7 Facts You Need To Know About Alcohol and Probably Don’t
Up until a few weeks ago, when I learned of the passing of a dear friend and colleague who lost his battle with alcohol, I remained quiet on the topics of alcohol and drugs. I’ve understood that as a therapist who has worked in the field since just before the Twin Towers fell, I am likely to have a biased view. After all, my very motivation to pursue psychology as a teenager was inspired by how drugs & alcohol work in the brain. Knowing that my level of ‘expertise’ is likely to distort my view is why I have ignored misinformation about alcohol when I happen upon it. That is, until now! Until the tragic loss of a friend, someone who had fought to help others in their battles with addiction, only one year after a family-friend died suddenly from organ failure from his alcohol abuse. Young men who will never live to see their 40th birthday’s.
It is in their honor, the untimely deaths of those I’ve known to go before them, and the many who will likely follow, that I have decided to share my knowledge. To do what I can to spread the truth about alcohol, the world’s most commonly used and abused mood-altering substance (WHO, 2024; NIDA, 2024). The one that is 100% legal, the most toxic to the human body, and that is responsible for more lives lost annually, particularly those of young men, than any other drug on earth (NHTSA, 2021; PBS, 2024; KSS, 2024).
#1 Alcohol Use Causes Anxiety, Though No One Realizes It
Those of us who have ever been ‘weekend warriors’, attended frat or house parties several nights of the week, had a habit of hitting up happy hours, tailgate parties, or going to the bars routinely on weekends, know this phenomenon more than you likely realize. If you’ve ever felt dread into the start of the work week after a few days or nights of ‘partying’, you’ve likely experienced ‘rebound anxiety’, your central nervous system (CNS) ramping up as it tries to rid itself of the alcohol from the hours or days before.
You see, all mood-altering substances directly impact the CNS, though in different ways. This is why they are attractive to us to begin with! This is how they get you “high”.
Importantly, the experience of a drug leaving the body (i.e., the withdrawal) is always the opposite of the intended effect of the drug!
In the case of alcohol, a CNS depressant, when the drug is leaving the body the effect is to speed up the CNS. The system responsible for nearly everything your conscious mind experiences. Those who binge drink only on rare occasions may just feel, a few days later, like they’ve had a tad too much caffeine. However, the more alcohol you consume, the greater the effect on the CNS, the greater the degree of over-arousal on the back end.
Understanding how rebound anxiety works also highlights the vicious cycle that those who do have a problem with alcohol fall victim to, relying on the depressant effects of the alcohol to alleviate the very anxiety that they don’t know the alcohol is causing.
#2 An Addiction to Alcohol is A Physical Disease, Not a Psychological One
Though addiction was officially declared a disease back on November 16, 2016 by the then Surgeon General, “addiction is a chronic illness accompanied by changes in the brain”, many continue to think of the ‘disease of addiction’ as a type of psychological metaphor. In actuality, however, severe substance use disorders (a.k.a. addictions) are more disease-like than arguably any other mental health diagnoses within the current version of the Diagnostic and Statistical Manual of Mental Disorders (DSM 5-TR) (APA, 2022). How do I mean?
To understand why this would be, let’s take a quick look at how an addiction to alcohol actually works.
Those who become addicted to alcohol do so by continually putting this very powerful substance into their body, over time. Though not everyone who drinks a lot becomes addicted, for those who do, their body (CNS) makes calculated changes in leu of repeatedly introducing this foreign, toxic, substance. You might recognize this idea from any basic biology class as the process of adaptation. When the internal processes of an organism must adapt to accommodate changes in the environment.
Unlike mental health conditions such as depression, bipolar disorder, even schizophrenia, we can measure the levels of a drug in the body, quantify how long someone has been using, and can see (feel), and measure the physical changes that occur in the brain and body as the drug leaves one’s system. We can also determine whether someone has the genetic predisposition to alcoholism and can measure the actions indicative of the loss of control we see with addiction. Behaviors that are similar across all who become addicted, that are predictable, and that become worse over time.
A predictable course with distinctive signs and symptoms across individuals, and that worsens over time, are the defining features of a disease.
#3 In the Case of An Alcohol Addiction, Alcohol Is Not The Problem
Once someone becomes “addicted”, alcohol is no longer ‘the’ problem. It is only a part of the problem. An addiction to alcohol is NOT the same thing as a person who drinks on occasion, only more. In that case, it would be correct to assume that to take away the alcohol would fix the problem. When someone is addicted, however, their brain and body has changed.
These changes result not only in compulsive behaviors related to drinking, but to changes to one’s mood, memory, thoughts, emotions, behaviors, and decision-making. Changes to what we might call someone’s personality. Changes that remain even when they are not drinking.
#4 You Do Not Have To Drink Every Day to be Addicted. In Fact, Most Who Are, Don’t!
In order to wrap your mind around this idea, you need only consider how alcohol is processed in the body. You see, it takes time for alcohol to leave the body completely, therefore, it’s not so difficult to go consecutive days without it. It’s typically by the end of the third day without a drink, when the alcohol is all but gone, when those who are addicted feel overwhelmingly compelled (i.e., the “desire”) to do it again. When their brain begins insisting that they do it again.
“Addiction is not about whether you can stop, it’s about whether you can stay stopped.”
#5 Alcohol Withdrawal Is The Most Dangerous
Most who abuse alcohol regularly simply do not realize the danger they may be in, and neither do their loved ones. When you repeatedly insist that someone you love “just stop drinking”, it’s important to understand the dangers inherent in that decision.
When someone who is addicted to alcohol goes ‘cold turkey’, or even just takes more than a few days off from drinking, as you now know, their CNS ramps up. At a minimum this results in varying degrees of anxiety, overwhelm, panic, feeling jumpy, having varying degrees of “the shakes” (shaky hands), sleep problems, insomnia, a rapid heart rate, headaches, and stomach problems. In more severe cases, the result can be seizures, delirium tremors (a feeling of psychosis mixed with a bad flu), and death.
Despite what you may guess, I have seen clients have seizures up to two weeks after they’ve quit drinking. For this reason, many do not connect the seizures to their drinking, at least not at first. Worse still, for those who do have a seizure, they are now more likely to have it happen again. Alcohol and benzodiazepine withdrawals are so dangerous, they are the only two mood-altering substances that all insurance companies will require be treated with inpatient detoxification, or the need for around the clock medical monitoring to ensure a patient’s safety.
#6 Alcohol Is The Only Drug That Impacts Every Major Organ System In The Body.
If you’ve guessed heroin, meth, crack-cocaine, or fentanyl, are the most poisonous drugs to the body, you’ve guessed wrong. According to the Cleveland Clinic (2024), and The National Institute on Alcohol Abuse and Alcoholism (2024) alcohol can have any number of devastating effects on the body. Here is a summary of those effects.
Alcohol can impair memory, attention, and decision-making, lead to nerve damage, cause pain, tingling, or weakness in the limbs. Excessive drinking causes the accumulation of fat in liver cells, inflammation, and cirrhosis, or the scarring of the liver tissue, which will lead to liver failure. Chronic alcohol use leads to elevated blood pressure, weakens the heart muscle, leads to irregular heartbeats that can cause heart failure and increases the risk of having a stroke. Alcohol causes inflammation of the stomach lining, leading to pain and nausea, as well as pancreatitis, which can be acute or chronic and life-threatening. Chronic alcohol use leads to esophageal varices or swollen veins in the esophagus due to liver cirrhosis causing severe bleeding, hormone imbalances, including those related to stress (cortisol) and reproductive health (testosterone and estrogen). Alcohol disrupts glucose metabolism, which increases the risk of Type 2 diabetes, causes immunosuppression (weakens the immune system), and makes individuals more susceptible to infections and illness. Additionally, alcohol can lead to systemic inflammation, which is linked to countless health issues, including a host of mental health issues such as Major Depression, Anxiety, and Fibromyalgia. It also puts someone at an increased risk of pneumonia, impairs the immune response in the lungs, and is linked to sleep apnea. Not to mention, alcohol abuse increases your risk of developing a host of cancers.
#7 Most Who Are Addicted to Alcohol Can’t Return to Normal Drinking
There are many reasons why those with an alcohol addiction find it very tough to return to alcohol use safely, even after long periods of abstinence. All of which are physiological, or because of brain chemistry!
First, an alcohol addiction changes the behavior of cells in the brain, which is what compels someone to go back to drinking regardless of the consequences. This speaks to the hijacking of the brain that takes place with all addictions. Despite the way in which pop culture depicts dopamine, as the pleasure neurotransmitter, in actuality, dopamine is the motivation neurotransmitter. Dopamine is what causes the ‘craving state’ and is the reason why one drink never feels like enough, and those who do stop (i.e., “dry January”), don’t stay stopped.
Tragically, when someone becomes addicted, the body does not forget it! Alcohol is a powerful, explosive-like, experience to the body. Just like we wouldn’t expect to forget someone we love, someone who has left their mark on us, you can’t forget alcohol either. This means not long after you start drinking again, the body will likely return to processing the alcohol in the same way as it did before.
Think about addiction as similar to a trauma response. For example, those who have been in active combat have experiences so intense, so jarring to the nervous system, that a strong imprint, or memory, is left behind. This ‘sensory encoding’ happens, in part, to ensure that we survive in the face of similar threats in the future. So that if the brain gets wind of similar sensory cues again, it can make quick decisions that will keep you alive. It does not matter to the brain if this happens two weeks, or thirty-years later. It simply, never forgets.
You can learn more about alcohol, drugs, addiction, or how to help those you love recover, here.
References
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787
Cleveland Clinic (2024, Feb 15). What Does Alcohol Do to Your Body? 9 Ways Alcohol Affects Your Health. Cleveland Clinic.https://health.clevelandclinic.org/effects-of-alcohol
National Highway Traffic Safety Administration (NHTSA) (2021). Traffic Safety Facts: Alcohol-Impaired Driving. Retrieved from [NHTSA] (https://crashstats.nhtsa.dot.gov/)
National Institute on Drug Abuse (NIDA) (2024). Commonly Used Drug Charts. https://nida.nih.gov/research-topics/commonly-used-drugs-charts.
National Institute on Alcohol Abuse and Alcoholism (2024). Alcohol effects on health. NIAAA.
National Institute on Alcohol Abuse and Alcoholism (NIDA) (2016, Nov). Surgeon General Issues Landmark Report on Alcohol, Drugs and Health. https://www.niaaa.nih.gov/news-events/announcement/surgeon-general-issues-landmark-report-alcohol-drugs-and-health#:~:text=A%20new%20Surgeon%20General's%20report,suffer%20from%20substance%20use%20disorders.
Public Broadcast Network (2024, Jan). Rise in alcohol deaths. PBS. https://www.pbs.org/video/america-addicted-1706138187/
Saunders, H., Rudowitz, R. (2024, May 23). A look at the latest alcohol death data and change over the last decade. KFF. https://www.kff.org/mental-health/issue-brief/a-look-at-the-latest-alcohol-death-data-and-change-over-the-last-decade/
Taylor, B., & Rehm, J. (2012). The relationship between alcohol consumption and fatal motor vehicle injury: high risk at low alcohol levels. Alcoholism, clinical and experimental research, 36(10), 1827–1834. https://doi.org/10.1111/j.1530-0277.2012.01785.x
World Health Organization. (2024, June). Over 3 million annual deaths due to alcohol and drug use, majority among men.WHO. https://www.who.int/news/item/25-06-2024-over-3-million-annual-deaths-due-to-alcohol-and-drug-use-majority-among-men#:~:text=A%20new%20report%20from%20the,attributable%20deaths%20were%20among%20men.
