Alcoholism as a Social Problem

Alcohol is everywhere: festivals, sporting events, weddings, backyard barbecues, concerts, brunch… It’s hard to think of any social event that doesn’t at least offer it. Many revolve entirely around it. For countless Americans, drinking is a normal part of spending time with friends or family. If it doesn’t get in the way of their overall functioning, they always make plans to be safe when drinking, and they don’t have any health problems from it, there’s nothing to worry about. Right? Well, maybe not.

According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, alcohol use disorder involves drinking in a harmful pattern that notably distresses or impairs an individual. Alcohol use disorder can be classified as mild, moderate, or severe, depending on how many diagnostic symptoms are present. However, just because a person doesn’t currently suffer from an alcohol use disorder (AUD) doesn’t mean his or her alcohol use is healthy.

Despite enormous effort, addiction is still highly stigmatized. People tend to think they would never become addicted. Yet, it is estimated that over 14.5 million Americans suffered from AUD in the past year, based on 2017 surveys. AUD impacts men and women of various ages, races, education levels, employment statuses, and financial situations. And it doesn’t start overnight.

Most people in the United States drink. Based on surveys from 2017, an estimated 86.3 percent of Americans 18 and older have drunk alcohol at some point in their lives. An estimated 55.9 percent drank in the past month. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), at-risk drinking is consuming more than 4 alcoholic drinks in a day or more than 14 drinks in a week for men. For women, it is drinking more than 3 alcoholic drinks in a day or more than 7 in a week. Among people who go over these limits, around 25 percent already have an alcohol use disorder. NIAAA states that these limits are exceeded by almost 40 percent of American adults.

Yet, different alcoholic beverages contain different amounts of alcohol and serving sizes can vary, so these limits may be confusing on their own. The concept of “standard” drinks can help with health guidelines. Every 0.6 fluid ounces of pure alcohol is one standard drink. This means that for a wine that is 12% alcohol, 5 ounces would be a standard drink. Twelve ounces of a beer that is 5% alcohol is a standard drink, and 1.5 ounces of a liquor that is 40% alcohol is a standard drink. Even if a drink’s serving size or alcohol content are different from these, with a little math (or an online standard drink calculator), a person can figure out how many standard drinks it contains so he or she can make safer choices.

Why should individuals limit their drinking if it isn’t causing them problems? Alcohol use can trigger the brain’s reward system. When this happens repeatedly, it can result in alterations to a part of the brain called the striatum, which is involved in the development of habits. This may prompt a person to compulsively drink. So even if a person is in control of his or her drinking now, regular drinking can change the brain in a way that makes it harder and harder for that person to stay in control.

Furthermore, the brain can link certain cues that are often present when a person drinks to drinking, so that when that person later encounter those cues he or she may have a strong desire to drink. These cues are often referred to as triggers. Triggers can be anything: friends a person often drinks with, football games a person often drinks during, emotions a person often drinks to cope with, and more.

Over time, more and more alcohol is needed to get the desired effects. Being able to “hold one’s liquor” is often a point of pride, but it can have dangerous consequences. Tolerance can prompt a person to increase his or her drinking, which may lead to dependence and medical problems.

Long-term use of large amounts of alcohol can cause the brain to adapt to its presence. If the person stops drinking, withdrawal symptoms can develop. These symptoms can push a person to drink more to make them go away. Alcohol withdrawal can be deadly so its symptoms should not be ignored. Anyone who experiences withdrawal symptoms when he or she stops drinking should seek medical help immediately.

Drinking too much may lead to injuries or deaths from unsafe behaviors (such as drunk driving), violence, suicide, and alcohol poisoning. It can negatively impact mental health. Excessive drinking is linked to several physical health issues, including problems with the heart, liver, and pancreas. It can weaken the immune system. It can even increase the risk of certain cancers. Furthermore, excessive drinking can cause relationship problems, school or work difficulties, financial trouble, and legal issues.

There are some groups in particular who should completely avoid alcohol, including (but not limited to) pregnant women, women who could be pregnant, individuals under age 21, and people who take medicines that may have interactions with alcohol. Additionally, if an individual does not already drink, starting is not recommended.

Of course, not everyone who regularly drinks becomes addicted. Factors that may impact the likelihood of an individual developing a substance use disorder include his or her genetics, personality, experiences, age of first use, and environment. Still, it is impossible to definitely predict whether any individual will develop AUD. It’s better to lower one’s odds by sticking to a low-risk drinking pattern or just not drinking at all.

Think about your drinking habits. Are you going beyond NIAAA’s guidelines? If so, it’s time to think about making some changes. If you’re drinking too much at once, decide on healthier limits. Consider alternating with non-alcoholic drinks, and keep count of how many standard drinks you consume. Avoid situations that lead you to drink too much. If you’re drinking too often, cut out some of those drinking days. Think about your activities for the week and when you want to safely drink, and plan which days you will abstain. If drinking is a hobby or a coping mechanism for you, find a healthy replacement. Brainstorm alternatives and try them out. If you are struggling with mental health problems, seek professional help.

Tell your goals to someone who can help hold you accountable. If you find that you can’t keep to your limits, talk to a healthcare professional. Even if you don’t yet have an alcohol use disorder, a professional can provide you more guidance and support. Don’t wait for it to escalate.

If you or someone you know experiences mental health issues, it is important to seek help from a qualified professional. Our Resource Specialist can help you find expert mental health resources to recover in your community. Contact us now for more information on this free service to our users.

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About the Author

Sophie Stein is a Clinical Editor at American Addiction Centers. She received her master’s of science in nursing from Vanderbilt University School of Nursing. She is credentialed by the ANCC as a psychiatric-mental health nurse practitioner (P.M.H.N.P.) and is licensed as an advanced practice registered nurse. Sophie previously worked as a P.M.H.N.P. at an outpatient psychiatric practice providing mental health care for children, adolescents, and adults. She performed patient evaluations and medication management, including using pharmacogenetic testing to guide her treatment plans.

Sophie is passionate about helping those struggling with mental illness and substance use disorders, and she believes that providing those individuals and their loved ones with thorough, accurate educational resources is essential. This is what led her to her current position as clinical editor at American Addiction Centers, where Sophie works to ensure the information provided is reliable and up to date.

Credentials

M.S.N. – Vanderbilt University School of Nursing
P.M.H.N.P. – American Nurses Credentialing Center (ANCC)
A.P.R.N. – Tennessee Board of Nursing

Photo by Kelsey Chance on Unsplash

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