In this article I explore what alcohol abuse is and 8 warning signs of how you can tell if you or a loved one is abusing alcohol. Additionally, I briefly explore some of the dangers of alcohol abuse and what you can do if you are abusing alcohol.
What is alcohol abuse?
Alcohol abuse is defined as repeated excessive consumption of alcohol despite its negative consequences. Alcohol abuse is relatively common, with almost 18 million people in the US (8% of all adults) suffering from it.
Negative consequences of alcohol abuse include: direct danger to your own personal physical and mental health; the risk of injuring yourself and others, as well as more indirect consequences such as: financial insecurity; damage to relationships; and not fulfilling responsibilities and commitments.
8 signs of alcohol abuse
Here are 8 warning signs of how you can tell if you or a loved one are abusing alcohol:
1. Excessive consumption (UK and USA recommended guidelines)
The UK Chief Medical Officer recommends that men and women should not drink more than 14 units of alcohol per week, spread over 3 or more days (i.e. not “saved up” for one big night).
A unit is defined as a 25ml measure of 40% spirits (e.g. 25ml of vodka is one unit). 14 units is equivalent to drinking:
- 14 measures / shots (25ml) of 40% spirits (whiskey, vodka, rum, gin etc.)
- 6 glasses (175ml) of 13% wine (regular white or red wine)
- 6 pints (568ml) of 4% beer (regular beer)
- 5 pints (568ml) of 4.5% cider
This means that one night of 6 pints of beer would use up your entire weekly consumption limit, as well as being 3x times more than the maximum recommended amount to drink on any given occasion!
The USA guidelines are a bit more lax: up to 2 drinks per day for men and 1 drink per day for women. However, in both countries it is clear that consumption of more than 2 drinks on a given day is considered excessive.
It should be noted that one off excessive consumption isn’t a sign of alcohol abuse. However, when excessive consumption becomes a regular occurrence (e.g. every week or 2-4x times per month) this is one of the clearest indicators of alcohol abuse.
When this regular excessive consumption continues despite any negative consequences that stem from it, then this is an even more significant sign – which brings us nicely to our next point.
2. Repeated excessive drinking – despite negative consequences
Most drinkers have drunk to excess on some occasion, often with disastrous results (such as vomiting in the neighbour’s garden, causing a scene at your friend’s birthday or falling flat on your face in front of your boss).
For most people this is enough to learn the simple lesson: don’t drink to excess again! In future they are careful not to drink to excess again.
However, for those who abuse alcohol the situation is different: they appear not to learn this lesson and continue to drink to excess despite the negative consequences.
Here are some of the typical negative consequences of excessive drinking – do you continue to drink to excess despite the presence of these consequences in your life?
- Inappropriate behaviour when drunk:
- Making offensive remarks to friends, colleagues or even to strangers
- Inappropriate sexual behaviour, such as making unwanted advances or cheating
- Dangerous actions like driving drunk, getting involved in fights or having unprotected sex
- Impact on other responsibilities by prioritising drinking first:
- Poor performance or missing days at work due to hangovers / still being drunk
- Damaged relationships with friends and family due to missing important occasions, showing up drunk, arguing with them, embarrassing them or letting them down
- Missing appointments and other commitments – alcohol abusers often stop participating in many other activities so that drinking becomes the centrepiece of their lives. We discuss this further in the next point.
Why would anyone do this? Because they do not consider the negative consequences before they start drinking – see this article for more details on why people drink despite the negative consequences.
3. Drinking has become main leisure activity
Have you stopped doing activities you previously used to enjoy and replaced them with drinking alcohol?
Our body has a natural reward system that incentives healthy behaviours: when we do something healthy, like exercise, we feel good. This system motivates us to exercise.
However, alcohol and drugs cheat this system: they enable us to feel good (get the “reward”) without doing anything to earn it! Why go for a run to feel good when you can just pop open a beer?
As we repeatedly drink excessive amounts of alcohol, our body’s natural reward system is rewired so that less and less activities other than drinking alcohol appeal to us and instead we find ourselves drinking more alcohol, more often.
If you notice that you’ve stopped doing activities you previously used to enjoy and have replaced these activities with alcohol then this is a clear sign that you might be abusing alcohol.
4. Need alcohol to enjoy social events
Do you plan all your social events around alcohol? Can you remember the last time you enjoyed – or even attended – a social event without alcohol?
Those who abuse alcohol tend to enjoy spending time with others who also abuse alcohol, as it makes their drinking appear normal.
They feel uncomfortable at social events where there is limited alcohol, as they do not enjoy drinking with “normal” drinkers as it highlights the excessive extent of their own drinking.
Many don’t go to social events that don’t involve drinking, or if they do go they may feel uncomfortable in social situations without alcohol.
5. Frequent blackouts
Do you have frequent periods of memory loss, where you can’t remember your actions while drunk? An alcohol induced blackout is caused by disruption to the brain’s memory formation function when the level of alcohol in the blood increases suddenly.
A blackout refers to a period of total memory loss while a “brownout” refers to a period of hazy memories which can often be recalled over time or if reminded of events by another observer. Both are caused by the same disruption to brain function.
An isolated blackout does not mean you are abusing alcohol, but it is a sure sign of excessive consumption on that particular occasion. When these blackouts become more regular it means that you are regularly consuming excessive amounts of alcohol which is a key warning sign of alcohol abuse. The changes to brain function experienced during regular blackouts pose long term health risks.
6. Drinking in the morning
After a heavy night, do you often need a drink of alcohol in the morning to help you get your day started?
In itself having a drink in the morning is not a sign of alcohol abuse. However, needing a drink to face the day after a night of drinking is more cause for concern, for two reasons:
- Needing a morning drink means that the previous night’s consumption was excessive: you feel like you must remain drunk as the hangover is too much to bear
- Needing a morning drink to avoid a severe hangover may be a sign that this “hangover” is actually the symptoms of alcohol withdrawal suffered by regular heavy drinkers and a sure sign of alcohol abuse
If you frequently need alcohol in the mornings to be able to function normally after the previous night’s drinking, then it is likely that you’re doing so to keep alcohol withdrawal symptoms at bay as your body has become physically dependent on alcohol. As well as being a clear sign of alcohol abuse, physical dependence on alcohol is a dangerous medical situation and a doctor should be sought at once.
7. Do you suffer from the physical withdrawal effects of alcohol?
Most people occasionally drink to excess and experience a bad hangover. These bad hangovers exhibit many of the effects of mild withdrawal symptoms such as insomnia, sweating and shaking.
But severe physical withdrawals from alcohol are a far more serious matter. They occur when the body is physically dependent on alcohol. This is a dangerous situation: alcohol is a brain sedative, and removal of this sedative when stopping heavy alcohol use requires medical supervision.
Symptoms of alcohol withdrawal range from minor (insomnia, sweating, shaking) to severe (seizures and delirium tremens, including hallucinations and fever).
If you experience these symptoms of alcohol withdrawal then it is a clear sign you have an abusive relationship with alcohol. As mentioned above, physical dependence on alcohol is a dangerous medical situation and withdrawal from alcohol requires close medical supervision. If you are suffering from physical withdrawal effects then a doctor’s advice should be sought immediately.
Read more about the 7 symptoms of alcohol withdrawal (that affect even moderate drinkers) here.
8. Devastating hangovers
- Do you ever feel remorseful or guilty after drinking?
As alcohol abuse deepens, we tend to lose control over our drinking and drink greater quantities and more often than we would like to. This excessive drinking can lead to feelings of guilt and remorse.
These feelings are often exacerbated by the inappropriate behaviours we might have committed while under the influence, or by other negative consequences that may have arisen as a result of our drinking.
- Do you ever feel anxious or depressed after drinking?
Alcohol is a brain sedative and repeated use can lead to changes in brain chemistry that leave users feeling anxious or depressed. As alcohol abuse continues it is not uncommon for abusers to suffer from hangovers spanning a number of days accompanied by severe anxiety, panic attacks and depression. Indeed, these feelings of anxiety and depression are a part of the symptoms of physical withdrawal from alcohol.
A final word on alcohol abuse
As the above article demonstrates, alcohol abuse comes in many shapes and forms. It may be that you experience all of these symptoms, or perhaps just one or too – it may even be that you do not experience any of the above symptoms – yet you still may have an abusive relationship with alcohol. For peace of mind and safety, if you are concerned that you or a loved one is abusing alcohol then nothing beats seeking the advice of a qualified doctor or therapist.
[If you believe that you might be abusing alcohol then check out this article on how you can reduce or stop your drinking.]