If alcohol abuse progresses to an alcohol use disorder, a person will begin to show physical, behavioral and emotional symptoms and other signs of an alcoholic.

Alcohol use disorder is rampant. It affects tens of millions of adults in the U.S. each year. Yet the signs of alcoholism or alcohol use disorder can be difficult to detect. People with alcohol use disorder may attempt to hide their symptoms or deny having a drinking problem. After all, 54.9% of American adults drink within any given month, so alcohol use is normalized.

Given the widespread use of alcohol, it can be challenging to determine who is struggling with an alcohol use disorder and who is simply a social drinker. Experiencing cravings, withdrawal symptoms and negative social or physical consequences because of alcohol use are signs of an alcohol use disorder and should not be ignored. Understanding the symptoms of alcoholism can help people identify an alcohol problem and know when to get professional addiction treatment.

Alcohol Abuse vs. Alcoholism

Alcoholism is a colloquial term for alcohol addiction. The politically correct diagnostic term for alcohol addiction is alcohol use disorder, which refers to a legitimate medical condition in which people cannot control their drinking. People with alcohol use disorder continue to drink despite harmful consequences and may be unable to stop drinking on their own. This disorder carries several significant side effects and symptoms that put those with alcohol use disorder at particular risk of harm. Alcohol use disorder can also have devastating consequences for people around them.

So, what is the difference between alcohol abuse vs. alcoholism or an alcohol use disorder? Alcohol use disorder is a serious illness. It is not simply a matter of willpower and should not be taken lightly. Most people with alcohol use disorder need professional treatment services to recover.

Alcohol abuse may lead to an alcohol use disorder, but alcohol abuse does not mean a person has an alcohol addiction. Binge drinking, which is defined as five or more drinks on a single occasion for a man and four or more drinks on a single occasion for a woman, is a form of alcohol abuse. Heavy alcohol use, defined as more than four drinks in a single day or 14 in a week for a man, and more than three drinks in a single day or seven in a week for a woman, also constitutes alcohol abuse.

Abusing alcohol does not necessarily mean a person has an alcohol use disorder. People may misuse alcohol but not meet the diagnostic criteria for an alcohol use disorder. What differentiates alcohol abuse vs. alcohol use disorder is people who abuse alcohol maintain a degree of control over their drinking. This means they can refrain from drinking when they desire to and do not experience significant consequences. On the other hand, if alcohol abuse progresses to an alcohol use disorder, a person will continue drinking despite significant consequences and have difficulty cutting back or controlling their drinking.

Signs and Symptoms of Alcohol Abuse

What are the signs of alcohol abuse? The symptoms may differ slightly between teens and adults because alcohol consumption is legal and normalized for adults.

Common signs of alcohol abuse in adults include:

• Repeated episodes of binge drinking (a man consuming five or more drinks in one sitting or a woman consuming four or more drinks in a sitting)
• Consuming large amounts of alcohol throughout the week (more than seven drinks in a week for a woman, or more than 14 in a week for a man)
• Using alcohol as a primary coping mechanism for stress
• Being unable to socialize without alcohol
• Using alcohol to relax or fall asleep each night
• Frequently consuming more than what is considered drinking in moderation (up to two drinks daily for a man or up to one drink per day for a woman)

Since alcohol misuse can begin interfering with workplace functioning and safety, it is important to identify signs of alcohol abuse in the workplace. Some signs of alcohol abuse in employees include:

• Appearing hungover at work
• Sudden decline in work performance (decreased productivity, sloppy performance, missing deadlines)
• Increase in tardiness or absenteeism from work
• Frequent or increased workplace accidents or injuries
• Being absent on Mondays or Fridays or having a sudden increase in the need to miss work for “family emergencies”
• Strained relationships with coworkers and supervisors.

There is no safe level of alcohol consumption for teens, as drinking is illegal for this age group. The teenage years are also a critical period for brain development, and this age group is more sensitive to the sedative effects and memory disruptions resulting from alcohol consumption. Alcohol misuse is particularly dangerous for teens because it can disturb brain development.

Some signs of alcohol abuse in teens include:

• Becoming less concerned with their appearance
• A sudden change in friend groups
• Receiving lower grades or developing apathy toward school-related activities
• Poor school attendance
• No longer respecting rules or boundaries at home, school or the workplace
• Changes in appetite
• Changes in sleep habits
• Increased conflict with family or friends

Alcoholism Signs and Symptoms

If alcohol abuse progresses to an alcohol use disorder, a person will begin to show symptoms, signs and side effects related to ongoing alcohol misuse.

Warning Signs of Alcoholism

Some classic warning signs of an alcohol use disorder can include:

• Drinking more or for longer than intended
• Repeated, unsuccessful attempts to cut down or stop drinking
• Alcohol use interferes with other hobbies or activities.
• Alcohol use continues despite harmful physical or social consequences, such as health problems or relationship conflicts resulting from alcohol misuse.
• Excessive time is spent drinking, seeking alcohol or recovering from alcohol’s effects.
• Experiencing alcohol cravings or an intense desire to drink
• Withdrawal symptoms if alcohol use is suddenly stopped

While not a comprehensive list, these signs are listed in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders as the defining criteria of an alcohol use disorder. Experiencing more than one symptom indicates that a person has an alcohol use disorder and needs specialized treatment to recover.

See Related: Signs You Need Rehab

Physical Symptoms of Alcoholism

Once a person develops an alcohol use disorder, they are at risk of physical side effects and health problems associated with heavy drinking. Some of the long-term physical symptoms that develop with alcohol misuse and alcohol use disorder include:

• Alcohol-related liver disease
• Increased cancer risk
• Higher risk of heart disease, high blood pressure and stroke
• Weakened immune system
• Digestive system problems

Over the short term, alcohol abuse can increase the risk of injuries, violence, sexual assault, unprotected sex, sexually transmitted infections and alcohol poisoning. 

Behavioral Signs and Symptoms of Alcoholism

A person under the influence of alcohol will demonstrate certain behavioral signs and symptoms. While not necessarily an indication of an alcohol use disorder, if a person frequently shows these behavioral signs, they are likely engaging in a dangerous level of drinking:

• Lowered inhibitions
• Difficulty with memory and concentration
• Slurred speech
• Motor skills impairment
• Confusion
• Difficulty learning and/or poor performance at school

Emotional Symptoms of Alcoholism

Alcohol use disorder can also increase the risk of emotional and mental health problems. Some emotional side effects of alcohol misuse can include:

• Developing mental health problems like depression and anxiety
• Difficulty regulating emotions
• Increased risk of psychosis
• Lack of motivation

Am I an Alcoholic?

Only a professional, such as a physician, psychologist or clinical social worker, should diagnose an alcohol use disorder. Still, some self-assessment tools can help determine if you may show signs of alcohol use disorder. If you have two or more of the following symptoms, you may meet the criteria for an alcohol use disorder:

• Using more significant amounts of alcohol than intended
• Wanting to cut back on drinking but being unsuccessful
• Experiencing intense alcohol cravings
• Continuing to drink, even when it causes relationship problems, like conflict about your alcohol use
• Drinking even when it causes a health problem or makes an existing health condition worse
• Being unable to fulfill duties at work or home because of alcohol use
• Giving up other hobbies or activities because of drinking
• Having a tolerance for alcohol, so greater amounts are needed to achieve the same desired effects
• Experiencing withdrawal symptoms like nausea, sweating or shakiness when not drinking
• Spending significant amounts of time drinking or recovering from drinking
• Repeatedly drinking in dangerous situations, such as driving while under the influence or becoming injured because of drinking

Alcohol Addiction Self-assessments

If you read the warning signs of alcohol use disorder and wonder, “Am I an alcoholic?” a few resources can help determine whether your drinking has exceeded moderate levels. These psychological tools have been empirically validated through countless studies and are available for free on the Internet. They include:

• The CAGE Questionnaire: is a quick screening tool that asks four questions. While simple, these four questions can assess symptoms effectively.
• The Alcohol Use Disorders Identification Test (AUDIT): is the world’s most frequently used alcohol screening tool. It includes tallying the responses to 10 questions to show whether the presence of alcohol use disorder is likely.
• The T-ACE: is a four-question test based on the CAGE that assesses specifically for prenatal alcohol misuse. It asks questions about tolerance and other factors linked to addiction. A score of two or higher indicates problem drinking, and having a tolerance to more than two drinks is worth two points.

These assessments are helpful tools, but when you’re asking yourself whether you have a drinking problem, it’s likely time to reach out for help. Follow up with a doctor or addiction treatment professional for a full assessment and diagnosis.

FAQs About Alcoholism

The following questions provide additional information about alcohol use disorders.

Is Alcoholism Genetic?

Alcoholism is partly a genetic disorder. The high rates of alcohol use disorder present in children of people who have alcohol use disorders hint at the connection, but researchers have investigated the genetic components of alcoholism even further. Looking at identical and fraternal twins and siblings adopted into different families, researchers concluded that alcohol use disorder was approximately 50% heritable, meaning about half of the risk of an alcohol use disorder can be attributed to genetics.

Remember that genetics is by no means a guarantee. Many other factors play into the development of an alcohol use disorder. However, having a parent with alcohol use disorder is a risk factor that may make a person more likely to develop the condition themselves.

Is Alcoholism a Disease?

Major medical organizations, such as the American Hospital Association, the National Association of Social Workers and the American College of Physicians, consider alcoholism a disease. The National Institute on Alcohol Abuse and Alcoholism has also labeled alcohol use disorder a medical condition.

The disease model of alcoholism states that alcohol use disorder is a chronic, relapsing brain disease. Support for this model comes from the fact that prolonged alcohol use results in structural changes in the brain. These brain changes occur primarily in the brain’s reward network, associated with repeated behaviors, learning and a sense of pleasure. After these changes have occurred, it becomes much harder for people to stop drinking independently.

Getting Help

When you’ve decided you need help, the next step is to find professionals with the skills and knowledge required to aid you in your path to recovery. The best treatment for alcohol use disorder occurs across several levels of care, including medical detox, residential treatment and outpatient services. Many people begin with a medical detox program to help them cope with withdrawal symptoms, and reaching out for help during this time is an important first step. After medical detox, you’ll transition to an ongoing treatment program, which may occur on a residential or outpatient basis.