For many people, drinking alcohol is just a pleasant way to relax. However, people with alcohol use disorders drink excessively, endangering their lives and the lives of others. This question-and-answer fact sheet explains the problems caused by alcohol use and how psychologists can help people recover.
When does drinking alcohol become a problem?
For most adults, moderate alcohol consumption — no more than two drinks a day for men and one for women and older adults — is relatively harmless. (A “drink” means 1.5 ounces of hard liquor, 5 ounces of wine, or 12 ounces of beer, each containing 0.5 ounces of alcohol.)
Moderate drinking, however, lies at one end of the range from alcohol abuse to alcohol dependence:
Alcohol abuse is a pattern of drinking that results in significant and recurrent adverse consequences. People who abuse alcohol may not fulfill important obligations at school, work, or family. They may have legal problems related to alcohol use, such as repeated arrests for driving under the influence of alcohol. They may have relationship problems associated with drinking. People with alcoholism, “technically known as alcohol dependence,” lose reliable control of their alcohol use. It doesn’t matter what kind of alcohol you drink or even how much; alcohol-dependent people often can’t stop drinking once they start. Alcohol dependence is characterized by tolerance (the need to drink more to achieve the same euphoria) and withdrawal symptoms if drinking is stopped abruptly. Withdrawal symptoms may include nausea, sweating, restlessness, irritability, tremors, hallucinations, and seizures.
While most public attention is given to serious drinking problems, even mild and moderate problems cause significant harm to individuals, their families, and the community.
What causes alcohol-related disorders?
Alcohol problems have multiple causes, with genetic, physiological, psychological, and social factors playing important roles. Not all people are equally affected by each cause. For some people who abuse alcohol, psychological traits such as impulsiveness, low self-esteem, and a need for approval cause them to drink alcohol inappropriately. Some people take to cope with or “cure” emotional problems. Social and environmental factors, such as peer pressure and the easy availability of alcohol, can play key roles. Poverty and physical or sexual abuse increase the chances of developing alcohol dependence.
Genetic factors make some people especially vulnerable to alcohol dependence. Contrary to popular belief, being able to drink without being noticed means that you are at greater, not less, risk of having an alcohol problem. However, a family history of alcohol use problems does not mean that the children of those with these problems will automatically grow up to have the same problems, just as the absence of alcohol use problems in the family does not necessarily protect children from developing these problems.
How do alcohol use disorders affect people?
While some research suggests that small amounts of alcohol can have beneficial cardiovascular effects, there is a consensus that drinking too much can lead to health problems. 100,000 people in the United States die from alcohol-related causes yearly. Short-term effects include memory loss, hangovers, and alcoholic amnesia. Long-term problems associated with heavy drinking include stomach disorders, heart problems, cancer, brain damage, severe memory loss, and liver cirrhosis. Heavy drinkers also dramatically increase their chances of dying from car accidents, homicides, and suicides. Although men are more likely to develop alcoholism than women,
Alcohol problems also have a very negative impact on mental health. Alcohol abuse and alcoholism can worsen existing conditions like depression or lead to new problems like severe memory loss, depression, or anxiety.
Alcohol problems don’t just hurt the drinker. According to the NIAAA, more than half of people in the United States have at least one close family member with an alcohol use problem. Wives and children of heavy drinkers are more likely to experience family violence as children are more likely to face physical and sexual abuse, neglect, and develop psychological problems. Women who consume alcohol during pregnancy are at serious risk of harming the fetus. Friends and family members can be killed or injured in alcohol-related accidents and assaults.
How can a psychologist help?
Psychologists trained and experienced in dealing with alcohol problems can help in many ways. Before the drinker seeks help, a psychologist can guide the family or others in helping the drinker increase motivation to change.
A psychologist may start with the drinker by assessing the types and degrees of problems they are experiencing. The evaluation results can offer an initial guide to the drinker on what treatment she should seek and help motivate him to undergo treatment. People who have problems with alcohol use undoubtedly improve their chances of recovery by seeking help early.
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By using one or more psychological therapies, psychologists can help people address the psychological issues underlying their alcohol problems. Several of these therapies, including cognitive behavioral therapy, which facilitates the development of coping skills, and motivational stimulation therapy (MET), was developed by psychologists. Additional therapies include 12-step facilitation therapies that assist those with alcohol use problems in using self-help programs such as Alcoholics Anonymous (AA). The three therapies, Cognitive Behavioral Coping Therapy, Motivational Stimulation Therapy, and 12-Step Facilitation Therapy, demonstrated their efficacy through well-designed, large-scale treatment trials. These therapies can help people boost their motivation to stop drinking, identify circumstances that trigger alcohol use, learn new ways to cope with high-risk drinking situations, and develop social support systems within their communities.
Many people who have problems with alcohol use also have other health problems, such as severe anxiety and depression, that occur simultaneously. Psychologists can be of great help in diagnosing and treating these psychological problems that occur at the same time they start to create problems. In addition, a drinker in treatment may receive services from many health professionals, and a psychologist may play an important role in coordinating these services.
Psychologists can also provide couples, family, and group therapy, which is often helpful in repairing interpersonal relationships and long-term success in resolving problems caused by alcohol use. Family relationships influence alcohol-related behavior, and these relationships often change during a person’s recovery. The psychologist can help the drinker and their partner navigate these complex transitions, help families understand the problem of alcohol use, learn how to support family members in the recovery process, and refer family members to self-help groups such as Alcoholics Anonymous and Alateen.
