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What is Alcohol Abuse?

I'm Sam and have strong interest in substance use and abuse and the psychology of behavioral problems.


You’re probably aware that there’s a difference between having a beer with dinner and being a full-blown alcoholic. Consuming a little bit of alcohol in a responsible manner does not constitute alcohol abuse. However, it’s hard to know where you should draw the line?

We aim to answer that question for you today. By the time you’re finished this article, you’ll understand the difference between responsible drinking and alcohol abuse. You’ll also know more about how alcohol exerts its effects on the body, and why it’s alright for you to have a beer with dinner and not so good to have six.

Drinking Alcohol Without Abusing

It’s possible to drink without abusing alcohol. It’s even possible to drink quite frequently without falling into a pattern of abuse. The bottom line depends on your constitution, the amount you drink, the way you act when you’re drinking, and the effects your drinking has on other people.

Alcohol abuse (which was actually reclassified as alcohol use disorder in 2013) describes a condition in which an individual repeatedly consumes alcohol despite the recurrence of negative consequences. There are several main types of alcoholics.

  • The first type of alcohol abusers are usually people who are either highly antisocial or highly extroverted. The antisocial individual drinks without regard to their surroundings and generally does so to numb themselves without considering how their actions affect those around them. The extroverted individual is often a pleasure seeker and drinks to liven up the evening, chasing exciting experiences.
  • The second type of alcohol abusers tends to be people who are either very anxious or who have limited self-control. These people are able to go weeks or months without drinking, but when they crack their first drink, they can’t stop themselves from overindulging.
  • Binge drinking technically constitutes a third kind of alcohol abuse, seeing as people from either category can engage in binge drinking.

Regardless of the type of alcoholic someone may be, they must meet the same criteria to be diagnosed as an alcoholic. For alcohol use to be considered abuse, the person has to continue drinking despite experiencing problems as a direct result of alcohol. This could mean causing significant harm to themselves, damaging relationships with their family or friends, or jeopardizing their employment. If you are able to drink at your own leisure without becoming dependent and haven’t found yourself in harm’s way or in a negative situation as a result of drinking, then you’re not abusing it.

Dangers of Alcohol Abuse

Alcohol abuse is inherently a dangerous condition, due to the substance’s ability to heavily cloud a user’s judgment. Frequent alcohol abusers are often more at risk for engaging in a dangerous or irresponsible alcohol-fueled activity. For example:

Driving Under Influence

A frequent drinker is more likely to get behind the wheel of a vehicle while intoxicated than an occasional drinker

Responsibility and Stability

People with alcohol use disorders are far more likely to miss deadlines for school or work, and serious alcoholics may have trouble finding stable housing.

Conflict With Law

Frequent drinkers are more often engaged in conflict with the law.


The rates of suicide and self-harm are higher among alcoholics than the non-drinking population.

Alcohol abuse also carries with it a significant risk of dependency and tolerance.

Alcohol Tolerance

Tolerance strikes first as a result of your brain’s GABA receptors undergoing a process known as downregulation. Drinking alcohol stimulates the GABA receptors, resulting in lowered anxiety and inhibitions.

However, your brain doesn’t know that you’re bombarding these receptors with an external substance. Your brain thinks that it’s producing all this extra GABA stimulation by itself, so it compensates by telling the receptors to desensitize themselves. This is what causes tolerance, and the same mechanism applies to most drugs that cause tolerance issues.

As your receptors desensitize, you require more and more alcohol to achieve the desired effects. Since you’re flooding your brain with more and more GABA stimulation, your tolerance builds, and the receptors continue to downregulate, leading to dependency.

Alcohol Dependency

Alcohol dependency arises for several reasons, the two most obvious being:

  • Glutamate rebound. Drinking alcohol inhibits the excitatory effects of glutamate, a neurotransmitter normally responsible for sending electrical charges through your brain to help with learning and memory. This is why it’s so easy to forget things when you’ve been drinking.

    When you stop drinking after building up a dependency, the glutamate system rebounds and causes excitotoxicity. Since they’ve been suppressed for so long, your brain overcompensates by firing the glutamate receptors much more than is necessary. This causes horrendous side effects and can potentially be fatal.

  • The other cause is downregulation. The GABA system is basically the opposite of the glutamate system. GABA would typically be released to relax you or reduce anxiety, but since alcohol has sufficiently downregulated your GABA receptors, there’s nothing to activate. They have become so downregulated that your body’s normal production of GABA can hardly activate them.
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A physical dependency results due to these mechanisms: a state in which a user physically needs a substance to function properly. Unfortunately, the more they consume that substance, the more severe the dependency becomes and the harsher the inevitable withdrawal will be.

How to Tell if Someone is Abusing Alcohol?

Some people are very good at hiding their behavior. This can make it difficult for loving family members to be certain whether or not somebody else in the family is abusing alcohol.

Many people with alcohol problems have found ways to cover up the scent of alcohol, excuses to disguise their hangovers, and manage to drink in secret or when they’re away from home. In addition, compassionate friends and families are more likely to believe an alcoholic even if they say that they’re not drinking.

There are many signs and symptoms that could indicate somebody having an alcohol problem. If somebody that you care about is exhibiting any of the following symptoms, you should consider talking to them or setting up a meeting for professional alcohol abuse treatment.

  • The individual may give away their own secret: many alcoholics are known to complain or comment about their difficulty maintaining personal relationships, or the trouble they have managing their work or schooling.
  • Alcoholics generally have a harder time controlling their emotions than those who don’t have any substance abuse problems. If someone you know has become unstable, moody, or irritable, you may have reason to suspect that they’re drinking too much.

    Alcoholics often develop aggressive or violent tendencies. If you’ve noticed your loved one starting fights or arguments more often, they may have a problem.

  • Alcohol abuse also has a tendency to cause fatigue.
  • Alcoholism can often seem similar to mania. The alcoholic will be lethargic and irritable when they’re not drinking, but may switch to an elated, sociable and happy person once they’ve started drinking.
  • Alcoholics often become more reserved. They’re only comfortable going out or interacting with people when they’re drunk, so they’ll spend the rest of the time alone, or trying to get alcohol.
  • Physical symptoms of alcoholism can include jaundice (yellowing of the skin and the eyes), extreme weight loss or weight gain, loss of appetite, and frequent nausea or vomiting. These symptoms can occur regardless of whether the alcoholic has been drinking or not.
  • Withdrawal symptoms only occur when the alcoholic hasn’t had a drink for a while. Withdrawal symptoms can include shaking hands, tremors, extreme anxiety, vomiting, malaise, hallucinations, insomnia, sweats or chills, and in the most serious cases, seizures.

Options to Help a Loved One or People in Need

Approaching somebody about their addiction is never easy – especially when you’re not entirely certain that they even have an addiction. If you think the problem hasn’t developed into a full-blown addiction, there’s no harm in approaching them. Tell them that you think their drinking is becoming a problem, show them what they’ve done wrong (but be kind and compassionate about it) and explain why you’re worried. Depending on your relationship, and the drinker’s relationship with themselves, this may or may not have an effect.

When problem drinking becomes a full-blown alcohol addiction, things are a bit different. The person no longer just drinks because they enjoy the effects but because they need alcohol to function. Addiction reaches an entirely new level when dependency comes into play.

Once an alcoholic reaches this stage, there’s not really much that you can do to help them. Some alcoholics are able to stop drinking when they realize the danger they’re putting themselves and their family in, but most cannot make it more than a few days. At this stage, they are going to need professional help and will likely need to go to rehab.

This is a difficult time for you because you have to step in between a substance abuser and their drug of choice, in this case, alcohol.

Assemble a Support Group

It’s best not to do this alone. Talk to others who are concerned about this person and assemble a support group so at least you have others to talk to about the problem. This makes it much easier for you to set up a plan of action and put it into play.

Sober is the Best Starting Point

When you do finally approach them about their problem, do so when they are sober. Oftentimes, an alcoholic feels remorse and regret for themselves and for others when they’re not drunk. If you’re going to get a message across, this is the best time.



Do not be accusatory or confrontational. Naturally, the alcoholic will be sensitive and probably defensive about their problem. Approach them with compassion and kindness and make it seem like you’re doing them a kindness.

Alcohol Rehab

You might not need to tell them to go to rehab right away. If this is the first time you’ve approached them about the problem, tell them that they can quit on their own. If you have the resources available, try to help them do this. If they try and fail, or have already failed, then you will need to talk about getting them to rehab.

Intervention Specialist

If none of these approaches work and the alcoholic refuses to accept help, then you may have to resort to ‘smoking them out.’ This means that you can’t give them help anymore. You can’t bail them out of legal problems, lend them money for food, and if they live with you, you may have to kick them out.

The sad reality for a lot of addicts is that they have to hit rock bottom before they recognize the severity of their problem, and most often, that involves them burning out all their resources.

Before resorting to this, you should consider contacting an intervention specialist. Ultimately, the alcoholic will still have to accept the help themselves, so this still might not work.

Professional Treatment for Alcohol Abuse

If your loved one has reached a level of abuse that requires treatment, you should try to locate a treatment center near you. Do a bit of looking around, first – alcohol treatments and rehab facilities vary greatly in the services they offer, their prices, and the cost of treatment. You may want to opt for a treatment that’s a bit farther if the services and the price are better.

If your loved one is going to need to detox, many rehab systems offer in-house detoxifications. They’ll provide the user with medication to ease them through the worst of the withdrawals. Before deciding whether or not to get a detox, you should decide whether you’re going to need an inpatient or outpatient rehab.

  • Inpatient rehabs keep the patient at the facility for the duration of the treatment. Inpatients are typically suited for people who have already attempted treatment and been unsuccessful, or for people who have serious addictions and couldn’t be trusted to abstain in between sessions.
  • Outpatient rehabs are much more lenient than inpatient rehabs. They allow the recovering addict to go to and from the facility at will, granted that they attend all their scheduled sessions.

Ending Alcohol Abuse By Talking About It

Alcohol abuse is a very common problem that can be frightening for the family and friends of the problem drinker. If the people close to the drinker are unable to put a stop to their drinking before it becomes a full-blown alcohol dependency, then professional treatment is likely the only solution to the problem.

Many treatment options are available for people with different degrees of substance abuse problems. Talk to your loved one about the possibility of attending rehab – it could save their lives.

Additional Resources

  • Downregulation and upregulation
  • GABA receptor
  • Pompili M., Serafini G., Suicidal Behavior and Alcohol Abuse, International Journal of Environmental Research and Public Health, 2010, 1392–1431.

This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

© 2018 Sam Shepards

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