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Alcoholism: Recognizing the Signs, Seeking Treatment

bottles with silhouette of a guy drinking in the back

“Salute!” “Cheers!” “L’chaim!” In most parts of the world, raising a glass in a toast is part of the fabric of society. In the United States, alcohol consumption is prevalent virtually everywhere we look. It’s no secret, though, that drinking has a dark side. When consumed in excess, it can lead to alcoholism.

“Drink affects everybody differently,” says Dr. Nabil Kotbi, a board-certified psychiatrist and Chief of The Haven and the Addiction and Recovery Unit at NewYork-Presbyterian Westchester Division. “Many factors need to be considered when it comes to drinking and its effects — how a person metabolizes the alcohol, gender, age, and medical conditions, to name a few.”

How much is too much?

It is well known that some people can “hold their liquor.” They can drink seemingly large amounts without many side effects — like purging or becoming drunk. “Alcoholism, on the other hand, is an addiction,” notes Dr. Kotbi. “It is an obsessive pattern of alcohol use that includes problems controlling it, knowing when to stop, and having it affect other aspects of life, including relationships with family and friends. Also, alcoholics will experience withdrawal symptoms when they suddenly stop drinking.”

Binge drinking is also an aspect of unhealthy alcohol use — a pattern of drinking in which a male consumes five or more drinks within two hours or a female downs at least four drinks within two hours. Binge drinking causes significant health and safety risks. 

Warning signs of addiction

It is when alcohol becomes a “need” rather than a “want” that hints at a problem.  Alcohol addiction symptoms can vary from person to person, but tend to include the following:

  • Temporary blackouts or short-term memory loss
  • Becoming irritable and having extreme mood swings
  • Thinking about drink often and anticipating the next drink
  • Making excuses for drinking (to relax, deal with stress, etc.)
  • Choosing drinking over other responsibilities and obligations
  • Seeking company of others who drink 
  • Drinking alone or in secrecy
  • Unable to cope when not drinking

“It is often difficult for any person afflicted with an addiction to come to terms with it,” says Dr. Kotbi. “But if a person’s pattern of alcohol consumption results in repeated distress and problems in everyday functioning, they likely have a disorder. It can range from mild to severe, but even a mild disorder can escalate and lead to serious problems, so early treatment is important.”

Alcoholism, like many chronic conditions, can be managed by different treatments. Depending on severity, a multidisciplinary approach is most effective, with the goal of breaking a patient’s physical and emotional dependence on alcohol.

“Often times, alcoholics will need detoxification from alcohol in a hospital setting to prevent painful withdrawal symptoms that can range from mild discomfort (anxiety, irritability, insomnia) to a full-blown delirium, seizures and/or severe agitation,” says Dr. Kotbi. “Withdrawal in a person with alcohol dependence is a medical emergency and with proper medical oversight, symptoms usually resolve within a week and rehabilitation can begin.”

When it comes to the recovery process, there is no one-size-fits-all solution. What may work for one person may not be a good fit for someone else. Behavioral treatments aimed at changing drinking behavior through counseling have shown to be beneficial. Several medications are available by prescription to help people stop or reduce drinking and prevent relapse. They are prescribed by a primary care physician or other health professionals and may be used alone or in combination with counseling.

Finally, there are support groups such as AA and other 12-step programs that provide peer support for people with an alcohol addiction. Dr. Kobti says, “Combined with treatment led by health professionals, mutual-support groups can offer a valuable added layer of support.”

For more information, visit nyp.org/psychiatry or call 877-NYP-WELL to find a physician.