Alcohol has been socially acceptable in most cultures around the globe for centuries. Although it is mostly used in moderation, the prevailing alcohol usage is still very high and has very harmful consequences for society. Efforts to abolish it have not been successful. It is, however, a substance which is controlled and monitored by authorities worldwide.
According to the World Health Organisation:
- About 40% of the world population uses alcohol. The other 60% does not use alcohol, either by personal choice or due to religion, culture or custom.
- Of the alcohol-using population, each person older than 15 years drinks 17 litres of pure alcohol annually.
- Alcohol usage results in more than 3 million deaths each year.
- Up to 40 years of age, 25% of total deaths and disabilities are alcohol-related.
- Alcohol is involved in more than 200 types of injuries, diseases, and mental disorders.
- About 16% of drinkers older than 15 years engage in binge drinking.
Of 194 countries monitored by another organisation, South Africa ranks as the 19th biggest drinking nation.
Alcohol abuse also causes serious personal financial losses, homelessness, as well as emotional pain and afflictions in children, which is difficult to quantify on a worldwide scale.
What is alcohol abuse?
Despite being a controlled drug, alcohol’s cultural entrenchment, widespread legal availability, ease of illegal production and black-market activities, render effective control by authorities almost impossible. Fortunately, public awareness means that most people use it in moderation.
Unfortunately, despite awareness, it is still the most abused drug in the world, with the highest incidence of harm. The complicated nature of humans, and of alcohol itself, makes it difficult to control our own destiny in terms of abuse and addiction.
The moderate use of alcohol is obvious and self-explanatory.
Abuse, dependency and addiction are more difficult to define. Clinical definitions are complicated and aimed at specific diagnostic interpretations, which differ from the standards applied by the person on the street. The words abuse, dependency and addiction are used more loosely by the average person. It has also become the norm for the media to use them randomly.
Abuse, in street parlance, is a blanket term for any and all forms of excessive alcohol usage. It only tells us that someone drinks (or drank) too much – it does not define the pattern or tell you how often it happens. It is randomly used to replace the words dependency and addiction. Although not decisive, infrequent abuse is the first indication that someone may be vulnerable to addiction.
Dependency is the next step on the way to addiction. The person needs alcohol to overcome a stumbling block but is still in reasonable control of the situation. They do not have dire, compelling cravings for alcohol. They use it whenever they want to overcome anxiety, stress, shyness, etc. The problem is that they are already starting to use alcohol as a crutch.
Addiction is generally seen as the point where someone has lost all control – alcohol completely dictates their lives. They persistently, desperately and compulsively crave alcohol. When alcohol intake is reduced or stopped, they have severe withdrawal symptoms. They will panic and go to extremes to obtain alcohol if it is not immediately available.
Although the stages indicate different risk levels, any alcohol abuse is a high-risk activity. It leads to accidents, fights, legal trouble, recklessness, and, ultimately, persistent abuse causes addiction. Not all people become addicted at the same rate. Some are more susceptible than others, but nobody knows how much they can take until it is too late.
Signs of alcohol abuse leading to addiction
The following are the most common signs that abuse is turning into addiction:
- Spends a lot of time obtaining, using, thinking about alcohol
- Does not know when to stop (keeps drinking until drunk)
- Has withdrawal symptoms when the effect of alcohol wears off
- Takes a morning-after drink to feel better (to stop withdrawals)
- Argues about alcohol usage and offers defensive justification
- Builds up reserve alcohol supplies (to prevent running out)
- Hides bottles of alcohol (fears others may take it away)
- Drinks on the sly, when nobody can see them
- Neglects duties, chores, responsibilities
- Accidents (on-road, in-home, anywhere)
- Reckless behaviour (squanders money, is sexually promiscuous)
- Avoided by friends, relatives, (replaced with drinking friends)
- Poor concentration and diminished decision-making skills
- Poor hand-eye coordination, slow reactions
- Frequently absent from work (or place of learning)
- Problems at work (or with studies)
- Financial and legal problems
- Slovenly or haggard appearance, trembling hands, dull eyes
- Carries on abusing alcohol, despite mounting problems
- Marital problems, wife and children unhappy, divorce threats
Long-term abuse has serious health consequences such as brain damage, heart damage, liver cirrhosis and cancer. See complete guide to alcohol addiction here.
The good and the bad of alcohol
Alcohol can actually make us feel good. For a short while, it soothes inhibitions, anxiety and stress and makes us happy, spontaneous, confident, relaxed and “creative”. Once we discover the rewards, we want to go back for more. That’s when it can turn into a nightmare.
People with emotional discomfort, find alcohol use for a break from unpleasant feelings. They start using it, not only socially, but also when they are alone. This reward-seeking activity is the ideal situation for alcoholism to take root. These are the two worst traps of the temptation:
Tolerance: Over time, you have to take more and more alcohol to get the same feeling you felt on previous occasions. This becomes a snowball that silently grows bigger and bigger until you can no longer control it.
Withdrawals: Your body becomes reliant on the chemicals that alcohol provides. When you stop taking alcohol, your body does not get those chemicals and you become extremely sick. You have to replenish the alcohol your body craves, just to feel “normal” again.
Some of the withdrawal symptoms are heart palpitations, anxiety, trembling, nausea, vomiting, weakness, headache, shortness of breath, tightness in the chest, irritability, depression, insomnia, convulsions, hallucinations, seizure.
There are numerous things that happen to you when you start abusing alcohol, but these two basic dysfunctions are enough to make you lose control of the situation.
Long term alcohol abuse symptoms
Once addicted, the person starts suffering from a range of negative symptoms, all of which have serious long term effects. Some of these symptoms are:
- Damaged organs (liver, heart, kidneys, stomach)
- Damaged brain and nervous system
- High blood pressure
- Emotional disorders
- Social, financial, employment and relationship problems
Here are just a few examples of disorders that may co-exist with alcohol abuse and may also have caused the abuse in the first place:
- Bipolar disorder
- Childhood traumas
- Personality disorder
- Post-traumatic stress disorder PTSD
- Attention-deficit/hyperactivity disorder
You may not be consciously aware of any problems, but a trained therapist can help you to uncover hidden emotional disorders and design an effective mental health programme for you. Without treating these underlying conditions, the chances of maintaining sobriety are slim. Treatment will enable you to live a normal and happy life.
Prevention and solutions
- Abstinence: Sadly, rather than abstaining, most societies are geared to favour alcohol. The huge beverage industry portrays alcohol products as either fun generators or objects of sophisticated prestige. This, together with our festive customs, conditions us to accept the drinking option from childhood. Abstinence is the best form of prevention, but first we have to cleanse our emotions and learn how to deal with the temptations.
- Prohibition: When the USA government abolished alcohol years ago, criminal syndicates exploited the gap by smuggling in alcohol, illegally brewing it and establishing shady sales outlets. This diminished the government’s control, led to huge crime problems and, eventually, resulted in alcohol being legalised again. Since then, no western government has tried to prohibit alcohol again.
- Government control: Governments can warn us about the dangers and pass laws about how, where and when alcohol may be produced, sold and used. They can police it, prosecute trespassers and maintain public order. However, this does not effectively prevent private abuse or addiction.
- Government limitations: The size of the industry, including retailers and entertainment venues, as well as the legality of private ownership of alcohol, makes it very difficult for governments to exercise full control.
- Policing: This is a valiant effort to deter alcohol-related criminality, rather than actually solving the addiction problem. However, a side effect, that of arousing public caution by arresting drunken offenders, does motivate abusers to go for rehabilitation. In this way, it contributes indirectly, yet positively, to rehabilitation.
- Increased taxes on alcohol: This decreases overall consumption, but mainly deters moderate users. Abusers are not phased by higher prices. They just channel more money away from other necessities to pay for the more expensive alcohol. Alternatively, they switch to cheaper brands or backyard breweries. They may even turn to crime to obtain more money. The alcohol industry also responds by vigorously introducing new products and plans to keep sales up. At least the extra taxes help governments to absorb the damage caused by alcoholism.
- Government assistance: Governments provide health and rehabilitation assistance, but this is done through bureaucratic public institutions, which are generally not proficient at specialised psychotherapy.
- The best option: For rehabilitation, the best solution is to attend a private rehab centre that specialises in addiction treatment, and therefore has the required resources to heal all underlying conditions, as well as preparing the patient for awkward situations and long term sobriety.
The widespread prevalence and social acceptability of alcohol lead to hard to break substance issues. Recovery Direct offers specialist counselling supported treatment for people struggling with alcohol issues. Secure, discreet, residential and outpatient programmes designed around an individual’s unique needs.
Successful sobriety equals the reintegration and restoration of valid relationships. Addiction is a family issue getting the family involved where necessary the family may support group to increase their knowledge of how the issues has affected them and also to share how they have been affected.