Alcohol addiction can be influenced by a number of factors. Most people use alcohol socially to change how they feel because they want to feel better or different. They use alcohol for the perceived benefits, or the benefits experienced, not for the potential harm. People use alcohol to relax, have fun, to be part of a group, out of curiosity, and to escape from physical and/or psychological pain. Many of the reasons young people use alcohol are the same reasons adults use alcohol.
What causes alcohol addiction? Many factors influence a person's initial alcohol use. Personality characteristics, peer pressure, and psychological stress can all contribute to the early stage of alcohol abuse. These factors are less important as alcohol use continues and the person repeatedly experiences the potent pharmacological effects.
This chemical action, which stimulates certain brain systems, produces the addiction, while other psychological and social factors become less and less important in influencing the individual's behavior. When the pharmacological action of a drug dominates the individual's behavior and the normal psychological and social control of behavior is no longer effective, the addiction is fully developed. This self-perceived "loss of control" is a common feature of alcohol addiction and reflects the biological nature of the problem. People who are physically dependent on alcohol usually develop a tolerance. This means that they need to drink more and more to get the same effect.
School and job performance may suffer either from the aftereffects of drinking or from actual intoxication on the job or at school; child care or household responsibilities may be neglected; and alcohol-related absences may occur from school or job. The person may use alcohol in physically hazardous circumstances (e.g., driving an automobile or operating machinery while drunk).
Legal difficulties may arise because of alcohol use (e.g., arrests for intoxicated behavior or for driving under the influence). Finally, individuals with alcohol abuse problems may continue to consume alcohol despite the knowledge that continued consumption poses significant social or interpersonal problems for them (e.g., violent arguments with spouse while intoxicated, child abuse). When these problems are accompanied by evidence of tolerance, withdrawal, or compulsive behavior related to alcohol use, a diagnosis of alcohol addiction, rather than alcohol abuse, should be considered.
People who drink Alcohol on a regular basis become tolerant to many of the unpleasant effects, and thus are able to drink more before suffering these effects. Yet even with increased consumption, many such drinkers don't appear intoxicated. Because they continue to work and socialize reasonably well, their deteriorating physical condition may go unrecognized by others until severe damage develops - or until they are hospitalized for other reasons and suddenly experience alcohol Withdrawal symptoms.
Psychological addiction to alcohol may occur with regular use of even relatively moderate daily amounts. It may also occur in people who consume alcohol only under certain conditions, such as before and during social occasions. This form of addiction refers to a craving for alcohol's psychological effects, although not necessarily in amounts that produce serious intoxication. For psychologically addicted drinkers, the lack of alcohol tends to make them anxious and, in some cases, panicky.
Physical addiction to alcohol occurs in consistently heavy drinkers. Since their bodies have adapted to the presence of alcohol, they suffer alcohol Withdrawal if they suddenly stop drinking. Alcohol Withdrawal symptoms range from jumpiness, sleeplessness, sweating, and poor appetite, to tremors (the "shakes"), convulsions, hallucinations, and sometimes death.
Alcohol Withdrawal symptoms include but are not limited to:
- Sweating or Rapid Pulse
- Increased Hand Tremor
- Nausea or Vomiting
- Physical Agitation
- Transient Visual, Tactile or Auditory Hallucinations or
- Grand Mal Seizures
Since alcohol so easily permeates every cell and organ of the body, the physical effects of chronic alcohol abuse are wide-ranging and complex. Large doses of alcohol invade the body's fluids and interfere with metabolism in every cell. Alcohol damages the liver, the central nervous system, the gastrointestinal tract, and the heart. Alcoholics who do not quit drinking decrease life expectancy by 10 to 15 years.
Alcohol also can impair vision, impair sexual function, slow circulation, cause malnutrition, cause water retention (resulting in weight gain and bloating), lead to pancreatitis and skin disorders (such as middle-age acne), dilate blood vessels near the skin causing "brandy nose," weaken the bones and muscles, and decrease immunity.
Persons suffering with alcohol abuse finally grow obsessed with alcohol to the exclusion of almost everything else. They drink despite the pleading of family and the stern advice of doctors. They may begin round-the-clock drinking despite an inability to keep down the first drinks in the morning. Although relationships with family and work may become completely severed, nothing, not even severe health problems, is enough to deter drinking.
The late-stage alcoholic suffers a host of fears, including fear of crowds and public places. Constant remorse and guilt is alleviated with more drinking. On top of mental disturbances, debts, legal problems, and homelessness may complicate his or her life. Late stage addiction is characterized by cirrhosis and severe withdrawal symptoms if alcohol is withheld (shakes, delirium tremens, and convulsions). Without hospitalization or residency in a therapeutic community, late-stage alcoholics usually succumb to insanity and death.
People suffering alcoholism do not have to "hit bottom" and reach the extreme late stages of alcoholism to decide to get help. Many men and women have recognized their alcohol problems before they lost their jobs or families, or began drinking in the morning, suffered DTs, or had to be hospitalized. For them, the labels "early stage," late stage," "problem drinker," or "alcoholic" were less important than the fact that their growing powerlessness over alcohol was causing them pain.
The liver breaks down alcohol in the body and is therefore the chief site of alcohol damage. Liver damage may occur in three irreversible stages.
- Fatty Liver. Liver cells are infiltrated with abnormal fatty tissue, enlarging the liver.
- Alcoholic Hepatitis. Liver cells swell, become inflamed, and die, causing blockage. (Causes between 10 and 30 percent mortality rate.)
- Cirrhosis. Fibrous scar tissue forms in place of healthy cells, obstructing the flow of blood through the liver. Various functions of the liver deteriorate with often fatal results. (Found in 10 percent of alcoholics.)
A diseased liver:
- Cannot convert stored glycogen into glucose, thus lowering blood sugar and producing hypoglycemia.
- Inefficiently detoxifies the bloodstream and inadequately eliminates drugs, alcohol, and dead red blood cells.
- Cannot manufacture bile (for fat digestion), prothrombin (for blood clotting and bruise prevention), and albumin (for maintaining healthy cells).
Alcohol in the liver also alters the production of digestive enzymes, preventing the absorption of fats and proteins and decreasing the absorption of the vitamins A, D, E, and K. The decreased production of enzymes also causes diarrhea.
THE BRAIN AND CENTRAL NERVOUS SYSTEM
Alcohol profoundly disturbs the structure and function of the central nervous system, disrupting the ability to retrieve and consolidate information. Even moderate alcohol consumption affects cognitive abilities, while larger amounts interfere with the oxygen supply to the brain, a possible cause of blackout or temporary amnesia during drunkenness. Alcohol abuse destroys brain cells, producing brain deterioration and atrophy, and whether the organic brain damage and neuropsychological impairment linked to alcohol can be reversed is unknown. Alcohol also alters the brain's production of RNA (a genetic "messenger"), and serotonin, endorphins, and natural opiates whose function may be linked to the addictive process.
A neurological disorder called Wernicke-Korsakoff's syndrome results from vitamin B deficiencies produced by alcoholism and the direct action of alcohol on the brain. Symptoms of this condition include amnesia, loss of short-term memory, disorientation, hallucinations, emotional disturbances, double vision, and loss of muscle control. Other effects include mental disorders such as increased aggression, antisocial behavior, depression, and anxiety.
The Digestive System
Large amounts of alcohol may inflame the mouth, esophagus, and stomach, possibly causing cancer in these locations, especially in drinkers who smoke. Alcohol increases the stomach's digestive enzymes, which can irritate the stomach wall, producing heartburn, nausea, gastritis, and ulcers. The stomach of a chronic drinker loses the ability to adequately move food and expel it into the duodenum, leaving some food always in the stomach, causing sluggish digestion and vomiting. Alcohol may also inflame the small and large intestines.
Moderate daily drinking may be good for the heart, but for many the risks outweigh the benefits. Even one binge may produce irregular heartbeats, and alcohol abusers experience increased risk of high blood pressure, heart attacks, heart arrhythmia, and heart disease. Alcohol may cause cardiomyopathy (a disease of the heart muscle). Cessation of drinking aids recovery from this condition.