Alcoholism: signs, symptoms and treatment

What is alcoholism?

Alcoholism is a term used to describe the most serious form of high-risk drinking, with a strong, often uncontrollable, desire to drink. It means drinking at a level that causes harm to your health.¹ Being dependent on alcohol means a person feels they’re not able to function or survive without it, and that drinking is an important, or sometimes the most important, factor in their life.²

Although it isn’t a term that is used anymore as part of medical care, some people who are recovering from alcohol dependence still use the term ‘alcoholic’ to describe themselves. Alcoholism is also known as alcohol addiction, alcohol misuse or alcohol dependence. 

Medically, it’s recognised as a type of ‘alcohol-use disorder’ which can be treated.³ It’s different to ‘harmful drinking’ (another type of alcohol-use disorder) which is a pattern of heavy drinking which causes damage to your health but without actual dependence.⁴

People who are becoming dependent on alcohol notice they need to drink more to get the same effect.⁵ They often give priority to drinking over other activities or obligations (such as work or family life), or continue drinking despite harmful consequences - for example, liver disease or depression caused by drinking.⁶ Alcohol dependence also causes physical withdrawal symptoms when you stop drinking.⁷

The UK Chief Medical Officers’ low risk drinking guidelines advise it is safest to drink no more than 14 units a week, have several drink-free days and never binge drink.

What are the signs or symptoms of alcoholism?

It can be tricky to spot the signs of alcohol dependence. People with an alcohol use disorder can feel ashamed about their drinking and may get upset if confronted. If you are worried about someone else's drinking it is important to choose the right moment to talk to them about it, and make sure you're both in a calm mood.

Common symptoms can inlcude:

• Drinking more, or for longer, than intended
• Finding it hard to cut down or stop drinking
• Needing to drink more to feel the same effects (increased tolerance)
• Feeling unwell when not drinking, such as sweating, shaking, nausea or anxiety
• Spending a lot of time thinking about alcohol, drinking, or recovering from drinking
• Drinking becoming a priority over work, relationships or other responsibilities
• Continuing to drink despite it causing problems with health, finances or relationships
• Hiding or downplaying how much you drink, or drinking in secret
• Feeling guilt, shame or regret about drinking
• Using alcohol to cope with stress, low mood, or emotions¹³

Doctors assess whether someone is dependent on alcohol by looking for signs that show they can’t regulate their drinking, and that they have a strong urge to drink alcohol. The specific symptoms they look for are:⁸

• Impaired control over alcohol use
  This might mean not being able to control how long a drinking session is, how much alcohol you consume when you do drink, how frequently you drink, being unable to stop drinking once you start, or drinking on inappropriate occasions or at inappropriate places.
• Giving increasing priority to alcohol
  If you give precedence to drinking over other daily activities and responsibilities, if drinking is more important to you than looking after your health, or you carry on drinking despite negative consequences for your health or life.
• Unwanted physical or mental effects from drinking
  Showing signs of increased tolerance to alcohol (having to drink more for the same effect), experiencing withdrawal symptoms, or using alcohol to prevent or alleviate withdrawal symptoms.

A doctor may diagnose alcohol dependence when they see two or more of the above symptoms based on an ongoing pattern of how you consume alcohol. Usually this is based on behaviour over the last 12 months or more, but alcohol dependence could be diagnosed based on continuous (daily or almost daily) for at least one month.^9,10 If you think you may be drinking too much, or that your drinking is beginning to have a damaging effect on your life, we have a quick online self-assessment that can help you understand if there is cause for concern.

Take the Drinking Check 

How much alcohol is too much?

There’s no risk-free level of drinking, but UK health guidelines are designed to help keep the risks as low as possible. 

​​The Chief Medical Officers’ low-risk drinking guidelines advise that, to reduce the risk of alcohol-related harm: 

• Adults should drink no more than 14 units of alcohol a week, both men and women
• It’s best to spread drinking across three or more days
• Having several drink-free days each week can help your body recover 

Drinking more than these guidelines can increase the risk of long-term health problems, including liver disease, heart problems, mental health issues, and alcohol dependence. 

Everyone’s relationship with alcohol is different, and how alcohol affects you can depend on factors like your health, age, weight, and life circumstances.

Treating alcoholism

If you think you might be alcohol dependent, either your GP surgery or a local self-referral alcohol or substance use support service should be your first port of call. For many people, it can be hard to discuss your drinking with anyone. If, for any reason, you feel nervous discussing your drinking with a health professional, you might like to take someone along with you. You can also ask for a telephone appointment.

A health professional at your GP surgery can give you confidential advice on how to access the right support for you. They can also advise on whether that service is open to self-referral or if you need to be referred into the service. 

Find out more about alcohol withdrawal symptoms

Ongoing treatment options can include:¹¹

• Detoxification (also known as ‘detox’) can be a key stage of treatment. Detox involves stopping drinking completely, whilst under medical supervision, so that the body can adjust to being without alcohol. This may require treatment with medication (e.g. a tranquiliser called chlordiazepoxide). During this time, a person may experience alcohol withdrawal symptoms
• Cognitive Behavioural Therapy (CBT) can be offered to help change negative thought patterns which may lead to drinking
• Self-help groups such as Alcoholics Anonymous - many people who are alcohol dependent find it useful to attend self-help groups. They can help people adjust their thinking and attitudes to themselves and others
• Pharmacological treatments (i.e. medications) can also have a role in preventing relapse for some people who are trying to abstain

What should I do if I think someone is dependent on alcohol?

If you think someone close to you is showing signs of alcohol dependence, it can be difficult to know what to do. You might feel worried about them, frustrated that they don’t seem to want help or frightened for them or even by them. All of these feelings are normal and there is help out there both for people who are dependent on alcohol and their loved ones.

If you can, talk honestly with the person you’re concerned about, and try to persuade them to see a doctor. It can be very difficult for people who are dependent on alcohol to admit they have a problem but listening, being supportive, patient, open and non-judgemental can make them feel safe.

If you accompany someone to an appointment, support them to get information that is simple and easy for them to understand. For example, what are the long-term health risks of being alcohol dependent and what support is available to them.

Ask how you can best support them. Be ready with as much information as possible so you can offer advice on how to seek professional help. 

A loved one’s drinking can have a negative impact on your own health. You may feel some anxiety and stress, blame yourself or feel unable to cope. It can help to talk to someone you trust, who is unaffected by the situation – whether that’s a friend, relative or confidential support line.

How to help someone else

Frequently asked questions on alcoholism