Alcoholism is a chronic disease characterized by an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences. It involves both the compulsive use of alcohol and loss of control over alcohol intake. Alcoholism can lead to severe damage to the brain and body.
What is alcoholism?
Alcoholism, also known as alcohol use disorder (AUD), is defined as an inability to control or stop drinking alcohol even though it is causing social, health, psychological, and legal problems. The exact causes of alcoholism are unknown, but likely involve a complex interplay of genetic, psychological, social, and environmental factors.
Alcoholism is a progressive disease, meaning it typically gets worse over time if the person continues to drink. Habitual drinking causes changes in the brain that make quitting harder with time. Alcoholism can be mild, moderate, or severe, based on the number of symptoms present. Generally, the more severe the alcoholism, the greater the impact on the brain.
What causes alcoholism?
The specific causes of alcoholism are not fully understood. Research suggests that certain genes may increase the risk of AUD by impacting levels of chemicals in the brain. Drinking a lot over a long time physically alters the brain to crave alcohol. Environmental factors like stress and easy access to alcohol may also contribute.
Main causes include:
- Genetics – Certain genetic factors likely account for 40-60% of a person’s vulnerability.
- Brain chemistry – Alcohol affects neurotransmitters like GABA, dopamine, serotonin.
- Social/cultural factors – Stress, trauma, peer pressure, and availability.
- Psychological factors – Underlying mental health issues or personality traits.
What happens to the brain?
Prolonged heavy drinking causes significant impairments in brain function due to alcohol’s effects on brain chemistry. Alcohol is a central nervous system depressant that can damage neurons and circuits important for thinking, movement, mood, and behavior.
Some key effects on the brain include:
Shrinking of the brain
Chronic alcohol abuse leads to wide-spread shrinkage in the brain. Gray and white matter brain volume is reduced. Important areas like the cortex, cerebellum, and limbic system decrease in size by up to 10%. Neuron cell death and loss of connections between neurons is responsible.
Damage to the frontal lobes
The prefrontal cortex located in the frontal lobe controls judgment, emotions, problem solving and impulse control. This region sustains significant neuron damage due to binge drinking and alcohol dependence. This impairs mental flexibility, attention, planning and memory.
Disruption of neurotransmitters
Alcohol alters levels of GABA, dopamine, serotonin, and endorphins in the brain. This can lead to depression, anxiety, mood instability, and difficulty feeling pleasure. The disrupted signaling between neurons causes problems with motor skills and cognition.
Increased neuron excitability
Alcohol withdrawal creates hyper-excitability among neurons. This causes anxiety, restlessness, tremors, seizures, and sleep disturbances. Chronic alcohol use leads to long-term neuron excitability that can cause epilepsy and change sleep patterns.
Interference with memory formation
The hippocampus and amygdala are involved in memory formation. Alcohol damages the hippocampus, causing blackouts and memory loss in alcoholics. This can persist even after someone stops drinking. The amygdala helps form emotional memories and alcohol may block its functioning.
Disruption of blood flow
Alcohol causes constriction of blood vessels, impairing blood flow to the brain. It may also cause small strokes in the cerebellum. This can contribute to balance problems and difficulty walking, speaking, and focusing. Chronic alcoholics often have significant brain damage due to impaired blood flow.
Reduced white matter
White matter connects different regions of the brain and transmits signals. Binge drinking and heavy alcohol use shrinks white matter fibers throughout the brain, which disrupts cognition, behavior, and physical coordination. This can lead to lasting impairments.
Increased risk of dementia
Prolonged alcohol abuse increases vulnerability to Alzheimer’s disease and other forms of dementia. This may be due to direct damage to brain cells, creation of toxins, vitamin deficiencies, and vascular problems cutting off oxygen to parts of the brain.
Brain Region | Effects of Alcohol |
---|---|
Cerebellum | Atrophy, impaired motor skills and balance |
Hippocampus | Disrupted memory formation and blackouts |
Prefrontal cortex | Impaired judgment, reduced inhibitions, poor decision making |
Hypothalamus | Disrupted body temperature, appetite and sex drive regulation |
What are the stages of alcoholism?
Alcoholism tends to progress through predictable stages if drinking continues:
Early stage
Drinking is recreational and social. People can stop or moderate consumption. Intoxication becomes more frequent and blackouts may happen. Early signs of tolerance and withdrawal may emerge. There are few obvious significant consequences.
Middle stage
Drinking becomes more frequent, leading to impaired control over consumption. Blackouts are more common and memory problems likely emerge. Withdrawal symptoms are more pronounced. Liver damage may occur. Work and relationships suffer.
Late stage
Alcohol dependence is established. Drinking becomes a dominant focus despite serious consequences. social isolation and relationship loss occur. Shakiness, severe mood swings, infections, and loss of appetite are likely. Liver cirrhosis, brain damage, and mental health disorders often develop.
What are alcohol’s effects on the body?
Chronic heavy drinking and alcoholism have widespread detrimental effects throughout the body. Some major effects include:
- Liver: Alcoholic liver disease like fibrosis, alcoholic hepatitis, cirrhosis
- Heart: Cardiomyopathy, arrhythmias, stroke
- Pancreas: Pancreatitis
- Cancer: Increased risk of mouth, throat, liver and breast cancer
- Immune System: Increased vulnerability to pneumonia, tuberculosis, HIV
- Reproductive System: Impotence, infertility, menstrual disruption
Alcoholism also causes vitamin deficiencies, sleep disorders, swelling, and a variety of other health complications. The health consequences tend to become more severe as alcoholism progresses.
What are the symptoms and signs of alcoholism?
Common physical and psychological symptoms of alcoholism include:
- Tolerance – needing more alcohol get desired effect
- Dependence – withdrawal symptoms when stopping alcohol
- Craving – intense urge to drink alcohol
- Loss of control – inability to limit drinking
- Neglecting responsibilities – due to drinking
- Continued use despite problems – health or social issues
- Unsuccessful attempts to quit – inability to stop entirely
- Risky use – driving drunk, unsafe sex, drinking despite medications
- Physical withdrawal symptoms – tremors, sweating, insomnia, anxiety
- Psychological disturbances – depression, mood swings, impulsivity
As alcoholism progresses to advanced stages, the signs and symptoms become more severe. Early stage alcoholism may involve social problems and risky drinking, while late stage alcoholism involves noticeable organ damage and physical dependence.
What are the treatments for alcoholism?
Key treatments for alcoholism include:
- Detoxification – Supervised medical detox to safely manage withdrawal symptoms
- Therapies – Cognitive behavioral therapy, 12-step programs, motivational enhancement
- Support groups – Alcoholics Anonymous, SMART recovery, group counseling
- Medications – Naltrexone, Acamprosate, Disulfiram help reduce cravings and withdrawal severity
- Dual diagnosis treatment – Addressing co-occurring mental health disorders like depression or anxiety
- Nutrition – Correcting vitamin/mineral deficiencies and providing a healthy diet
The most effective treatment combines therapy, support groups, skills training, and medications. Treatment must address physical dependence as well as underlying psychological drivers of addiction. Long-term follow-up care and support is crucial to prevent relapse.
What is the outlook for alcoholics?
The outlook for alcoholics depends on the severity of the disease, access to treatment, and commitment to staying sober. Mild alcoholism has a better prognosis if treated, while late-stage alcoholism can lead to permanent brain damage or be fatal.
Relapse rates are high without adequate treatment and support. But many alcoholics are able to achieve lasting sobriety through comprehensive treatment programs. The longer someone abstains from alcohol, the more their brain can heal and regain healthy functioning.
Ongoing treatment, lifestyle changes and social support can sustain long-term sobriety. The outlook is best when professional treatment is combined with community-based recovery groups and maintenance of a sober lifestyle.
Conclusion
Alcoholism causes widespread and severe damage to the brain that can significantly disrupt thinking, behavior, mood and coordination. Brain shrinkage, neurotransmitter disruption, and neuron death are common effects. Additionally, heavy drinking leads to impaired memory, decreased brain volume, and increased dementia risk.
However, treatment and sobriety can allow healing in the brain and recovery of function. This underscores the importance of intervening early and treating alcoholism as a chronic disease requiring ongoing management. Comprehensive treatment paired with sustained lifestyle changes can lead to long-term recovery.