- What is Alcohol?
- History of Alcohol and Prohibition
- What is Alcohol Abuse?
- Am I A Problem Drinker?
- What is the Difference Between Alcohol Abuse and Alcohol Dependence?
- Alcohol Withdrawal Symptoms
- Alcohol Detox
- Alcohol Addiction Treatment
- Alcohol Treatment at Vogue Recovery Center
Alcohol is everywhere in modern society, and many Americans drink alcohol with little concern of dependence, or consideration of the potential for alcohol abuse and addiction. Some studies suggest that alcohol, in very modest amounts, for non-pregnant and otherwise healthy adults, may have some health benefits, but as a society, we tend to blur the line between moderate drinking, and what clearly constitutes alcohol abuse. But, how did we get here? How did alcohol become a daily part of our lives and culture, where we associate alcohol with holidays, celebrations, even days of the week? Many people may be on the cusp of alcohol abuse, or even deeply entrenched into it. There are countless reasons people have for drinking alcohol; courage, relaxation, stress relief, celebration, a night cap, hair of the dog, eye-opener, etc. But what is okay, and what is dangerous? When is helped needed? And if you suffer negative consequences from drinking, does that mean you're an alcoholic?
What is Alcohol?
Alcohol (ethanol or ethyl alcohol), is an intoxicating liquid, produced by the natural fermentation of sugars in various foods. Started as a natural process, the natural chemical process of producing alcohol is often synthetically expedited today, to supply a massive demand.
When yeast or other bacteria react with sugars from foods like grains, grapes or potatoes, the result of the bacteria’s metabolism of the sugars is ethyl alcohol, in the forms of beer, wine, or vodka, respectively.
Alcohol is a depressant drug, which causes relaxation, decreased inhibitions, and feelings of euphoria for the user. Often referred to as, "liquid courage,” many people find it easier to engage socially, or engage in otherwise embarrassing activities, like singing karaoke or riding a mechanical bull, with lowered inhibitions provided by alcohol intoxication.
Alcoholic Beverages and Alcoholic Content
The various types of common alcoholic beverages consist of wine, beer, and liquor. Although there are average amounts of pure alcohol that each type of beverage contains, alcoholic content varies greatly in today's production. The Federal Alcohol Administration (FAA) requires that all alcoholic beverages are clearly labeled with the content of pure alcohol by volume.1 It should be noted that some wines, beers, and liquors may have slightly more or less alcohol content than general averages. A guideline for these average amounts of pure alcohol is below2
The classification of wine includes any drink made from the fermentation of sugar in grapes. This can be red, white, rose, sparkling wine, or champagne. The typical alcoholic content for one standard 5oz. glass of wine is 12% of pure alcohol.
Beer is classified as any drink made from fermented grain, which can include barley, wheat, rye, and common addition of hops, for flavor and bitterness. Despite hundreds of flavors and strengths of beer, it comes in two main styles; lager and ale. The pure alcohol content of a standard 12oz glass of beer is about 5%.
Differing from beer, is malt liquor, which does not contain hops, and is generally fermented from foods other than barley, like combinations of sugars and fruit. A standard 8-9oz glass of malt liquor consists of about 7% alcohol.
Distilled Spirit (Liquor)
Any beverage which is distilled after fermentation, is considered a liquor. Alcoholic beverages in this category include vodka, rum, gin, tequila, brandy, scotch, whiskey, and bourbon. A standard 1.5oz glass of liquor contains about 40% of pure alcohol.
Although a standard serving of liquor is much less liquid volume than a glass of wine, for example, the amount of pure alcohol in liquor is much higher than that of wine, which accounts for the difference in the size of a standard drink of each.
Alcohol and Prohibition in the United States
The United States has a complicated history with alcohol, it's use, abuse, and legality, from early colonial times through today. The effects of alcohol throughout American history was once attempted to be painted with a broad stroke of prohibition, but the "noble experiment” of prohibition proved that alcohol had already been deeply woven into the fabric of American society, and could not be simplified in one stroke.
Prohibition had noble intentions but lead to many unintended consequences. One unintended impact of prohibition was seen in the cruise industry. Cruises allowed people to drink legally, once the ship entered international waters, and so they boomed in popularity, quickly gaining notoriety as booze cruises.
Prohibition had several more unintended consequences, including the following four major failures:
- Economic expectations where that prohibition would lead to increases in sales for household goods, clothing, improvements in neighborhoods as saloons closed, and a rise in revenue for entertainment venues, such as theaters. Unfortunately, restaurants failed, theater ticket sales sharply declined, and entertainment revenue did not increase as expected. The most profoundly negative economic effect of prohibition was the sudden cessation of taxes from alcohol sales. Lost revenue from alcohol sales during prohibition reportedly cost the United States $11 billion.4
- Prohibition had some exceptions; one was that whiskey could be legally dispensed by pharmacists for treatment of various ailments, including influenza, depression, and asthma. Additionally, alcohol, specifically sacramental wine, was permitted for religious purposes. These two exceptions were exploited, and lead to a dramatic rise in membership at churches and synagogues, and in the number of registered pharmacists.
- Prohibition officers were frequently bribed, or tempted to turn a blind eye to bootleggers, and many became bootleggers themselves. Regular Americans with boats were recruited to illegally smuggle high quality liquor from other countries and islands and became known as rumrunners. The most notorious of them was William McCoy, who smuggled liquor from the Bahamas, up the eastern coast. His reputation for supplying the best quality alcohol is where the term "the real McCoy" originated. As the illegal production and trade of alcohol continued to grow, the prohibition period transformed millions of Americans into criminals.
- The most widely recognized problem with prohibition was that its effects were the complete opposite of its intentions. Instead of creating more temperance from alcohol, prohibition did just the opposite, and lead to intemperance and excess in alcohol consumption, and the growing pervasiveness of alcohol abuse.
Although the intentions of prohibition were to curb mounting problems in American society resulting from alcohol consumption, and thwart increased occurrences of drunkenness, injuries, and accidents, attempts to force Americans to abandon recreational alcohol consumption created a boomerang effect, with long-lasting consequences which can be felt to this day.
Some argue that it is because of prohibition that alcohol is so pervasive in American culture today, while others argue that it would be a far worse problem had we not had the prohibition period. Whether it is one, the other, or some combination of both, alcohol today is widely available in any flavor for any palette, and any strength for any tolerance. Our lifestyle as Americans is laden with alcohol, from weddings to wakes, sporting events to celebrations, brunches to dinners, and pool parties to post workout low-carb refreshers. It is understandable why alcohol abuse happens, but not everyone understands what alcohol abuse actually is…
What Is Alcohol Abuse?
Alcohol abuse is a serious problem, which often falls just short of alcohol dependence. Although it does not necessarily constitute an addiction to alcohol, it is defined as “problem drinking”.
Problem drinking can range from binge drinking to any form of drinking which results in negative and dangerous consequences.
Binge drinking is defined as a pattern of drinking that brings a person's blood alcohol concentration (BAC) to 0.08 grams per percent, or above, in a short time period of about 2 hours5 or less.
The CDC (Centers for Disease Control and Prevention) refers to binge drinking as the most common, costly and deadly pattern of excessive alcohol use in the United States. Binge drinking is generalized as 5 or more drinks in roughly 2 hours for men, and 4 or more drinks in 2 hours for women.
As the most common form of alcohol abuse, binge drinking has a wide range of consequences and dangers associated with it.
Dangers of Binge Drinking
- Health Risks
- Long term binge drinking can lead to chronic health issues such as high blood pressure, stroke, liver disease, and heart disease. Additionally, cancers of the throat, esophagus, liver and colon have been linked to binge drinking. Long term binge drinking increases the risk of developing alcoholism, which can lead to permanent brain damage, cognitive impairment, and memory problems.
- Hazardous Risks
- Whether intentional or unintended, binge drinking episodes often lead to situations in which individuals are making riskier and more hazardous decisions. As alcohol lowers inhibitions and impairs coordination, some of the most common hazardous situations include falls, burns, car crashes, unsafe sex, and violent, or otherwise physical assault against others.
- Fetal Risks
- Despite widespread knowledge that drinking any amount of alcohol during pregnancy is risky and can lead to fetal alcohol spectrum disorders (FASD), between 2011 and 2013, 1 in 10 pregnant women reported some alcohol use, and 1 in 33 reported past month binge drinking.6
While binge drinking is undoubtedly dangerous, and often leads to negative consequences, most people who binge drink are not alcoholics.7 There is a broad line between many alcohol abuse patterns and alcoholism, however, one needs not be an alcoholic to face the imminent threat of alcohol related dangers.
Alcohol abuse can turn deadly at any time. It only takes one bad decision, or a slightly delayed reaction, for a life to change forever.
Binge drinking is one form of alcohol abuse, but it is not the only way to abuse alcohol. Many abuse alcohol frequently, without necessarily binge drinking. Repeated patterns of dangerous drinking make problem drinkers, and that classification is one which inevitably leads to serious and dangerous consequences.
Am I A Problem Drinker?
Make no mistake, problem drinking can be just as dangerous and deadly as alcoholism. The fact is that approximately 30% of all fatal vehicle accidents involve a drunk driver, yet most people who engage in binge or excessive drinking are not alcoholics.7
Certainly, this fact does not preclude alcoholic individuals from engaging in binge drinking, drunk driving, or any other risky drinking behavior. However, of the over 10,000 alcohol-related car crash fatalities in 2016, none discerned between alcoholism and alcohol abuse.8
Alcohol abuse and alcoholism are defined differently, but they do share many behavioral symptoms. Problem drinking is a form of alcohol abuse, and there can be a fine line between moderate drinking and problem drinking. The following questions can give you a clearer picture of where on the scale from moderate to problem drinker you may fall.
- Do you frequently drink alcohol before midday, even if it’s brunch with friends?
- Do you think about drinking alcohol, when it is not available to you?
- Do you drive after drinking alcohol?
- Have you ever driven while drinking alcohol?
- Have you bypassed alcohol-free events or gatherings, to instead be in environments where you could drink?
- Have you found that you drink more alcohol, or for longer periods of time than originally intended?
- Do you surround yourself with other heavy or frequent drinkers?
- Do you continue to drink even though you know it is causing harm to your health, or increasing depression or anxiety symptoms?
- Have you attempted to cut down or stop drinking, but have been unsuccessful?
- Have you, more than once found yourself in dangerous or risky situations due to drinking? (i.e. driving, unsafe sex, swimming, venturing into unsafe areas, fighting, etc.)
A yes answer to two or more of the aforementioned questions is a strong indicator that problem drinking is taking place, and that it is a good idea to rethink the habits and patterns of drinking right away.
Alcohol abuse does not always lead to alcoholism, but affects up to 16 million Americans, according to the National Institute on Alcohol Abuse and Alcoholism9. Now referred to as alcohol use disorder (AUD), the NIAAA defines it as a "chronic relapsing brain disease characterized by compulsive alcohol use, loss of control over alcohol intake, and a negative emotional state when not using."9 Broader than the definition of alcoholism, AUD spans to cover a more severe aspect of alcohol abuse. A notable difference in the definition of AUD is not limiting its scope to
- characterization as a specific dependence on alcohol
- experiencing physical withdrawal symptoms without alcohol
- a decreased ability to function socially and vocationally
Although it was once thought that only bona fide alcoholics presented a threat to society and themselves, any individual who abuses alcohol is at a significantly higher risk of danger and alcohol related injury and death.
What is The Difference Between Alcohol Abuse and Alcohol Dependence?
Although alcohol abuse is now more broadly defined as alcohol use disorder, it still is not alcohol dependence. There are certain unique characteristics of alcohol dependence which are unmistakable, notwithstanding the degree of alcohol abuse.
Alcohol dependence is marked by a physical dependence on alcohol. Upon sudden cessation or severe reduction of alcohol consumption, physical withdrawal symptoms will begin to present themselves within approximately 6 hours. Alcohol dependence is more than simply a desire to drink alcohol or thinking about drinking when alcohol is not available. While these may be signs of alcohol use disorder, they are not indicative of alcohol dependence.
Alcohol dependence is:
- experiencing withdrawal symptoms without a constant presence of alcohol
- an increasing need to drink more alcohol, for the same effects, whether to ease withdrawal symptoms, or to get a buzz (i.e. tolerance)
- an inability to cut down or stop alcohol consumption without experiencing withdrawal symptoms
As opposed to a desire to drink alcohol, alcohol dependence is a need to drink alcohol. During the development of alcohol dependence, the brain experiences consistent levels of alcohol, and therefore adjusts to maintain balance with the continued effects of alcohol. This adjustment is referred to as tolerance, which is why it takes more alcohol to achieve the same effects as time goes on.
As alcohol tolerance grows, so does alcohol dependence. The brain's reliance on alcohol to maintain balance, per the adjustments made, is behind everything that characterizes alcohol dependence, from the need for alcohol, to the withdrawal symptoms.
Alcohol Withdrawal Symptoms
Alcohol withdrawal symptoms are very difficult and uncomfortable, and in severe cases of dependence, these symptoms can be deadly without medical supervision. One of the most dangerous aspects of alcohol withdrawal is the fact that the severity of symptoms typically do not peak until 1 to 3 days into detox, and symptoms can become severe very quickly.
Not everyone will experience the same withdrawal symptoms, but the more heavily and more frequently an individual consumes alcohol, the more severe alcohol withdrawal will likely be. Alcohol withdrawal symptoms can range from mild to severe. Some of the most common include:
- mood swings
- hand tremors
- confused thinking
- rapid heart rate
- clammy skin
On a baseline of alcohol withdrawal these symptoms are most common and may be mild to severe at the onset, becoming more severe between 24 and 72 hours into detox. If any withdrawal symptoms are experienced upon the cessation of alcohol, it is important to seek medical attention right away. As symptoms worsen, delirium tremens (DT’s) may become a threat, presenting symptoms which include tremors, hallucinations, severe confusion, and seizures, all in addition to the aforementioned symptoms.
To determine the severity of alcohol withdrawal symptoms and the potential need for hospitalization, a clinical assessment may be performed by a physician.
This assessment is called the Clinical Institute Withdrawal Assessment for Alcohol-Revised, or CIWA-Ar, and includes 10 questions, each of which are graded on a 0-7-point scale of severity.10
Questions included in this clinical assessment are the following:
- nausea and vomiting
- presence of tremors
- severity of sweating
- anxiety levels or panic attack
- agitation and restlessness
- tactile hallucinations
- auditory hallucinations
- visual hallucinations
- disorientation, understanding of surroundings and time
Again, not everyone will have the same experience with alcohol withdrawal, but it is always better to have some level of medical consultation to help assess the potential severity of any attempts to stop use of alcohol. Although it is not generally recommended to attempt alcohol detox alone, there are a number of ways in which it can be completed safely, and as comfortably as possible.
Alcohol detox isn't as scary as it may seem, especially with the assistance and care of medical professionals. The process of detoxification is to physically remove drugs, and their toxins from the body, and this process does play out naturally. There is no magic pill, nor special means by which drugs are forced out more expeditiously. The process of alcohol detox is much more than just ridding the body of alcohol and its byproducts.
Alcohol detox has a further purpose which is to rid the body of the substance in as safe and comfortable manner as possible. Alcohol detox is not a pleasant process to endure, and there is no way to ensure complete comfort. However, there are multiple ways in which the process of alcohol detoxification can be made more comfortable and manageable while also ensuring absolute safety and stability.
What is Alcohol Detox?
Alcohol Detox Is
A constant assessment of symptoms and their severity, and providing appropriate medications and dosages based on the management of those symptoms, in careful consideration of any other potential health complications.
Alcohol Detox Is Not
Providing all the drugs you want, until you're passed out.
Alcohol Detox Does
Address the symptoms of alcohol withdrawal, including anxiety, insomnia, high blood pressure, agitation, nausea, and delirium tremens (DT’s). This is in an effort to reduce distress and discomfort, provide safety, as well as to help induce sleep.
Alcohol Detox Does Not
Rid the brain of cravings, nor does it begin to address the psychological and behavioral aspects of addiction itself. Detoxification is only a physical process, whereas addiction treatment programs are designed to assist with the healing process of identifying the underlying causes of addiction and treating the illness itself.
In general alcohol detox lasts between 3 and 10 days, depending on individual circumstances, health, and the severity of alcohol abuse or dependence.
Whether detoxification from alcohol is mild, or severe and accompanied by the full range of withdrawal symptoms including delirium tremens, it is crucial that it be followed by an addiction treatment program for successful long-term recovery. Detoxification is necessary, but repeated occurrences of alcohol withdrawal can cause sensitization in the brain, exacerbating the symptoms of each successive detox attempt.11
This process of sensitization is referred to as kindling, and it progressively gets more severe with each relapse and detox period.
If alcohol detox is necessary, so is an addiction treatment program, to ensure there is no future need for repeated detox.
Alcohol Addiction Treatment
Once detoxification has been completed, it is time for an addiction treatment program. The detox process is a first crucial step in the process of recovery from alcohol abuse and dependence. Alcohol addiction treatment programs are intended to do many things in order to equip each individual with the tools necessary for sustained recovery.
Regardless of the length and severity of alcohol abuse and/or dependence, an effective addiction treatment program can be tailored to address the unique needs of each individual. To address the various behavioral and psychological aspects of alcohol abuse and addiction, treatment programs offer a wide range of services, including but not limited to:
Addiction education helps addicts to understand how they got to where they are, how the disease of addiction develops, and how it can be managed. This usually involves a great deal of individual and familial reflection, to begin laying the groundwork to understand the dynamics of and contributors to the disease of addiction.
One of the most comforting and welcoming elements of addiction treatment is the feeling that one is not alone in his or her struggles. Group therapy helps to create bonds between individuals beginning the recovery process, encouraging each to share his or her experience, strength and hope, to listen to the experiences of others, and to find healing through commonalities.
Coping Skills and Life Skills Building
One of the most prevalent commonalities among addicts and alcoholics is a lack of coping and life skills. Whether or not these skills were previously possessed, the availability of alcohol to cope with pain and hardships quickly replaces healthy coping skills. Addiction treatment helps to rebuild, or build from scratch, the skills needed to handle life's curveballs and challenges, without reaching for a drink.
Developing Healthy Habits and Living Patterns
It has been said of addicts in recovery that they need change only one thing; and that is everything. People, places and things. Treatment programs expose addicts to a healthy schedule of waking up in the morning and sleeping at night and engaging in healthy activities to replace old bad habits. Many offer supplemental therapies like art therapy, yoga, equine therapy, music therapy, experiential therapy, massage therapy, exercise, etc. to gain healthy habits.
Individual Counseling and Therapy
As the direct path to discovering the underlying issues and contributors to addictive behaviors and patterns, individual therapy is an integral part of addiction treatment. It aims to get each individual to understand his or her own addictive nature and identify his or her own strengths, in efforts to overcome the thought patterns which contributed to the development of addiction.
Establishing a Strong Recovery Plan and Support System
As the finishing touch on any individual's time with an addiction treatment program, there must be a plan for what will happen once that person is outside the safety net of the center. The sole purpose of addiction treatment is to arm addicts in recovery with the tools needed to stay sober on their own for the rest of their lives. Essential in achieving this goal, is to have a plan for a healthy life and the necessary level of support after treatment, whether it is sober living, stepping down in intensity to continued outpatient care, or simply remaining active in the recovery community. It is also helpful to have a strong support system, whether through groups like AA/NA, other recovery support groups, or simply spending time with healthy friends and family and co-workers who are supportive of your recovery. Often, treatment programs can assist with resume writing, and even recommend paths to employment in the recovery field.
Vogue Recovery Center Alcohol Addiction Treatment
If you or a loved one are in need of treatment, reach out to us, we’re here to help. Alcohol abuse and alcohol dependence will continue to get worse, without treatment.
At Vogue Recovery Center we understand what you’re going through, as many of us are in recovery ourselves. We've been where you've been and have felt the burden of not knowing where to turn or who to trust. That’s why we’re here, to offer a helping hand and a comforting shoulder, as you and your loved ones begin the journey of recovery. We know that addiction is a family disease, and everyone needs healing. We incorporate family group counseling into our program because we understand how important it is that families heal together.
Whether ultimately you attend treatment with us or not, by all means call us to start on the path to recovery. We are here to help, however we can.
Vogue Recovery Center Alcohol Addiction Treatment
- Alcohol and Tobacco Tax and Trade BureauTTB
- National Institute on Alcohol Abuse and AlcoholismNIAAA
- Mendelson, Jack H. and Mello, Nancy K. Alcohol: Use and Abuse in America. Boston, Massachusetts: Little, Brown & Co., 1985
- Public Broadcasting Station(PBS)
- Centers for Disease Control and Prevention(CDC)
- Centers for Disease Control and Prevention(CDC)
- Prevalence of Alcohol Dependence Among US Adult Drinkers, 2009-2011CDC
- National Highway Traffic Safety AdministrationNHTSA
- National Institute on Alcohol Abuse and AlcoholismNIAAA
- National Library of Medicine, National Institutes of Health(NIH)
- National Institute on Alcohol Abuse and AlcoholismNIAAA