Alcohol
Alcohol is the most commonly used addictive substance in the United States, with approximately 29.5 million people aged 12 and older having alcohol use disorder (AUD) in 2022.
Quick Facts
Understanding Alcohol Addiction
Alcohol use disorder (AUD) is a chronic medical condition characterized by an inability to control or stop drinking despite negative consequences. The National Institute on Alcohol Abuse and Alcoholism defines AUD on a spectrum from mild to severe, based on the number of diagnostic criteria met.
How Alcohol Affects the Brain
Alcohol increases the effects of GABA, the brain's primary inhibitory neurotransmitter, producing relaxation and sedation. It simultaneously reduces glutamate activity, further depressing the central nervous system. Chronic alcohol use causes the brain to adapt to these changes, leading to tolerance and dependence.
Signs of Alcohol Use Disorder
- Drinking more or longer than intended
- Unsuccessful attempts to cut down
- Spending significant time obtaining, using, or recovering from alcohol
- Cravings or strong urges to drink
- Continuing to drink despite relationship, work, or health problems
- Needing more alcohol to achieve the same effect (tolerance)
- Experiencing withdrawal symptoms when not drinking
Alcohol Withdrawal Timeline
Hours 6–12: Mild Symptoms
Anxiety, insomnia, nausea, and tremors. These symptoms begin shortly after the last drink.
Hours 12–48: Moderate Symptoms
Increased blood pressure, rapid heartbeat, confusion, and mild fever. Seizures may occur, typically within 12 to 48 hours.
Hours 48–72: Severe Symptoms (Delirium Tremens)
Approximately 3 to 5% of people going through alcohol withdrawal develop delirium tremens (DTs), which can be life-threatening. Symptoms include hallucinations, severe confusion, fever, and seizures.
Treatment for Alcohol Addiction
Medical detoxification is critical for alcohol withdrawal because of the risk of seizures and delirium tremens. Treatment options include:
- Benzodiazepines: Used during medical detox to prevent seizures
- Naltrexone: Reduces cravings and the rewarding effects of alcohol
- Acamprosate (Campral): Helps restore brain chemistry damaged by chronic alcohol use
- Disulfiram (Antabuse): Creates unpleasant effects when alcohol is consumed
- Behavioral therapy: CBT, motivational interviewing, and 12-Step facilitation
Withdrawal Timeline
Onset
6–12 hours after last drink
Peak Symptoms
24–72 hours
Duration
5–7 days (acute), weeks to months (post-acute)
Overdose Warning Signs
If you suspect an overdose, call 911 immediately.
Approximately 29.5 million people aged 12+ had AUD in 2022. Alcohol causes approximately 178,000 deaths annually in the U.S.
Frequently Asked Questions
Can alcohol withdrawal kill you?
Yes. Alcohol withdrawal can be life-threatening. Delirium tremens (DTs), the most severe form, occurs in 3 to 5% of people and carries a mortality rate of up to 37% if untreated. Medical detoxification in a supervised setting is strongly recommended.
How many drinks per day is considered alcoholism?
There is no specific number. Alcohol use disorder is diagnosed based on 11 behavioral criteria, not solely quantity consumed. However, NIAAA defines heavy drinking as 4+ drinks per day or 14+ per week for men, and 3+ per day or 7+ per week for women.
Is alcohol a drug?
Yes. Alcohol is a psychoactive substance classified as a central nervous system depressant. While legal and socially accepted, it carries significant addiction potential and health risks. The WHO classifies alcohol as a Group 1 carcinogen.