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Are You Addicted to Alcohol?

Denial is common for many living with addiction, but behavioral red flags don’t lie.

It’s just a few drinks, right? Nothing to be concerned about. For approximately 15 million Americans with alcohol use disorder (AUD), that’s a statement of denial.

Alcohol use disorder is a chronic disease often ignored by the millions in its grasp. Nearly 1 in 13 American men has AUD. For women, it’s 1 in 25. More than 400,000 children are dealing with addiction, too.

“Sadly, it’s common,” says addiction psychiatrist Akhil Anand, MD. “And often, people don’t recognize that they have a problem.”

Here’s how to tell.

Red flags for alcohol addiction Dr. Anand talks about the “Four C’s” regarding alcohol addiction. It’s a simple way of looking at alcohol consumption and determining if it has reached a concerning (and possibly dangerous) level.

The Four C’s of alcohol addiction are as follows:

  1. Cravings. Getting a drink —a beer, glass of wine, or cocktail — mimics a physical need. The urge can be as demanding as a hunger pain. It often manifests as restlessness, irritability, and trouble sleeping.

  2. Compulsion. Finding a drink becomes the main mental objective. “It becomes irresistible and overpowering,” says Dr. Anand. “You’re always thinking about it and looking for it.”

  3. Control. It’s Friday night, and you plan on having one drink. But you lose control. After a few hours of binge drinking, you’ve built quite a collection of empty bottles or glasses … and you’re unable to say no to the next one.

  4. Consequences. Regularly drinking alcohol in mass quantities often brings behavioral changes and unintentional problems, notes Dr. Anand. Negative consequences could include:

    • Relationship issues and people problems. Arguments, lying, unreliability, and even violence can all flow out of a drinking episode and harm those closest to you.

    • Health troubles. “Alcohol causes more than 200 medical diseases,” states Dr. Anand. The list includes various cancers, diabetes, high blood pressure, liver damage, osteoporosis, early-onset dementia, and more.

    • Accidents. Alcohol increases impulsivity, disinhibition, and fatigue, leading to mishaps.

    • Work worries. AUD can lessen your problem-solving ability, diminishing your strength, stamina, and focus.

Addiction and personality metamorphosis Let’s start with this basic fact: An addiction is a brain disorder.

Addictive substances like alcohol essentially commandeer the “reward pathway” in your brain. The reward pathway makes mental connections between activity and pleasure.

“Natural things like romance and exercise stimulate the same pathway,” explains Dr. Anand. “But addictive substances artificially hijack it. So, even things you used to enjoy naturally, you suddenly can’t — because it’s all about that addictive substance.”

A person with an addiction develops a relationship with a substance that can eventually override everything else in their life. What follows is often described as a “personality metamorphosis.”

“At that point, a person’s actions are built around obtaining whatever their substance of choice is,” says Dr. Anand. “That’s the relationship they work the hardest to protect.”

Behaviors linked to addiction People who struggle with addiction “do all kinds of terrible things” that impact themselves and those around them, warns Dr. Anand. Someone with AUD will:

  • Issue denials.

  • Minimize their actions.

  • Justify or rationalize their behavior.

  • Manipulate people.

  • Engage in victim-blaming.

  • Take “emotional hostages.”

  • They use deception to get what they want.

“I always emphasize that these behaviors illustrate the severity of addiction, not the person,” stresses Dr. Anand. “It’s important to understand this if you’re trying to communicate with someone with an addiction.”

Getting help for alcohol addiction Reaching out after recognizing you have an addiction — or talking to someone else about their addiction — can be highly challenging. Emotions run deep. There are often worries, concerns, and even anger.

“It’s not easy,” acknowledges Dr. Anand. “If you have a loved one who struggles with addiction, be honest, open, and nonjudgmental when speaking with them. Communicate in a concise manner that’s calm, constructive, and not emotional. Remember that the goal is to get them help.”

Treatment for AUD often revolves around a plan that includes rehabilitation, care from addiction specialists, and self-help programs such as Alcoholics Anonymous (AA). But the process starts with simply identifying the issue.

Talk to someone if you see yourself in the description of the Four C’s or the behaviors connected to personality metamorphosis. Maybe it’s your doctor, another healthcare professional, a family member or friend, or someone in recovery.

Find someone who can support you and start the process.

Call Us if you or a loved one are struggling with anxiety, substance abuse, or addiction and need help. Our non-profit offers free Clinical Evaluations and Case Management services to individuals and families needing them.


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Contributing Resource:

Akhil Anand, MD

Addiction Psychiatry and Psychology

Cleveland Clinic

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