According to the NHS, alcohol misuse means drinking excessively, which is more than the lower-risk limits of alcohol consumption. Alcohol consumption is measured in units, where a unit is 10ml of pure alcohol. A Unit is equivalent to a half a pint of lower to normal-strength lager/beer/cider (ABV 3.6%) or a single small shot measure (25ml) of spirits (25ml, ABV 40%). A small glass (125ml) of wine contains about 1.5 units of alcohol.
You are likely to be misusing alcohol if you:
- Regularly or frequently (most of the weeks) drink more than 14 units of alcohol a week
- Regularly or frequently drink as much as 14 units a week on a weekend
- Do not have any alcohol-free days
Alcohol misuse in itself is not a mental illness, however, people often use alcohol to cope with difficult feelings, situations or memories, such as grief, stress, the break-up of a relationship or childhood abuse. In clinical practice, we often find that people are unaware that they use alcohol to control their emotions. If the emotional problems are not addressed in a more helpful way, alcohol abuse could develop into a mental illness like alcoholism, such as depression, anxiety or post-traumatic stress disorder (PTSD). Although in the short-term alcohol can take ‘the edge off’ things, drinking excessively for a long time can lead to alcoholism, create significant problems at work and with close relationships, and make your mental health worse.
There are a number of causes of alcohol misuse and it usually is a mix of various factors that can lead to someone developing alcohol problems. These include:
- Mental health problems or emotional difficulties, such as depression, anxiety, bipolar disorder.
- High levels of stress.
- Having low self-esteem or self-worth.
- Difficulties in your personal and work life.
- Personality factors, such as being extremely shy, being someone who pursues or disregards risk (risk-taker), or someone who is less inhibited.
- A long history of using alcohol or drinking a lot of alcohol – alcohol rewires the brain so that you crave it and start depending on it.
- Genes – if your biological parents have been alcoholics, you are also more likely to develop alcohol problems.
- Environment – if heavy drinking is widely accepted within your family and your social circle, or you live in a country that alcohol is cheap and easy to buy.
- Age – starting to drink in your teens.
You don’t have to drink uncontrollably to have a problem with your drinking. Even if you are misusing alcohol, you probably still have some ability to set limits on your drinking. However, even with these put in place, your alcohol use is likely to be self-destructive and dangerous to you and those around you. Some of the most common symptoms of alcohol misuse include:
- Repeatedly neglecting your responsibilities at home, work, or school because of your drinking. For example, doing poorly at work, missing classes or appointments, or neglecting your children because you are drunk or hangover.
- Using alcohol in situations where it is physically dangerous, such as drinking and driving.
- Experiencing repeated legal problems on account of your drinking. For example, getting arrested for driving under the influence or for drunk and disorderly conduct.
- You are worried about your drinking and feel you should cut down on it.
- Other people have been suggesting that you drink too much.
- You feel guilty or bad about your drinking.
- You need a drink first thing in the morning to ‘steady your nerves’ or get rid of a hangover.
There are a number of treatments available to help you stop or reduce drinking. These range from short- to long-term psychotherapy and depend on the severity of your drinking problems. Below is a list of the most common treatments:
- Talking therapies, such as Cognitive Behavioural Therapy (CBT) where the focus is on how your thoughts and beliefs about alcohol impact on your drinking behaviours. CBT can also help you identify triggers to your drinking.
- Brief Interventions (BI) lasts about 5 to 10 minutes and covers risks associated with your pattern of drinking, advice about reducing the amount you drink, alcohol support networks available to you, and any emotional issues around your drinking. This is typically the type of intervention one can get from an informed GP. You may also be asked to keep a ‘Drinking Diary’.
- Family Therapy provides family members with the opportunity to learn about the nature of alcohol dependence and how best to support the member of the family who is trying to abstain from alcohol.
- Drinking Diary is aimed at those who try to moderate their drinking.
- Self-help, including online resources, support groups like Alcoholics Anonymous.
- Medication is recommended for those who are diagnosed as having moderate and severe alcohol dependence and are undergoing detoxification (detox), a gradual and carefully planned withdrawal from alcohol. However, medication can also be offered to someone with mild alcohol problem if talking therapy on its own is not helpful.
Yes, many people have recovered from alcohol misuse. However, recovering from alcohol misuse often involves changes in lifestyle and accepting a life without alcohol.