Symptoms of Alcohol and Substance Abuse/alcoholism symptoms and signs
Abuse of alcohol or a substance (such as cocaine, nicotine, marijuana, etc.) is generally characterized by a maladaptive pattern of alcohol or substance use leading to significant impairment or distress, as manifested by 1 or more of the following, occurring within a one year period:
- Recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home (e.g., repeated absences or poor work performance related to substance use; substance-related absences, suspensions, or expulsions from school; neglect of children or household)
- Recurrent alcohol or substance use in situations in which it is physically dangerous (e.g., driving an automobile or operating a machine when impaired by substance use)
- Recurrent alcohol or substance-related legal problems (e.g., arrests for alcohol or substance-related disorderly conduct)
- Continued alcohol or substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol or substance use (e.g., arguments with spouse about consequences of intoxication, physical fights)
The symptoms must also have never met the criteria for alcohol/substance dependence for this class of substance or alcohol.
Alcohol and substance dependence symptoms (alcoholism, addiction)
The dependence from alcohol or other psychoactive substances (marijuana, cocaine, nicotine, caffeine etc.) is characterized by the inadequate use of these substances, leading to clinically significant impairment or distress, as manifested by 3 or more of the following, occurring at any time in the same 12-month period:
Tolerance, as defined by either of the following:
- A need for markedly increased amounts of the alcohol or substance to achieve intoxication or desired effect
- Markedly diminished effect with continued use of the same amount of the alcohol or substance
Withdrawal, as manifested by either of the following:
2 or more of the following, developing within several hours to a few days of reduction in heavy or prolonged alcohol or substance use:
- Sweating or rapid pulse
- Increased hand tremor
- Nausea or vomiting
- Physical agitation
- Transient visual, tactile, or auditory hallucinations or illusions
- Grand mal seizures
- The same substance (or another substance) or alcohol is taken to relieve or avoid withdrawal symptoms
The substance or alcohol is often taken in larger amounts or over a longer period than was intended
There is a persistent desire or unsuccessful efforts to cut down or control use of alcohol or the substance
A great deal of time is spent in activities necessary to obtain alcohol or the substance (e.g., visiting multiple doctors or driving long distances), using alcohol or a substance (e.g., chain-smoking), or recovering from its effects
Important social, occupational, or recreational activities are given up or reduced because of the continued alcohol or substance use
The substance or alcohol use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance (e.g., current cocaine use despite recognition of cocaine-induced depression or continued drinking despite recognition that the hypertension was made worse by alcohol consumption)
Some of the most common physical, psychological, and behavioral signs and symptoms of alcohol abuse are:
- Poor coordination
- Slurred speech
- Impaired thinking
- Memory impairment
- Wanting to stop drinking but not managing to do so
- Diverting energy from work, family, and social life in order to drink
- Being secretive about the extent of the alcohol abuse in order to protect it
- Engaging in risky behavior, such as drunk driving
- Being in denial about the extent of the alcohol abuse problem
- Becoming distressed at the prospect of not having access to alcohol
When a person who regularly abuses alcohol stops drinking or significantly reduces the amount of intake, withdrawal symptoms will emerge. Such symptoms can begin as soon as two hours after the last drink and continue for weeks. Symptoms can include shaking, anxiety, and the desire for a drink. Delirium tremens (DTs), a severe withdrawal symptom, can include confusion, fever, and rapid heartbeat.
Other signs and symptoms of alcoholism
You’ve lost control over your drinking. You often drink more alcohol than you wanted to, for longer than you intended, or despite telling yourself you wouldn’t.
You want to quit drinking, but you can’t. You have a persistent desire to cut down or stop your alcohol use, but your efforts to quit have been unsuccessful.
You have given up other activities because of alcohol. You’re spending less time on activities that used to be important to you (hanging out with family and friends, going to the gym, pursuing your hobbies) because of your alcohol use.
Alcohol takes up a great deal of your energy and focus. You spend a lot of time drinking, thinking about it, or recovering from its effects. You have few if any interests or social involvements that don’t revolve around drinking.
You drink even though you know it’s causing problems. For example, you recognize that your alcohol use is damaging your marriage, making your depression worse, or causing health problems, but you continue to drink anyway.
Five myths about alcoholism and alcohol abuse
Myth: I can stop drinking anytime I want to.
Fact: Maybe you can; more likely, you can’t. Either way, it’s just an excuse to keep drinking. The truth is, you don’t want to stop. Telling yourself you can quit makes you feel in control, despite all evidence to the contrary and no matter the damage it’s doing.
Myth: My drinking is my problem. I’m the one it hurts, so no one has the right to tell me to stop.
Fact: It’s true that the decision to quit drinking is up to you. But you are deceiving yourself if you think that your drinking hurts no one else but you. Alcoholism affects everyone around you—especially the people closest to you. Your problem is their problem.
Myth: I don’t drink every day OR I only drink wine or beer, so I can’t be an alcoholic.
Fact: Alcoholism is NOT defined by what you drink when you drink it, or even how much you drink. It’s the EFFECTS of your drinking that define a problem. If your drinking is causing problems in your home or work life, you have a drinking problem—whether you drink daily or only on the weekends, down shots of tequila or stick to wine, drink three bottles of beers a day or three bottles of whiskey.
Myth: I’m not an alcoholic because I have a job and I’m doing okay.
Fact: You don’t have to be homeless and drinking out of a brown paper bag to be an alcoholic. Many alcoholics are able to hold down jobs, get through school, and provide for their families. Some are even able to excel. But just because you’re a high-functioning alcoholic doesn’t mean you’re not putting yourself or others in danger. Over time, the effects will catch up with you.
Myth: Drinking is not a “real” addiction like drug abuse.
Fact: Alcohol is a drug, and alcoholism is every bit as damaging as drug addiction. Alcohol addiction causes changes in the body and brain, and long-term alcohol abuse can have devastating effects on your health, your career, and your relationships. Alcoholics go through physical withdrawal when they stop drinking, just like drug users do when they quit.