More than 18 million American adults and counting have reported heavy alcohol use, which means that the line between alcohol use and alcohol dependency is drawing thinner as Americans’ growing relationship with alcohol continues to strengthen. And while it is common for American adults to overindulge in alcohol, knowing when to stop is becoming increasingly harder for many.
There are two terms that are often used to describe the way most Americans consume alcohol: binge drinking—5 drinks for men and 4 drinks for women on the same day, at least once a month—and heavy drinking, which is binge drinking 5 or more days in a month. But for some, it’s hard to decide when enough is enough.
A strong indication whether drinking has become a problem or not is when it starts creating problems for personal relationships, work or school, or your mental and physical health. The National Institute on Alcohol Abuse and Alcoholism (NIAA) defines this impaired ability to stop or control alcohol intake as alcohol use disorder (AUD).
Despite the adverse effects that heavy drinking may have, it is important to realize that AUD is considered a brain disorder (mild, moderate, or severe depending on the case) and not a matter of moral failing. In fact, AUD impacts everyone differently, and there are many factors at play when increasing the risk of developing AUD.
Struggling has many faces
The truth about AUD is that it looks different across different age groups, genders, and ethnicities. While AUD should be taken seriously across all groups, the rise of AUD may pose a larger threat against women and older adults. There are a few physical and behavioral elements that increase women’s risk for developing AUD:
Physical
Alcohol-related issues can appear sooner from lower amounts of alcohol than men and women for a few reasons:
- Women’s bodies contain less water content than men do and because alcohol is hydrophilic (meaning it dissolves in water) that means a woman drinking the same amount as a male would have a higher blood alcohol level, resulting in longer-lasting effects.
- Women possess less alcohol dehydrogenase—an enzyme that helps break down alcohol and remove it from the body— than men, which also results in women experiencing higher levels of intoxication than men when consuming the same amount of alcohol.
Behavioral
- Women are also less likely to receive treatment for AUD than men. A recent study proved that women were twice as likely as men to think a problem will get better by itself.
- Another effect observed in alcohol use amongst women is called the ‘telescoping effect’ which speaks to women’s tendency to accelerate the progression of their alcohol use and more rapidly develop AUD.
As we age, we also become more prone to alcohol use and vulnerable to the effects of heavy drinking. For older adults, AUD symptoms are often overlooked for many reasons like closely mimicking depression, dementia, or symptoms of medications. Even circumstances like living alone or being far from loved ones can cause signs to go unnoticed.
With age also comes a slower metabolism and lower tolerance for withstanding the effects of alcohol—a similar event that women face—which means alcohol-related issues can occur faster or sooner as you age. Weakening changes to the central nervous system, brain, and spinal cord also makes older adults more vulnerable to substances passing through the body and having a bigger impact than they once did at a younger age.
Influences exist beyond your control
There are still a few things that all people—men, women, young, and old—have in common when it comes to alcohol use. Genetics and patterns in environment, and certain psychological factors and patterns like stress, trauma, or the loss of a loved one are all commonly shared elements that can individually or collectively influence or increase the risk of developing AUD.
Genetics and early exposure to alcohol
Like other chronic health conditions, genetics play a role in more than half of those at risk of developing AUD. Studies of an “alcoholism gene” show that those with this gene are predisposed to have a stronger inclination to heavy drinking. A parent’s drinking patterns or dependency on alcohol can also have influence on a child. Research also shows those who drank before age 15 are five times more likely to have AUD, and the females of this group are at higher risk.
Environmental impacts on alcohol use
External factors like stress can lead to alcohol dependence as a coping mechanism for such matters or to help ‘dull’ the negative impact that stress may have on mental and physical well-being. Living in a society that equates winning with happiness and has zero tolerance for failure sets unrealistic expectations and sends an unhealthy message of inadequacy whenever obstacles or defeat arise. Feeling overwhelmed all the time creates an unhealthy environment that for some may lead to stress and anxiety or compel them into coping with substances.
Even concerning matters like a global pandemic can bring on the need to cope. Recent data points to a 14% increase in alcohol use during the recent COVID-19 pandemic compared to the year prior. The pandemic had an accelerated effect on the rate of alcohol-related deaths in middle aged women (ages 35-44) with an increase of 42% from 2019 to 2020.
Mental health, trauma, and AUD
A history of trauma can weigh heavily on one’s alcohol dependency as a coping mechanism. Alcoholism is also often associated with a wide range of mental health conditions like depression, anxiety, post-traumatic stress disorder, and attention deficit hyperactivity disorder.
Once all factors have been considered, it is apparent that AUD has nothing to do with weakness and everything to do with illness and the way in which individuals develop a dependence as a means of coping with conditions, preexisting or not.
Tips for taking back control
While recent data has placed alcohol-related deaths as the third-highest preventable cause of death in the U.S., it’s important to have a positive outlook on the matter. The key word here is “preventable,” and there are effective ways to regain control of alcohol use before it gets out of hand or even identify when you or a loved one might need help.
Check your consumption
Being mindful of how much you drink and how often is a good start. Ask yourself if you can go a day without a drink or if you feel the need to hide your drinking habit. If you suspect that you may be abusing alcohol, you should not feel ashamed for seeking the help of a professional. Quitting is not as easy as flipping a switch—stopping cold turkey can have serious physiological withdrawal symptoms and should not be done without professional help.
Watch for warning signs
If there’s concern that alcohol is causing a problem in your life or a loved one’s, there are telltale signs to look for that may indicate harmful behavior or AUD.
- Unable to stop drinking once you have started.
- Feel a strong need for a drink.
- Try cutting back without much success.
- Find that alcohol is interfering with work or family.
- Replace activities you once enjoyed with drinking.
- Drink more than you used to for the effect you want.
Acknowledge your feelings
When considering help for yourself or a loved one, it is important to acknowledge any of the feelings you or a loved one may be experiencing at this stage like:
- Fear for loved ones or for causing chaos or disfunction.
- Failure or feeling stuck.
- Denial that drinking behavior may be causing problems.
- Doubt in the ability to stop drinking.
Facing these fears and changing your thoughts are no easy feat—offering compassion to those looking to make a change goes a long way in acknowledging their bravery, strength, and courage for seeking help. Once you realize that progress doesn’t always have to be a straight path, you can begin to understand that recovery looks different for everyone and can happen for anyone.
Take the next step
If you recognize that you or a loved one may need help, remember that recovery is within reach with professional help. Help make the ideal next step by seeking patient-centered care from evidence-based treatment models like Caron Treatment Centers—a non-profit leader in addiction treatment and behavioral healthcare with a focus on treating both the individual and the family.
Like most diseases, the right treatment for AUD can be different for some than others to improve and achieve recovery. Caron Treatment Centers’ addiction specialists can help determine if addiction is the issue, or something else, and discuss available treatment options that may be right for their condition.
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