Alcohol dependency
Continued excessive alcohol consumption can lead to the development of dependence that is associated with a withdrawal syndrome when alcohol consumption is ceased or substantially reduced. This syndrome comprises physical signs as well as psychological symptoms that contribute to distress and psychological discomfort. For some people the fear of withdrawal symptoms may help perpetuate alcohol abuse; moreover, the presence of withdrawal symptoms may contribute to relapse after periods of abstinence. Withdrawal and relapse have been studied in both humans and animal models of alcoholism. Clinical studies demonstrated that alcohol-dependent people are more sensitive to relapse-provoking cues and stimuli than nondependent people, and similar observations have been made in animal models of alcohol dependence, withdrawal, and relapse. One factor contributing to relapse is withdrawal-related anxiety, which likely reflects adaptive changes in the brain in response to continued alcohol exposure. These changes affect, for example, the body’s stress response system. The relationship between withdrawal, stress, and relapse also has implications for the treatment of alcoholic patients.
When an alcohol-dependent individual abruptly terminates or substantially reduces his or her alcohol consumption, a characteristic withdrawal syndrome ensues. In general, alcohol acts to suppress central nervous system (CNS) activity, and, as with other CNS depressants, withdrawal symptoms associated with cessation of chronic alcohol use are opposite in nature to the effects of intoxication. Typical clinical features of alcohol withdrawal include the following (Becker 2000; Hall and Zador 1997; Saitz 1998):
Signs of heightened autonomic nervous system activation, such as rapid heartbeat (i.e., tachycardia), elevated blood pressure, excessive sweating (i.e., diaphoresis), and shaking (i.e., tremor);
Excessive activity of the CNS (i.e., CNS hyperexcitability) that may culminate in motor seizures; and
Hallucinations and delirium tremens in the most severe form of withdrawal (Becker, 2008).
Alcohol dependence is characterized by symptoms of withdrawal when a person tries to quit drinking. Drinking to excess but not being physically dependent is called alcohol abuse.
Alcohol dependence was originally defined as a chronic medical condition characterized by experiencing symptoms of withdrawal when the person stops consuming alcohol. To avoid experiencing withdrawal symptoms, the person has to keep consuming alcohol.
People who have a dependence on alcohol exhibit some or all of the following characteristics.
Alcohol tolerance: Needing to drink increasing amounts over time to achieve previous effects. For example, you used to drink three cocktails every night, but now you need five to get the feeling you're looking for.
Withdrawal symptoms: Experiencing physical symptoms, such as insomnia, tremors, and mood swings after going for a short period without drinking.
Drinking to relieve or avoid withdrawal symptoms, such as drinking to stop the shakes or to "cure" hangovers.
Awareness of the compulsion to drink or craving for alcohol, regardless of whether you admit it to others.
Drinking larger amounts or over a longer period than intended and making unsuccessful efforts to cut down (Buddy, 2023).
Alcohol dependence is defined by physiologic dependence on alcohol from consistent, heavy use. It manifests as physical withdrawal symptoms such as shakiness, nausea, vomiting, delirium, and even seizures when alcohol is stopped abruptly. Alcohol use to this extent is very serious and can result in cirrhosis, liver cancer and death if it goes on long enough (Schreiber, 2024).
Alcoholism is a word which many people use to mean alcohol dependence (alcohol addiction). Some people are problem drinkers without being dependent on alcohol. If you are alcohol-dependent then detoxification ('detox') can help you to stop drinking, alongside other support.
Some people are dependent on alcohol. This can also be called alcohol addiction. People with alcohol dependence feel a strong urge to drink, and often find that they need to drink more and more alcohol to get the same effect. People with alcohol dependence often prioritise drinking over other things - such as family life, relationships, work, and other interests - or continue drinking despite evidence that it's causing harm.
People with alcohol dependence may also get unpleasant, and potentially dangerous, withdrawal symptoms, and use alcohol to prevent these from happening (McKechnie, 2023).
Becker, H. C. (2008). Alcohol dependence, withdrawal, and relapse. PubMed Central, National Library of Medicine. Retrieved from: https://shorturl.at/qjHn1.
Buddy, T. (2023, November 15). Alcohol dependence vs. alcohol abuse: What's the difference? Verywell Mind. Retrieved from: https://shorturl.at/HkUER.
McKechnie, D. (2023, February 24). Alcoholism and problem drinking. Patient. Retrieved from: https://shorturl.at/vsHZX.
Schreiber, C. (2024). Alcohol abuse vs. alcohol dependence. Sutter Health. Retrieved from: https://shorturl.at/5pDSd.