Alcohol Symptoms and Warning Signs

A complete guide on how to recognize alcohol use disorder and where to find help.

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ARTICLE OVERVIEW: Drinking too much, too often is considered “alcohol abuse”. It can be a warning sign of a drinking problem. One major indication of alcoholism is physical dependence on alcohol. In this article, we review dependence and other symptoms of a true drinking problem… and offer suggestions on how can you deal with them.


Half of all Americans Drink Regularly

Do you drink alcohol?

If so, you are like half of all adult Americans. If truth be told, the National Survey on Drug Use and Health of 2015 found that 56% of people 18 aged 18 and older were current, past-month alcohol consumers. The survey also reports that 86% of all people aged 18 + said that they drank alcohol at some point in their lifetime.

But, just because you drink regularly doesn’t mean that you have a drinking problem…

Just to clear the air…

In the U.S. a ‘standard drink‘ is any drink that contains about 0.6 fluid ounces or 14 grams of pure alcohol.

And the AMOUNT you drink of these standard drinks does not – in an of itself – determine a problem. In fact, the development of a drinking problem varies from person to person. Some people may trigger a problem after only a few drinking sessions, while others may develop drinking problems after years of prolonged use. And some people only binge drink on parties…with little to no real consequences.

A Drinking Problem, or Not?

So, how do you know whether you have a drinking problem or not?

The National Institute on Alcohol Abuse and Alcoholism(NIAAA) gives us the general definition for having a problem as follows:

For women:

  • If you drink more than 1 drink per day.
  • If you drink more than 7 drinks per week.
  • If you drink more than 3 drinks on any single day.

For men:

  • If you drink more than 2 drinks per day.
  • If you drink more than 14 drinks per week.
  • If you drink more than 4 drinks on any single day.

But there are also two high-risk drinking patterns that can lead to a problem with booze.

  1. Binge drinking defined by the NIAAA is a pattern of drinking that elevates the blood alcohol concentration levels (BAC) to 0.08 g/dl, which is after 4 drinks for women and 5 drinks for men in a timeframe of about 2 hours.
  2. Heavy drinking defined by SAMHSA is binge drinking on 5 or more days in a period of one month.

NIAAA’s Rethinking Drinking claims that about 1 in 4 people who exceed these limits can be diagnosed with alcohol use disorder, while the others are at great risk for becoming dependent to alcohol over time. The SAMSHA survey on drug use and health reported that in 2016, 15 million people aged 12 or older meet the criteria for being diagnosed with an alcohol use disorder. This means that 1 in 18 Americans have a drinking problem.

Do you fit into this definition?

If so, keep reading. Next, we review the common signs of alcohol abuse and dependence, and we provide help on what to do next. If you have any questions, please feel free to write them in the comments section at the end. We will try to respond personally and promptly to all legitimate inquiries.


Signs of Alcohol Abuse

As a socially acceptable psychoactive substance, alcohol is widely used. It’s safe to say that most social events are organized around a drink. But, when do you start to ‘abuse’ alcohol?

Alcohol abuse is considered when you drink too much, and too often, and your drinking starts to have a negative impact on your life.

BUT, alcohol abuse is not the same as being physically dependent on alcohol. These two drinking conditions are different. According to the DSM-IV Diagnostic Criteria for Alcohol Abuse and Dependence, you are abusing alcohol if you meet at least one of the following criteria within 12-month period:

  • Recurrent alcohol-related legal issues.
  • Recurrent drinking in situations that are dangerous, like driving under the influence.
  • Recurrent use of alcohol resulting in a failure to fulfill obligations at work, school, or home.
  • You continue to drink despite constant problems with family and friends due to alcohol use.

Alcohol abuse is serious drinking condition that may lead you to dependence and addiction. However, this condition is treatable!

Let’s verify your coverage for addiction treatment at an American Addiction Centers location. Your information is always confidential.

Signs of Alcohol Dependence

According to the “Neurobiology of Alcohol Dependence”, alcohol dependence is a chronic relapsing disorder that is progressive and has serious detrimental health outcomes. The DSM-IV states that you have alcohol dependence if you meet three or more of the following criteria in the same 12-month period:

  • A persistent desire for drinking.
  • Drinking in larger amounts or over a longer period than intended.
  • Experiencing withdrawal symptoms once you cut down or quit drinking.
  • Giving up or reducing important social, occupational, or recreational activities because of drinking.
  • You continue to drink despite having health problems.
  • You need to increased amounts of alcohol to achieve intoxication or desired effect.
  • You spend a great deal of time spent in activities necessary to obtain, to use, or to recover from the effects of drinking.
  • The diagnosis of liver disease, high blood pressure, or heart disease.
  • One or more unsuccessful efforts to cut down or control drinking.

Alcohol dependence is a way more serious drinking condition than alcohol abuse. It is an indication that you may suffer from alcoholism.

On the contrary of DSM-IV, the updated version DSM-V lists 11 criteria that one person needs to meet in order to be diagnosed with alcohol use disorder:

1. Use alcohol in larger amounts, or longer than intended.
2. Spend a lot of time using, and/or recovering from use.
3. Experiencing strong urge/cravings to drink.
4. Fail to perform normally at work/school/home due to drinking.
5. Continue to drink despite the negative consequences caused in relationships with loved ones, friends, and family.
6. Continue to drink despite being aware of harmful risks and side effects.
7. Continue to drink despite the risk of developing health problems or worsen physical or psychological condition.
8. Give up hobbies, recreational activities, or social interactions because of drinking.
9. Experiencing withdrawal symptoms once the drinking is cut down or stopped. (dependence)
10. Tried and failed to quit.
11. Need to drink more in order to feel the desired effect (tolerance).

Having at least two symptoms indicates a level of alcohol use disorder. The levels of severity are classified as following:

  • Mild disorder: Presence of 2 to 3 symptoms.
  • Moderate disorder: Presence of 4 to 5 symptoms.
  • Severe disorder: Presence of 6 or more symptoms.

Recognizing an Alcohol Addiction

Alcohol use disorder may be hard to spot it. How can you know whether someone is drinking in moderation or if they have a drinking problem?

The best way to recognize any drinking problem is by learning the drinking patterns or habits mentioned earlier.

Some patterns, such as binge drinking, are easy to spot, but for some you may need more insights.

People who have drinking problems may:

  • Consume alcohol to feel the buzz.
  • Drink large amounts at social gatherings.
  • Drink throughout the whole day.
  • Drive under influence.
  • Engage in trouble like picking fights.
  • Have an urge to drink every day.

You can always check out these online alcohol screening tools and questionnaires to assess a possible problem:

Intervention for Alcoholics

Intervention involves a group of individuals who are ready to confront the person who has drinking problems in order to persuade them to seek treatment. This group usually consists of family members, close friends, loved ones, or even close colleagues. The goals of an intervention are to:

  • Help the addict see the problem.
  • Help them find a treatment.
  • Help them follow through by setting up consequences.

Interventions led by certified professionals are more effective that when you attempt to approach a loved one on your own.

A successful intervention is best when it is planned and arranged with an intervention specialist. The 7 principles of intervention for alcohol use disorder include:

1. Meet with a certified interventionist.
2. Plan in advance.
3. Choose the right people to take part.
4. Choose the right time for the intervention.
5. Speak with respect and love, but never with anger.
6. Follow through.
7. Take care of yourself.

Here are two websites where you can find certified interventionists:

Alcohol Withdrawal & Detox Symptoms

Alcohol withdrawal is a set of symptoms that occurs when people who are dependent to alcohol cut down their drinking or quit for good. Why does this happen?

Your brain and body have adjust to the constant presence of alcohol because is a nervous system depressant. So, once you cut back on drinking, your body needs time to adjust. Withdrawal syndrome is actually the manifestation of symptoms meant to “reverse” the effects of alcohol. It takes time for the brain’s chemistry to even out again…but can be dangerous by provoking seizures, hallucinations, or life-threatening situations.

For this reason, always seek medical supevision when you detox off alcohol.

Withdrawal usually occurs within 8 hours after last drink, but symptoms can last for days or weeks. Some of the most common symptoms include:

  • Agitation.
  • Anxiety.
  • Depression.
  • Difficulty concentrating.
  • Disorientation.
  • Fatigue.
  • Headache.
  • Heightened.
  • Irritability.
  • Jumpiness or shakiness.
  • Mood swings.
  • Nausea.
  • Nightmares.
  • Sweating.
  • Tremors.
  • Vomiting.

Moreover, some individuals may experience post-acute or protracted withdrawal symptoms (PAWS). According to SAMHSA protracted withdrawal is the presence of withdrawal symptom beyond the general timeframe.

Some PAWS include:

  • Anxiety.
  • Depression.
  • Increased blood pressure and pulse.
  • Increased body temperature
  • Increased breathing rate.
  • Sleep disruption.
  • Tremor.

Check out our infographic to learn a detailed list of alcohol withdrawal symptoms, with timetable of their appearance.

Alcohol Use Disorder Treatment

Alcohol treatment is the process of treating alcoholism. There are two main types of treatment: inpatient  rehab you live at the facility with 24/7 medical surveillance and outpatient rehab where you come and go to the facility for several hours, a few days per week. The most successful rehabs are those that implement evidence-based strategies that include:

1. Assessment.

The first stage of any rehab is assessment. Doctors and staff should take your full medical history, perform a physical exam, interview you for an hour or more, and help you complete paper work. Also, you may be asked to submit a blood or urine sample for drug testing.

During assessment, the medical staff will run both physical and psychological evaluations. This stage helps clinicians to plan out the treatment plan, which can be adjusted over time.

2. Medical detox.

This stage provides medical supervision while you are going through the process of withdrawal.

3. Psychotherapy.

During this stage of treatment, you will be invited to identify the roots and underlying issues for your drinking problems. Talk therapy will help you move towards a life without alcohol, and you will learn how to live without needing to drink. Most therapies that are used in rehabs include some form of:

  • Behavioral Therapy
  • Individual Therapy
  • Group Therapy
  • Family Therapy

4. Pharmacotherapy.

One way to address alcohol problems is with the help of medications. Medicine combined with talk therapy leads to best results. Medications included in the treatment of a drinking problem include:

Acamprosate may be used to reduce symptoms of protracted withdrawal, such as insomnia, anxiety, restlessness, and dysphoria.

Antabuse (disulfiram) is used to prevent future drinking; it can make a person sick if even a small amount of alcohol is consumed.

Barbiturates can help manage withdrawal and address specific symptoms.

Benzodiazepines are used to address symptoms of withdrawal. Sample regimen includes 3 days of long-acting benzodiazepine (such as lorazepam, diazepam, and chlordiazepoxide) intake on a fixed schedule.

Naltrexone blocks the rewarding effects of alcohol.

5. Education sessions.

This stage helps people to learn how alcohol affects and changes the brain activity, and how can drinking destroy your life. Also, during this stage, patients will learn some coping mechanism to deal with stress, triggers, and avoid relapse.

6. Aftercare.

Aftercare services provide support to maintain sobriety in the mounts and years after you complete the program. Most common aftercare services include:

  • Coaching.
  • Counseling therapy.
  • Living in sober house.
  • Support Groups.

Next Steps

Do you think that you may have drinking problems? Don’t waste your time. Admit that the problem is real, and act!

You can reach out for help with any of the following organizations:

American Academy of Addiction Psychiatry

American Psychological Association
1–800–964–2000 (ask for your State’s referral number to find psychologists with addiction specialties)

American Society of Addiction Medicine
301–656–3920 (ask for the phone number of your State’s chapter)

NAADAC Substance Abuse Professionals

National Association of Social Workers
(search for social workers with addiction specialties)

National Institute on Alcohol Abuse and Alcoholism

National Institute on Drug Abuse

National Institute of Mental Health

Substance Abuse Treatment Facility Locator


According to the 2016 National Survey on Drug Use and Health there are 21 million people aged 12 or older who need treatment for alcohol and/or drug use. But many people are not getting the help that they need!  NIAAA states that less than 10% of people who need help for drinking problems receive any treatment.

Don’t wait to be a statistic!

Get help today.

Reference sources: NIDA: Evidence-Based Approaches to Alcohol Addiction
SAMHSA: Alcohol
U.S. Department of the Interior Signs and Symptoms Fact Sheet on Drugs and Alcohol
NIAAA: Alcohol Facts and Statistics
About the author
Lee Weber is a published author, medical writer, and woman in long-term recovery from addiction. Her latest book, The Definitive Guide to Addiction Interventions is set to reach university bookstores in early 2019.
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