Alcohol isn’t harmful in and of itself, but when used to excess, it can cause physical and psychological distress. When a person can’t control their drinking and suffers professional, social, or health consequences because of it, they may be diagnosed with a condition known as alcohol use disorder (AUD).

The more familiar term “alcoholism” may be used to describe a severe form of AUD, but physicians, researchers, and others in the medical community tend not to use the word.

Causes and Risk Factors of Alcohol Use Disorder

Genetic, psychological, social, and environmental factors all play a role in a person’s risk for alcohol abuse.
Genes may account for as much as half of the risk for AUDs, according to the National Institute on Alcohol Abuse and Alcoholism (NIAAA).

Other factors that may play a role in the development of AUD include:

  • History of emotional or other trauma
  • Mental illnesses and mood disorders, including anxiety, depression, bipolar disorder, or schizophrenia
  • Social and cultural pressure, including having a partner who drinks regularly (or a parent who does, for adolescents)
  • Starting to drink — especially to binge drink — at an early age
  • Regularly drinking too much over a long period of time
  • Personality disorders, including antisocial personality disorder and borderline personality disorder

Duration of Alcohol Use Disorder

Excessive drinking or an alcohol use disorder can be successfully managed with treatments such as therapy and medication, to help you to modify your behaviors and help your brain adapt to the absence of alcohol.

Between 40 and 60 percent of people with a substance abuse problem relapse, or return to alcohol, after attempting to stop.

Relapsing doesn’t mean that treatment has failed, though — it takes time to change behavior. You can work with a health professional to try new treatments that may work better for you.

Receiving treatment improves your chances of recovering from AUD.

Complications of Alcohol Use Disorder

Drinking heavily over long periods of time may lead to changes in how the brain functions, from memory slips to more debilitating conditions. The impact depends on when a person started drinking, how long they’ve been drinking, and how often and how much they drink.

Other neurological issues from long-term alcohol abuse can include short-term memory loss, disordered thinking, and dementia. In a five-year longitudinal French study of more than 31 million people, published in March 2018 in Lancet Public Health, researchers found that 56.6 percent of individuals with dementia had an alcohol use disorder noted in their medical history.
According to the NIAAA, up to 80 percent of people with AUD have a deficiency in thiamine, which can cause Wernicke-Korsakoff syndrome.

Wernicke-Korsakoff syndrome is a degenerative brain disorder that causes mental confusion, vision problems, lack of coordination, and memory problems, among other symptoms.

Beyond brain issues, alcoholism can cause:
  • Cardiovascular problems, such as arrhythmias, stroke, high blood pressure, or cardiomyopathy (impaired function of the heart)
  • Liver problems, including steatosis (fatty liver), hepatitis, and or cirrhosis (scarring of and permanent damage to the liver)
  • Pancreatitis (pancreas inflammation)
  • Cancer, including of the mouth, esophagus, throat, liver, breast, and colon
  • Increased risk of infections, particularly pneumonia and tuberculosis
  • Bone damage, including osteoporosis, as alcohol can interfere in new bone production
  • Birth defects in your baby, if you drink while pregnant, due to fetal alcohol syndrome
  • Reproductive problems, including erectile dysfunction in men and irregular or missed periods in women
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According to the National Cancer Institute, the link between alcohol use and breast cancer is well-established, and research suggests that even lighter drinking (meaning one alcoholic drink per day) may lead to a slightly increased risk of breast cancer.In a study of 88,000 women, Nurses’ Health Study researchers found that for nonsmoking women, drinking up to one alcoholic drink per day was associated with a 1.13-fold increase in cancers, particularly breast cancer.
Excessive drinking and alcohol use disorder is also linked to mental health problems, such as depression and anxiety, as well as problems with relationships and work.

BIPOC and Alcohol Use Disorder

A number of studies have looked at alcohol use among specific racial and ethnic populations, including Black, Indigenous, and People of Color (BIPOC) communities.

A review that included large U.S. surveys, published January 2017 in Alcoholism: Clinical and Experimental Research, found that Native Americans were significantly more likely to experience AUD than other populations, and that the rates of AUD were similar among white, Black, and Hispanic individuals. According to data from one of those surveys, 43.4 percent of Native Americans experienced an AUD in their lifetime compared with 22.9 percent of Hispanic Americans, 22 percent of Black Americans and 32.6 percent of white Americans. Fifteen percent of Asian Americans and Pacific Islanders experienced an AUD in their lifetime.
Another review of large U.S. surveys, published in 2016 in Alcohol Research: Current Reviews, came to similar conclusions, and noted that Native Americans are most likely to experience health consequences because of excessive alcohol use.
Women — particularly Black women — may be especially susceptible to the effects of alcohol. Women are more likely than men to experience negative impacts of excessive drinking on their physical and functional health, write the authors of a study published in 2017 in Biodemography and Social Biology.
The researchers looked at data on AUD in women age 25 and older and found that while Black and white women had similar rates of AUD, Black women were significantly more likely to experience health problems linked to AUD, even when other potential contributing factors, such as education, income, and body mass index, were taken into consideration.
The authors suggested the findings may be linked to systemic racism and the stress resulting from it, as well as differences in the body’s inflammatory response to alcohol use.

RELATED: What Experts Want BIPOC Women to Know About Menopause

Resources We Love

NIAAA Alcohol Treatment Navigator

Learn more about AUD from the government organization in charge of studying alcohol use and abuse in Americans. The website offers in-depth information on the treatment for AUD, tips to find a treatment program, and a tool to find specialty programs, therapists, and doctors who are located near you or offer their services via telehealth.

Alcoholics Anonymous (AA)

This peer-run, international fellowship is open to anyone who wants to address a drinking problem. Research has suggested that the program can be successful in helping some people cut back on or eliminate alcohol from their lives. Check out the website to learn more about how AA works, find a chapter near you, and download e-books to help with your journey.

Additional reporting by Joseph Bennington-Castro.

Editorial Sources and Fact-Checking

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