Is My Alcohol Consumption Becoming a Problem?

Do you enjoy a glass of wine with friends at dinner or a beer with friends at a sports game?

“Occasional, responsible drinking is a part of social interactions for many people,” said Lawrence Ferber, Ph.D., Director of Behavioral Health Central Intake Services at Catholic Health. “But when alcohol consumption happens frequently, especially when alone or as a coping mechanism for stress, that can be a red flag for alcohol use disorder.”

He emphasized that recognizing you may be developing a dependency on alcohol before it becomes a more severe problem can make a difference in getting proper treatment and heading down the path to recovery.

“Also, looking at your genetics is a good start,” he said. “If there is anyone in your immediate bloodline—parents, grandparents, aunts, uncles—who has alcohol/substance use issues, that can be cause for concern, and you should monitor your alcohol consumption.”

What is considered responsible drinking?

“There are guidelines by gender for the responsible amount of alcohol consumption, but they are not for people diagnosed with alcoholism or anyone who has major health problems impacted by drinking alcohol,” said Dr. Ferber.

For men:

Two drinks in one day
14 drinks in a week

For women:

One drink in one day
Seven drinks in a week

The National Institute on Alcohol Abuse and Alcoholism defines one alcoholic beverage as:

1.5 ounces of hard liquor or spirits
5 ounces of wine
12 ounces of regular beer
8 to 9 ounces of malt liquor

“Anyone who drinks alcohol more frequently than the recommended guidelines may be at risk for alcohol use disorder,” said Dr. Ferber.

What is alcohol use disorder?

Alcohol use disorder is a medical condition that is considered a brain disorder. The diagnosis is mild, moderate or severe, depending on the number of symptoms.

People with this condition cannot stop drinking alcohol even when it affects relationships, compromises their health, leads to avoiding social situations, and makes them unable to meet family, school or work obligations.

“The amount of alcohol and type of alcohol does not matter—they drink for the sake of drinking because the craving is so strong for them,” said Dr. Ferber. “They have built up their tolerance and drink more alcohol to achieve the same desired effect.”

Severe alcohol use disorder is commonly known as alcohol dependence or alcoholism.

What are the risk factors for alcohol use disorder?

“Although anyone can begin abusing alcohol, certain factors make certain people more at risk for alcohol use disorder,” said Dr. Ferber.

Onset of drinking. A national survey found that those who began drinking before age 15 were three times more likely to develop alcohol use disorder than those who waited until age 21 or later. The risk for females was higher than for males.
Genetics. The risk for alcohol use disorder increases if a person has a family history of alcoholism.
Mental health. People diagnosed with depression, post-traumatic stress disorder (PTSD), and attention deficit hyperactivity disorder (ADHD) are at an increased risk for alcohol use disorder.
Social pressure. Being around friends or family who drink frequently can influence a person’s inclination to drink. Alcohol ads, such as on billboards or social media, can also influence a person by showing drinking as something acceptable and “cool.”

What are the symptoms of alcohol use disorder?

“Even one or two symptoms of alcohol use disorder is cause for concern and the need to seek help,” said Dr. Ferber. “But the more symptoms a person has, the more severe the alcohol use disorder and the need to get immediate help before the person endangers themselves or others.”

Symptoms of alcohol use disorder include:

Unable to stop drinking.
Building a tolerance that leads to drinking more for the same effect.
Constantly craving and excessively thinking about finding and consuming the next drink.
Drinking more or longer than planned or intended; unable to limit consumption.
Drinking or the after-effects of drinking interfere with family, job and school obligations.
Negatively affects and/or impinges on relationships with family and friends.
Negatively impacts and/or impinges on finances and health.
Feeling depressed or anxious.
Being dishonest or secretive by concealing, hiding and lying about alcohol consumption.
Becoming aggressive, moody or temperamental.
Drinking causes physical health complications.
Using alcohol in situations that could be hazardous, like drinking and driving.
Losing interest in once-enjoyed activities or becoming socially isolated.
Attempts to cut down or stop drinking were unsuccessful.
Alcohol-related memory blackouts.
Feeling sick from drinking or frequent and longer recovery from hangovers.
Alcohol withdrawal symptoms occur, such as anxiety, depression, insomnia, nausea, sweating, hand tremors/"the shakes," confusion, seizures and visual hallucinations.

Physical symptoms include:

Rapid weight gain or loss
Slow or staggering walk
Inability to sleep or stay awake
Unexplained bruises or marks
Glazed or red eyes
Cold, sweaty palms or shaking hands
Puffy face, blushing or paleness
Nausea, vomiting or excessive sweating
Low or no energy
Deterioration of personal appearance or hygiene

What are the health complications of alcohol use disorder?

Long-term alcohol abuse is associated with numerous health conditions, including:

Heart disease
Liver disease
Diabetes
Cancer
Digestive problems
Neurological conditions
Compromised immunity
Bone loss

How is alcohol use disorder diagnosed?

A health care professional will complete a physical examination, review family history, and discuss symptoms and drinking patterns. Based on the number of symptoms and criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), they will diagnose mild, moderate or severe alcohol use disorder.

“Often, people with alcohol use disorder will minimize how their drinking was out of control and that they needed help,” said Dr. Ferber. “This is a function of denial, which is a defense mechanism that grows alongside the disorder.”

He explained that it may take a loved one to point out they spend a lot of time drinking and get them medical intervention. Or something significant happens that is a wake-up call, such as they have an accident while driving under the influence.

It is important to seek help on your own or listen to loved ones before your symptoms worsen and cause irreversible damage.

What is the treatment for alcohol use disorder?

“There is no one-size-fits-all approach to treating alcohol use disorder because it depends on the severity of a person’s diagnosis, their symptoms and what led to their alcohol abuse,” said Dr. Ferber. “Treatment must be tailored to their unique needs.”

Medical treatments

A person diagnosed with alcoholism requires medical intervention to begin the process of alcohol withdrawal.

A health care professional will recommend an inpatient or outpatient alcohol detox program that will combine medical and behavioral treatments. The U.S. Food and Drug Administration (FDA) has approved non-addictive medications that may help stop, reduce or return to drinking. Your care team will advise if taking medication is right for you.

“Suddenly stopping drinking can be life-threatening for someone with alcoholism,” said Dr. Ferber. “A health care professional should supervise the alcohol withdrawal process to ensure effective and continued recovery.”

Behavioral treatments

Behavioral treatments for alcohol use disorder focus on the patterns of drinking, such as how often and when, including binge drinking. Also, the causes of drinking such as to cope with mental illness, trauma or situational stress such as a divorce, loss of a job, or death of a loved one.

Cognitive behavioral therapy (CBT) overseen by licensed therapists can help with overcoming and preventing a return to alcohol abuse by:

Recognizing and breaking drinking patterns
Teaching new coping mechanisms
Discussing how to repair relationships
Setting attainable goals
Recognizing drinking triggers and how to cope with them

CBT uses motivational interviewing as a therapeutic tool to “meet the patient where they are” to help change behavior. This promotes change from the inside out instead of being told what to do.

In addition to individual counseling sessions, a therapist may recommend family therapy and group therapy.

Support groups

Dr. Ferber explained that talking with individuals who share a common understanding of how alcoholism has impacted their daily lives can help the recovery process and provide support that can reduce the likelihood of drinking again.

Your therapist can recommend local support groups, including Alcoholics Anonymous (AA).

“AA is an evidence-based treatment for alcoholism that can be used to replace people, places, and things that need to be changed or modified once the patient decides to become abstinent,” said Dr. Ferber.

What is the likelihood of a return to drinking?

“First, give yourself credit for taking the critical step of recognizing you had a drinking problem and seeking help,” said Dr. Ferber. “Setbacks can happen, especially in the early days of recovery.”

He emphasized that keeping up with therapy and finding a support group is critical to identifying triggers and finding new coping mechanisms to help prevent a relapse.

“Recovery from alcohol abuse is a long-term commitment,” he said. “The good news is that there are numerous resources to ensure you do not have to go through it alone.”

Visit the National Institute on Alcohol Abuse and Alcoholism to learn more about available support.

Find Care at Catholic Health

Catholic Health offers services and programs across Long Island to help with substance abuse problems. Our experts are skilled in all aspects of detoxification, rehabilitation and recovery. We create a treatment plan that fits your unique situation and needs. Because recovery is ongoing, we also provide tools to help you maintain a substance-free life.

View our substance abuse programs.

Find a Catholic Health doctor near you. Or call 866-MY-LI-DOC (866-695-4362).