What are the Signs of Alcoholism?

Alcoholism is the most serious type of problem drinking. It describes an often uncontrollable and strong desire to consume alcohol. Alcoholism is known by a variety of terms such as alcohol addiction, alcohol dependence or alcohol abuse and it has been more recently referred to as alcohol use disorder. It occurs when a person drinks so much that their body becomes physically dependent on, or addicted to, alcohol.

People who suffer from alcoholism will often be unable to prioritise anything else above their need to drink; this can include their work commitments and their family and friends. Even when their drinking is having a negative and often devastating impact on their life and relationships, this is still not enough to make them stop as the pull to use alcohol is so strong.

UK Government and NHS statistics show that there are an estimated 589,000 people who are dependent on alcohol in England and, according to government and NHS statistics, in 2018/2019 there were 358,000 estimated admissions to hospital, where the main reason for admission was attributable to alcohol.

In England in 2018, there were 5,698 alcohol-specific deaths. A further 1,920 deaths were also due to unspecified hepatitis and fibrosis and cirrhosis of the liver. These deaths are not included in the alcohol-specific charts because they are defined as only being partially attributable to alcohol.

If you are interested to learn more about UK alcohol statistics, you can find these in more detail by visiting the alcohol change website.

The NHS advise that to keep health risks from alcohol to a minimum, neither men nor women should regularly drink more than 14 units of alcohol a week. One unit of alcohol would be the equivalent of half a pint of lower to normal-strength lager/beer/cider or a single small shot measure of spirits.

A small glass of wine contains about 1.5 units of alcohol. If you drink as much as 14 units a week, the NHS advise that this is spread evenly over three or more days.

Please visit the following link for further information and advice about recommended alcohol use from the NHS.

What are the signs and symptoms of alcoholism?

Alcohol addiction is not always obvious. The disease convinces people they don’t need to get help, and they can become skilled at hiding or covering up their drinking or the extent of the problem.

Here are some signs that someone’s drinking is becoming problematic and they may need some support:

• Lying about or covering up their drinking levels.
• Drinking alone and to excess.
• Drinking until they pass out.
• Drinking alcohol first thing in the morning.
• Appearing drunk more often or needing to drink more to get the same effect.
• An inability to say no to alcohol.
• Feeling anxious or depressed or having trouble sleeping.
• Appearing unwell, irritable or tired.

The types of alcoholism?

When someone hears the word ‘alcoholic’, a particular image may come to mind, and someone who is labelled an alcoholic may be stereotyped according to society’s view of what an alcoholic is or isn’t. There are five alcoholic subtypes and it is important for society and individuals suffering from alcoholism to understand these alcoholic subtypes in order for the right support to be sought and accessed.

Young adult alcoholic 

The largest percentage of alcoholics fall into this group, making up nearly one-third of all alcoholics. This group is typically in their late teens or early 20s and often this group of young people are within a culture that promotes and encourages excessive social drinking; for example, these may be university students where it would be the norm for them to socially drink to excess on a regular basis.

The Centers for Disease Control and Prevention (CDC) report that young drinkers usually consume more alcohol at a time than older drinkers and 90% of the alcohol consumed by this group is through binge drinking. Binge drinking is classified as excessive alcohol use within a short period of time.

In the UK, binge drinking is drinking more than 8 units of alcohol in a single session for men and 6 units of alcohol in a single session for women. Binge drinking can increase tolerance levels of alcohol which can then lead to a physical dependence on alcohol. This can then lead to alcohol addiction.

Often young adult alcoholics will not seek help as it is often considered to be ‘normal’ within this age group. Neither the young person themselves or their family members would consider it to be an ongoing or long-lasting problem that they need to access support for and therefore opportunities to access help and support can often be missed.

Alcoholism is often considered to be a heritable disease and the National Institute on Alcohol Abuse and Alcoholism (NIAAA) report that genetics can account for approximately half of the risk of developing the disease.

However, within the young adult alcoholic group, they rarely have a family history of alcoholism, and it is environmental and other factors which contribute to them developing the disease. Binge drinking, using drugs whilst drinking, peer pressure and drinking before the brain is fully formed can result in the onset of alcoholism.

Young antisocial alcoholic 

This subtype of alcoholics are usually in their mid-20s and have been drinking from a young age. It is thought that regular exposure to alcohol may actually change the way the brain’s circuitry works. This is because alcohol impacts the chemistry in the brain.

Over time the person may have cravings or withdrawal symptoms when alcohol is not being used, which will encourage them to drink more. Young people are usually more likely to take bigger risks in life and it can be difficult for them to control impulses or emotions. Young people do not have a fully developed prefrontal cortex until the age of 25.

It is thought that more than half of all young antisocial alcoholics have a family history of alcoholism and also more than half struggle with antisocial personality disorder. When someone has a mental health diagnosis, their risk of developing alcoholism or substance abuse issues is increased.

Alcohol can often be used by people suffering from a mental health condition to ‘self-medicate’. This can also include bipolar disorder, anxiety disorders and depression. It is thought that only one-third of antisocial alcoholics will seek support and treatment.

Functional alcoholic 

This group are usually middle-aged, well educated, have the appearance of a stable family life and a steady, possibly even successful job. They often do not fit into the traditional stereotype of alcoholics and are not what society would perceive as being an alcoholic. They can often be successful in life and are often able to keep their drinking separate and lead what could be thought of as a double life.

They can be skilled at covering up when issues of alcohol abuse are raised and family members can often make excuses for them which enables their behaviour. As they usually deny they have a problem with alcohol, this means that they are more unlikely to seek professional help.

It is thought that about one-third of this group have a family history of alcoholism and one-quarter have had at least one major depressive episode in their life. Depression and other mood disorders are thought to increase the risk of becoming alcohol dependent due to their increased vulnerability and alcohol being used as a way to ‘self-medicate’.

Intermediate familial alcoholic 

This group will usually be middle-aged, and about half of all cases have multigenerational family members suffering from alcoholism.

One in five intermediate familial alcoholics are thought to also use cocaine and marijuana. Using more than one substance increases the risks associated with substance and alcohol abuse, as opposed to using one substance in isolation, and the risk that the person will become addicted to one or more substances is increased.

Nearly half of all intermediate familial alcoholics have been diagnosed with clinical depression and 20% have a diagnosis of bipolar disorder. As with other mental illnesses, alcohol can be used as a way of ‘self-medicating’. Around one-quarter of intermediate familial alcoholics are thought to access treatment for their drinking.

Chronic severe alcoholic 

A chronic severe alcoholic is what many people may think of as a stereotypical version of an alcoholic. They are often middle-aged and began drinking at a young age. Often they will get into trouble with the police and have antisocial personality disorder.

Chronic severe alcoholics usually suffer from mental illnesses more than in other alcoholic subtypes, including bipolar disorder, depression and anxiety disorders. To find out more about how drugs and alcohol affect mental health, please visit our knowledge base.

Chronic severe alcoholics usually have issues with other drugs more than you would expect to see in other alcoholic subtypes. This can include cocaine, opioid and marijuana addiction in addition to alcohol dependence. Further reading around the different types of substance abuse can be found on our knowledge base.

This alcoholic subtype is more likely to seek and access professional help as the implications of their alcohol abuse are often severe which can include homelessness, loss of their job, criminal and legal problems, relationship breakdowns and physical and mental health issues.

How do i support someone suffering from alcoholism?

If you are concerned about someone’s alcohol use it can be difficult to know how to support them. It is important to remember that if the person concerned does have an alcohol dependency or addiction, then they will likely be struggling and will need your support and understanding.

Being non-judgemental in your language can really help in making someone feel supported and understood and they will be more likely to confide in you. Using labels such as ‘alcoholic’ is likely to make them feel judged so this should be avoided when having these sensitive conversations.

It is important to remember that the person needs to first recognise themselves that there is a problem and want to change; you cannot force this upon them. This may take time, and having patience will be important when having these conversations. Their recovery cannot happen overnight.

It may be useful for you to have an understanding of what support is available before having the conversation. If they are open to accessing support, you will then already have this information to give them.

Some useful things to say may be ‘I’ve noticed you are not as positive since you’ve been drinking more’ or ‘you seemed really happy when you were going to the gym/taking dance lessons/playing football’ or ‘what is it that you think may be making you drink more?’. It is important not to make assumptions and allow them to open up about how they view their situation.

If you would like some further information about how to help someone who is suffering from alcoholism, you can find this here Healthline.

What help is available for alcoholism?

Recognising that you have a problem with alcohol is the first major step on the road to accessing support and recovering from alcohol addiction. Making an appointment with your GP is a great starting point. It is important to be honest about your struggles, how much alcohol you are using and what impact this is having on your life.

The GP may be able to suggest or refer you for assessment and for you to receive support through local community alcohol services. There may also be local support groups or alcohol counselling that may suit your needs. If you have become physically dependent on alcohol it may be harmful to stop drinking completely and therefore you will need professional/medical help with this. To stop drinking safely you may need medicine.

Some of the symptoms that may suggest you need medicine include:

• Anxiety after waking.
• Sweating or tremors.
• Nausea or retching in the morning.
• Vomiting.
• Hallucinations.
• Seizures or fits.

Useful contacts for alcohol-related problems 

• Drinkline is the national alcoholic helpline. You can call free and in confidence on 0300 123 1110 (weekdays 9 am-8 pm and weekends 11am – 4pm).
• Alcoholics Anonymous (AA) is a 12-step programme self-help group focussing on getting sober with the help of regular support groups.
• Al-anon family groups offer support to the family members aged 12-17 where they are being or have been affected by their family member’s or parent’s problem drinking.
• We Are With You is a treatment agency that supports individuals, families and communities to manage the effects of drug and alcohol use. If you are over 50 and worried about your alcohol use, call 0808 801 0750.
• Adfam is a national charity working with families affected by drugs and alcohol. They have an online message board and information about local support groups.
• The National Association for Children of Alcoholics (Nacoa) provides a free and confidential email and telephone helpline for the children of parents who are dependent on alcohol. Call their helpline for free on 0800 358 3456.
• SMART recovery groups help people decide whether they have a problem, offer techniques to aid recovery and assist with building motivation to change.