There is no cure for alcoholism. It is a disease that with proper treatment and maintenance can be controlled or managed, but never cured. The designation of alcoholism as a disease helps explain why the vast majority of those suffering from an alcohol use disorder cannot “just stop” or rely on “willpower” to stop drinking for an extended period of time. That expectation is unrealistic, just as it would be for any other person diagnosed with any other disease.

When an addict is able to stop for a few months and then begin drinking again, the amount usually increases and there are more severe consequences, either medically, or with their family, the law, or their employment. No amount of sheer willpower is enough to help you quit drinking for an extended length of time without this recurring disease returning. It is not a weakness or a moral failing. You are not a bad person. You are the victim of an insidious disease that is beyond your ability to control.

The best alcohol rehab programs are evidence-based, which means that the treatment approach is grounded in the latest statistics, empirical data, clinical trials, and measurable success benchmarks. Accredited treatment programs such as Lasting Recovery adhere to established standards of addiction and mental health care.

What is Alcoholism?

In the broadest sense, alcoholism can be defined as any uncontrollable drinking of alcoholic beverages that causes problems for the drinker, be it health, psychological, relationships, work, school, or legal issues. More specifically, alcoholism can be described as a chronic, progressive disease characterized by excessive drinking. It is defined by a person’s inability to stop, and that, if not treated, will result in severe negative consequences for the sufferer—both psychologically and physiologically.

It is “progressive” because over time, the symptoms of the disease and the damage done by the abuse of alcohol worsen (while a physical dependency and tolerance for alcohol increases). It is “chronic” because it is a condition that will last for a person’s entire life.

Judy Saalinger, Co-Founder and Executive Director of San Diego’s premier alcohol and drug addiction treatment center Lasting Recovery, discusses “What is alcoholism?

What Causes Alcoholism?

The latest research suggests that there are a number of factors (genetic and environmental) that put a person at risk for developing alcoholism.

  • Variations in the genes that affect how alcohol is metabolized within the body can affect a person’s risk of alcohol use disorder. A good indicator of this is a family history of alcoholism.
  • People who are genetically disposed to alcoholism may also start drinking at an earlier age than people who are not.
  • Individuals who have suffered severe childhood trauma have a significantly higher risk of an alcohol use disorder.
  • Individuals who lack positive family or peer support also have an increased risk of alcoholism.
  • Certain co-occurring mental disorders, such as PTSD, depression, and bipolar disorder, can make a person more vulnerable to developing alcoholism as a coping mechanism. This is called co-morbidity.

It is important to note that not everyone who is influenced by the above factors will definitely develop alcoholism. Because there are so many factors, each person with an alcohol use disorder develops the disease differently.

In this video, Judy Saalinger from Lasting Recovery discusses “Why An Alcoholic Can’t Stop At 2 Drinks

Alcohol Abuse Exists on a Continuum

Alcohol use/misuse, alcohol use disorder, or AUD, is not an “all-or-nothing” proposition. Addiction is a progressive disease, and there are various stages along the way:

  • Non-Use/Abstinence – No current alcohol/drug use.
  • Experimental Use – Usually influenced by curiosity or peer pressure, this is when a person tries a substance. The younger a person is when they initiate use, the more likely it is that it will become problematic.
  • Recreational Use – When a person uses it occasionally, depending upon the social setting. 85-90% of the population find that their use doesn’t become alcoholism.

Stages Of Alcoholism

  • Early Stage – The 10-15% of the population who progress beyond Recreational Use to Early Stage Alcoholism, may notice an increase in alcohol tolerance, drinking to calm their nerves, or drinking before a function. At this stage the person finds occasional memory lapses begin to occur after heavy drinking, and he or she may feel a secret irritation when their drinking is discussed. This irritation may develop into denial – a flat disagreement and justification as to why their drinking is not a problem.
  • Middle Stage – Use becomes more regular – every day or every week, for example. At this stage, some consequences may begin to arise – DUIs, hangovers, conflicts with family, etc. While family and/or close friends are pointing out to the person that their use is a problem, the defenses to protect their growing physical dependency on the substances, mount.

Toward the end of the Middle Stage, the use becomes compulsive – the person is physically or psychologically dependent upon the substance and is losing the ability to regulate use. It is only when the consequences of using are more emotionally painful than the problems created by the alcohol, that a person will try to quit on their own or seek treatment. Interventions tried at this stage are often successful if the family is fully prepared to follow through with the consequences.

  • Late Stage – The negative consequences of use are plainly evident – relationship difficulties, health problems, work/school issues, legal entanglements, etc. – but use continues in spite of the impact.

Different Levels of Drinking

Although the amount of alcohol that an individual consumes is not, in and of itself, a criterion of alcoholism, the amount and frequency with which an individual drinks can be a reliable predictor of that person’s risk level. The National Institute on Alcohol Abuse and Alcoholism sets the following thresholds:

  • Moderate alcohol consumption – 1 drink per day for women; 2 drinks per day for men.
  • Heavy drinking – 5 + drinks on the same occasion on 5 + days in the past month (this threshold is recognized by the Substance Abuse and Mental Health Services Administration)
  • Low risk for developing an AUD – no more than 3 drinks on any one day and no more than 7 drinks in a week for women; no more than 4 drinks on any one day and no more than 14 drinks in a week.
  • Binge drinking – 4 drinks for women within a two-hour period; 5 drinks for men within the same timeframe.

*The Substance Abuse and Mental Health Services Administration (SAMHSA) has a slightly different definition of binge drinking – 5 + alcoholic drinks on the same occasion at least once during the past month.

disease of alcoholism recovery progression

Developed by E. Morton Jellinek. The Jellinek Curve, and later revised by Max Glatt, is a chart that describes the typical phases of alcoholism and recovery. E. Morton Jellinek is one of the fathers of the science of alcoholism. You can Download the Chart Here.

Signs and Symptoms of Alcohol Abuse

Like any and every drug in the world, the symptoms of alcohol abuse generally present themselves through behavior first, with the end result of use causing physical damage. In chronic cases of alcohol use, the physical and long term effects can lead to a stroke, heart attack, and even death.

Behavioral Symptoms

When someone is abusing alcohol, it always presents itself in behavior first. The following are some behaviors that may indicate alcohol abuse:

  • Drinking in secret
  • Hiding alcohol
  • “Blacking out” – not remembering actions, conversations, or commitments
  • Excessive talking / Chattiness
  • Aggression to the point of violence
  • Reckless and risky behavior
  • Lack of judgment
  • “Chugging” drinks
  • Needing to drink to feel “normal”
  • Promiscuity
  • Legal problems due to alcohol (DUI, OMV, etc.)

Mental / Emotional Symptoms

Once an individual begins to lose control, alcohol will begin to affect their mental and emotional states. This can be seen with symptoms like:

  • Intense depression
  • Intense elation
  • Alertness
  • Anxiety
  • Loss of contact with reality
  • Paranoia
  • Air of superiority
  • Invincibility
  • Wild mood swings
  • Extreme irritability
  • Hallucinations

Physical Symptoms

With chronic use, all drugs eventually take a physical toll on the body. The following are both short term and long term physical effects that alcohol can have on an individual:

  • Insomnia
  • Dizziness
  • Itchy and/or dry skin
  • Flushing
  • Numbness
  • Dry mouth
  • Yellow skin
  • Liver Disease
  • Abnormal heart rhythm (arrhythmia)
  • Rapid heartbeat (tachycardia)
  • Heart palpitations
  • High blood pressure (hypertension)
  • Hyperactivity
  • Constipation or Diarrhea
  • Blurred vision
  • Low blood pressure (hypotension)
  • Twitching and tremors
  • Headache
  • Rapid breathing (tachypnea)
  • Elevated body temperature (hyperthermia)
  • Profuse sweating (diaphoresis)
  • Nausea

Scientific Criteria For Defining Alcoholism

If you feel you or a friend or family member may be suffering from the disease of alcoholism, there are some questions you can ask yourself to help define the diagnosis.

In May 2013, the American Psychiatric Association published the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). According to this new diagnostic threshold, anyone meeting any 2 of the 11 criteria within a single 12-month timeframe would be diagnosed with alcoholism.

The severity of the rating (mild, moderate, or severe) depends upon the number of criteria met.

  • Alcohol is often taken in larger amounts or over a longer period than was intended.

1. “An inability to control when or how much one drinks”

  • There is a persistent desire or unsuccessful efforts to cut down or control alcohol use.

2. “An inability to stop drinking”

  • A great deal of time is spent in activities necessary to obtain alcohol, use alcohol, or recover from its effects.

3. “Substantial time is spent ‘seeking’ and using alcohol”

  • Craving, or a strong desire or urged to use alcohol.

4. “Feeling an overpowering compulsion to drink”

  • Recurrent alcohol use resulting in a failure to fulfill major role obligations at work, school, or home.

5. “Alcohol interferes with other activities and responsibilities

  • Continued alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol.

6. “Drinking even when it damages personal relationships”

  • Important social, occupational, or recreational activities are given up or reduced because of alcohol use.

7. “Reduced interest in formerly-pleasant activities and hobbies; increased isolation”

  • Recurrent alcohol use in situations in which it is physically hazardous.

8. “Poor decision-making; engaging in risky behavior because of alcohol”

  • Alcohol use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by alcohol.

9. “An inability to grasp or an apathy about the effects of alcohol”

  • Tolerance, as defined by either of the following:

a) The need for markedly increased amounts of alcohol to achieve intoxication or desire to affect.

b) A markedly diminished effect with continued use of the same amount of alcohol.

10. “Needing to drink more and more in order to get drunk”

  • Withdrawal, as manifested by either of the following:

a) The characteristic withdrawal syndrome for alcohol. b) Alcohol (or a closely related, such as a benzodiazepine) is taken to relieve or avoid withdrawal symptoms.

11. “Suffering unpleasant and dangerous physical and psychological problems when the consumption of alcohol is ceased”

As is evidenced, a diagnosis of alcoholism does not depend upon any particular type of alcohol (liquor, wine, beer), how long a period of time a person has been drinking (several years or a few months), the amount of legal trouble a person gets in because of alcohol (DUI’s, public intoxication charges, etc.), or even how much a person drinks.

If you feel that you or a loved one might have a problem with alcohol abuse or alcoholism, take our brief self quiz to find out.

Alcohol Use and Co-Occurring Disorders in San Diego

It is estimated that approximately 7% of American adults have some level of Alcohol Use Disorder, AUD. That means that in San Diego County, there are over 230,000 people who need specialized professional help for a drinking problem that is beyond their control.

In 2018, San Diego was named the “booziest city in America”. Local residents spend more money on alcohol than any other city in the country. The average household in the city spends over $1100 annually on liquor, beer, and wine.
In some ways, that isn’t surprising, because in addition to the “normal” places to get a drink, such as liquor stores and bars, San Diego County has the most craft beer breweries of any county in the United States.

AUD is also associated with a number of serious mental disorders. Excessive drinking worsens and is worsened by:

  • Depression: 2 out of every 3 alcoholics struggle with depression.
  • Anxiety: 45% of people with AUD have some type of anxiety disorder.
  • PTSD: Over 70% of rehab patients have a personal history of trauma.
  • Bipolar Disorder: 60% of patients with bipolar disorder will abuse alcohol and/or drugs.
  • Attention Deficit Hyperactivity Disorder: Up to 50% of adults with ADHD meet the clinical standard for a substance use disorder.
  • Eating Disorders: The rate of substance abuse among people with bulimia or anorexia is five times that of the general population.
  • Schizophrenia: 37% of schizophrenics experience a SUD before their first episode of psychosis.
  • Obsessive-Compulsive Disorder: 24% of people with OCD meet the lifetime criteria for an AUD diagnosis.
  • Conduct Disorder: Among people with conduct disorder, 78% of men and 65% of women will develop an AUD.

An alcohol use disorder is considered a Primary Disorder meaning that other mental health problems or diagnoses are not treated effectively if the alcohol use disorder goes untreated. This prevalence of such dual diagnoses is so high that when choosing an alcohol rehab program, your successful recovery absolutely depends on finding one that includes mental health treatment.

For more information about alcoholism and starting down the path to recovery, we have put together this collection of Alcohol Abuse Videos and Resources.

Treatment For Alcoholism and Alcohol Use Disorder

Alcoholism is chiefly characterized by a person’s uncontrollable and overpowering need to drink – regardless of consequences and desire to stop, but there is hope and recovery from alcohol addiction is possible.

Lasting Recovery’s premium Intensive Outpatient Program (IOP) and Partial Hospitalization Program (PHP) address the disease of alcoholism on multiple levels and are designed to support and further your journey of recovery. Our individualized services address the unique mental, emotional, spiritual, physical, and social needs of each client. While we do not provide residential detoxification services we are also able to recommend other options for detoxification.

Additional strategies that could help a person recovering from alcohol use disorder include:

  • Adhering to a healthy diet.
  • Getting plenty of regular exercise (physical, mental, and spiritual).
  • Distancing from people, places, and things that are a bad influence (i.e. drinking buddies).
  • Monitoring their moods.
  • Taking the time to seek help from others.
  • Seeking treatment to learn more about alcoholism and addiction, develop a sober support network, and learn how to enjoy the new sober lifestyle.

In other words, it is possible for a person with an alcohol use disorder to learn how to manage their disease and arrest its progress so they can go on to live a healthy, productive life — just like others in San Diego County.

If you or a loved one is struggling with alcohol abuse or alcoholism there is help available. As one of the most respected alcohol recovery programs in Southern California, Lasting Recovery uses evidence-based and wellness-focused treatment protocols that give you your best chance of a successful and enduring return to sobriety.

Lasting Recovery – “Where Wellness Begins…”

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