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Signs You Have a Drinking Problem, According to Experts

Doctor explains how to help someone with a drinking problem and what signs to look out for.

Many people who have a drinking problem don't realize they have one. The Centers for Disease Control and Prevention states, "Excessive alcohol use is a leading preventable cause of death in the United States, shortening the lives of those who die by an average of 29 years. Excessive alcohol use includes: Binge drinking, defined as consuming 4 or more drinks on an occasion for a woman or 5 or more drinks on an occasion for a man. Heavy drinking, defined as 8 or more drinks per week for a woman or 15 or more drinks per week for a man." If you or someone you know might have an issue with alcohol, here are the signs to look for according to Dr. Ryan Wade, MD, Attending Psychiatrist, Clinical Team Lead Dual Diagnosis Transitional Living Program Silver Hill Hospital who spoke with Eat This, Not That! Health. Read on—and to ensure your health and the health of others, don't miss these Sure Signs You've Already Had COVID.


Signs of a Drinking Problem

violently shaking hands of a PD sufferer (Parkinson's disease), tremors of the wrist and hand joints are the main symptom of the disorder

Dr. Wade explains, "Several things may indicate that a person's alcohol consumption has become more 'problematic.' Most notably, when a person is experiencing withdrawal symptoms (shaky, sweaty, restless, irritable, unable to sleep, etc.) it indicates the person is drinking consistently and heavily enough to have developed a physical dependence on alcohol, at which point seeking medical attention is strongly recommended – untreated alcohol withdrawal can be very dangerous, even lethal.

Other signs include when people do not modify their drinking behavior despite negative consequences, which may be medical (eg. liver damage, cognitive impairment), personal (eg. getting a DUI, disputes with family/friends), or professional (eg. too hungover to go to work, intoxicated/inappropriate behavior at a work social function). Those that are close to the person who are developing unhealthy drinking patterns may even hear the person express that they want to cut back on their drinking, which may be the first indicator that it has become a problem for them, and is most concerning when the person is unable to sustain any change in their alcohol consumption despite stating it is their goal to do so."

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Personality Changes

Irritated man crossing legs while sitting on the bed and shouting at home

According to Dr. Wade, "Alcohol affects behavior differently for each person, so describing potential personality changes is challenging. Most commonly, someone consuming alcohol excessively will demonstrate more impulsive, erratic behavior and may speak or express emotion with less inhibition (this can range from yelling in frustration, to crying and despondent, or anywhere in between). A more subtle shift some may notice about a person developing more concerning drinking habits would be when it seems the person is more focused on alcohol than the event/context it is associated with. Some common examples may include: spending a substantial amount of time visiting the bar during a wedding (also expressing frustration during parts of the ceremony when the bar isn't operating, or that it is not an open bar) as opposed to socializing with other wedding guests, planning a social gathering with more of a focus on alcohol than other aspects of entertaining (eg. planning multiple drinking games or novelty drinks with little effort on food or hosting), or reaching the point of intoxication/lack of behavioral control in these types of social settings (or similar) where alcohol is commonly present."

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How Alcohol Affects Your Body

Doctor examines MRI scan of head, neck and brain of patient

"Alcohol can impact essentially every organ system in the body and detailing all the effects of alcohol use would certainly extend beyond the scope of this report," Dr. Wade says. "Most notably, alcohol can have negative impacts on your brain, cardiovascular system, and liver/gastrointestinal system. The short-term effects on the brain are what most people are familiar with: loss of coordination, reduced impulse control, drowsiness/impaired consciousness, slurring of speech, etc., though long-term and/or excessive alcohol consumption can lead to lasting memory impairments and reduced cognitive functioning overall (processing speed, attention, etc.). Though alcohol can function to relax blood vessels, which leads to short-term decreases in blood pressure, the rebound effect when the body is recovering from alcohol produces constriction of those blood vessels, subsequently increasing blood pressure and strain on the heart (not to mention alcohol and metabolites of alcohol can damage the heart tissue directly). The liver is responsible for breaking down alcohol and the byproducts of alcohol, both of which are toxic to the liver, thus the liver is damaged while metabolizing alcohol; consistent and heavy alcohol use can lead to permanent liver damage, ultimately leading to Hepatic Cirrhosis, a condition where there is so little functional tissue left in the liver that it profoundly affects your health and typically warrants a liver transplant. Alcohol use can also be directly toxic to the esophagus and stomach, with notable increases in the likelihood of developing cancer in these regions with consistent alcohol use, as well as the increased likelihood of having acid reflux and gastric ulcers."

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How to Approach Someone with a Drinking Problem

Elderly couple arguing.

Dr. Wade explains, "Generally speaking, when attempting to discuss a person's problematic drinking behaviors, you want to convey concern for the person first and foremost. As difficult as these conversations are to initiate, they are often even more difficult for the person who has been drinking. It can feel like an attack for the person being confronted about their patterns of alcohol use and it is important for them to know that you are discussing it because you care about them, not because you think they are a 'bad person' or that they are deficient in some way ('no willpower' or 'lazy' are common refrains). Also, prepare yourself for the potential the person will be upset with this, even if you approach them compassionately, as there often is a significant amount of shame the person will have when discussing their alcohol use, particularly now that they know It has been impacting other people."

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Best Way to Help Someone

Close-up of psychiatrist hands together holding palm of her patient

Dr. Wade says, "Support them. There is no one tactic or treatment method that works consistently for all of those with difficulty managing their alcohol consumption, and the course of treatment can be challenging. Thus, the person going through treatment, and even in recovery, will benefit substantially from having support from friends and family members. Alcohol Use Disorder is a condition that is considered to be lifelong and people can achieve remission – though this often is not a linear process – during which the person will benefit greatly from support guiding them to return to treatment if their concerning patterns of alcohol consumption resurface." And to protect your life and the lives of others, don't visit any of these 35 Places You're Most Likely to Catch COVID.

Heather Newgen
Heather Newgen has two decades of experience reporting and writing about health, fitness, entertainment and travel. Heather currently freelances for several publications. Read more about Heather