October 19, 2023 PCI Centers

How to Spot & Treat Alcohol Use Disorder?

Alcohol use is a common cause of addiction in the United States. According to the latest data from 2021, 29.5 million people ages 12 and older met diagnostic criteria for alcohol use disorder and from that statistic, 22.2 million had alcohol use disorder only¹.

How do you get diagnosed for Alcohol Use Disorder?

Alcohol use disorder does not immediately develop after initial use. People can drink alcohol casually and experience its biphasic effect of feeling pleasant and more sociable, then less stressed or depressed. However over time as tolerance is increased and risk factors become activated, casual drinking develops into an alcohol use disorder.

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) suggests that a person’s risk for developing a disorder depends on the quantity, frequency, and duration of consumption².

• People may begin misusing alcohol by binge drinking large amounts in a short period of time or heavy drinking more on more days than not³.
• The NIAAA defines heavy drinking as follows: 5+ drinks in a day or 15+ per week for men and 4+ drinks in a day or 8+ per week for women³.
• Some risk factors that can increase a person’s risk for developing an alcohol use disorder are: drinking at an early age, genetics and family history, and mental health conditions such as depression, PTSD, and ADHD².

When is alcohol use considered a problem?

The criteria for alcohol use disorder requires a problematic pattern of use leading to clinically significant impairment or distress in the past year. Some manifestation of the problem include:

• Drinking larger amounts or over a longer period than intended
• Cravings and inability to cut down
• Long time spent drinking or recovering from drinking
• Recurrent drinking negatively impacts functioning at home, work, or school
• Giving up important or enjoyable activities for alcohol
• Getting into risky or dangerous situations due to drinking
• Increased tolerance

What are the impacts of drinking too much alcohol?

Alcohol is considered a neurotoxin that can negatively impact functioning and size of brain cells as well as communication between key brain areas⁶⁻⁷. During adolescence, while the brain is still undergoing development, drinking can cause permanent changes in brain structure and function⁸. Long-term alcohol consumption can lead to:

• Impaired memory, mood, judgment, insight, communication
• Insomnia, long-lasting headaches, chronic pain or numbing
• Difficulties with balance and coordination
• Mental health issues
• Driving accidents
• Alcohol poisoning
• Liver damage, hearth damage, inflammation of pancreas
• In severe cases, it can even lead to dementia and neurological syndromes (e.g.. Wernicke-Korsakoff syndrome).
• Brain damage
• Cancer

Can heavy alcohol use cause withdrawals?

Alcohol use disorder also results in experiences of withdrawal when effects of alcohol wear off⁴. Alcohol withdrawals symptoms include:

• Sleep disturbances
• Shaking, restlessness
• Nausea, vomiting
• Rapid heartbeat, sweating
• Dysphoria
• Occasionally, auditory and visual hallucinations or perceptual disturbances
• Liver damage, hearth damage, inflammation of pancreas

The most severe form of withdrawals may include:

• Seizures
• Delirium tremens: confusion, agitation, autonomic hyperactivity, impaired consciousness, hallucinations, and tremors or seizures⁵.

Withdrawals are treatable and require immediate medical attention at a detox facility  or hospital emergency room.

Can you overdose from alcohol?

Alcohol overdose can occur if drinking is not halted despite significant impairment. An overdose results from having too much alcohol in the bloodstream, subsequently affecting important areas of the brain responsible for basic life support functions such as breathing and heart rate⁷.

How do you treat Alcohol Use Disorder?

The FDA has three approved medications for alcohol dependence:

• Naltrexone (Trexan, Vivitrol): can reduce cravings of alcohol and feeling of intoxication thus reducing consumption
• Disulfiram (Antabuse): acts as an aversive reinforcement, such that if people drink alcohol while on disulfiram they will experience negative medical symptoms including but not limited to heart palpitations, flushing, nausea, vomiting, and headaches.
• Acamprosate (Campral)⁹: helps maintain abstinence by restoring the balance of neurotransmitters altered by alcohol during addiction¹⁰.

All pharmacotherapies are believed to be most effective when combined with individual and/or group psychotherapy and support groups (e.g. AA meetings, fellowships). There are many psychotherapeutic treatments for alcohol use disorders including:

• Inpatient detoxification treatment
• Inpatient residential programs
• Intensive outpatient programs
• 12-step/AA programs
• Individual and group psychotherapy, and pharmacotherapies

For people who have difficulty stopping habitual consumption and experience withdrawal symptoms, being admitted at a medically-supervised detoxification program could be a good start. This will allow close medical monitoring and stabilization. After detox, people may choose to support their sobriety by going to inpatient residential programs (structured, limited access to external triggers) or intensive outpatient programs (semi-structured, flexible with private lifestyle).

A hybrid between inpatient and outpatient is a partial hospitalization program, which includes an inpatient treatment structure with outpatient flexibility. All programs will offer some form of therapeutic support and guidance with help from certified drugs and alcohol counselors and/or mental health therapists. After completion of an inpatient program or while attending an outpatient program, some may choose to live in sober living environments to physically limit access to alcohol. The AA and 12-step programs can reinforce abstinence through peer support, anonymity, and guiding principles designed to fundamentally shift perspective toward alcohol.

Get the help you need now

Intensive outpatient programs are effective for people with substance use disorders and underlying mental health conditions. They promote psychological and social support in addition to relapse prevention via coping strategies. PCI’s intensive outpatient program specializes in alcohol use, and offers a variety of treatment modalities to ensure healing and recovery. Contact us today to speak with a care coordinator.