Drinking too much alcohol can cause serious health problems, including liver disease, high blood pressure, stomach ulcers, heart failure, mental illness, and relationship problems. It can also lead to legal problems and death, especially when driving or mixing alcohol with medications or other drugs.

Treatment for alcohol abuse includes counseling and support groups. There are also three medicines approved by the FDA to help people stop drinking: naltrexone (Vivitrol), acamprosate, and disulfiram.

Causes

There is no one-size-fits-all explanation for alcohol abuse, but a combination of factors often contributes. Genetics and physiology play a role; people with family members who struggle with alcoholism are at higher risk. People who have certain psychological traits, such as impulsivity or low self-esteem, may be more likely to drink excessively. Social influences, such as peer pressure, can also prompt drinking. For example, heavy drinking is common among students at university; a student’s drinking can be reinforced by other students and the culture around campus bars and fresher’s week.

Drinking heavily can cause a variety of health problems, such as heart disease and damage to the liver. It can also lead to depression, anxiety and other mental health conditions. Some people drink to cope with these conditions and find that they can become dependent on alcohol in order to relieve their symptoms. This is called a dual diagnosis and can be dangerous when left untreated.

Symptoms

People drink socially or as a way to relax, but alcohol abuse is problematic when it becomes excessive. If you find that drinking is interfering with your work, family or social life, is making you feel depressed or anxious or is adding to a health problem, it is time to talk with your health care provider.

Long-term alcohol use can cause damage to the liver, brain and other organs. Your health care provider will ask questions about your drinking habits and may order lab tests or imaging scans to check for signs of damage.

If you have a drinking problem, your doctor will probably recommend treatment. This can include counseling or mutual-support groups, and it may include medications to help you stop or reduce your drinking, such as naltrexone (oral and long-acting), acamprosate, and disulfiram. These drugs can cause unpleasant or dangerous withdrawal symptoms if you suddenly stop or cut down your drinking, so it is best to take them under medical supervision in a hospital-based program.

Treatment

There are a number of treatments available to help people with alcohol use disorder. These may include counseling, which can help people change their thinking patterns and develop skills to stop drinking. Family therapy is often part of treatment, as people's drinking can have a direct impact on their relationships.

Medications are also an option. Three medications are approved by the FDA to help people control cravings and reduce heavy drinking: naltrexone (oral Depade or long-acting injectable Vivitrol), acamprosate (Campral) and disulfiram (Antabuse). Medications can be used alone or with counseling.

Other therapies that are helpful in reducing alcohol abuse include cognitive-behavioral therapy, which helps people identify and change unhelpful thoughts and behaviors; and stress management techniques like yoga, meditation and acupuncture. Some people who have a serious alcohol problem may choose to live in a residential rehabilitation facility, which is more structured than standard outpatient treatment. These facilities typically offer around-the-clock care and prepare patients for life after treatment.

Prevention

The primary prevention of alcohol abuse involves awareness, education and discussion with a health care provider. Health professionals should discuss a person’s risk factors, such as genetic makeup and family history, and the broader social and cultural environment that affects a person’s likelihood of misusing alcohol or suffering from its adverse effects.

Binge drinking and heavy drinking increase a drinker’s risk of developing an alcohol use disorder, and they are also linked to many other physical and mental health problems. Alcohol is also a leading cause of fetal alcohol spectrum disorders (FASD), which can have devastating long term effects on the brain and body.

Harm reduction programs encourage at-risk individuals to minimize or stop their drug and alcohol use by providing safe and nonjudgmental services for connection. They also provide support and recovery skills to sustain abstinence. Communities should work to create social and physical environments that discourage excessive alcohol consumption, and implement evidence-based community strategies for reducing it.