose life is negatively affected by alcohol on a consistent basis is considered to have an alcohol use disorder. Alcohol is commonly consumed as a drink in various forms, including beer, wine and hard liquor.

Beer:

Beer, when compared to wine and hard liquor, has the lowest alcohol content by volume (ABV) and ranges between 2% to 12%. Beer has become synonymous with many activities – sporting events, socializing after work etc – this has led to what is often termed a ‘drinking culture’.

Even people who drink during social activities or only drink craft beer are susceptible to an alcohol use disorder. This is especially true when “social drinkers” continue to drink when everyone else has stopped or feel the need to drink during uncomfortable or boring situations.

Wine:

Compared to beer, wine has a more concentrated amount of alcohol. An average pour of wine (5 oz.) is equivalent in alcohol content to 12 oz. of beer. Wine is often consumed at dinner parties or alongside gourmet cheese and cracker pairings. Its status as a “classy” drink can make it harder to spot when someone has a problem.

Women make up 59 percent of wine drinkers in the United States and are often the targeted audience in advertising campaigns promoting the drink.  Women have less body mass and less water content than men in their bodies. When consuming wine, body water diffuses the alcohol content. This means that women have a higher concentration of alcohol in their blood stream when they drink than men. This causes women to become impaired more quickly when drinking wine and also exposes their brains and other organs to more alcohol before it’s broken down.

Because of this, women may be disproportionately susceptible to a wine use disorder. However, either gender can develop a problem. If you or someone you care about has been drinking wine more frequently than intended or using it to combat anxious or depressive feelings, there may be a deeper issue at play.

Hard Liquor:

Hard liquor is the umbrella term for hard alcoholic drinks or spirits like tequila, vodka, gin, rum and whiskey. Liquor has a much higher ABV than beer or wine and is often mixed with sodas, juices or water. The average size of a liquor pour is 1.5 oz. When not added to non-alcoholic mixers, hard liquor is consumed as a shot or “neat.” Carbonation speeds up the absorption of alcohol into the bloodstream, so drinking liquor mixed with soda can cause quicker intoxication. The lower liquid content of shots make them easier to consume, leading to a higher risk of abuse and subsequent drunkenness.

Those with a severe alcohol use disorder may feel that they can’t start their day without a swig of vodka, or finish it without a glass of whiskey on the rocks. Regardless of the type of hard liquor consumed, alcohol of any kind possesses serious addiction potential.

What is ‘Binge Drinking’

A subset of problem drinkers, binge drinkers are men who consume five or more alcoholic drinks or women who consume four or more over a two-hour period. An infrequent binge drinker may be able to stop on his or her own for some period of time. Someone addicted to alcohol, however, may want to stop drinking completely and not be able to without help. In many cases, prolonged binge drinking can develop into alcoholism.

Immediate Effects of Alcohol

Alcohol is a central nervous system (CNS) depressant, so it slows down mental and bodily processes. With the first drink of alcohol, users may experience a decrease in feelings of anxiety or stress. It is commonly touted as a social lubricant, meaning drinkers are more likely to feel confidence in meeting new people and less concerned with how they are perceived by others.

Because alcohol is legal and widely accepted in society, it can be hard to tell the difference between casual use and abuse. In general, any usage of alcohol that results in negative consequences is considered abuse. Some of the negative consequences of alcohol use include:

• Physical harm or illness
• Strained relationships
• Problems at work
• Financial difficulty

When abuse becomes more frequent, it can escalate into an addiction.

Alcohol Addiction

Alcohol addiction, also known as alcoholism, is marked by a craving for alcohol and the inability to stop drinking—even when it causes extreme personal or social harm. Signs of an alcohol addiction include frequently drinking more than intended, wanting to stop drinking but being unable to, developing a tolerance to alcohol, feeling symptoms of withdrawal when stopping, letting personal and professional responsibilities flounder in favour of drinking and spending an extreme amount of time trying to get and drink alcohol.

In addition, a mental obsession joins the physical craving for alcohol. Under the influence of alcohol, the drinker will become distracted with thoughts of alcohol (i.e. Do I have enough? Is anyone noticing how much I’m drinking? Why isn’t my friend drinking the same as me? Can I drive without someone telling me not to? What did I do last night? … the list goes on and on).

The effects of alcoholism on family, colleagues and friends can be devastating. Many professionals call alcoholism a “family disease” because of the impact that ripples through members of the user’s family. Untreated alcoholism is a major factor in relationship break-ups, as well as many cases of domestic disturbance and violence.

High-Functioning Alcoholics

There is a specific class of alcoholism known as high-functioning alcoholism. People who are high-functioning alcoholics are capable of keeping their alcoholism from interfering in their professional and personal lives for a period of time.

A New York Times article estimated that as many as half of all alcoholics are high-functioning alcoholics. Lawyers, accountants, professors and doctors make up a large portion of these individuals.

High-functioning alcoholics rarely recognize they have a problem until they face severe alcohol-related consequences. The danger of high-functioning alcoholism is that it can continue for years without a person ever recognizing they have a problem.

Signs of Alcohol Abuse

Alcohol abuse is defined as any use that causes negative consequences to the user. This encompasses health effects, such as bad hangovers and alcohol-induced accidents, as well as social effects, such as doing or saying regrettable things while intoxicated. Just because someone abuses alcohol, does not mean they are dependent on or addicted to alcohol, but it is generally the first step towards the development of an issue later.

Binge drinking and alcohol abuse can start in the teenage years or even earlier, though adults and the elderly may pick up the habit too.

Alcoholism often begins in a person’s early 20s and is characterized by frequent heavy drinking. This behaviour leads to an increased tolerance to alcohol and eventually presents social and health problems. Recognizing when someone you care about is abusing alcohol can help you determine if they need help.

Some of the signs of alcohol intoxication include:

• Slurred speech
• Bloodshot eyes
• Lack of coordination
• Rambling or repetitive statements
• Difficulty standing up or walking
• Disorientation
• Agitation or anxiety
• Glassy or blank stares

The Dangers of Alcohol Abuse

Many people don’t recognize the damaging effects of alcohol because it is so prevalent in society. Whether it’s having one too many drinks at happy hour after work one night or developing a pattern of frequent binge drinking, the effects of alcohol can be seen across the country in many forms. Long-term abuse of alcohol takes a serious toll on the brain and body, as every organ is affected by it. Certain organs, such as the liver and the brain, are affected more than others.

Although many people drink to feel buzzed, the ramifications of alcohol abuse can persist long past the initial period of intoxication. Short-term side effects of alcohol abuse can include:

• Trouble breathing
• Impaired judgment
• Headaches
• Blackouts
• Nausea
• Distorted vision and hearing

Long-term effects of alcohol abuse are more serious and can include irreversible damage that could lead to death. Some of the common long-term effects of alcoholism include:

• Depression
• Permanent brain damage
• Psoriasis
• Anxiety disorders
• Neurological impairment
• Cirrhosis of the liver
• Chronic pancreatitis
• Hand tremors
• Compromised immune system
• High blood pressure
• Sexual problems
• Nerve damage
• Vitamin B1 deficiency
• Malnutrition
• Gastritis
• Unintentional injuries such as car crashes, falls, burns, and drowning
• Intentional injuries such as firearm injuries, sexual assault, and domestic violence
• Alcohol poisoning
• Cancer of the mouth and throat

Alcohol abuse can cause many non-medical effects as well, some of which are as serious or worse than many of the health consequences. Non-medical effects of alcohol abuse include:

• Legal issues
• Relationship issues with family, friends, and significant others
• Financial issues
• Feeling guilt or shame about drinking or actions while under the influence
• Needing alcohol to relax or feel better
• Issues at work such as tardiness, absenteeism, and decrease in productivity
• Spending the majority of time on activities that involve drinking
• Drinking alone
• Being unable to control alcohol intake
• Making excuses to drink
• Continuing to drink even when legal, social, or economic problems develop
• Giving up important social, professional, or recreational activities because of alcohol abuse
• Cravings or obsessive thoughts about drinking
• Lapses in memory

Studies have shown that those who use alcohol as a teen have up to five times the risk of developing a dependence on alcohol compared to those who began drinking at 21. Teens who abuse alcohol also have significant issues with normal brain development.

Recognizing Alcohol Addiction

Because alcohol is so prevalent throughout society, diagnosing an addiction to it can be difficult. Heavy drinking can lead to dependence, but a heavy drinker doesn’t necessarily have a use disorder — at least by the clinical definition according to the DSM-V. Here are the 11 criteria used by professionals to diagnose alcoholism.

1. Taking alcohol in larger amounts or for longer than you’re meant to.
2. Wanting to cut down or stop using alcohol but not managing to.
3. Spending a lot of time getting, using, or recovering from the use of alcohol.
4. Cravings and urges to use alcohol.
5. Not managing to do what you should at work, home, or school because of alcohol use.
6. Continuing to use alcohol, even when it causes problems in relationships.
7. Giving up important social, occupational, or recreational activities because of alcohol use.
8. Using alcohol again and again, even when it puts you in danger.
9. Continuing to use, even when you know you have a physical or psychological problem that could have been caused or made worse by alcohol.
10. Needing more alcohol to get the effect you want (tolerance).

Development of withdrawal symptoms, which can be relieved by taking more of the substance.

An alcohol use disorder (“AUD”) can be mild, where the drinker only meets two or three of the criteria for addiction; four or five is considered a moderate disorder. The more criteria present, the more severe the disorder. These are what people traditionally think of as alcoholics.

Recognizing an AUD comes down to the negative effect of alcohol on the user’s life. When alcohol takes priority over close relationships, work responsibilities or personal health, the user likely has a problem. Alcohol has the highest rates of abuse and addiction in America, with millions of people suffering.

NOT SURE IF YOU ARE AN ALCOHOLIC? Take a look at our online self-assessment questions here: https://www.thelighthousebali.org/addiction-self-assessment/

Withdrawal and Treatment of Alcohol Addiction

The first step of recovery is alcohol detox, or cleansing the body from all physical traces of alcohol. Those who have used alcohol heavily over a prolonged period have developed a dependence on it, meaning their body doesn’t quite function normally without it. 

Alcohol detox can be painful, distressing, and dangerous because it requires a person to experience the full range of withdrawal symptoms. Withdrawal often causes a person to relapse, but detox affords them the opportunity to stop drinking safely and less painfully. Someone who resolves to experience withdrawal and not suppress it by having another drink will take the process most seriously, but the gain is lost if they endanger their life by doing so.

The Lighthouse Bali is one of only a few rehabs in Bali that can carry out a medical detox from alcohol. A medical detox is necessary to prevent potentially fatal complications. Shaking, sweating, seizures, hallucinations and even fatality are all very possible alcohol withdrawal symptoms. A medical detox is by far the safest and most comfortable way of withdrawing from alcohol.

What Are the Symptoms of Alcohol Withdrawal?

Everyone who undergoes alcohol withdrawal will have a different experience, but the most common symptoms of alcohol withdrawal are:

• Anxiety
• Confusion
• Fatigue
• Headaches
• Heart palpitations
• Heightened blood pressure
• Insomnia
• Irritability
• Nausea and vomiting
• Shaking and tremors
• Sweating
• Diarrhoea

Delirium Tremens

Delirium tremens is a condition which characterizes extreme alcohol withdrawal. Delirium tremens (the “DTs”) is potentially fatal because it can cause seizures. About 1 in every 20 people who experience alcohol withdrawal will also suffer delirium tremens. The condition is most likely to occur in people who are severely addicted to alcohol and have experienced alcohol withdrawal in the past.

Most symptoms of delirium tremens usually begin within two to three days after a person stops drinking. If you or someone you know exhibits signs of delirium tremens, it is important to get help right away. The symptoms of delirium tremens include:

• Emotional distress
• Fatigue
• Fever
• Hallucinations
• Hypersensitivity to sound, touch, and light
• Intense agitation or irritability
• Intense confusion
• Seizures (usually within one day of the last drink)

Alcohol Detox and Withdrawal Time Line

Most alcohol withdrawal symptoms begin within six hours after a person stops drinking, and they usually become most intense after two or three days. The withdrawal cycle usually lasts for about one week.

During the first 12 hours of withdrawal, a person may start sweating and become nauseous and irritable. Their blood pressure will rise and their heartbeat will accelerate. Withdrawal-induced insomnia and tremors usually begin within the first 12 hours as well. After 24 to 48 hours, the symptoms will worsen. In severe cases of withdrawal, the seizures (“shakes”) and hallucinations which characterize delirium tremens may begin to occur.

During the third, fourth, and fifth days of withdrawal, a person may experience emotional distress and delirium tremens may continue. After five days, the physical symptoms of withdrawal begin to subside, but psychological symptoms often persist. Some people will continue to have anxiety, irritability and insomnia for weeks or even months.

Post-Acute Withdrawal Symptoms (PAWS)

Post-acute withdrawal symptoms are not the norm, but can continue to occur for six months or longer after ceasing alcohol use in severe cases. Symptoms of PAWS include:

• Persistent anxiety
• Chronic insomnia
• Difficulty performing complex tasks
• Poor concentration
• Loss of sex drive
• Depression

Inpatient Care and Rehab

The Lighthouse Bali’s proven combination of an initial Primary Inpatient Program*¹  followed by Outpatient Care and Ongoing Therapy has helped alcohol addicts from around the world get their lives back on track. Through individually tailored treatment, professional therapy, medically assisted detox (if required), and compassionate support, you will be given the tools you need to ensure the best possible chances of a long term recovery.

If you are concerned about yourself or a loved one, we urge you to reach out and contact us in confidence. Our private programs are tailormade to suit individual needs and our doctorate level clinical staff have extensive experience in the field of addiction. If you are not currently in Bali but would like to begin a recovery program immediately, contact us and we may be able to arrange a VISA for entry in to Indonesia. We also have online recovery options available which can be taken should you not wish to travel.

To talk to one of our team members, contact us on WhatsApp or by Phone. Alternatively, send us an email and we will either answer your questions in writing or call you back, according to your preference Contact Us.

We understand how difficult it can be to reach out for help but it’s the first step towards recovery and a happier, healthier way of living.

*¹ The duration of Primary Inpatient Programs and Outpatient Care varies according to individual circumstances. Both Inpatient and Outpatient treatment is based around monthly (28 day) increments. As a general guideline we recommend between one to three months Primary Inpatient Programs for alcoholics, followed by one to two months Outpatient Care in Bali, and up to six months of ongoing therapy (by Zoom or Skype from home). Program durations are dependent on individual circumstances – no too drinking disorders or individuals are the same. The longer you stay in rehab, the better your chances of staying sober when you return home.