So it may be tough to tell when drinking alcohol turns into a problem. Alcohol abuse occurs when someone drinks too often or too much at one time. It starts to negatively impact your life, ruining relationships and interfering with school and work performance. Still, despite the devastating risks, individuals who abuse alcohol don’t stop drinking.

Some people don’t stop drinking because they become addicted to alcohol. This is when alcohol abuse leads to dependence, also known as alcoholism. When a person is dependent on alcohol, they have a strong urge to drink, are unable to stop once they start drinking, experience withdrawal symptoms if they do stop and need more alcohol to feel similar effects.

Signs & Symptoms

• Drinking alone
• Problems remembering things (i.e., blackouts)
• Legal trouble, like driving under the influence (DUI)
• Frequent arguments with others
• Missing class, school assignments or work
• Spending substantial time recovering from drinking
• Creating rituals around drinking and getting upset if they’re interrupted
• Losing interest in activities previously enjoyed
• Drinking with the goal to get drunk
• Intoxicated often
• Keeping alcohol in unexpected places like the car
• Suffering physical symptoms when not drinking (e.g., nausea, sweating, shaking, restlessness)
• Tolerance to alcohol
• Having more than four drinks a day (for women) or five (for men)
• Making excuses for drinking
• Feeling guilty about drinking
• Needing to drink as soon as they wake up

Causes

Several factors can increase your risk for alcohol abuse or dependence. For instance, alcoholism tends to run in families, so genetics might play a role. However, that doesn’t mean that you’re doomed to have alcohol problems if someone in your family does. Just be aware that the possibility is present. Having a mental health condition, like anxiety or depression, can boost risk because some people self-medicate. Other factors include increased levels of stress and the availability of alcohol.

Becoming physically addicted to alcohol happens over time. Chronic drinking affects certain brain chemicals associated with pleasure, so after a while your body craves alcohol — and more of it — to feel good.

Treatment

There are various effective treatments for alcohol abuse and dependence. Certain factors go into determining which treatment is best, like the severity of the problem and if the person is alcohol dependent. If the person is addicted to alcohol, they usually need hospitalization or a residential treatment center. Physical dependence can also require detoxification, or detox, when alcohol is flushed out of the body. Medications can be prescribed to reduce withdrawal symptoms.

Also effective is psychotherapy, which helps individuals treat the underlying issues and other mental health conditions that can accompany alcohol problems; better understand their abuse or addiction and anticipate the triggers; and use healthy coping strategies.

A doctor might prescribe medications created specifically to treat alcoholism. These medications have different functions, such as creating adverse physical reactions when you drink alcohol or reducing the urge to drink.

Group and family counseling can also help, as do support groups like Alcoholics Anonymous. Some people must quit drinking altogether, while others can learn to drink in moderation. If a person is addicted to alcohol, abstinence is best.

What You Can Do

• Seek help. If alcohol is interfering with your life or you can’t stop drinking on your own, it’s important to see a counselor and get help. Untreated alcohol abuse or dependence has serious complications. Everything in your life can suffer, including school performance, relationships and your health. Alcohol lowers inhibitions and can lead to poor choices and potentially harmful situations.

• Practice healthy habits. Whether you’re already in treatment or not, taking good care of yourself is vital. Get enough sleep, eat well, exercise and find healthy ways to cope with stress.

• Stay around people who are supportive. Some friends might not understand why you’re not drinking — or worse, might pressure you to drink. As cliché as it sounds, these are not your friends. Spend time with people who support you and genuinely care about your well-being.