What is Alcohol Abuse?

The lexicon of long standing terms such as alcohol addiction, abuse, dependence is constantly changing. At Origins Behavioral HealthCare, we are mindful of this evolving language in both the public and professional arenas. For the purposes of this particular article, we are utilizing the term “abuse” although it should be noted that both alcohol abuse and alcohol addiction sit on the same continuum and are now often identified by categories of varying severity such as mild, moderate and severe.

Alcohol abuse is more often than not seen when an individual continues to use alcohol in spite of the knowledge that their life has become unmanageable. It is often experienced as social, physical or psychological issues.  

It is often difficult to distinguish abuse from addiction. In order to determine if abuse is a problem, it is important to receive a professional assessment when it is suspected. Since abuse can actually be the first stage of addiction, early intervention may save lives and valuable resources.

According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA) although most adults can use moderate amounts of alcohol without harm, about 18 million adult Americans have an alcohol use disorder (AUD) which results in their drinking causing distress and harm to self or others. It includes alcoholism and alcohol abuse.

Alcohol abuse as defined by the NIAAA is characterized by a maladaptive pattern of using alcohol that leads to clinically significant impairment or distress. Alcohol abuse is defined as intentional overuse in cases of celebration, anxiety, despair, self-medication, or ignorance, resulting in one or more of the following occurring within a 12-month period:

• Failure to fulfill major role obligations at work, school, or home
• Recurrent drinking in physically hazardous situations
• Recurrent alcohol-related legal problems
• Continued alcohol use despite having persistent or recurrent social and/or interpersonal problems caused or exacerbated by the effects of alcohol.

These symptoms tend to decline with adverse consequences. Alcohol abuse requires that the symptoms have never met the criteria for alcohol dependence in terms of persistence, frequency, quantity, etc.

Alcohol abuse is a serious problem. Though the individual does not yet have a physical need to drink, his or her dangerous behavior may lead to legal or social problems at home, work, or school. Included in this category can be what is known as binge drinking: five or more drinks in two hours for men and four or more drinks in two hours for women.

Alcohol abuse among Baby Boomers and Older Adults is common, with millions of people remaining under the radar. Without enduring protector factors, major life transitions may wreak havoc with a person’s life, causing maladaptive behaviors to become coping mechanisms.

Life transitions are often seismic shifts in an older person’s perspective or lifestyle. The loss of family members or a spouse may also mean a shift in personal roles in society and life. Loss of job through retirement or layoff may leave a void. Older people may find that, in a retirement community, the daily Happy Hour can create an addictive pattern of drinking alcohol. The family members of many seniors showing signs like these eventually research alcoholic treatment centers to find help for their loved one.

People abuse alcohol to self-medicate chronic pain, stress and other emotional problems and, over time, even more alcohol is needed for the same effects. According to the NIAAA, a standard drink contains 0.6 fluid ounces of alcohol. This relates to a 12-ounce beer, a 5-ounce glass of wine and 1.5 ounces of hard liquor. When normal levels of intake are exceeded, it may be a sign that an Older Adult or Baby Boomer is in serious trouble.

The reason for this is that older people, even those in good health, cannot physically process alcohol the same way younger bodies do. Many sources recommend just one drink for women and two for men, although the NIAAA states that for those over age 65, three drinks maximum per day and no more than seven per week is advisable.

Prolonged alcohol usage that becomes severe can lead to an Alcohol Use Disorder (AUD). To be diagnosed with an AUD, individuals must meet certain criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5^®). Under, DSM-5^® anyone meeting any two of the 11 criteria during the same 12-month period receives a diagnosis of AUD. The severity of an AUD—mild, moderate, or severe—is based on the number of criteria met.

To assess whether you or loved one may have an AUD, here are some questions the NIAAA suggests you may try asking yourself. In the past year, have you:

• Had times when you ended up drinking more, or longer than you intended?
• More than once wanted to cut down or stop drinking, or tried to, but couldn’t?
• Spent a lot of time drinking? Or being sick or getting over the aftereffects?
• Experienced craving — a strong need, or urge, to drink?
• Found that drinking — or being sick from drinking — often interfered with taking care of your home or family? Or caused job troubles? Or school problems?
• Continued to drink even though it was causing trouble with your family or friends?
• Given up or cut back on activities that were important or interesting to you, or gave you pleasure, in order to drink?
• More than once gotten into situations while or after drinking that increased your chances of getting hurt (such as driving, swimming, using machinery, walking in a dangerous area, or having unsafe sex)?
• Continued to drink even though it was making you feel depressed or anxious or adding to another health problem? Or after having had a memory blackout?
• Had to drink much more than you once did to get the effect you want? Or found that your usual number of drinks had much less effect than before?
• Found that when the effects of alcohol were wearing off, you had withdrawal symptoms, such as trouble sleeping, shakiness, irritability, anxiety, depression, restlessness, nausea, or sweating? Or sensed things that were not there?

If you have any of these symptoms, your drinking may already be a cause for concern. The more symptoms you have, the more urgent the need for change. A health professional can conduct a formal assessment of your symptoms to see if an alcohol use disorder is actually present.

Older Adults and Baby Boomers often take medications and should consider possible interactions of these when drinking socially. Older women become intoxicated faster than older men do, because they have lower amounts of body water. Since alcohol diffuses through water, higher concentrations of alcohol result. Women also do not process alcohol the same as men because they have a lower level of the enzyme that metabolizes alcohol in the stomach.

Age-specific treatment works. Older people tend to relate the words associated with alcohol abuse to a moral failing, so age sensitivity and awareness of generational values, including respect for peers, is very important when addressing these sensitive subjects.

If you or a loved one is exhibiting signs of alcohol abuse, please contact us at any time to receive more information: 561-841-1296.