Alcohol habit forming?

Dear Alice,

What kind of alcohol is habit forming?

— Drinker

Dear Drinker,

Wine. Beer. A vodka martini with extra olives, shaken, not stirred. Each person may have different preferences when it comes to alcoholic beverages, but what all types of alcohol have in common is that when consumed in excess, any may become habit forming (addictive).

The way that alcohol addiction has been diagnostically defined has changed over time, but there are specific ways in which the medical community defines it. The Diagnostic and Statistical Manual of Mental Disorders (DSM–IV) previously described alcohol dependence and alcohol abuse as two distinct disorders. Alcohol dependence was characterized by an intense craving for alcohol, despite recognizing that alcohol use may be destructive to the people drinking it and to their family and friends. Those who are dependent on alcohol develop a tolerance to it, meaning that they need to consume more of the alcohol to achieve the desired feelings. On the other hand, alcohol abuse was characterized by excessive alcohol consumption, without a physical dependency on alcohol. However, someone who abuses alcohol for an extended period of time may become alcohol dependent. The likelihood of becoming dependent on alcohol may be genetic: people who have alcohol dependent family members have a greater likelihood of becoming alcohol dependent themselves, if put in similar drinking situations.

The newer version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) integrates alcohol dependence and alcohol abuse into a single disorder called alcohol use disorder (AUD). AUD is best characterized by compulsive alcohol use, loss of control over alcohol intake, and a negative emotional state when not using. The following reflective questions can be used to assess whether you or a loved one may have AUD. In the past year, have you or someone with whom you're close:

  • Had times when you ended up drinking more, or longer, than you intended?
  • More than once wanted to cut down or stop drinking, or tried to, but couldn’t?
  • Spent a lot of time drinking? Or being sick or getting over other aftereffects?
  • Wanted a drink so badly you couldn’t think of anything else?
  • Found that drinking — or being sick from drinking — often interfered with taking care of your home or family? Or caused job troubles? Or school problems?
  • Continued to drink even though it was causing trouble with your family or friends?
  • Given up or cut back on activities that were special or interesting to you, or gave you pleasure, in order to drink?
  • More than once gotten into situations while or after drinking that increased your chances of getting hurt (such as driving, swimming, using machinery, walking in a dangerous area, or having unprotected sex)?
  • Continued to drink even though it was making you feel depressed or anxious or adding to another health problem? Or after having had a memory blackout?
  • Had to drink much more than you once did to get the effect you want? Or found that your usual number of drinks had much less effect than before?
  • Found that when the effects of alcohol were wearing off, you had withdrawal symptoms, such as trouble sleeping, shakiness, restlessness, nausea, sweating, a racing heart, or a seizure? Or sensed things that were not there?

List from National Institute on Alcohol Abuse and Alcoholism.

Excessive drinking, no matter what you call it, may result in a destructive pattern of physcial health effects, poor judgment, affect families and friendships, and may even have legal consequences. If any of these reflective questions ring true for yourself or someone close to you, seeking support from professionals may be beneficial. The Substance Abuse and Mental Health Services Administration has a Behavioral Health Treatment Services Locator that can help those who need it find resources for substance use and addiction. For more information on AUD, you may want to check out the responses in the Go Ask Alice! Alcohol and Other Drugs archives.

Cheers to increased knowledge about a preferred beverage!

Last updated Aug 09, 2019
Originally published Apr 30, 1994

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