Dr Zana Marovic, Phd

Clinical Psychologist, Johannesburg

Alcohol Abuse

Social drinking is common and popular is many cultures all over the world. In several cultures, for example, a glass of wine or beer with a meal is common practice. Celebrations are often punctuated with a glass of champagne or other celebratory cocktail. And in many jobs, going out for drinks after work or entertaining clients with alcohol is the norm.

But getting to the bar, or making a drink after coming home from work might become more important than connecting with friends or family. Alcohol might be your way to avoid painful feelings or troubled relationships. And you might resort to dangerous behavior, like driving while drunk or even increased violent behavior.

Causes of alcohol abuse

Why can one person drink responsibly, while another drinks to the point of losing their health, their family and their job? There is no simple reason. Alcohol abuse and addiction is due to many factors. What’s more, since drinking is so common in our society, problem drinking can be hard to identify. Do you drink to share enjoyment or share a connection with others?

If drinking is the only way you feel comfortable connecting to others, or you drink to mask depression, grief, anxiety or loneliness, you are at risk for alcohol abuse. Some other risk factors include:

  • Family history of alcoholism. While the interplay between genetics and environment is not entirely clear, if you have a family history of addiction, you are at higher risk for abusing alcohol.
  • History of mental illness. Alcohol abuse can worsen mental illness or even create new symptoms.
  • Social situations & pressure. If people around you drink heavily, it’s hard to resist. If you are a teenager, you might feel you won’t be accepted. If drinking is common practice for work celebrations or entertaining clients, you might feel pressure to conform.
  • Stressful situations or a big life change. If you
    have a major change or a stressful situation in your life, without other coping skills, you might turn to alcohol to help you get through.

Signs & symptoms of alcoholism

Alcohol abusersare people who either drink too much on a regular basis or binge drink (excessive drinking on weekends). The alcohol use is self-destructive and can present a danger to others. Alcohol abuse may progress to alcoholism and this might happen in response to a large stressful event, such as retirement or losing a job, or it might gradually progress as tolerance to alcohol increases.

Physical signs of alcohol abuse and alcoholism
  • While intoxicated: slurred speech, dizziness, clumsiness or unsteadiness
  • Blackouts, when you drink so much you pass out
  • Weight loss
  • Unexplained sore or upset stomach
  • Redness in the face or cheeks
  • Numbness or tingling in hands and feet
Mental signs of alcohol abuse and alcoholism
  • Unable to control drinking: “just one drink” rapidly leads to more
  • Drinking leads to dangerous situations like driving drunk, walking in an unsafe area
  • Increased irritability, agitation and anger, lowered threshold for violence
  • Avoiding activities that do not involve the opportunity to drink
  • Excessive weeping and emotional displays
  • Unexplained absences and sick days from work, or difficulty making commitments
  • Oversleeping or difficulty sleeping

Effects of alcohol abuse

Similar to drug abuse, alcohol abuse doesn’t only affect the health, finances and stability of the person drinking. It reaches family, friends, colleagues and even the community. What’s more, the strong denial and rationalization of the person using alcohol makes it extremely difficult to get help, and can make concerned family members feel like they are the problem.

Long-term alcohol use can cause serious health complications, affecting virtually every organ in your body. These effects include:

  • Liver inflammation, which can lead to cirrhosis, a serious, irreversible liver condition
  • Increased risk of heart disease, stroke and cancer
  • Stomach problems and nutritional deficiencies
  • Neurological problems such as confusion, numbness and trouble with memory
  • Birth defects
  • Erectile dysfunction
Staying addicted: denial and rationalization

One of the most powerful effects of alcohol abuse and addiction is denial. The urge to drink is so strong that the mind finds many ways to rationalize more drinking. Someone abusing alcohol may drastically underestimate how much they are drinking, how much it is costing them, and how much time it takes away from their family and work. Denial is so powerful that an alcoholic often sincerely believes that there is no problem. They may lash out at concerned family members, so convincingly that family members might feel like they are exaggerating and overstating the problem.

This denial and rationalization can lead to increased problems with work, finances and relationships. The person abusing alcohol may blame an “unfair boss” for losing her job, or a ‘nagging wife’ for why he is increasingly going out with friends to the bar. While work and relationship stresses happen to everyone, an overall pattern of deterioration and blaming others may be a sign of trouble.

Effects of alcohol abuse on the family

Sadly, alcohol abuse and addiction doesn’t only affect the person abusing alcohol. It affects friends, family and the entire society. Lack of impulse control can lead to increased physical and emotional abuse. Domestic violence also happens more frequently. Abusing alcohol leads to higher risk of injuries and death to self and others in car accidents.

What the person abusing alcohol might say if you confront them about their usage

“I can get sober any time I want to. I’ve done it lots of times”. The key to recovery is staying sober, not constantly cycling through the process. Even if the alcoholic is able to resist for a little while, usually the cravings are too strong to resist during times of stress.

“Why do you exaggerate so much? I hardly drink at all!” Remember denial is a key part of alcoholism. The person abusing alcohol might actually believe they are not using as much as they are.

“It’s your fault. If you wouldn’t stress me out so much, maybe I wouldn’t need to drink as often” It is never your fault that someone drinks too much. Even if they are feeling stressed, there are other coping skills they can choose to use.


Treatment for Alcohol Abuse

Three general steps are involved in treating the alcoholic once the disorder has been diagnosed: intervention, detoxification, and rehabilitation. Studies find that more people enter treatment if their family members or employers are honest with them about their concerns, and try to help them to see that drinking is preventing them from reaching their goals.

Once the problem has been recognized, total abstinence from alcohol is required for those who are dependent; for those who are problem drinkers, moderation may be successful. Since many alcoholics initially refuse to believe that their drinking is out of control, a trial of moderation can often be an effective way to deal with the problem. If it succeeds, the problem is solved. If not, the person is usually ready to try abstinence. Because alcoholism affects the people closely related to the alcoholic person, treatment for family members through counseling is often necessary.

Medications are sometimes prescribed to prevent relapses. Naltrexone decreases alcohol cravings while Antabuse works by producing very unpleasant side effects if even a small amount of alcohol is ingested within 2 weeks after taking the drug. These medications are not given during pregnancy or if the person has certain medical conditions. Long-term treatment with counseling or support groups is often necessary. The effectiveness of medication and counseling varies.

Alcoholics Anonymous is a self-help group of recovering alcoholics that offers emotional support and an effective model of abstinence for people recovering from alcohol dependence.

Links and Resources

Alcoholics Anonymous

Narcotics Anonymous

Addiction Clinic