What Do You Know About Alcohol Abuse?

The NIAAA reports that the highest rate of alcohol-use disorder is among young adults 18 to 29 years old. But no matter what age, alcohol abuse can lead to many health problems. These include liver disease, harm to the immune system, and brain damage. Heavy drinking raises the risk of developing cancer of the liver, esophagus, throat, and larynx. Alcohol also raises the risk for death from car crashes, falls in older adults, recreational injuries, and work-related injuries.

For women, it's only 1 standard drink. For men, it's 2 drinks. A drink is defined as 1 12-ounce bottle or can of beer or wine cooler, 1 5-ounce glass of wine, or 1.5 ounces of 80-proof distilled spirits. Women have a lower recommended drinking limit than men because a woman's body doesn't process alcohol as quickly as a man's. This is after drinking the same amount of alcohol. Heavy drinking is defined as more than 14 drinks a week for men, and more than 7 drinks per week for women. Binge drinking is defined as having 5 or more drinks on an occasion for men or 4 or more drinks on an occasion for women.

Healthcare providers use a guideline called the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to diagnose alcohol-use disorder. If you meet at least 2 of the 11 criteria over a 12-month period, you are diagnosed with the disorder. Depending on the number of criteria you meet, your diagnosis could be mild, moderate, or severe.

A person who has a family history of alcohol-use disorder is at greater risk for abusing alcohol. But research shows that the genes are responsible for only half of the risk for alcohol-use disorder. Things in a person’s environment make up part of the remaining risk. So does the interaction of a person’s genes with their environment.

Severe alcoholism is now called severe alcohol-use disorder. Its symptoms may include:

• A strong craving for alcohol
• A loss of control over how much alcohol is consumed at any one time and what the consequences of drinking are
• Withdrawal symptoms such as tremor or nausea if alcohol is not consumed regularly
• The need for more and more alcohol to feel good.

A person with mild, moderate, or severe alcohol-use disorder can get help from treatment.

Mixing alcohol with either over-the-counter or prescription medicines can be dangerous or even fatal. As people age, they are often prescribed more than 1 medicine for long-term (chronic) health problems. Many medicines interact harmfully with alcohol. Alcohol also can make many chronic conditions worse. These include high blood pressure and ulcers. Older people also have slower reaction times. They also may have problems with balance, hearing, and seeing. They also tend to have more brittle bones that can break easier in a fall. These factors combined with drinking can raise the risk for falls, car crashes, and other injuries in older adults.

Alcohol-use disorder also increases your risk for type 2 diabetes, stroke, heart attack, falls, and accidental death. Alcohol-use disorder may also make depression worse and affect memory.

Keep a diary for a week to track why and how much you drink. Wait an hour between drinks to slow down alcoholic intake. Pick 1 or 2 days a week to abstain from alcohol. If you think you may have a problem with alcohol, ask yourself these questions: Have you ever felt that you should cut down on your drinking? Have people annoyed you by criticizing your drinking? Have you ever felt bad or guilty about your drinking? Have you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover? If you answered "yes" to 1 of these questions, you may have a problem with alcohol. If you had more than 2 "yes" answers, it is very likely that you have a problem with alcohol. Talk with your healthcare provider to help you plan the best course of action. If you don’t feel comfortable talking with your current healthcare provider, find another provider.