Alcoholism: signs, symptoms and treatment

What is alcoholism?

Alcoholism is a term used to describe the most serious form of problem drinking at a level that causes harm to your health. It describes a strong, often uncontrollable, desire to drink.

Although it isn’t a term that is used anymore as part of medical care, some people who are recovering from dependence still use the term ‘alcoholic’ to describe themselves. Alcoholism is also known as alcohol addiction, alcohol misuse or alcohol dependence.

Medically, it’s recognised as a type of ‘alcohol-use disorder’ which can be treated. It’s different to ‘harmful drinking’ (another type of alcohol-use disorder) which is a pattern of heavy drinking which causes damage to your health but without actual dependence.

Someone who has alcohol dependence will often place drinking above all other obligations, including work and family, and builds up a physical tolerance, meaning they drink more and more for a similar effect, and they experience withdrawal symptoms if they stop.

The UK Chief Medical Officers’ low risk drinking guidelines advise it is safest not to drink more than 14 units a week on a regular basis.

What are the signs or symptoms of dependence on alcohol?

It can be tricky to spot the signs of alcohol dependence. People with an alcohol use disorder can be secretive about their drinking, and may become angry if confronted.

Doctors assess whether someone is dependent on alcohol by looking for signs that show their patient can’t regulate their drinking, and that they have a strong internal drive to use alcohol. The specific symptoms they look for are:¹

• Impaired control over alcohol use
  This might mean not being able to control how long a drinking session is, how much alcohol you consume when you do drink, how frequently you drink, being unable to stop drinking once you start, or drinking on inappropriate occasions or at inappropriate places.
• Giving increasing priority to alcohol
  If you give precedence to drinking over other daily activities and responsibilities, if drinking is more important to you than looking after your health, or you carry on drinking despite negative consequences for your health or life.
• Unwanted physical or mental effects from drinking
  Showing signs of increased tolerance to alcohol (having to drink more for the same effect), experiencing withdrawal symptoms, or using alcohol to prevent or alleviate withdrawal symptoms.

A doctor may diagnose alcohol dependence when they see two or more of the above symptoms based on an ongoing pattern of how you use alcohol. Usually this is based on behaviour over the last 12 months or more, but alcohol dependence could be diagnosed based on continuous daily (or almost daily) use of alcohol over a period of at least three months.

If you think you may be drinking too much, or that your drinking is beginning to have a damaging effect on your life, we have a quick online test that can help you understand if there is cause for concern.

Take the Drinking Check

Treating alcohol dependence

In many cases, the first step of treating alcohol dependence is the drinker acknowledging there is a problem. As with many health problems the second step is to seek help from a healthcare professional, usually your local GP surgery, who can refer you to a specialist.

There are different treatments available for people diagnosed with alcohol-use disorders.

Find out more about alcohol withdrawal symptoms

Ongoing treatment options can include:

• Detoxification (also known as ‘detox’) can be a key stage of treatment. Detox involves stopping drinking completely, whilst under medical supervision, so that the body can adjust to being without alcohol. During this time, a person may experience alcohol withdrawal symptoms
• Cognitive Behavioural Therapy (CBT) can be offered to help change negative thought patterns which may lead to drinking
• Mutual help groups such as Alcoholics Anonymous help partly because of the new network of support a person gains. They can help people adjust their thinking and their attitudes to themselves and others
• Pharmacological treatments (i.e. medications) can also have a role in preventing relapse for some people who are trying to abstain

What should I do if I think someone is dependent on alcohol?

If someone close to you is displaying signs of alcohol dependence, it can be difficult to know what to do. You might feel worried about them, frustrated that they don’t seem to want help, frightened for them or even by them. All of these feelings are normal and there is help out there both for people who are dependent on alcohol and those caring for them.

If you can, talk honestly with the person you’re concerned about, and try to persuade them to see a doctor. It can be very difficult for people who are dependent on alcohol to admit they have a problem but being supportive, open and non-judgemental can make them feel safe.

If you accompany someone to an appointment, try to get an explanation for the person in simple language about the illness, the long-term effects and the options for recovery.

Ask how you can best support the person. You could perhaps request an out of hours emergency telephone number – there are services that can help you support the person receiving treatment, as well as other services to support families.

How to help someone else

Alcohol support services

If you’re worried about your drinking, get in touch with your GP surgery who will be able to help.

You can also search for alcohol support services in your area using the below links:

• England 
• Northern Ireland 
• Scotland 
• Wales

Whether you are looking for information for yourself, or on behalf of someone else, there’s more information, including useful links and phone numbers, in the dedicated alcohol support services section of our website.

Support services