How Much is Too Much? What You Need to Know About Alcohol Use Disorder

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Alcohol use disorder (AUD) encompasses the conditions that some people refer to as alcohol abuse, alcohol dependence, alcohol addiction, and alcoholism. This video explains the effects that alcohol can have on your health if drinking excessively and/or heavily. Learn what you can do for yourself or someone you know who may have AUD.

Transcript:

Do you think alcohol is absolutely harmful or beneficial?

This video will help you learn about what is considered drinking too much alcohol, the effects alcohol can have on your body and health based on how much you drink, as well as during withdrawal, and lastly, medication and treatments to stop or reduce drinking alcohol. Let’s get started.

Many of you might have consumed alcohol before, such as celebrating at a party or having a small amount of wine before you go to bed. Alcohol may be good for our health. According to the Mayo Clinic: the appropriate amount of alcohol can decrease the risk of developing heart disease and diabetes. However, alcohol use can be dangerous when you are drinking more than the appropriate amount.

Did you know alcohol can be dangerous or even life-threatening if using it excessively? According to the Alcohol-Related Disease Impact (ARDI) application, excessive alcohol use was responsible for an annual average of 95,000 deaths during 2011–2015. However, if using alcohol responsibly, it can be safe. Let's start with learning the standard drink first.

Do you know what a standard drink is? According to the CDC, a standard drink is any drink that contains 0.6 ounces of pure alcohol. Different alcohols have different portions.

a. For beer, a standard amount is 12-ounces.

b. For wine, it will be 5-ounces.

c. Surprisingly, it will be only 1.5-ounces of 80-proof distilled spirits or liquor, such as whiskey.

d. In other words, 1.5 ounces of whiskey is equivalent to 12 ounces of beer. This shows that if the beverage contains different amounts of pure alcohol, the standard drink for each drink is different.

“Drink in moderation” is usually safe but do you know what moderation means? The Dietary Guidelines for Americans recommend the limiting intake for men is 2 drinks or less in a day and limiting 1 drink or less in a day for women

After learning about moderate drinks for men and women, you might notice that the amount of alcohol for women and men is different. But why is that? It’s because men and women have biological differences in body structure and chemistry. Most women can absorb more alcohol and it takes a longer time for their body to metabolize it. To put it another way, when drinking the same amount of alcohol, women will usually have a higher blood alcohol level, a quicker response to alcohol, and the effects of alcohol last longer than men. Therefore, this also shows that alcohol will have more health impacts on women than men.

When a person is drinking more than a moderate amount of alcohol, it can lead to binge drinking. What’s Binge drinking? Binge drinking is the most common form of excessive drinking. For women, it is considered binge drinking when they consume 4 or more drinks during a single occasion. For men, binge drinking is 5 or more drinks on one occasion.

Besides binge drinking, drinking a lot of alcohol within a period of time might also mean heavy drinking. What is heavy drinking? For women, heavy drinking is 8 or more drinks per week. For men, it is 15 or more drinks per week.

Well, what is the difference between binge drinking and heavy drinking? Binge drinking is mainly focusing on the amount of alcohol consumed within one single occasion, while heavy drinking is based on the amount of alcohol consumed within a week.

Let's play a small game to see if you fully understand. John consumes 3 drinks per day for 1 week. Is this act considered binge drinking or heavy drinking?

Now, let’s take a look at the question together. For men, binge drinking is 5 or more drinks on one occasion. Since John only intakes 3 drinks daily. It is not considered binge drinking. However, he drank 3 drinks per day for 7 days, which is 21 drinks within a week. For men, 15 or more drinks in a week will be considered heavy drinking. Then, John’s situation is considered as heavy drinking, which can impose a health risk for John.

Both Binge drinking and heavy drinking are considered excessive drinking. Excessive drinking means when a person is drinking more than a moderate amount of alcohol. Excessive drinking can have many other situations, such as pregnant drinking and underage drinking.

We just learned what excessive drinking is, which is a drinking behavior that people have. However, there is a medical term that describes people who have alcohol use problems. It’s called Alcohol Use Disorder aka AUD. What is AUD?

According to the National Institute on Alcohol Abuse and Alcoholism, “Alcohol use disorder (AUD) is a medical condition characterized by an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences. It encompasses the conditions that some people refer to as alcohol abuse, alcohol dependence, alcohol addiction, and the colloquial term, alcoholism."

Do you know what causes alcohol use problems? First of all, the drinking age. The earlier a person drinks, the higher the chance of developing AUD. A national survey shows that the number of people who began drinking before the age of 15 was more than 5 times more likely to report having AUD than people who began drinking at the age of 21 or later. Second, genetics and family history of alcohol problems. Parents who have alcohol use disorder can increase the risk for their child to develop AUD as well. For instance, children of alcoholic parents have a 3 to 4 times increased risk of becoming alcoholics themselves. Third, mental health conditions and a history of trauma. People with mental health conditions, such as depression and post-traumatic stress disorder, can have a higher risk of developing AUD. Also, people with childhood trauma are more likely to develop AUD. Last but not least, A person’s drinking habit. AUD can be developed depending on how much, how often, and how quickly a person consumes alcohol. When you are drinking more than a moderate amount of alcohol within a time period, it would be either considered binge drinking or excessive drinking. As a reminder, both binge drinking and excessive drinking are different types of alcohol use disorder.

What are the symptoms of alcohol use disorder? AUD symptoms can range from mild to severe. These symptoms may include:

● Being unable to limit the amount of alcohol you drink

● Wanting to cut down on the amount you drink or unsuccessfully doing so

● Spending a lot of time drinking, getting alcohol, or recovering from alcohol use

● Having a strong urge to drink alcohol

● Failing to fulfill major obligations at work, school, or home, due to repeated alcohol use

● Continuing to drink knowing it’s causing physical, social, or interpersonal problems

● Giving up or reducing social and work activities and hobbies

● Drinking alcohol when it’s not safe, such as when driving or swimming

● Developing alcohol tolerance so you need more of it to feel its effects, or you have a reduced effect from the same amount

In addition to these symptoms, alcohol use disorder can include periods of alcohol intoxication and withdrawal symptoms.

Let’s start by first explaining alcohol intoxication, also known as alcohol poisoning. Alcohol intoxication is also referred to as drunkenness or inebriation. It is a condition in which a person drinks an excessive amount of alcohol to the point of negative effects in behavior, as well as to physical and mental function. The higher the blood alcohol concentration is, the more impaired you become. Effects may include inappropriate behavior, mood swings, impaired judgment, slurred speech, impaired attention or memory, and poor coordination (such as driving or running). You may also experience “blackouts,” where you don’t remember events. It is possible that very high blood alcohol levels can lead to coma or even death.

As for alcohol withdrawal, it can happen when drinking heavily or excessively and is then suddenly stopped or greatly reduced. It can occur within 6-12 hours after the last drink, with relatively mild symptoms of early withdrawal, including headaches, mild anxiety, insomnia, small tremors, and stomach upset. By 24 hours, some people may experience hallucinations. Symptoms usually peak within 24-72 hours, but it is possible some symptoms can go on for weeks.

A rare complication from alcohol withdrawal is something called Alcoholic hallucinosis. It can happen 12-24 hours after your last drink or when your alcohol consumption is greatly reduced. It is a state of mind where, although you are still conscious of your surroundings and function, you are experiencing hallucinations. This could be seeing shadowy figures, animals, objects, or other things that aren’t actually there. The hallucinations can also affect your sense of sound and touch, hearing or feeling things on your body that aren’t actually there.

There is a severe form of alcohol withdrawal called delirium tremens (DT), which can cause sudden and severe mental or nervous system changes. These include agitation, fever, visual or auditory hallucinations, seizures, and severe confusion. Unlike alcoholic hallucinosis, DT affects your mental state, going back and forth between clear and confused. This change can happen in minutes or hours and multiple times a day.

Depending on the level of physiological alcohol dependence, the level of severity of withdrawal will be different for everyone. All these symptoms can be severe enough to impair your ability to function at work or in social situations. Without treatment by a healthcare professional, some people can progress from Stage 2 to Stage 3 rapidly. If you are experiencing these withdrawal symptoms when you don’t drink, or are drinking to avoid these symptoms, it is a sign of alcohol use disorder.

So, do you have a good picture of how drinking can affect a person? Let's do a quick survey to see if you have an alcohol issue!

Please answer yes or no for the following questions.

a. C – Have you ever felt you should cut down on your drinking?

b. A – Have people annoyed you by criticizing your drinking?

c. G – Have you ever felt bad or guilty about your drinking?

d. E – Eye opener: Have you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover?

This is a simple assessment called CAGE. If you have two or more positive responses, it indicates that you might be alcohol-dependent.

How does alcohol affect people’s health? For pregnant women who drink alcohol, it will increase the risk of having a baby with fetal alcohol spectrum disorder, aka FASD. What’s FASD? According to the CDC, Fetal alcohol spectrum disorders (FASDs) are a group of conditions that can occur in a person whose mother drank alcohol during pregnancy. These effects can include physical problems and problems with behavior and learning. Often, a person with an FASD has a mix of these problems. To avoid FASD, women should not drink any types of alcohol when she is trying to become pregnant or is pregnant. Drinking alcohol during pregnancy can not only lead to an increased risk of FASD, but also lead to an increased risk of miscarriage, stillbirth, premature delivery, and Sudden Infant Death Syndrome.

Besides drinking during pregnancy, alcohol use disorder can also lead to other harmful health conditions. The short-term health risk of using alcohol can lead to injuries, alcohol poisoning, and violence. In addition, risky sexual behaviors are one of the short-term health risks for alcohol use disorder. Under the influence of alcohol, people will have a higher chance of having unprotected sex or sex with multiple partners. Then, it will result in an increased risk of sexually transmitted disease infections or unintended pregnancy.

Another harmful effect caused by alcohol is car accidents. Alcohol may slow down people’s reaction time, reduce concentration, decreased vision, and inhibit judgment. When people are driving on the road, drivers are required to have these driving skills. For example, they need to see if there are any pedestrians crossing the street. With slow reaction time and impaired vision, it will be easier to get into car accidents.

Alcohol may lead to many other health issues. One of the most common long-term health effects is liver damage because it is the primary site of alcohol metabolism. Excessive drinking can lead to inflammation and scar tissue. Then the liver can’t function as well as it should be. As a result, it will lead to loss of energy, weight loss, belly pain, and nausea. As the situation gets worse, there will be more symptoms, which include yellow color in the skin or eyes, easy bruising, a fluid buildup of the legs and in the abdomen, and redness on the palms of the hands. Most importantly, liver damage caused by alcohol can be fatal.

As heavy alcohol use causes liver damage, such as scar tissues, it also increases the risk of developing liver cancer! Also, alcohol use may lead to other cancers, such as mouth, breast, throat, and colon cancers. You might wonder, how can alcohol lead to cancers? Well, when people are drinking alcohol, their cells are being damaged by the alcohol at the same time. Then, when the cells are trying to repair, it could lead to DNA changes, which is the first step of developing cancers. In other words, the more alcohol you consume, the higher your chance of developing cancers.

Other than liver damage and cancer, excessive drinking can lead to many other health issues, such as high blood pressure, learning and memory problems, and bone damage. Also, it can weaken a person’s immune system. This means, when people drink alcohol almost every day, it will be easier for them to get sick compared to other people. Besides physical health problems, alcohol can also lead to mental problems, social problems, and alcohol dependence.

If you or someone you know is experiencing these problems, it may be time to see a doctor. Your doctor will perform a physical exam to see if you are experiencing alcohol withdrawal. Under an exam, this may reveal abnormal eye movements, abnormal heart rhythms or rapid heart rate, dehydration, fever, rapid breathing, and shaky hands. A blood and urine test may also be done to determine the amount of alcohol you have taken.

It is also a good idea to see a doctor regarding your alcohol use. If you feel that you sometimes drink too much alcohol, or your drinking is causing problems, or your family is concerned about your drinking, you might want to talk with your doctor, then. Don’t want until it’s too late.

After hearing about the health issues that are caused by alcohol use disorder, we should learn about the available treatments for people who have alcohol use disorder. Treatments are to reduce withdrawal symptoms, prevent complications of alcohol use, and provide therapy to get you to stop drinking. Different treatment approaches work for different people and situations. Now let me introduce some available treatments and the strength of each treatment approach to you.

People with moderate-to-severe symptoms of alcohol withdrawal may need inpatient treatment at a hospital to treat it. You will be monitored for signs of delirium tremens, such as hallucinations. If symptoms of withdrawal are mild to moderate, you can usually be treated in an outpatient setting. During this time, you will need someone to stay and keep an eye on you. It is also likely that you need to make daily visits to your provider until you are stable.

Treatment for mild-to-moderate withdrawal symptoms usually includes:

● Sedative drugs to help ease withdrawal symptoms

● Blood tests

● Patient and family counseling to discuss the long-term issue of alcoholism

● Testing and treatment for other medical problems linked to alcohol use

It is important to go to a living situation that helps support you in staying sober. Some areas have housing options that provide a supportive environment for those trying to stay sober. Permanent and life-long abstinence from alcohol is the best treatment for those who have gone through withdrawal.

To address alcohol use disorder, there are 3 specific medications that are approved by the U.S. FDA (deleted some words here). They are naltrexone, acamprosate, and disulfiram. These medicines are designed to help discourage drinking and are non-addictive medications, so people don’t have to worry about being addicted to them. Also, people may use the medicine alone or combine it with mutual support groups. The strength of the medicine is that it can help people who have a higher risk of relapse to drinking when they are facing unhappy events, such as divorce.

Alcohol and Medication Interactions

It is important to note that alcohol can often have harmful interactions with prescription medications and over-the-counter drugs. These problems include nausea and vomiting, headaches, drowsiness, dizziness or fainting, changes in blood pressure, abnormal behavior, loss of coordination, leading to accidents. Commonly used medicines that interact with alcohol include Benadryl, Advil, Aspirin, and Tylenol.

Mixing alcohol and medications may also increase the risk of complications, such as liver damage, heart problems, breathing problems, internal bleeding, and depression, or even suicidal behavior! As some medications contain more than one ingredient that can react with alcohol, it is best to read the label on the medication bottle to know what ingredients a medicine contains.

If you mix a prescription drug with alcohol, either by accident or specifically to get high, there is a high risk of overdose or damage to the body. If you see someone experiencing a drug overdose or alcohol poisoning, it is extremely important to call 911 immediately. Talk to your pharmacist or health care provider if you have any questions regarding alcohol interaction with your medication.

Besides medication, there are mutual support groups. Mutual support groups mean there are groups of people who share the same health problem and voluntarily support each other throughout the recovery process. In other words, participants will receive peer support for stopping or reducing drinking. The strength of mutual support groups is that it is available in most communities at a low or no cost.

Last but not least, behavioral treatments are very effective for people to reduce alcohol consumption. Behavioral treatments are provided by licensed therapists. Also, the earlier people seek help from professional therapists, the more effective for them to control alcohol consumption. The benefit of attending behavioral treatments is that patients will learn skills that are needed to change their drinking behavior. For example, they will learn how to prevent relapse to drinking and keep the motivation to stop or reduce their drinking.

Trying to get rid of alcohol but need a guide? Consider talking with someone who has had a problem drinking, but has stopped, such as Alcoholics Anonymous. Alcoholics Anonymous (AA) is a social group dedicated to helping alcoholics become and staying sober. AA is known for its 12 -step program, which involves self-improvement methods, acknowledging powerlessness over alcohol and its damage, and the goal to make amends for past actions, while at the same time helping other alcoholics through the same steps.

Here are some other community resources to help you reach your goal.

Alcoholics Anonymous -- www.aa.org
Al-Anon Family Groups/Al-Anon/Alateen -- al-anon.org
National Institute on Alcohol Abuse and Alcoholism -- www.niaaa.nih.gov
Substance Abuse and Mental Health Services Administration -- www.samhsa.gov/atod/alcohol

How to get rid of alcohol use problems by yourself? Here are some tips for you to reduce or stop drinking.

Write down. Write down a list of reasons that you need to reduce drinking and can motivate you. For example, your relationship with your family and having better health can be reasons that you should stop drinking.

Set a goal. You should set a goal to limit your drink. For example, the moderate amount of alcohol for men is 2 or fewer drinks per day. Then, men can set a goal of drinking 1 drink per day. However, for people who have certain medical conditions, the amount of alcohol that they can drink might be different. Therefore, you can consult with your doctors to set the goals together.

Don’t keep alcohol in your house. When you have alcohol at your house, it is very accessible to the alcohol and makes it harder to limit your drinking.

Drink slowly and never drink with an empty stomach. When people are drinking too fast or drink with an empty stomach, they will get drunk faster and do more harm to their bodies.

Watch for peer pressure. You don’t have to force yourself to drink just because other people are drinking. Also, you shouldn’t feel obligated to accept every drink that you are offered. You should learn how to say no politely and think about your health first.

Keep yourself busy. You can exercise, watch a movie, play games, or develop a new hobby. Keeping yourself busy can help you have less craving for alcohol.

Ask your family and friends for support. For example, they can supervise the amount of alcohol you drink or provide mental support to you while you are trying to cut down the alcohol.

Because denial is common, you may not feel like you have a problem with drinking. You might not realize how much you’re drinking or how many problems in your life are related to alcohol use. Listen to relatives, friends, or co-workers when they ask you to examine your drinking habits or to seek help.

Be persistent. There is no endpoint for quitting or reducing alcohol intake. You will have to continue to control the amount of alcohol you drink even if you have successfully cut down or stopped drinking for many years.

Let us know by commenting on this video what you’ve learned about alcohol use disorder and what you would like to learn more in our next videos. If you liked this video, please check out our other videos on this channel. Make sure to leave a like, comment, or share this video. Subscribe and click the bell to get notified of when the latest videos go up on the AAMG YouTube Channel. Follow us on our social media platforms in the description to keep up-to-date on the latest health news, free health workshops, and community events. Thank you for watching!