If you are reading this article, you are probably looking for information about what alcoholism is, either for yourself or for someone you love. Alcoholism is a problem that receives far too little public attention compared to the level of suffering it causes, both directly and indirectly. In this article and in the ones that follow, we will try to provide you with as much relevant, verified, and objective information as possible.
Alcoholism, also known as alcohol use disorder (AUD), is a chronic, relapsing disorder characterized by the inability to control or stop alcohol use despite its harmful consequences. AUD is one of the most common and harmful addictions, affecting countless millions of people around the world.
The effects of alcoholism spread through families, workplaces, and communities, causing emotional, physical, and financial wounds. In this first article, we will explore the nature of alcoholism as a disorder, its effects on the brain and body, and why it is much more than “drinking too much.”
Understanding alcoholism as a disorder is essential in order to break down the stigma surrounding it and to encourage people to seek help.
Alcoholism as a disorder: what does it mean?
Alcoholism is a disorder because it disrupts the normal functioning of the brain and body.
In medical terms, a disorder is defined as a disruption of normal physical or mental functions, and alcoholism, or AUD, fits this definition very well. People who suffer from AUD experience changes in the structure and function of the brain, which makes it difficult to control alcohol use, even when they want to. Loss of control is a hallmark of addiction and one of the key reasons why alcoholism is classified as a disorder by doctors and psychiatrists.
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) of the American Psychiatric Association, AUD is diagnosed when a person meets a specific set of criteria related to their behavior around alcohol use.
These criteria include the inability to cut down on drinking, spending excessive time drinking alcohol or recovering from its effects, and continuing to drink even when it causes problems in relationships or at work. AUD ranges in severity from mild to severe, depending on the number of criteria met. This classification describes severity at assessment; it does not mean everyone passes through the same stages or that worsening is inevitable. NIAAA explains AUD assessment and severity.
Read the infographic explanation
Alcohol addiction: how the cycle is maintained
An explanatory model, especially for moderate and severe forms. You can enter at any phase. Arrows do not show a timetable.
The cycle
Heavy drinking and intoxication. Immediate reward may reinforce repetition and habit formation.
Discomfort and withdrawal. Stress and discomfort may encourage use for temporary relief.
Craving and anticipation. Cues associated with alcohol may trigger craving; control may become harder.
The phases can reinforce each other.
Reward, stress and decisions are involved in this model.
Possible connections
Repeated use may build associations with places and times; these cues may trigger craving.
Discomfort may encourage use for temporary relief; the cycle may continue.
Impaired control of decisions may make delaying use harder and contribute to returning to use.
Severity
Mild, moderate and severe.
Mild does not mean risk-free. Severity is assessed medically. These categories are not phases of the cycle, mandatory steps or a self-test.
You can seek medical assessment before things worsen.
Individual paths differ. Progression does not mean inevitable deterioration.
Medical help and emergencies
If you have been drinking heavily for a long time, stopping suddenly can cause life-threatening withdrawal. Talk to a doctor before you change how much you drink. Confusion, hallucinations or seizures are emergency signs: call 112 immediately. Do not wait for an appointment or a reply from a community programme. The emergency number here is for readers in Romania.
Sources
The brain and alcoholism: how alcohol hijacks the brain’s reward system
Alcoholism begins in the brain. Normally, the brain’s reward system motivates behaviors that are essential for survival, such as eating and socializing. When you engage in these activities, the brain releases dopamine, a neurotransmitter associated with pleasure and reward. Alcohol, like other addictive substances, hijacks this reward system, artificially increasing dopamine levels in order to create feelings of euphoria. This intense pleasure becomes something the brain begins to crave, and over time, it starts to prioritize alcohol over healthy activities.
One of the main areas of the brain affected by alcohol is the prefrontal cortex, which is responsible for decision-making, impulse control, and self-regulation. Alcohol impairs the functioning of this region, making it difficult for people with AUD to make rational decisions about their drinking. Even when they recognize that drinking is harmful, their ability to control the impulse to drink is severely compromised.
In addition, chronic alcohol use damages the limbic system, the part of the brain involved in emotion and memory. This damage can lead to mood changes, emotional instability, and difficulty forming new memories. Alcohol-related memory gaps, called blackouts, can occur: a person may be awake and acting without later remembering some events. A blackout is different from losing consciousness and does not establish AUD on its own. NIAAA explains this distinction.
As a result of these changes in the brain, people with AUD may find themselves trapped in a vicious cycle: drinking makes them feel good in the short term, but over time, it worsens their ability to function and cope with life’s challenges. This cycle is what makes AUD a chronic, relapsing disorder.
Tolerance and alcohol dependence: physical changes in the body
Over time, as someone drinks more and more alcohol, their body develops tolerance — the need to consume increasing amounts of alcohol in order to achieve the same effect. This means that someone who once felt intoxicated after a few drinks will now need much larger amounts of alcohol to feel the same euphoria. Tolerance is one of the first signs that a person’s alcohol use is becoming problematic and can often lead to increased drinking and much more serious consequences over time.
Alongside tolerance, dependence develops when the body begins to rely on alcohol in order to function normally. This physical dependence is marked by withdrawal symptoms when alcohol use is reduced or stopped. Common withdrawal symptoms include anxiety, irritability, sweating, nausea, tremors, and, in severe cases, seizures. The severity of withdrawal can vary, but in some cases it can be life-threatening. Fear of these unpleasant symptoms often drives people to continue drinking, even when they desperately want to stop.
One of the most dangerous effects of long-term alcohol use is alcohol withdrawal syndrome, which can occur when a person suddenly stops drinking after prolonged heavy use. Severe withdrawal can lead to delirium tremens (DTs), a condition characterized by confusion, hallucinations, and high blood pressure. Without medical intervention, DTs can be fatal. This is why medically supervised detoxification is often necessary for those with severe alcohol dependence.
