Finding help for alcohol use disorder

^{Dr. Ximena Sanchez-Samper is a Blue Cross Blue Shield of Massachusetts psychiatrist and an expert in substance use disorders.}

Amid rising rates of alcoholism, it’s important to know the signs and dangers – and how to get help for one of the most treatable forms of substance use disorder.

A steep toll

Because alcohol is legal, many people minimize or simply don’t understand the health risks it poses. We in the field of addiction have learned that as the perceived risk of its harm goes down, the risk of misuse and overuse of a substance goes up. 

This makes legal drugs like alcohol potentially more dangerous, especially among younger people whose brains are still developing. Studies show that alcohol use among adolescents impacts both cognitive development, or the way the brain processes information, and neural development, the physical structure of the brain.

Alcohol leads to the deaths, on average, of 140,557, Americans every year, including deaths from chronic conditions closely associated with alcoholism such as liver cancer and cirrhosis, as well as acute causes of death such as alcohol poisoning and motor vehicle crashes. The toll is about double the rate of fatal overdoses caused by drugs like fentanyl.  

In the U.S. more than 29.5 million people ages 12 and older have experienced alcohol use disorder, an intense focus on using alcohol to the point where their ability to function in day-to-day life is impaired, according to the 2021 National Survey on Drug Use and Health.

Because alcohol lowers inhibitions and impairs judgement, it can lead to an increase in aggressive behavior such as domestic violence, sexual assault, child abuse and aggravated assault. One study by the Department of Justice found that nearly 4 in 10 violent incidents involved the use of alcohol.

Red flags

It may be time to seek help if a person experiences any two of the following conditions within a 12-month period:

• Binge drinking
• The desire or unsuccessful attempts to cut or control alcohol use
• Spending a great deal of time and energy to get, use or recover from alcohol
• Craving alcohol
• Unusual absences or poor performance at work, school or home due to alcohol use
• Continued use of alcohol despite knowing it has caused physical and psychological harms and/or negatively impacted relationships
• Foregoing important or once enjoyable social, occupational, or recreational activities to drink  
• Increased tolerance for alcohol and or signs of withdrawal, which range from tremors to nausea to confusion and hallucinations
   

Hope, and help

Medications, counseling and self-help support groups -- alone and in combination -- can help individuals overcome alcohol use disorder.

First, people struggling with alcohol and those close to them need to know they are not alone. Others have walked this path and reached recovery.

Loved ones should raise the issue with love and empathy. Gently probe to find out if anxiety, depression or other mental health issues are driving the behavior. Start with phrases like, “I care about you…” or “I’m concerned you…”