Signs and Symptoms of Alcoholism – How to Know if Someone Has a Drinking Problem

Medically Reviewed by
Nzinga Harrison, MD
March 31, 2023

Throughout history, alcohol has played a significant role in different cultures around the world. Alcohol is used by people as a way to relax, bond, celebrate, and socialize. In the United States, it’s common for adults to have a drink with friends on the weekends, at weddings and parties, or as a way to unwind from work.

Alcohol’s effects vary from person to person and depend on a variety of factors, such as:

  • Number of alcoholic drinks consumed
  • How often alcohol is consumed
  • Age
  • The general state of health

  • Family history

What is Alcohol Use Disorder (AUD)?

For many people, alcohol has a strong effect but when consumed in a moderate amount, it is not unhealthy or dangerous. Over time though, excessive drinking can develop into alcohol use disorder (AUD), or more commonly known as alcoholism. AUD is characterized by cravings, physical and emotional dependence on alcohol, uncontrollable alcohol use, and negative emotions when not drinking. According to the National Institute on Alcoholism and Alcohol Abuse (NIAAA), an estimated 15 million people in the United States have AUD.

AUD is a chronic, relapsing brain disorder that can lead to significant health problems, including liver damage, depression, high blood pressure, heart failure, and certain types of cancers. It can also result in negative life consequences, such as strained relationships with loved ones, job loss, and arrests or jail time. In this article, we’ll explore how to identify the signs and symptoms of alcoholism.

Early Signs of a Drinking Problem

Despite what movies and television shows portray, it’s not always easy to tell if someone has a problem with drinking. A person with alcoholism might not hang out in a bar all day or fall down after they’ve been drinking heavily. Some people seem fine and functional in their daily lives despite their alcohol addiction.

One of the early signs is a pattern of excessive drinking. This pattern includes both binge drinking and heavy drinking. Binge drinking is defined as consuming five or more drinks for men and four or more drinks for women within two hours. Heavy drinking is 15 or more drinks per week for men and eight or more drinks per week for women. While drinking excessively from time to time doesn’t mean someone has an alcohol addiction, it does increase the risk of developing AUD. Other early signs include:

  • Frequent intoxication
  • Blacking out while drinking
  • Becoming violent or angry when drinking
  • Drinking in risky or dangerous situations, like driving or having unprotected sex

Physical Signs of a Drinking Problem

Excessive drinking and alcoholism also has a range of physical side effects, including:

  • The smell of alcohol on the breath that lingers for hours after heavy drinking
  • Weight loss from drinking instead of eating
  • Dry skin, brittle hair and nails, and an increased appearance of aging and wrinkles
  • Broken capillaries (small blood vessels) on face and nose
  • Yellow eyes and skin due to liver damage
  • Poor hygiene
The signs and symptoms of alcoholism

Symptoms of Alcoholism or Alcohol Use Disorder

The DMS lists 11 symptoms of Alcohol Use Disorder, including:

  • Frequently drinking a larger amount of alcohol or for longer than intended
  • Wanting to cut down or control drinking but not being able to stop
  • Spending a lot of time drinking and feeling sick from alcohol’s aftereffects
  • Experiencing strong cravings or urges to drink
  • Facing problems at home with family, work, or other commitments as a result of drinking or being sick from drinking
  • Continuing to drink even though it causes issues with loved ones
  • Giving up on interesting, important, or pleasurable activities to drink instead

  • Getting into repeated situations while or after drinking that increase the risk of getting injured or hurt (such as driving, swimming, using machinery, walking in a dangerous area, or having unsafe sex)
  • Continuing to drink despite feeling depressed or anxious, adding to another health problem, or after having had a memory blackout
  • Drinking much more to get the same effect or finding the usual number of drinks has become less effective than before
  • Experiencing withdrawal symptoms, such as trouble sleeping, shakiness, irritable moods, anxiety, depression, restlessness, nausea, or sweating after the alcohol wears off

If someone has at least two of these symptoms, they are considered to have AUD. The severity of AUD can range from mild to severe depending on the number of symptoms present:

  • Mild AUD: two to three symptoms
  • Moderate AUD: four to five symptoms
  • Severe AUD: six or more symptoms

It’s important to point out that even mild alcoholism can progress in severity, which is why seeking treatment early is important.

Seeking Treatment for Alcoholism

Depending on your specific goals and needs, there are many types of treatment programs and supportive resources available. Treatment may include:

  • Detox and withdrawal: Under medical supervision, your body can safely adjust to not drinking.
  • Medication for Addiction Treatment (MAT): Prescription drugs like Naltrexone and Vivitrol can reduce the urge to drink.
  • Counseling and therapy: Individual or group therapy sessions, or a combination of both, can help you manage your emotions in a private, judgment-free environment.
  • Support groups: These groups bring together individuals with AUD. Your fellow peers act as a support system for each other throughout recovery.
  • Treatment for other medical conditions: Medical services can manage and treat any of the short- and long-term health effects associated with AUD.
  • Treatment for mental or behavioral health needs: You can receive prescribed psychiatric medications for mental health issues, such as depression or anxiety, that occur at the same time as AUD.

Even though alcoholism is a complex and challenging disorder, it is treatable and manageable. With a treatment plan, the brain and body can heal, while providing the support needed to regain control, improve the quality of your life, and recover.

If your loved one needs help with alcohol addiction, contact us today. We are here to help you better understand your loved one and support them. Check out our eBook, “How to Help a Loved One Struggling with Substance Use Disorder,” for information on addiction and how to best help someone experiencing it while still caring for your own mental health.

If you need help with your substance use disorder, we are here to help you build your confidence and momentum towards the future you want. We provide treatment services for adults with alcohol, opioid, and other substance use disorders. We are currently located in Florida, Louisiana, Massachusetts, North Carolina, New Jersey, Ohio, Texas, and Washington.

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Nzinga Harrison, MD

Dr. Harrison serves as the Chief Medical Officer for Eleanor Health with more than 15 years experience practicing medicine. She is a double-board certified physician with specialties in general adult psychiatry and addiction medicine. Dr. Harrison has spent her career as a physician treating individuals from marginalized communities with substance use and other psychiatric disorders. As a physician executive, she has served as Senior Vice President and Chief Medical Officer roles committed to creating and improving systems-based delivery of psychiatric and substance abuse care. She is a vocal advocate for stigma reduction, and is passionate about the necessity for whole-person care as individuals and communities seek to recover from and prevent substance use disorders.

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