Alcoholism lies at the extreme end of the spectrum of alcohol use disorders and is defined as an addiction to alcohol that causes changes in the structures and functions of the brain. As such, addiction is widely considered to be a brain disease that’s both chronic, meaning it is persistent and long-term, and relapsing, meaning that once in remission, using alcohol again can lead to a recurrence of these changes in brain structures and functions.
Understanding alcoholism is the first step in getting help for an alcohol use disorder, which may consist of abusing alcohol, being addicted to it, or developing a physical dependence on it.
How Alcohol Abuse Transitions to Addiction
Alcohol addiction is characterized by the compulsive use of alcohol despite the negative consequences it causes in your life. If you’re addicted to alcohol, you probably can’t seem to quit using it, no matter how much you want to or how hard you try.
An article published by Harvard Health Publications explains that this is because the brain doesn’t differentiate among pleasurable activities, such as having sex, eating food or using psychoactive substances, all of which cause a release of the “feel-good” neurotransmitter dopamine in the pleasure center of the brain.
Repeated exposure to a pleasurable experience eventually leads to changes in the learning and reward centers of the brain that cause us to crave an experience or substance again and again. The drive to seek out the pleasure is far stronger than willpower alone can withstand, which is why successful recovery from an addiction typically requires professional help.
How Alcohol Abuse and Addiction Transitions to Dependence
Alcohol dependence is characterized by changes in the structures and functions of the brain that lead to physical withdrawal symptoms when alcohol is withheld from the body.
According to the National Institute on Alcohol Abuse and Alcoholism, alcohol initially increases the activity of GABA, a neurotransmitter responsible for feelings of relaxation and wellbeing.
With chronic abuse, however, the brain compensates for the presence of alcohol by suppressing the activity of GABA, leading to the need for higher doses of alcohol in order to get the desired effects, a phenomenon known as tolerance. At the same time, the glutamate system, which is responsible for feelings of excitability, begins functioning at a far higher level to compensate for the depressive effects of alcohol.
Continued chronic abuse of alcohol can lead to a tipping point wherein these changes become the standard function of the brain, and as a result, you feel more normal when alcohol is present than when it’s not. If you quit using alcohol, the suppressed GABA and increased glutamate activities lead to withdrawal symptoms, which typically involve nausea, tremors and insomnia and may include hallucinations, seizures and a potentially deadly condition known as delirium tremens, or DTs.
Willpower alone is rarely enough to help you overcome an addiction for the long-term, and trying to quit alcohol when physical dependence has set in will most likely lead to near-immediate relapse in an attempt to make the withdrawal symptoms stop.
Dependence and the resulting withdrawal symptoms are addressed through medical detox, the first step in addiction treatment. This medically supervised detox process is essential for withdrawing from alcohol, which can be dangerous or even deadly, depending on the severity of the dependence. Medical detox involves administering medications that help reduce the intensity of withdrawal symptoms to make the process safer and less uncomfortable.
The second step in treatment addresses the underlying issues behind the addiction, or the compulsion to drink. Motivational interviewing, for example, helps you identify and strengthen your intrinsic motivation for wanting to stop using alcohol, while cognitive behavioral therapy helps you identify the self-destructive thoughts, attitudes and behaviors surrounding alcohol abuse and replace these with healthier thoughts and behaviors.
Through a high-quality, holistic alcoholism treatment program, you’ll learn a great deal about yourself and your reasons for drinking, and you’ll improve your self-concept, your physical and mental health and your overall quality of life. Professional assistance is essential for beating an addiction to alcohol, and the sooner you ask for help, the better your chances of enjoying successful long-term sobriety.