Chronic alcohol abuse can lead to the development of various medical and mental health issues. Over time, consumption of alcohol can negatively impact several major organ systems, including the liver, heart, central nervous system, and gastrointestinal (GI) tract.1,2,3 Additionally, withdrawal from alcohol after long-term abuse and significant physical dependence can be very dangerous and even fatal if not done with proper supervision and medical management.1 Beyond the withdrawal period, there are various forms of treatment available to help treat alcoholism to help individuals maintain lasting sobriety.
What is Alcoholism?
Alcoholism, or alcohol addiction, is a chronic condition characterized by compulsive drinking regardless of negative effects on a user’s life. It is often progressive, meaning that it tends to worsen over time as drinking continues. While not all drinkers go on to develop alcohol use disorders, binge drinking or excessive alcohol consumption can increase the risk of addiction development.1,2 It can sometimes be difficult for people to detect alcoholism in themselves or loved ones, which is why it is important to be aware of the signs and symptoms of alcohol use disorder.
Some of the signs and symptoms of alcoholism include:1
- Drinking despite interference with the ability to function at work, school, or home.
- Drinking in dangerous situations, such as when driving.
- Drinking in larger amounts or for a longer period of time than planned.
- Experiencing difficulties in relationships, social situations, or health issues due to drinking.
- Experiencing withdrawal when alcohol use is stopped or significantly reduced.
- Building a tolerance, or needing to drink more to get the desired effect.
- Feeling strong urges to drink alcohol.
Admitting that you have a problem is a good step. Once you acknowledge your alcoholism, you can seek the proper treatment necessary to begin on the path to a healthier and happier life.
Effects of Chronic Drinking
While drinking behavior may begin for a number of seemingly benign reasons, chronic alcohol abuse can ultimately exact a huge toll on your interpersonal relationships, your productivity at work or school, as well as your financial security.1 Important social activities may be pushed aside in favor of drinking, and relationship issues are also common.1 Work duties can suffer due to alcohol use and its after-effects, such as hangovers or the development of physical or mental health conditions. Finally, increasingly large amounts of money may be allocated to purchase alcohol or cover any legal fees associated with alcohol-related problems, such as drunk driving.
In addition to the psychosocial effects of chronic drinking, there are many physical and mental health problems that can arise from long-term alcohol abuse. Several vital organs, such as the liver, heart, and brain, are susceptible to damage from alcohol, and it can also give rise to or worsen existing neurologic and psychiatric issues.1,3 Further, alcohol can also increase the risk of various types of cancer.2,3
The liver is the organ responsible for metabolizing alcohol and eliminating it from the body.4 As a result of alcohol’s toxic byproducts, the liver is highly susceptible to damage from heavy or long-term use of alcohol.2,3,4,7 Alcohol is known to cause various issues with the liver, including:7
- Steatosis (fatty liver): Even a few days of heavy drinking can create a buildup of fat in the liver. This condition makes it difficult for the liver to work properly and can lead to the development of alcoholic hepatitis.
- Alcoholic hepatitis: This is often the next stage of alcohol-related disease in the liver, and it occurs when the liver is inflamed. It can have no symptoms in some, while others may experience fever, nausea, loss of appetite, stomach pain, and confusion. As this disease progresses, the liver may become enlarged and, as several vital hepatic processes become increasingly compromised, a range of pathologies may be seen, including jaundice, bleeding issues, and widespread fluid imbalances.
- Fibrosis: This occurs when scar tissue builds up in the liver. Fibrosis can further severely impair the ability of the liver to function properly.
- Cirrhosis: This condition involves excessive scarring throughout the liver, causing the organ to deteriorate slowly. Women are prone to develop cirrhosis faster than men.4 Cirrhosis prevents the liver from working effectively, and is associated with complications such as insulin resistance, type 2 diabetes, and liver cancer.
Alcohol may also negatively affect the heart and other elements of the cardiovascular system.2,3 Some potential cardiovascular issues resulting from chronic drinking can include:2,3,7
- High blood pressure: Drinking over a long period of time or consuming many drinks in a short period of time can lead to high blood pressure. This is due to a loss of elasticity in the blood vessels and the fact that alcohol triggers the release of certain stress hormones, which further constricts the blood vessels.
- Cardiomyopathy: This means that the heart muscle weakens to the point where it stretches and droops. The heart essentially becomes an inefficient pump, and the resulting decline in blood delivery throughout the body can lead to widespread organ damage. Cardiomyopathy may eventually result in heart failure. Symptoms can include fatigue, swollen lower extremities, fluid on the lungs, shortness of breath, and irregular heartbeat.
- Arrhythmias: This is an irregular heartbeat. Alcohol can alter the heart’s ability to regulate the rhythm of the heart by interfering with the body’s natural pacemaker, causing the heart to beat improperly or too fast. Certain arrhythmias may increase the risk of embolic, or clot-generated strokes.
Chronic or heavy drinking can cause serious changes in the structure and function of the brain.3, 4,7 The most common neurological and psychological issues associated with alcohol intake are:1,2,3,4,7
- Stroke: This occurs most often when the flow of blood in a cerebral blood vessel is compromised—either due to a blockage or blood vessel rupture. Chronic alcohol consumption can increase the risk factors for having a stroke, such as high blood pressure, a hypercoaguable state, irregular heartbeat, and cardiomyopathy.
- Cognitive deficits: Alcohol can lead to harmful changes in the areas of the brain responsible for processing information, memory, and coordination. These deficits can persist well into sobriety.
- Shrinking of the brain: Alcohol has been shown to reduce the size of brain cells, causing the brain to shrink over time. This may ultimately lead to impaired coordination, body temperature dysregulation, disturbed sleep cycles, mood changes, and a decline in cognitive functioning.
- Mental health issues: Anxiety, depression, bipolar disorder, schizophrenia, and antisocial personality disorder are often associated with alcoholism.
- Wernicke-Korsakoff Syndrome: This is a devastating neurologic development that results from a deficiency in thiamine (vitamin B1). It consists of two different syndromes, Wernicke’s encephalopathy and Korsakoff’s psychosis. The former is short-lived and is characterized by symptoms, such as confusion, coordination problems, and paralysis of the nerves that control eye movement. An estimated 80 to 90 percent of alcoholic individuals with Wernicke’s encephalopathy progress to Korsakoff’s psychosis—a chronic condition characterized by serious memory and learning difficulties.
- Hepatic encephalopathy: Over time, cirrhosis and other liver dysfunction can lead to a potentially life-threatening brain condition, hepatic encephalopathy. This occurs when toxic waste products are not adequately filtered through the liver and reach the brain. Hepatic encephalopathy can lead to altered personality traits, mood, or sleep patterns; mental health disorders like anxiety and depression; a significantly decreased ability to focus; asterixis (flapping or shaking hands); coordination issues; and even coma or death.
Chronic alcohol abuse has been linked to an increased risk of cancer in various parts of the body, including:2,3
At least 70% of those who have mouth cancer are heavy drinkers.7 Further, research has revealed that women who drink five alcoholic drinks a day are 1.2 times more likely to develop rectal or colon cancer than non-drinking women.7 Drinkers are more likely to smoke, which compounds the risk of cancer. The cancer rates for people who both smoke and drink include:7
- 25 to 30% of liver cancers.
- 65% of mouth and throat cancer in women.
- 80% of mouth and throat cancer in men.
- 80% of esophageal squamous cell carcinoma, a kind of esophagus cancer.
People who drink and smoke are about 15 times more likely to develop throat or mouth cancers than those who abstain from both.7
Deadly Withdrawal Risks
While withdrawal from any substance can be an uncomfortable process, alcohol withdrawal can be particularly distressing and even fatal, which is why it is so important to undergo with the appropriate medical supervision. Withdrawal from alcohol can include marked agitation, grand mal seizures, and delirium tremens (DTs), which can be deadly if you’re trying to stop using alcohol on your own.1,8 Some other possible dangerous complications associated with alcohol withdrawal include:8
- Dysregulation of blood pressure, pulse, and body temperature.
- GI bleeding.
- Liver failure.
- Low blood sugar.
- Cardiac rate and rhythm disturbances.
Because of these possible medical complications, it is strongly recommended that alcohol withdrawal is completed under medical supervision to ensure safety and comfort, and to facilitate the administration of certain medications or other medical interventions, should they be needed.8
How to Get Help
Over time, alcohol abuse can develop into addiction, which is a chronic condition marked by an uncontrollable urge to drink alcohol even after experiencing negative consequences related to your physical or mental health, relationships, or performance at work or school, as well as legal issues. If you or someone you love has a problem with alcohol, help is available. However, treating alcoholism is more involved than merely helping someone abstain from alcohol. As previously stated, it is strongly recommended that you seek detox services when quitting alcohol in order to receive proper treatment if complications do arise. To further promote lasting recovery, detox should ideally be followed by formal substance abuse treatment.8 Detox options include:8
- Hospital detox: If you struggle with severe alcoholism, are addicted to other substances as well as alcohol, have experienced previous withdrawal complications, or have co-occurring medical or psychiatric health issues, a hospital may be a good choice for detox. Some local hospitals have dedicated detox wards where patients are vigilantly supervised and receive alcohol withdrawal medications to mitigate symptoms and minimize seizure risks. However, if you are in active withdrawal from alcohol, any acute care setting can provide the intensive withdrawal management necessary to minimize the risk of serious or even fatal events.
- Inpatient detox: This type of setting provides similar care to that of a hospital by providing medical supervision and monitoring, medications to ease the symptoms of withdrawal, and additional supports as you detox from alcohol.
- Outpatient detox: In this type of detox, treatment is provided on an outpatient basis, so that you can go about your daily routine while attending scheduled meetings with a medical professional trained in addiction medicine. Outpatient settings may not be the most ideal detox solution for those who have a long history of alcohol abuse, severe addictions, co-occurring medical or mental health conditions, or who have previously experienced complicated withdrawal due to an inherent inability to provide uninterrupted supervision and any needed emergent medical interventions.
While detox is a good start to recovery, it is not a substitute for formal addiction treatment.8 Since addiction is a complicated condition with many factors that contribute to and reinforce drinking and drug use, it is important to follow up with additional treatment. Addiction treatment programs can help address the underlying issues driving substance use and alcoholism by providing counseling in group and individual settings. Various behavioral therapies help you develop healthy coping skills to better prevent relapse and stay sober long-term. Options for addiction treatment include:
- Inpatient facilities: These provide a safe place to reside for the duration of treatment. Group and individual counseling sessions are provided on a daily basis. Therapists assist patients in identifying situations where they have a high risk of relapse and building the skills required to cope with life without turning to alcohol or drugs. This is a good choice if you have a relatively more severe addiction, previous failed attempts at getting sober, co-occurring health issues, or a weak sober support system.
- Outpatient facilities: These are often somewhat less restrictive than inpatient programs, allowing you to get treatment in group and individual sessions, while still having the freedom to participate in normal life activities at work, school, or home. This is ideal if you have a milder addiction and strong sober supports.
- American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th). Arlington, VA: American Psychiatric Publishing. Pp. 490–497, 499–501
- Centers for Disease Control and Prevention. (2016). Fact Sheets – Alcohol Use and Your Health.
- National Institute on Alcohol Abuse and Alcoholism. (N.D.) Alcohol’s Effects on the Body.
- National Institute on Alcohol Abuse and Alcoholism. (2004). Alcohol’s Damaging Effects on the Brain.
- National Institute on Alcohol Abuse and Alcoholism. (N.D.) Alcohol Use Disorder.
- American Society of Addiction Medicine. (2011). Definition of Addiction.
- National Institute on Alcohol Abuse and Alcoholism. (2010). Beyond Hangovers: Understanding Alcohol’s Impact on your Health.
- Center for Substance Abuse Treatment. (2006). Detoxification and Substance Abuse Treatment. Treatment Improvement Protocol (TIP) Series, No. 45, HHS Publication No. (SMA) 15–4131, Rockville, MD. Pp. 4, 17–19, 52–54.