Inexcess: In search of recovery

Help and support for people and families
dealing with drug and alcohol problems

Addiction Info

Find out more about addiction and recovery

Addiction to Alcohol


Alcohol AddictionIn moderation, alcohol can be harmless. It is often consumed with friends and family in social situations; when we celebrate, commiserate, after work and when we relax.

However, for many people the regular consumption of alcohol can become a habit, leading to heavier drinking as their tolerance grows.

Patterns of habitual drinking can become part of an individual’s everyday behaviour without them even noticing it is happening. It can be attributed to an active social life which often entails visits to the pub or drinking from home with friends or during periods of increased stress, which may be brought on through bereavement, financial problems, depression, longer working hours or a hectic lifestyle.

Several million people in the UK drink excessively on a regular basis, i.e. more than the government’s guideline of 3/4 units a day for men and 2/3 units a day for women, yet many of these people are able to maintain a seemingly ‘normal’ work/life balance.

There are however people who are not able to manage the different variables in their life, where alcohol is a compulsion and takes precedence over all other activities. Such people are said to be ‘alcohol dependant’.

How to tell if you are addicted?


There are many organisations that offer ‘tests’ to determine whether or not a person is dependent on alcohol.

One of the most comprehensive is provided by the World Health Organisation (WHO). It might be a good idea to take the test to see whether your drinking habits are damaging your health?

1. How often do you drink alcohol?

  • a. Never (0)
  • b. Monthly or less (1)
  • c. Two to four times a month (2)
  • d. Two to three times a week (3)
  • e. Daily or almost daily (4)

2. How many standard drinks do you have on a typical day when you are drinking? (A standard drink is half a pint of beer; a single measure of spirits or a small glass of wine.)

  • a. 1 or 2 (0)
  • b. 3 or 4 (1)
  • c. 5 or 6 (2)
  • d. 7 to 9 (3)
  • e. 10 or more (4)

3. How often do you have six or more drinks on any one occasion

  • a. Never (0)
  • b. Less than monthly (1)
  • c. Monthly (2)
  • d. Weekly (3)
  • e. Daily or almost daily (4)

4. How often during the last year have you found that you were unable to stop drinking once you had started?

  • a. Never (0)
  • b. Less than monthly (1)
  • c. Monthly (2)
  • d. Weekly (3)
  • e. Daily or almost daily (4)

5. How often in the last year have you failed to do what was expected of you because of drinking?

  • a. Never (0)
  • b. Less than monthly (1)
  • c. Monthly (2)
  • d. Weekly (3)
  • e. Daily or almost daily (4)

6. How often in the last year have you had a feeling of guilt or remorse after drinking?

  • a. Never (0)
  • b. Less than monthly (1)
  • c. Monthly (2)
  • d. Weekly (3)
  • e. Daily or almost daily (4)

7. How often in the last year have you been unable to remember what happened the night before because you had been drinking?

  • a. Never (0)
  • b. Less than monthly (1)
  • c. Monthly (2)
  • d. Weekly (3)
  • e. Daily or almost daily (4)

8. Have you or someone else been injured because of your drinking?

  • a. No (0)
  • b. Yes, but not in the last year (2)
  • c. Yes, during the last year (4)

9. Has a relative or health worker been concerned about your drinking or suggested you cut down?

  • a. No (0)
  • b. Yes, but not in the last year (2)
  • c. Yes, during the last year (4)

Your score:

  • Add up the scores for each question to give a total out of 40.
  • If it is eight or above, you are a ‘hazardous’ drinker at risk of conditions such as liver disease and depression.
  • If your total is over 16 you are a ‘harmful’ drinker and your health is likely to be damaged.

Symptoms of an alcohol dependency

It is estimated that one in 13 people in the UK are alcohol dependant. These people have a strong desire to drink large amounts of alcohol throughout the day and experience withdrawal symptoms if they go without it for a relatively short time period.

A person who is alcohol dependant will display the following:

  • A strong compulsion to drink;
  • Continued use of alcohol despite being aware of its damaging effects;
  • A difficulty in controlling their consumption of alcohol;
  • Withdrawal symptoms when decreasing or stopping alcohol consumption;
  • Increasing tolerance to alcohol, and;
  • A pre-occupation with acquiring and consuming alcohol.

Continued habitual drinking will have a negative affect on a person’s work and relationships. Besides the social and personal implications, excessive drinking can also lead to a host of heath problems. Large quantities of alcohol can lead to -

Physical effects

  • Cirrhosis of the liver
  • Impotency
  • Coronary heart disease
  • High blood pressure

Psychological effects

  • Memory loss
  • Anti-social behaviour
  • Depression
  • Hallucinations

Cancer

  • Liver
  • Larynx
  • Mouth
  • Breast

The excessive consumption of alcohol may also contribute to wider social problems such as domestic violence and crime.

Why do people become alcohol dependant?


There a number of reasons that may explain why some people become dependant on alcohol and others do not. Many scientists for example believe that there is a genetic link to alcohol dependence whereby a person’s genes can influence their drinking habits and susceptibility to alcohol. This ‘weakness’ can manifest itself during social occasions where alcohol is easily available and widely accepted.

Many ex-drug users become alcohol dependant due to a belief that it is not possible to become addicted to another substance. Over time these people find it difficult to control their consumption and experience withdrawal symptoms when they go for a period of time without alcohol.

The heavy consumption of alcohol over time can have a harmful effect on an individual’s physical and mental health. Alcohol can change the chemistry of the body and lead to both short and long-term internal damage. At worst it can lead to death.

What are the physical and psychological effects of alcohol abuse?


The excessive consumption of alcohol over a long period of time is likely to be harmful to a person’s physical health. Doctors are still discovering the damage that alcohol can inflict upon the human body, some of which is permanent.

Short term consequences


If a person drinks a large volume of alcohol over a relatively short period of time, they will experience a number of unpleasant physical effects. It is important to note that any damage incurred is reversible and that symptoms will improve when a person abstains or reduce their consumption of alcohol. The most common short-term effects are –

  • Lack of co-ordination
  • Impaired judgement
  • Diarrhoea
  • Loss of short term memory
  • Loss of consciousness
  • Weight gain
  • Nausea
  • Casual and unprotected sex (STIs)
  • Vomiting
  • Impotence
  • Anxiety
  • Slowed breathing and heartbeat

However, long term consequences can be more severe and will often not improve when a person abstains or reduces their consumption of alcohol. The most common long term effects are –

  • Liver damage: the liver breaks alcohol down into chemicals as part of the body’s digestion process. The liver can only break down a certain amount of alcohol per hour and so if a person drinks a lot of alcohol in a short space of time the liver cannot cope. This can lead to:
    • Cirrhosis of the liver: where normal liver tissue is replaced by scar tissue. The scar tissue affects the structure of the liver and re-growth of new liver cells. Cirrhosis of the liver can eventually lead to liver cancer and women who drink more than three units of alcohol a day dramatically increase their risk of developing breast cancer
  • Coronary heart disease and heart muscle damage: alcohol is calorific and when consumed in excess, without an adequate amount of exercise can lead to weight gain and cause heart disease.
  • Stroke: excessive drinking can lead to dehydration, making the blood thicker and more likely to clot and clog the arteries in the brain (ischemic stroke). Alternatively, alcohol can increase blood pressure and cause the blood vessels to burst and leak into the brain (haemorrhagic stroke).
  • Cancer: alcohol can dramatically increase the likelihood of a person developing cancer. According to doctors, alcohol is the second biggest risk factor for throat and mouth cancer.
  • Pancreatitis: affects long term heavy drinkers. The pancreas is used to make insulin to help food digest properly, however alcohol can cause severe damage to the pancreas and lead to malnutrition and diabetes. Every year 500 people die in the UK due to alcohol-related pancreatitis.
  • Diabetes: alcoholic drinks contain a lot of sugar, which can lead to diabetes. This condition is not life threatening and is manageable, but a person must maintain a healthy lifestyle, eat a balanced diet and take prescribed medicines such as insulin in order to live life to the full.
  • Stomach ulcers: alcohol increases the amount of acid in the stomach. This can erode the muscles lining the stomach and lead to an infection.
  • Depression: there is a strong link between heavy drinking and mental health disorders, such as depression.
  • Loss of long-term memory: vitamin B1 deficiency, due to poor diet and excessive alcohol consumption, can lead to a dementia like illness called Nernicke-Korsakoff.
  • Hallucinations: visual hallucinations are common for people when experiencing withdrawal from alcohol. Often people ‘see’ worms or insects crawling over all over the walls and their skin. Sometimes people ‘feel’ the insects or worms on their skin (tactile hallucinations) or hear noises that don’t exist (auditory hallucinations).
  • Infertility: excessive alcohol shrinks a man’s genitals and lowers a woman’s fertility; this may lead to problems when a person decides that they would like to start a family.
  • Aspiration: caused by breathing materials from the mouth into the lungs. For those who drink excessively this is often the liquid they are consuming or vomit. This may lead to inflammation of the lungs, an infection or choking and subsequent suffocation.

Can addiction lead to any psychological problems?


There is a strong link between heavy drinking and the development of a mental illness. Known as psychiatric morbidity in the medical world, mental illnesses such as depression and memory loss often affect vulnerable groups such as the homeless, young people and offenders.

Whilst seeking treatment for alcohol dependence, a mental illness or psychological disorder is more likely to be recognised and therefore treated; this is often referred to as ‘dual diagnoses’. Often the symptoms of their disorder disappear with treatment for their dependency; however, there are occasions where their disorders become more apparent with treatment as the dependency masking the symptoms disappears.

Will addiction lead to social problems?


It is not surprising that when alcohol is at the centre of a person’s world it can lead to a number of wider social problems such as:

  • Workplace problems: absenteeism/ impaired performance
  • Divorce
  • Domestic violence
  • Homelessness
  • Child abuse
  • Criminal behaviour

Getting help


Before any person can begin their personal journey of recovery, it is crucial that they acknowledge that they have a problem. This is the first step towards getting better, but is often the hardest one. The next step is to seek professional help.

Before this, it may be a good idea to keep a ‘drinks diary’ for a couple of days or weeks, logging the number of alcoholic drinks consumed, number of alcohol units, what time they were consumed and where. This provides a reference point and will highlight the amount the person is drinking so that a professional can suggest and provide the most appropriate treatment programme.

With a dependency on heavy alcohol use, stopping using altogether can provoke severe withdrawal symptoms.

Withdrawal from Alcohol


Reducing the volume or abstaining from alcohol can lead to a number of withdrawal symptoms within hours of a person’s last drink. The most common symptoms are listed below and when combined is likened to a bad case of flu.

  • Restlessness
  • Sweating
  • Agitation
  • Nausea and vomiting
  • Insomnia
  • Delirium
  • Tremors
  • Anxiety
  • Hallucinations
  • Seizures

Such withdrawal symptoms are said to peak within the first 24 – 48 hours, which is when a person is most likely to relapse. However, if an individual is able to maintain their sobriety these withdrawal symptoms will disappear within 5-7 days.

It is recommended that withdrawal from alcohol takes place under professional supervision. Every local community will have a healthcare team, involving GP’s, hospitals, nurse specialists and councillors that will help plan recovery over the long-term. It is worth remembering that these people understand the ups and downs of recovery and can help a person through the really tough times.

Visiting your GP


A GP is probably the best person to visit when a person initially decides that they want to get better and begin the process of recovery. A person needs to be honest from the very start about the amount of alcohol that they are drinking and any other symptoms and concerns they may have as a result of alcohol dependency. It is important to provide a GP with as much information as possible so that they can assess any physical problems and offer advice and support regarding the next step. Depending on the severity a person’s alcohol dependence sudden withdrawal from alcohol altogether can be life threatening and so a medical doctor should always be the first port of call.

Detoxification


Along with advice and help, a doctor may also prescribe some medication to be taken during the detoxification process; this is to help reduce the unpleasant withdrawal symptoms that may be experienced during recovery. A group of medicines called Benzodiazepines are often used during detoxification as they make detoxification more tolerable and the dangerous alcohol withdrawal effects are less likely to occur. Typically a high dose of the medication is taken on the first day of the detox, which is gradually reduced over the following 5-7 days until it is withdrawn completely. Under no circumstances should alcohol be consumed during this process.

Talking through recovery


Many people find that talking about life without alcohol to a trained professional or a group to be very helpful to their recovery.

  • One-to-one sessions: talk regularly with trained counsellors about thoughts, feelings and emotions during the journey through recovery. The session provides an opportunity to discuss any of the queries and issues a person may have in more detail. The counsellors can also help plan and forecast how to best control and manage a person’s drinking over a long term period. Cognitive Behavioural Therapy (CBT) is often used to treat those who are alcohol dependant as it helps people change their attitude and behaviour towards alcohol and therefore increase their chance of living a life of sobriety.
  • Group Therapy: this involves meeting with a group on a regular basis to discuss the challenges faced since the previous meeting, but also listen to other people about theirs.

The most well-know group therapy is ‘Alcoholics Anonymous 12-Step Programme’ whereby a group of people with an alcohol problem meet to discuss their recovery process. The benefit of the programme comes from meeting people who have been through similar experiences, lifting the shame that often prevents recovery. Attending meetings and socialising with people fills the void that their addiction once filled and gives people a sense of belonging to a group, without the crux of a substance.

There is no charge for the 12-step programme and the new friendships and support made between group members may act as free aftercare. However it is important to note that some treatment organisations insist on charging a fee for the information, advice and support offered.

Residential rehabilitation


Some people find that recovery is too difficult from their home and local community because there are too many reminders of their life during addiction. In such cases it is recommended that a person stays at a residential rehabilitation where there is 24-hour medical care and assistance to help a person deal with the uncomfortable withdrawal symptoms and other problems.

This level of care can take place in an NHS hospital ward or a privately funded unit, often over a twelve week period. It is often reserved for those who have unsuccessfully attempted to tackle their addiction in the past via other methods and for people with a medium or high level of alcohol dependence.

A residential rehabilitation unit offers a structured programme throughout the day that often includes one-to-one and group therapies along with family/couples therapy for relatives. There are also a selection of recreational activities such as cooking, sports and art therapy that contribute to providing a routine and predictability to a person’s life.

Self Help

Not everybody feels that they require professional help in order to tackle their dependence on alcohol. In fact it is estimated that a third of people with an alcohol problem are able to reduce their consumption or stop completely without any external help.

There are many self-help books and websites that provide information and advice to people who want to stop drinking and maintain sobriety. In addition there are a number of significant changes to a person’s lifestyle that can help them reduce and manage their alcohol consumption.

Staying Sober

It may take several attempts before a person can successfully control their consumption of alcohol or maintain sobriety altogether. It is important to remember that withdrawing from alcohol is only the beginning; the real challenge is staying alcohol-free over a long period of time. Support from friends, family and professionals is crucial to success as it can help a person better understand their illness and ultimately recognize and overcome the issues that may contribute to their dependence.

Friends and Family

When a person is heavily addicted to alcohol, it is a very difficult time for the friends and family that surround and care for them. Many feel a compulsion to approach a person and inform them of their concern and desire to help. It is advised that before any person is approached and confronted about their problem, it is vitally important that their loved one undertakes as much research as possible about the subject of alcohol and addiction so that they are armed with the right facts and information about where to go and seek help.

It is important to choose the right moment to broach the subject with a loved one; choose a time when everyone is feeling calm and relaxed, not too emotional and not too drunk. Consider an approach from the other person’s point of view and think about how they may react to a suggestion that they may have a drinking problem.

Show concern and empathy rather than disapproval. Do not criticise them, make a judgement or label them. Try and keep questions open so to avoid yes/no answers, and keep the language positive, but always maintain a feeling of concern.

Finding help


The Inexcess Support Directory lists more than 1600 service providers throughout the UK and is divided by region to help support and advise people how to find help in their own area. Click here to visit the Support Directory.