Alcohol Addiction: Signs and Side Effects of Alcohol Abuse

Drinking alcohol is a common, normalized part of many Americans’ day-to-day lives and social activities. Alcohol is ethanol (ethyl alcohol) and is a central nervous system (CNS) depressant found in beverages like beer, wine and spirits.

Sometimes referred to with terms like booze, hooch and liquor, drinking alcohol is a casual, social activity for many people. While occasional drinking may be safe, it’s possible for casual alcohol consumption to shift into risky patterns and behaviors that may lead to alcohol addiction.

This article covers the basics of alcohol use disorder (AUD), with a focus on the signs and side effects of alcohol misuse. Keep reading to learn how alcohol consumption can lead to addiction, key warning signs and common risk factors.

Alcohol can lead to addiction over time because of the way it interacts with your brain. It’s vital to note that alcohol addiction is officially referred to as alcohol use disorder (AUD), though many people still use the term addiction.

When you drink alcohol, the levels of certain neurotransmitters in your brain change, therefore changing your brain chemistry. Specifically, alcohol increases gamma-aminobutyric acid (GABA) and dopamine activity, which are involved in your brain’s stress, relaxation and reward systems.

However, alcohol also decreases glutamate levels, which slows brain activity down, making alcohol a CNS depressant. These changes in chemistry can make you feel pleasure, calmness and euphoria that reinforce the behavior of drinking alcohol. Some people actually start to notice that certain environments or emotions trigger them to drink.

Over time, your body and brain may build up a tolerance to alcohol. You may reach for alcohol to feel pleasure, but notice that you need more alcohol to feel the same effects you once did. A higher tolerance can encourage you to drink larger amounts of alcohol or drink more frequently, which can lead to dangerous drinking behaviors.

While many substances can lead to addiction, alcohol is particularly habit-forming for a few reasons. First, alcohol is very socially normalized and easy to access. Additionally, alcohol is heavily marketed and can easily become part of a routine.

When talking about AUD, you may hear people use the terms alcohol abuse and alcohol addiction interchangeably, but there are key differences between these two conditions. We should note that substance abuse is officially referred to as substance misuse, though many people still use the term abuse.

Alcohol misuse is any harmful use or behavior that increases your risk of developing AUD. Common examples of alcohol misuse include binge drinking, frequent heavy drinking and drinking despite negative consequences.

On the other hand, AUD is a pattern of compulsive drinking often defined by a psychological dependence on alcohol. Impaired control, cravings and continued use despite damage to your health, relationships or responsibilities can be seen in AUD.

While alcohol misuse and AUD are separate conditions, misuse can often lead to AUD. Alcohol misuse doesn’t mean someone is addicted to alcohol, but ongoing misuse increases the risk of becoming addicted.

Developing AUD from alcohol misuse can happen quickly or over time, which is why it’s vital to keep an eye on harmful behaviors around drinking. For example, drinking to cope with stress, sadness or mental illness symptoms can cause the line to blur.

Yes, alcohol can lead to dependence. There are two kinds of dependence associated with alcohol use, physical dependence and psychological dependence.

Physical dependence occurs when the body starts to rely on the presence of alcohol to function properly. As time goes on, your body adapts to regular alcohol exposure, and physical dependence causes it to react when alcohol levels drop.

Psychological dependence, however, causes the brain to rely on alcohol to go through day-to-day activities. Psychological dependence can cause strong cravings and compulsions to drink. Relying on alcohol to sleep, manage emotions, socialize or relax can be signs of psychological dependence.

It’s crucial to note that a dependence on alcohol doesn’t automatically mean someone has AUD. However, alcohol dependence is a strong warning sign that someone may need intervention. Dependence can develop slowly and may not be easy to identify early on.

The signs of alcohol addiction fall into four categories: physical, emotional, functional and behavioral. Understanding these signs can help you identify AUD in yourself or a loved one.

Physical signs of AUD are often easier to identify in others. Withdrawal symptoms, frequent hangovers, blackouts and sleep disruption are common. In comparison, emotional or psychological signs of alcohol misuse can include mood swings, irritability and anxiety.

Functional signs may become more apparent as misuse increases. Addiction can cause people to miss work or school, neglect responsibilities, strain their finances, experience declining professional or academic performance, or get into legal trouble.

Signs of AUD can also appear in someone’s behavior. Drinking alone, sudden secrecy, risky behavior, drinking more than intended, planning your day around drinking and unsuccessful attempts to reduce alcohol intake may all point to AUD.

People who have AUD may experience alcohol withdrawal symptoms between drinking episodes. Withdrawal symptoms go hand-in-hand with physical dependence, as mentioned above.

When your body adjusts to the presence of alcohol regularly, it becomes accustomed to its depressant effects and learns how to function under these conditions. When alcohol levels suddenly drop, the body rebounds and reacts with withdrawal symptoms.

Common withdrawal symptoms of alcohol include:

• Shaking
• Sweating
• Nausea
• Headache
• Insomnia
• Anxiety
• Irritability
• Heart palpitations
• Increased blood pressure
• Increased heart rate

In cases of long-term, heavy alcohol use, severe withdrawal symptoms may occur, such as:

• Confusion
• Hallucinations
• Seizures
• Delirium tremens (DTs)

Alcohol withdrawal is a variable experience that can differ significantly from person to person. Both severity and duration of symptoms can depend on numerous factors, including length of use, typical amount consumed, age, underlying health conditions and withdrawal history.

In most cases, withdrawal symptoms start about 6 to 12 hours after your last drink. Symptoms peak in severity about 24 to 72 hours after you stop drinking and can last for several weeks, depending on your overall health.

In addition to withdrawal symptoms, alcohol misuse, especially over an extended period of time, can cause an array of side effects. These effects may be short-term or long-term, which in some cases can permanently affect your well-being.

Short-term side effects of alcohol use occur while you’re drinking or shortly after consuming alcohol. Typically, short-term side effects go away after a short period of time once you stop drinking.

Short-term side effects of alcohol use can include:

• Impaired judgment
• Slowed reaction time
• Poor coordination
• Memory gaps
• Increased risk-taking
• Nausea/vomiting

Repeated heavy drinking can also lead to several health risks. Sleep disruption, stomach irritation, dehydration and a weakened immune system are a few of the short-term health risks you may experience with alcohol misuse.

Long-term side effects tend to occur in people who misuse alcohol for an extended period of time. Long-term side effects may have a permanent impact on your health, even if you stop drinking alcohol.

Long-term side effects of alcohol misuse can include:

• Liver disease
• Heart problems
• High blood pressure
• Oral cancer
• Esophageal cancer
• Colorectal cancer
• Stroke
• Muscle wasting
• Myopathy
• Pancreatitis
• Reduced bone density
• Breast cancer
• Memory loss
• Heart arrhythmias
• Erectile dysfunction
• Cirrhosis

In addition to your physical health, alcohol misuse can also affect your mental health. Substance addiction and mental health disorders are strongly correlated and often feed off of each other.

Mental health side effects of alcohol misuse can include:

• Anxiety
• Depression
• Irritability
• Increased risk of self-harm

Finally, regular alcohol misuse can lead to safety risks. People may make risky choices or have impaired judgment that leads them to participate in dangerous activities when drinking.

Safety risks of alcohol use can include:

• Driving while impaired
• Becoming violent
• Having unsafe sex
• Overdosing (particularly when mixed with opioids, benzodiazepines or other depressants)

Anyone who misuses alcohol is at risk for developing AUD. However, certain groups of people may be particularly vulnerable to becoming addicted to alcohol.

If you have a family history of alcohol or substance addiction, you may be at higher risk for developing AUD. In some cases, a genetic factor can make you more prone to substance addictions, including alcohol.

Early exposure to alcohol and drinking can also increase your risk. If you were exposed to alcohol at a young age, you may become more susceptible to dangerous drinking habits. Additionally, the longer you’ve been drinking, the more likely you are to develop a tolerance to alcohol and drink more over time.

Other environmental factors can heighten the risk of substance use disorders, too. Peer pressure, workplace culture and environments that encourage heavy drinking may all lead to irresponsible behaviors around alcohol.

People who have a history of certain mental health conditions may be more likely to become addicted. Conditions like anxiety, depression, trauma or chronic stress can lead people to drink to cope with symptoms.

For some people, certain behaviors are what put them at greater risk. Unhealthy habits like frequent binge drinking, using alcohol to cope with stress or emotions and increasing tolerance that leads to heavier use are all troubling signs to watch for.

Lastly, practical factors may also be to blame. Alcohol is relatively easy to access, low in cost and socially accepted, plus Americans are frequently exposed to it. All these variables, combined with the risk factors above, can make individuals susceptible to addiction.

While some signs and symptoms can indicate someone might have alcohol use disorder, only a healthcare provider can officially diagnose AUD. If you’re concerned that you or a loved one is addicted to alcohol, seek a medical evaluation.

Clinicians use alcohol use disorder criteria from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to diagnose alcohol addiction. The diagnostic process looks at alcohol use patterns over time rather than an isolated incident.

AUD criteria include looking at behavior over the past year to determine if you’ve:

1. Had times when you ended up drinking more, or longer, than you intended?
2. Wanted to cut down or stop drinking more than once, or tried to, but couldn’t?
3. Spent a lot of time drinking? Or being sick or getting over the aftereffects?
4. Wanted a drink so badly you couldn’t think of anything else?
5. 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?
6. Continued to drink even though it was causing trouble with your family or friends?
7. Given up or cut back on activities that were important or interesting to you, or gave you pleasure, to drink?
8. Gotten into situations more than once, either while or after drinking, that increased your chances of getting hurt (such as driving, swimming, using machinery, walking in a dangerous area, or having unsafe sex)?
9. 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?
10. 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?
11. 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 weren’t there?

The presence of at least two of these criteria meets an AUD diagnosis. Healthcare providers often describe the severity of addiction on a spectrum, from mild to severe. Getting a proper evaluation is crucial to understand your risk, functioning and overall safety. Screening tools may also help assess alcohol-related health complications and withdrawal risk.

Alcohol use disorder is a serious condition that can have damaging effects on your physical, psychological and social health. Certain people may be more likely to become addicted to alcohol, but it’s essential to watch for early signs of alcohol misuse in anyone who drinks regularly.

If you notice signs and symptoms of alcohol use disorder in yourself or a loved one, reach out for support. Explore Help.org, a free, confidential resource to help you find the right addiction treatment center for your needs.