What Is Considered an Alcoholic?

When drinking adversely affects someone's health, relationships and daily functioning, they may be considered an alcoholic.

A person may be considered an alcoholic when drinking adversely affects one’s personal or professional life, causes serious consequences, or when people lose control over their drinking. The medical term is “alcohol use disorder.”

Signs and symptoms of alcoholism (alcohol use disorder) include:

• Drinking more than planned, or longer than planned
• A desire to cut down on alcohol, but an inability to do so
• A lot of time spent trying to get alcohol, getting drunk, or recovering from being drunk
• Craving for alcohol
• Failure to do tasks required for work, school, family obligations, or home maintenance because of drinking
• Drinking persists despite causing or worsening problems in relationships or interactions with other people
• Stopping or decreasing important social, work, or fun activities a person used to do
• Drinking even in situations where it is dangerous to do so (such as while driving)
• Drinking despite knowing a physical or mental problem was likely caused or worsened by alcohol use
• Tolerance: A need to drink more and more to get the same effects as before with less alcohol use, or less effect from using the amount that used get a person drunk
• When alcohol use is stopped, withdrawal symptoms occur such as:
  • Sweating or a racing heart
  • Shaking
  • Insomnia
  • Nausea or vomiting 
  • Hallucinations: seeing, hearing, or feeling things that aren’t there 
  • Restlessness
  • Anxiety
  • Seizures 

The exact cause of alcoholism (alcohol use disorder) is unknown but there are factors that increase a person's risk of developing a problem with alcohol, such as: 

• Genetics: alcohol use disorder runs in families
• Gender: more common among men 
• Age: Most common among those aged 18 to 25 and people over age 65
  • In older people it can be dangerous since alcohol can interact with many medications and can be responsible for fall-related injuries
  • In young people, alcohol abuse can lead to car crashes, suicide, and homicide
• Other mental health problems, such as severe anxiety, depression, or a personality disorder, increases the risk of alcohol abuse

Alcoholism (alcohol use disorder) is often diagnosed with a patient history and consideration of certain factors such as whether: 

• The patient has lost control of their drinking
• The patient has developed tolerance or other signs of addiction
• Alcohol has contributed to problems such as the loss of a job, legal troubles, or problems in relationships

Screening questionnaires may also be used. These questionnaires ask specific questions that have been shown to help predict when a person has a problem with alcohol use, and are designed to identify people who may have a drinking problem. 

Treatment for alcoholism (alcohol use disorder) usually includes:

• Counseling
• Medications
  • Disulfiram (Antabuse): use of this drug results in unpleasant effects when alcohol is consumed
  • Naltrexone (Vivitrol, Revia): helps reduce the urge to drink
  • Acamprosate (Campral): can help restore a balance among neurotransmitters
• Support groups such as Alcoholics Anonymous (AA)

It is not advisable for people dependent on alcohol to attempt to cut down on or stop drinking without the help of a healthcare provider because of potential life-threatening withdrawal symptoms.

Complications of alcoholism (alcohol use disorder) include: 

• Traffic accidents
• Suicide
• Drowning
• Serious injuries
• Alcohol-related liver disease that can lead to end-stage liver disease (cirrhosis) and death
• Increased risk of certain cancers of the mouth, esophagus, throat, liver, and breast 
• Heart failure 
• Several types of dementia