Alcoholism and Alcohol Abuse
Recognizing the signs and symptoms of a drinking problem
Ready to let go of a binge drinking habit? If you have trouble stopping drinking once you start, these tips can help you build a healthier relationship with alcohol.
When you hear the term “binge drinking,” you might picture wild high school or college parties. But people of any age group can engage in binge drinking. Some research even shows that the habit is increasing among older adults.
Binge drinking involves a pattern of short but heavy bursts of alcohol use. When you drink like this, you consume enough alcohol over the course of two hours to raise your blood alcohol concentration to the legal limit of intoxication (0.08 percent in the U.S.) or higher. That translates to about four or more drinks for an adult female or five or more drinks for an adult male.
Although drinking this much might not seem like a big deal in the moment, you may regret your choices later. You might struggle with the immediate physical consequences—headache, nausea, weakness, and poor sleep quality. Or perhaps you later feel shame and embarrassment about things you said and did while under the influence. You might wake up with questions like, “Did I do something stupid to endanger my loved ones?” or “Did I pass out and leave myself vulnerable?” These lapses in memory only add to the sense of dread and confusion you experience the next day.
You might also worry about whether alcohol is causing permanent damage to your brain or heart health. If your excessive alcohol use is a reoccurring issue, you might admonish yourself for your poor self-control or even develop a sense of self-loathing.
If any of that sounds familiar, consider rethinking your relationship with alcohol. You don't have to give up drinking entirely—there's plenty of middle ground between alcohol abuse and abstinence. Once you find that middle ground, you can continue to enjoy your favorite drinks without jeopardizing your health, safety, or sense of well-being.
Understanding the effects of binge drinking might increase your motivation to cut back on how much alcohol you consume in one sitting.
The effects can vary based on genetics, how much alcohol you drink at one time, how often you binge, and any preexisting health conditions you may have, such as cardiovascular disease. However, the impact of binge drinking on your physical and mental health can be varied and far-reaching, increasing your risk of:
Alcohol poisoning or alcohol overdose. This occurs when the level of alcohol in your bloodstream is so high that it creates a life-threatening situation. Drinking too much in a short period of time can reduce your heart rate, breathing, and body temperature. Seizures, loss of consciousness, and even death can occur.
Chronic physical conditions. Excessive drinking can lead to vascular diseases, such as high blood pressure, heart disease, and stroke. Digestive problems and liver disease are also potential long-term health risks that binge drinkers face.
Weight gain. Many alcoholic beverages have lots of calories, and you might not notice that because they're so easy to consume. For example, if a 12-ounce beer has about 150 calories, and you drink five, you've consumed an additional 750 calories which can quickly add inches to your waistline.
Cancer. Alcohol can damage body tissues and interfere with your body's ability to absorb nutrients and break down harmful chemicals. These effects can increase your risk of various types of cancer, including mouth, throat, esophagus, breast, liver, and colon cancer.
Fetal alcohol spectrum disorders (FASDs). Pregnant women who binge drink can affect their child's physical and cognitive development. A child with FASD might experience heart or bone problems, reduced attention span and memory, or learning disabilities. Research suggests that alcohol consumption is also a risk factor for sudden infant death syndrome.
Impaired memory functions. Studies show that binge drinking can affect your working memory, which is your ability to store short-term information and keep track of what you're doing. Drinking in excess can also lead to alcohol-induced “blackouts.” This is when your brain fails to move information from short-term to long-term storage, resulting in fragmented memories or difficulty recalling events.
Impulsivity. Binge drinkers often have a harder time with tasks that involve impulse control, leading to reckless or dangerous behavior.
Impaired learning. Alcohol abuse can affect brain structure development, so people who start binge drinking as teens or young adults may experience issues with learning and concentrating.
Mental health problems. Alcohol abuse can cause or worsen symptoms of depression, anxiety, and sleep disorders. You might experience adverse effects on your mood while you're intoxicated and even after you sober up. Alcohol abuse and mood disorders can even form a dangerous cycle. You might binge drink to cope with depression. Then, experience sleep disruptions due to your drinking. The lack of sleep worsens your depressive systems, so you turn to alcohol again.
Because excessive alcohol use impairs judgment and inhibitions, it can lead to risky behavior that can come with some serious consequences.
Many of us enjoy drinking on occasion, but if you binge drink you consume enough in just a short period to be considered legally intoxicated—five or more drinks in two hours if you’re a man, four or more if you’re a woman. However, even if you’re drinking less than this in one session, if your binge drinking is having unwanted consequences in your life, it may be time to reassess your drinking habits.
Some binge drinkers only drink once a week; others even less frequently. In fact, abstaining from alcohol between sessions of excessive alcohol consumption is a key characteristic of binge drinking. You may think that because you’re not physically dependent on alcohol and don’t have to drink every day that your drinking isn’t harmful. However, binge drinking can have serious consequences and any unhealthy patterns of alcohol use can lead to more serious problems.
You often drink more than you intend. You might start the night with the intention of drinking one or two beers. But then, you lose track of time and your pace. An hour or two later, you're more intoxicated than you wanted to be.
You have a hard time cutting yourself off once you start drinking. Perhaps you frequently get caught up in the feeling of euphoria that comes with being intoxicated. You feel compelled to keep drinking to maintain that high.
You frequently experience blackouts. Memory loss or fragmented memories of the previous night might leave you feeling uneasy or worried about your health.
You feel guilty or ashamed about how much you drink. You might arrive at a friend's party in an upbeat and energized mood, but by the end of the night, you're feeling sick and regretting your decisions. You might wonder why you always seem to make the same mistakes.
Your mental health problems worsen after drinking. A few mixed drinks might lighten your mood in the evening. But the next morning, you notice that your depressive symptoms or anxious thoughts are worse than usual.
You engage in reckless behavior. Maybe you feel overconfident in your ability to drive while intoxicated, or you don't think of the risks involved with physical stunts or going home with a stranger.
Only about 10 percent of people who binge drink struggle with a dependence on alcohol. However, the more frequently you binge drink, the more at risk you are of developing an alcohol abuse problem.
[Read: Alcoholism and Alcohol Abuse]
The spiral from binge drinking into alcohol addiction can be a gradual process. As you build a tolerance to alcohol, you may find that you need to drink more and more to feel the same effects. You may begin to binge drink more often, the days you abstain between sessions becoming fewer.
As you start to prioritize your alcohol use, it can have a negative effect on your work, school, or social life. You might try cutting back on your drinking but find that you suffer headaches, fatigue, anxiety, or irritability on the days when you don’t drink.
Alcohol use continues to take up more of your time and energy, impacting your physical and mental health until you need to take serious steps to address your drinking problem.
If you're a binge drinker, the first step to changing your drinking problem is to understand what factors drive your behavior. Depending on your age, different factors may come into play, but some motivations are common among all age groups.
Stress. People often use binge drinking as a way to self-medicate anxiety, depression, and stress. You may do it as a way to relax after a difficult day at work or blow off steam after college exams. Many people also use drinking to cope with difficult periods in their life, such as the death of a loved one or the end of a romantic relationship. However, alcohol is a depressant, so it will ultimately make you feel even worse.
[Read: Self-Medicating Depression, Anxiety, and Stress]
Boredom or loneliness. When you feel isolated or lack direction and purpose, it’s common to turn to alcohol and other drugs to fill that void. For example, you might feel tempted to recline on your couch, drink beer, and watch television simply to kill the hours spent alone.
Lack of awareness of alcohol tolerance. It’s easy for teens and young adults who aren't sure how much alcohol they can handle to go past their limits. Even older adults can overestimate their tolerance and wind up drinking far more than they can handle.
Social anxiety. Alcohol lowers inhibitions and, in the moment, makes you feel more relaxed. Because of this initial effect, people often use alcohol to cope with social anxiety. You might binge drink in order to feel confident talking, flirting, or making jokes with strangers.
Peer pressure. It's not uncommon for young adults to encourage one another to drink in excess, mix their drinks, or add rounds of shots. Even older adults can find it harder to turn down “one more drink” when they’re out having fun with friends. And peer pressure doesn’t necessarily come in the form of friends loudly encouraging you to drink more. You might convince yourself that you need to drink to impress someone or fit in with the crowd. This can be particularly true of teens who want to drink to seem older or more mature.
Certain personality traits can make you more prone to engage in binge drinking. If you're a highly impulsive person, you may be more likely to reach for another drink without stopping to think about the consequences. If you're the type of person who likes to seek out novel sensations and situations, you might also be more willing to engage in risky drinking habits.
Whatever your personality, though, there are steps you can take to modify your habits and take back control of your drinking.
If you’re a binge drinker, you may not drink every day, but when you do start drinking, you likely have a hard time calling it quits after just one or two drinks. Completely cutting alcohol out of your life is always an option. But if you don't want to take that big of a step, there are ways to drink more responsibly.
[Read: Overcoming Alcohol Addition]
Set a hard limit. For example, you can resolve to stick to one or two drinks during your outing with friends. To keep that limit in mind, consider writing it down, setting a reminder on your phone, or telling a friend about your intentions. Remember that drinking can lower inhibitions and impair judgment, so once you go past your set limit you might have a harder time stopping.
Drink more water. Whether you decide to set a hard limit or not, make a habit of following up every alcoholic beverage with a non-alcoholic one. This can help you slow down and better pace yourself.
Hangovers aren’t solely caused by dehydration. Therefore, drinking more water won't necessarily protect you from a hangover the next day. The only sure way to reduce or avoid a hangover is to drink less alcohol.
Take small sips. In addition to taking breaks for water, make a habit of slowly sipping your alcohol. Take a more mindful approach to drinking. Rather than chug your beer or mixed drink, take time to hold it in your mouth and appreciate its taste. If you have a hard time moderating your pace, try to stick with drinks that have low alcohol content.
Eat before you drink. Having a full stomach may make you less likely to drink as much as you would on an empty stomach.
Don't keep alcohol in your home. Avoid storing beer, liquor, and wine in your kitchen. It might seem convenient when you have company over, but it also makes it easier to reach for multiple drinks while you're alone. If you do end up storing alcohol at home, keep in the back of the fridge or in the basement—somewhere out of immediate sight.
If someone is trying to coerce you to have another beer, be polite but firm in saying no. A simple, “No, thank you” is all you need to offer. If you want to offer a more concrete reason, you can say you need to get up early tomorrow. From there, you can change the subject.
In some cases, the people around you might continue to pressure you to drink. Perhaps you're worried that they'll think less of you if you don't drink more. Keep in mind that people who really care about you will accept your decision. Consider avoiding people who pressure you as well as people who tend to binge drink.
[Read: Staying Social When You Quit Drinking]
If no one's pressuring you, but you still feel a desire to fit in, have a non-alcoholic beverage. Simply having a drink to sip on might make you feel more at ease. This strategy can also come in handy if you're with a group of friends who want to play drinking games.
If you tend to drink to calm your nerves in social situations, consider these healthier approaches:
Practice slow and steady breathing. Inhale for four seconds, hold it for two seconds, and exhale for six seconds. This stimulates your parasympathetic nervous system, which reduces stress. You should notice your heart rate slow, muscle tension fade, and feelings of anxiety subside.
Direct your focus outward. Rather than concentrate on internal feelings, worrying about about how you feel or what people think, try to focus more on what's going on around you. What are your friends actually saying? What's their body language communicating? Are there any interesting sights or sounds in the room?
Challenge negative inner monologue. If you're having a hard time shifting your focus from internal to external, consider the quality of your inner self-talk. Are you expecting other people to judge you? Are you beating yourself up for a mistake you made earlier? Dissect and challenge those worries with more realistic thoughts. Do you know for sure you're being judged? Does it matter? The truth is other people are usually far less focused on you than you believe.
For more tips, see Social Anxiety Disorder.
Watching a friend or family member struggle with a binge-drinking habit can be difficult, even heart-wrenching. You'll likely be there to witness their most reckless behavior, painful hangovers, and their sense of shame and depression afterwards.
Their volatile behavior and emotions might even have an effect on your relationship. Maybe your loved one has a tendency to say insensitive things while intoxicated, or perhaps they routinely drink and drive.
While you can't force a loved one to abandon their binge drinking habits, voicing your concerns and offering support in the right way may help motivate them to change their ways.
Pick the right time. Don't bring up the subject when they're already drinking or hungover. If they're intoxicated, they might be more likely to misunderstand you, lash out, or forget the details of the conversations. Wait until you're both able to have a clear, unrushed, and uninterrupted conversation.
Be respectful but honest. Don't take on a judgmental tone or try to shame them. Simply explain why you're concerned about their binge drinking. You might point out the effects that it's having on their mood or physical health. Or you could let them know how it's affecting your relationship. The goal isn't to preach, threaten, or punish them. Just let them know you care.
Expect pushback. It's not uncommon for people to get defensive when others point out their unhealthy drinking habits. Your loved one might deny the problem, deflect, or get mad at you. Reassure yourself that speaking up is a compassionate gesture. If you don't voice your concerns now, your loved one may not give up their alcohol abuse until they experience more severe consequences.
Keep trying but recognize your limits. So what should you do if your loved one initially denies having a binge drinking problem? You might want to give them a few days to reflect on what you said. If they continue to engage in the same unhealthy patterns, you could revisit the conversation later.
[Read: Helping Someone with a Drinking Problem]
Always keep in mind that you can't control someone else’s behavior. You shouldn't blame yourself for their unhealthy habits, either.
While you can't control how other adults handle alcohol, if you're the parent of a teen who binges, you'll want to take action. Alcohol use can have life-long effects on developing brains and bodies. Teens who drink are also more likely to struggle with school, use other risky substances, or experience alcohol poisoning.
To help an underage drinker drop the habit, you'll need to understand their motivations and be willing to converse with them in a nonjudgmental way. Because underage drinking can come with legal consequences, it's also necessary to establish rules and consequences.
For more information, see: Underage Drinking and Teen Alcohol Use.
If and when your loved one is ready to make a change, you can take several steps to support them.
Make a concrete plan with them and write it down. For example, they might decide to stick to one drink per occasion or no more than three drinks per week. When you're drinking together, remind them of the limit they set for themselves. But remember it's not your job to enforce this limit.
Set an example. Don't drink in excess. You might even want to vocalize when you're done drinking. Saying something like, “Well, that's my one drink for the night,” might help your loved one remember their own limit.
Give them more responsibility. In social situations where drinking is encouraged, you can give your loved one reasons to practice self-control. For example, if you and your husband are going to a party together, agree beforehand that he will be the designated driver.
Pursue new interests with them that don't involve drinking. Instead of inviting your loved one out for drinks at a bar, work on a crafting project or go see a movie. Be mindful of how often you engage in activities that could involve alcohol, such as local trivia nights or sports events. Try to make those types of activities take a backseat to other hobbies.
Be there in times of stress. In times of stress, hardship, or loss, help your loved one find better ways to cope with negative emotions. If they're going through a breakup or job loss, for example, be there to listen and assure them that things will get better. Instead of going to a bar where they can “drown their sorrows,” offer other alternatives, like taking a hike together or going on a road trip.
No matter how you choose to support your loved one's efforts to stop binge drinking, remember you're not their therapist. You also can't be expected to constantly monitor their decisions. Your role is simply to remind them of commitments they made and offer small nudges in the right direction.
Most of these organizations have worldwide chapters:
Al-Anon and Alateen – Support groups for friends and families of problem drinkers.
Alcoholics Anonymous (AA) – Learn more about AA’s 12 steps and find a support meeting in your area.
Women for Sobriety – Organization dedicated to helping women overcome addictions.
SMART Recovery – Self-Management and Recovery Training (SMART) is a program that aims to achieve abstinence through self-directed change.
SMART Recovery – Self-Management and Recovery Training (SMART) is a program that aims to achieve abstinence through self-directed change.
Call SAMHSA’s National Helpline at 1-800-662-4357 or search SAMHSA's Behavioral Health Treatment Services Locator.
Call Drinkline at 0300 123 1110, visit Drinkaware, or find NHS support services for alcohol addiction.
Download Finding Quality Addiction Care in Canada for regional helplines and other resources.
Call the Family Drug Helpline at 1300 660 068, contact Counselling Online, or find regional Help and Support Services.
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