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From the deadly consequences of lockdown-driven alcohol consumption to the binge-drinking partying culture, Britain has its fair share of challenges relating to alcoholism.
Any member of the community can fall into the vicious cycle of alcohol addiction, with harrowing statistics indicating a rise in those seeking treatment from all walks of life.
According to the latest government data set, 275,896 adults came into contact with drug and alcohol services between April 2020 and March 2021, compared to 270,705 the previous year.
Of these services, the NHS are among the hardest hit, with hospitals recording 318, 596 admissions for alcohol-specific conditions in 2021.
NHS statistics for the same year also revealed that 167,000 prescription items dispensed in 2020/2021 were to treat alcoholism, which is a 1% increase from the previous year.
These items were prescribed after preliminary hospital admissions for a variety of alcohol-related concerns. These included mental or behavioural disorders (14% of admissions), cardiovascular disease (45%), and alcoholic liver disease.
Tragically, too many people desperately needing such treatment for their Alcohol Use Disorder (AUD) don’t receive it in time. The Local Alcohol Profiles for England and Wales discovered that in 2020, 6,984 adults lost their lives to causes relating specifically to alcohol.
In the same year, 20,486 individuals lost their battles with AUD due to alcohol-related conditions. More specifically, mortality from chronic liver disease stood at 7,402, while deaths resulting from the alcoholic liver disease were at 5,284.
With many UK residents enjoying a “tipple” regularly, it can be difficult to tell when someone’s casual drinking has morphed into a bigger problem.
Before diving into the specific behavioural signs of alcoholism, it’s first important to understand Alcohol Use Disorder as a condition.
While alcohol addiction carries the stigma of being a choice, it’s in reality a debilitating medical condition beyond someone’s control.
The Diagnostic and Statistical Manual of Mental Disorders recognises AUD as a chronic condition arising from a combination of genetic, environmental, and behavioural factors.
AUD occurs when an individual uses alcohol to the extent that their brains and bodies become dependent on it. This causes a chronic relapsing brain disorder characterised by an impaired ability to stop or control alcohol consumption despite the ramifications.
This is because alcohol stimulates the brain’s reward pathway to release dopamine: causing the feeling of pleasure.
However, as the affected individual continues drinking, their tolerance will grow and their system will require more and more to achieve the same effects of relaxation or euphoria.
Ultimately, those with AUD will find themselves drinking to satiate withdrawal symptoms, and will no longer feel the same pleasurable effects as before. This leads to a long list of both physical and mental health concerns, alongside other behavioural warning signs of alcoholism.
Whether you’re concerned about your alcohol consumption or suspect that a loved one is drinking hazardously, these 10 signs are an effective way to gauge someone’s severity.
This phenomenon is also referred to as “secret drinking“, and describes the process of an addicted person lying about their alcohol consumption, or concealing the amount they are drinking in social situations. This is to make their behaviour seem less of an issue to those around them: whether this is their GP, family, or work colleagues.
Even if they are visiting a doctor for an unrelated problem, when asked to estimate the amount they drink, addicted individuals are likely to conceal the true amount. This could be out of shame and the fear of their alcohol intake being judged, or more commonly out of denial.
Lying or being dishonest about alcohol consumption can often manifest in denial behaviours. Affected individuals may avoid telling others that they are drinking, or outright deny telling someone when directly asked.
For example, when attending a social event, someone with an alcohol addiction may have to secretly drink before they arrive so it appears they’ve had no more to drink than anyone else.
This is often referred to as “pregaming”, and is common among those with a high tolerance to alcohol who must drink more than others to achieve the same effect.
Someone hiding their alcohol consumption in the home or even a working environment may leave some more obvious signs.
These include using a secret flask containing spirits such as vodka or hiding “empties” in the bottom of rubbish bins and behind furniture.
While countless individuals drink as a form of social lubrication or to feel at ease in group situations, using alcohol as an emotional crutch is indicative of a more serious problem.
The majority of people suffering from Alcohol Use Disorder start drinking for emotional reasons: whether it’s underlying anxiety, depression, or another underlying mental health condition.
While it may provide a form of temporary relief, drinking as a method of numbing negative feelings will make things worse in the long term.
When the effects of alcohol wear off in a few hours, these negative emotions will likely come back and feel even worse than before.
Unfortunately, many people will continue chasing the temporary solace that alcohol provides: making them more likely to drink daily. This leads to a vicious cycle in which a problematic drinker will consume more and more alcohol to take away the emotional pain.
However, perhaps the most prolific cause of over-drinking is unavoidable, daily stress.
For instance: someone has just got home after a stressful day at work and pours themselves a glass of wine to take the edge off. Before they know it, they’ve finished the entire bottle and the events of their day seem far behind them.
While many individuals can enjoy a glass of wine or pint of beer and not exceed their limit, this is rarely the case for victims of Alcohol Use Disorder.
One of the most common signs of alcohol addiction is being unable to stop drinking once you start: leading to an array of negative consequences and health complications.
Rather than choosing to drink in an uncontrolled way, victims of AUD often find that after the first beverage, they feel an intense need to continue drinking that cannot be ignored.
Instead of deciding to call it a night like the rest of their social circle, these individuals will continue to drink even if this is alone at the bar or at home.
Oftentimes, this has to do with increased tolerance. If someone is drinking heavily regularly, they’ll have to drink more and more to become intoxicated and feel the pleasurable effects of alcohol.
This makes it incredibly difficult for them to stop drinking once they’ve started, as they are chasing the same feeling that they used to experience.
However, someone doesn’t have to drink daily to be an alcoholic. They might find that, though they don’t drink every day, they cannot control their consumption when they do.
This is referred to as binge drinking: a form of excessive alcohol consumption occurring over a few hours.
Most people are familiar with the phrase “hair of the dog“, which refers to alcohol consumed to lessen the effects of a hangover.
While this is an occasional process for many, those addicted to alcohol often find themselves having to drink every morning to avoid a hangover from the previous day or evening of drinking.
Those drinking every morning will likely be doing so alone, which is another cause for concern.
This means that their alcohol use has shifted from sociable drinking to a dependence on alcohol where they must consume it to feel normal.
Such individuals will wake up feeling that they need a drink to face the day and function normally: one of the most worrying psychological signs of alcohol abuse.
This often extends into the realm of physical symptoms: where someone must drink in the morning to avoid alcohol withdrawal symptoms.
A morning alcoholic drink is also referred to as an “eye-opener“, and appears as one of the four questions in the CAGE substance abuse screening tool.
When using CAGE, individuals with suspected alcohol dependence are asked: “Have you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover (eye-opener)?”.
One of the most devastating impacts of AUD is the hold it establishes over an individual’s life. As an addiction festers, they’ll spend most of their time thinking about alcohol, or engaging in activities necessary to consume, obtain, or recover from heavy drinking.
Unfortunately, this means that there’s suddenly little room outside of drinking for their daily responsibilities. In their compulsive need for alcohol consumption, addicted individuals will repeatedly neglect both personal and professional duties.
For example, an addicted teenager might start failing classes or neglecting school work, while an adult with AUD may perform poorly at work or frequently call in sick.
While high-functioning individuals might be able to hide this behaviour initially, it won’t take long for negative consequences to manifest.
Unfortunately, such behaviour will migrate from the addicted person’s professional life into their personal life. Giving precedence to drinking mean they’ll start to cancel social engagements or plans they’ve made with loved ones.
They might also start to neglect daily responsibilities involving self-care: failing to cook for themselves, wash, or clean.
Alongside the risks that drinking poses to long-term health, AUD often leads to people taking risks and consuming alcohol in dangerous situations. They might be in denial about their level of intoxication, and believe it’s safe for them to drive, or be so overcome with cravings that they consider drinking behind the wheel.
This can lead people to experience repeated legal problems on account of their drinking. Some addicted individuals will find themselves getting arrested for driving under the influence, which can cause problems not only for themselves but for their families or dependents.
Though common, drink-driving is just one example of using alcohol in situations where it’s physically dangerous. Someone with AUD might operate machinery while intoxicated at work, or mix alcohol with other prescription medicine that they need to take.
Our families and loved ones often know us better than we give them credit for, and it’s often easy for them to tell when something is wrong. Even high-functioning alcoholics who are adept at hiding their addiction will struggle to conceal every part of their disorder.
Oftentimes, family members and close friends will notice even the subtler behavioural and physical effects of drinking: such as the lapse in self-care, neglecting responsibilities, and more of the above-mentioned signs.
As they only want the best for their loved ones, addicted individuals might notice those close to them intervening in some way.
On one end of the spectrum, loved ones might comment on how much alcohol the addicted individual is consuming, or express concern about their excessive drinking.
This could be as simple as playfully noting how much wine someone is getting through, or outright asking them to disclose how many drinks they’ve consumed.
On the other end of the spectrum, family members or Concerned Significant Others (CSOs) might choose to stage an intervention.
This is a pre-arranged meeting involving a family group and someone battling an alcohol dependency, in which their loved ones ask the addicted individual to seek help.
Many people with undiagnosed AUD will receive some form of intervention, which is often an open and honest discussion encouraging them to discuss their alcohol use with professionals. However, someone’s denial of their alcohol addiction might be so strong that they discount the gravity of these meetings.
Alcohol abuse and hazardous drinking will negatively impact a variety of relationships in someone’s life: from significant others and spouses to parents, siblings, and friends.
AUD can be a catalyst in estranged marriages and strained friendships, and even cause people to remove themselves from the addicted person’s life after a particularly destructive drinking session.
Someone with AUD will battle intense, daily compulsions to drink: causing them to make decisions that negatively impact their own lives and the lives of those close to them. This can mean failing to turn up to work and arguing with their colleagues, or failing to carry out responsibilities at home to the dismay of their partner.
Victims of excessive drinking may also exhibit behavioural and emotional changes that can lead to further damage in their relationships. This can be exacerbated by their loved ones assuming they are feeling the effects of heavy drinking, rather than suffering from a condition.
As alcohol is a depressant, it often causes periods of low mood or irritability in those that abuse it. Increased feelings can lead to more arguments with frustrated loved ones, fuelled by a lack of understanding.
When the consumption of alcohol is ceased abruptly by someone with AUD, they’ll start to notice adverse symptoms known as withdrawal. Whether they’re actively trying to quit alcohol or haven’t been able to procure another drink, the outcome of feeling physically and/or mentally unwell will be the same.
Alcohol withdrawal occurs when the body and brain’s chemistry attempt to readjust without alcohol. The body’s central nervous system and brain’s neurotransmitters will go into overdrive: causing elevated blood pressure and a host of other uncomfortable symptoms.
Symptoms of mild alcohol withdrawal can appear within 8 hours of someone’s last drink and include sweating, shaking, headaches, nausea, loss of appetite, and fatigue. These may also be accompanied by psychological symptoms such as irritability, anxiety, or low mood.
While mild cases can be easily managed from home, a severe form of alcohol withdrawal requires assistance from a medical professional. Acute symptoms include irregular heartbeat, elevated heartbeat, elevated body temperature, and hallucinations.
In some cases, these are experienced alongside life-threatening symptoms such as seizures and delirium tremens. These form the dangerous condition known as Alcohol Withdrawal Syndrome (AWS) and should be treated in an inpatient setting right away.
While some people will deny the severity of their alcohol addiction, just as many others will have the desire to quit and be unable to. There’s a misconception surrounding AUD that only those with strong enough willpower can stay sober, but this isn’t the case.
Because AUD victims are both physically and mentally addicted to alcohol, simply ceasing consumption without medical assistance will likely fail.
On the psychological side, addicted individuals will experience intense cravings that override their other emotions: even those that are making them want to quit.
Furthermore, undergoing withdrawal without medical assistance is often so uncomfortable, that individuals must consume alcohol to make their distress tolerable.
Symptoms are particularly severe in the first 48 hours following cessation, making relapse even more likely within this initial time frame.
Maybe some of the above warning signs are ringing true for your situation, or perhaps you’re seeing someone dear to you enacting them. Whatever the case, there is plenty you can do to get yourself the help you need for a growing alcohol dependency or ensure a loved one receives professional help.
These resources might be as close as your nearest computer or doctor’s office and may lead to residential rehab treatment or peer support groups in your local community such as Alcoholics Anonymous.
While there are multiple routes for treatment, the first important step is often to gauge someone’s severity by using a clinical reference such as those provided by The NHS.
In their medical guideline, dangerous patterns of drinking are quantified in a way that allows you to gauge your severity or someone else’s.
According to this guideline, someone consuming more than 14 units of alcohol per week would likely be diagnosed as having AUD in a clinical setting.
To make this figure more applicable to daily life, one unit equates to a 125ml glass of wine or half a pint of medium-strength lager/cider.
While these self-assessment methods shouldn’t be treated as a replacement for the advice of health professionals, they are useful for indicating whether someone needs to seek help.
For example, screening tools such as CAGE are often used to facilitate future treatment, or simply put someone’s mind at ease.
The CAGE Assessment is a questionnaire used to diagnose problematic drinking and is an initial measure used by clinicians.
CAGE can be both administered and completed in under 10 minutes, making it a popular way for GPs to see how hazardous a patient’s drinking is. Individuals in their home environment can also utilise it.
The four questions focus on a particular feature of alcohol addiction, and how it appears in daily life. As a result, CAGE becomes an acronym for Cut-down, Annoyed, Guilty, and Eye-opener.
If you were to take the CAGE test, the questions would appear in the following format:
Depending on how many questions they answer “yes” to, subjects are given a score to indicate their severity upon completing the questionnaire: which will be between 1-4. Someone scoring 2 or 3 should seek the support of a clinician, while scores of 4 indicate an immediate need for treatment.
Seeking treatment for Alcohol Use Disorder doesn’t have to be an overwhelming process placed on the shoulders of one individual or even a group of concerned loved ones.
Here at Rehab 4 Alcoholism, we understand that each case of AUD is different and that what helps one person on their road to recovery might not be optimal for others.
As such, we’ve designed a fully personalised referral service to help you find an alcohol rehab centre suited to your needs.
The UK has an overwhelming number of alcohol rehab clinics, each with a different setting, treatment methodology, and price point – which can make narrowing down a select few clinics tricky.
Fortunately, we’ve partnered with a selection of certified clinics delivering expert care, with a range of facilities to suit each client’s needs.
To receive your free consultation and start planning an alcohol-free future for yourself or a loved one, simply reach out to 0800 111 4108.
 Local Alcohol Profiles For England and Wales Local Alcohol Profiles for England – Data – OHID (phe.org.uk)
 Alcoholics Anonymous https://www.aa.org/
 Statistics on Alcohol, England 2021 Part 1: Alcohol-related hospital admissions – NHS Digital
 Alcohol-Specific Deaths in the UK: Registered in 2020 Alcohol-specific deaths in the UK – Office for National Statistics (ons.gov.uk)
 Rehab 4 Alcoholism: What is Alcohol Addiction? What is Alcohol Addiction? | Signs, Symptoms & Treatment (rehab4alcoholism.com)
 Alcohol Use Disorder: A Comparison Between DSM–IV and DSM–5 Alcohol Use Disorder: A Comparison Between DSM–IV and DSM–5 | National Institute on Alcohol Abuse and Alcoholism (NIAAA) (nih.gov)
 Neurobiology of Alcohol and the Brain Neurobiology of Alcohol and the Brain – Ashok K Singh – Google Books
 Dynamic Pathways to Recovery from Alcohol Use Disorder: Meaning and Methods Dynamic Pathways to Recovery from Alcohol Use Disorder: Meaning and Methods – Google Books
 The Addiction Solution: Unravelling the Mysteries of Addiction Through Cutting-Edge Brain Science The Addiction Solution: Unraveling the Mysteries of Addiction through … – David Kipper, Steven Whitney – Google Books
 The CAGE questionnaire for alcohol misuse: a review of reliability and validity studies The CAGE questionnaire for alcohol misuse: a review of reliability and validity studies – PubMed (nih.gov)
 Adult Substance Misuse Treatment Statistics Adult substance misuse treatment statistics 2019 to 2020: report – GOV.UK (www.gov.uk)
 12-Step Facilitation Therapy https://pubs.niaaa.nih.gov/publications/projectmatch/match01.pdf