PIH HEALTH

Noticeable Signs of Alcoholism

Despite the recent emphasis on opiate addiction and related deaths, alcohol still kills more people in our country than all the other illicit drugs combined.  According to the National Institute on Alcohol Abuse and Alcoholism, an estimated 88,000 people (approximately 62,000 men and 26,000 women) die from alcohol-related causes annually, making alcohol the third leading preventable cause of death in the United States. The first is tobacco, and the second is poor diet and physical inactivity. In 2014, the World Health Organization reported that alcohol contributed to more than 200 diseases and injury-related health conditions, most notably alcohol dependence, liver cirrhosis, cancers, and injuries.

Alcoholism is the culmination of long-term drinking. Alcoholism is a very destructive disease on many levels. Drinking problems often play a role in the breakdown of relationships, abusive behavior, lost productivity (sick days, missed work, job loss, etc.) health troubles, and in some cases legal troubles.  Almost 74% of adults suffering from a substance use disorder in 2017 struggled with an alcohol use disorder.

So how does a person know that they are drinking too much?  The American Psychiatric Association’s description of an Alcohol Use Disorder describes it as a spectrum from mild to moderate to severe.  They use thirteen criteria to gauge how problematic a person’s drinking may be.  Here are the criteria with the scale to decide if you or someone you care about or know may have a problem.

Impaired Control

  1. The individual may take the substance in larger amounts over a longer period than was intended.
  2. The individual may express a persistent desire to cut down or regulate substance use, or may report unsuccessful efforts to decrease or discontinue use.
  3. The individual may spend a great deal of time obtaining the substance, using the substance, or recovering from its effects… most of the individual’s daily activities revolve around the substance.
  4. Craving, manifested by an intense desire or urge for the drug that may occur any time, but is more likely in an environment where the drug was previously used or obtained.

Social Impairment

  1. Failure to fulfill major role obligations at work, school, or home.
  2. The individual may continue substance use despite having persistent or recurrent social or interpersonal problems caused or worsened by the effects of the substance.
  3. Important social, occupational or recreational activities may be given up or reduced because of substance use, or the individual may withdraw from family activities and hobbies in order to use the substance.

Risky Use

  1. Recurrent substance use in situations in which it is physically hazardous.
  2. Continued substance use despite knowledge of a persistent or recurrent physical or psychological problem that is likely to have been caused or worsened by the substance.

Pharmacological/Physical Markers

  1. Tolerance – signaled by requiring a markedly increased dose of the substance to achieve the desired effect.
  2. Withdrawal – is a syndrome which occurs when blood or tissue concentrations or a substance decline in an individual who had maintained prolonged heavy use of the substance.  After developing the withdrawal symptoms, the individual uses the substance to avoid the effects of the withdrawal syndrome.

Mild, Moderate, Severe

Mild: 2 to 3 of the above

Moderate: 4 to 5 of the above

Severe: 6 or more of the above


If you or a loved one is experiencing signs of alcoholism, local resources are available. Click here to talk to a Substance Abuse Professional.

Blog courtesy of Substance Abuse Professional, Mark Scott, LAADC