Alcoholism and alcoholic are terms commonly used in the United States, but they are nonclinical descriptors. If you have been wondering what is an alcoholic is or what a chronic alcoholic, this guide explores what constitutes a drinking problem, identifies the symptoms of alcohol use disorder, and categorizes the different stages of alcoholism, a chronic brain condition that presents on a spectrum from mild to severe.
Individuals with this disease are those diagnosed with severe alcohol use disorder. Substance use disorders (addictions) like alcohol use disorder are diagnosed according to the criteria outlined by APA (American Psychiatric Association) in DSM-5-TR.
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We’ll begin with the definition of a chronic alcoholic.
Chronic Alcoholic Definition
Chronic alcoholism is a nonclinical term that is often used interchangeably with severe alcohol dependence or severe alcohol use disorder.
What does it mean to be an alcoholic, then?
As described clinically, alcohol use disorder is a chronic, relapsing brain condition. Central to alcoholism is the compulsive consumption of alcohol in the face of obviously adverse outcomes. Chronic alcoholism is a progressive condition that typically triggers physical, psychological, and social problems for the person abusing alcohol and their loved ones.
Those with chronic alcoholism frequently experience intense cravings for alcohol and are often unable to control their consumption of alcohol. As tolerance to alcohol builds, chronic alcoholics require more alcohol to deliver the same initial effects. Chronic alcoholism is also characterized by the presentation of withdrawal symptoms when alcohol use is discontinued.
Additional symptoms of chronic alcohol abuse may include:
- Drinking alcohol alone or secretively.
- Neglecting personal and professional obligations.
- Ongoing alcohol consumption despite occupational, social, or legal complications.
- Physical health issues may include gastrointestinal complaints, liver damage, or neurological problems.
Chronic alcoholism can seriously impact your health, relationships, and quality of life.
What is a Chronic Severe Alcoholic?
Alcoholism is a condition that occurs on a spectrum, and every case of alcohol use disorder is unique. Alcoholism is clinically diagnosed according to the number of DSM-5-TR criteria that present as follows:
- Mild alcoholism: 2 or 3 diagnostic criteria
- Moderate alcoholism: 4 or 5 diagnostic criteria
- Severe alcoholism: 6 or more diagnostic criteria
The criteria for alcohol use disorder are as follows:
- Experiencing powerful cravings for alcohol.
- Spending a lot of time drinking alcohol and recovering from the effects.
- Trying and failing to control or discontinue your alcohol intake.
- Drinking alcohol for longer than planned or in larger quantities than intended.
- Tolerance developing so that you need more alcohol than previously to deliver the same intoxicating effects.
- Failing to meet personal and professional obligations due to alcohol abuse.
- Withdrawal symptoms presenting in the absence of alcohol.
- Spending less time on hobbies and interests due to alcohol abuse.
- Continuing to consume alcohol even though it is causing problems in your closest relationships.
- Consuming alcohol in dangerous situations.
- Ongoing alcohol consumption even though it is triggering or inflaming a health condition, whether physical or psychological.
Individuals with chronic alcoholism will meet six or more of these diagnostic criteria for alcohol use disorder.
What Does Chronic Ethanol Abuse Mean?
Chronic ethanol abuse (also known as chronic ethanol use disorder) refers to a long-term pattern of excessive alcohol consumption that can provoke physical, psychological, and social problems. Ethanol is the main active ingredient in alcoholic beverages, and chronic abuse of ethanol can cause a range of negative consequences. These include:
- Physical health problems: Chronic ethanol abuse can cause a range of physical health problems, from liver disease, heart disease, and gastrointestinal problems to high blood pressure levels and an increased risk of certain cancers.
- Mental health problems: Chronic ethanol abuse often leads to the development of mental health problems like depression and anxiety. When addiction and mental health issues co-occur, this is known as a dual diagnosis or co-occurring disorder.
- Social problems: Chronic ethanol abuse can lead to social problems at home, work, or school.
- Addiction: Chronic ethanol abuse can lead to addiction, a condition in which you become physically and psychologically dependent on alcohol, clinically described as alcohol use disorder.
Treatment for chronic ethanol abuse typically involves a combination of behavioral therapies and MAT (medication-assisted treatment).
Degrees of Alcoholism
Alcohol use disorder is diagnosed according to the number of symptoms that present as mild, moderate, or severe. Alcoholism, by contrast, is often discussed in terms of the following stages based on the research of E.M. Jellinek:
- Pre-alcoholic: At this stage of alcoholism, it is possible that none of the DSM symptoms of alcoholism will present. Many people in the pre-alcoholic stage use alcohol to self-medicate mental health symptoms or as a general coping mechanism. Binge drinking is another abusive form of alcohol consumption that often begins during the pre-alcoholic stage. While some people at the pre-alcoholic stage develop alcohol use disorder, some continue adhering to moderate drinking guidelines.
- Early stage alcoholic: An early stage alcoholic may present with two to four DSM symptoms. The most common signs of an early stage alcoholic include drinking excessively, lying about alcohol consumption, binge drinking, and blacking out after drinking alcohol. Early stage alcoholism may or may not involve physical dependence.
- Middle stage alcoholic: Middle stage alcoholism correlates with severe alcohol abuse. Signs of alcoholism will be apparent to loved ones and may include facial redness, weight gain or weight loss, conflict in personal relationships, irritability, and neglected responsibilities at home, work, or school. Although a middle stage alcoholic likely has severe alcohol use disorder, they may still function normally – at least outwardly. Middle stage alcoholics risk dementia, cirrhosis of the liver, anemia, cancer, cardiovascular disease, depression, seizures, and many other adverse outcomes, short-term and long-term.
- End stage alcoholic: End-stage alcoholism can be life-threatening without intervention and treatment. By this terminal stage of alcoholism, drinking alcohol takes priority over everything else in life. Serious health complications can occur, including cirrhosis and Wernicke-Korsakoff syndrome (wet brain). That said, evidence-based treatments can be effective, even for chronic alcoholics.
Symptoms of Chronic Alcoholism
Chronic alcoholism, also known as severe alcohol use disorder, is associated with the presentation of at least six symptoms. Chronic alcoholism for men or women often involves:
- Physical symptoms: Chronic alcoholism can cause physical symptoms like tremors, sweating, nausea, vomiting, seizures, and liver disease.
- Psychological symptoms: Chronic alcoholism is linked to psychological symptoms including depression, anxiety, irritability, and memory loss.
- Social symptoms: Chronic alcoholism frequently brings about social symptoms like neglecting personal and professional responsibilities, difficulty maintaining relationships, and legal or financial problems.
- Tolerance and dependence: Individuals with chronic alcoholism often develop a tolerance to alcohol, meaning they need to drink more alcohol to achieve the same effects. Chronic alcoholism is also associated with physical dependence on alcohol.
- Withdrawal: When individuals with chronic alcoholism who are dependent on alcohol stop drinking, they may experience withdrawal symptoms that include tremors, sweating, nausea, vomiting, seizures, and hallucinations.
- Loss of control: Individuals with chronic alcoholism are typically unable to control their alcohol intake and may continue to drink despite negative consequences.
Chronic alcoholism can have serious consequences on your health, relationships, and overall quality of life. A healthcare provider or addiction specialist can help develop a personalized treatment plan to manage the symptoms of chronic alcoholism effectively.
Treatment for Chronic Alcoholics
Treatment for chronic alcoholics usually involves a combination of behavioral therapies and medication-assisted treatments. Here are some common approaches:
- Supervised medical detox: Those with chronic alcoholism are at risk of severe and life-threatening withdrawal symptoms that are best managed in a clinical setting. Medications approved by the FDA can reduce the severity of cravings and withdrawal symptoms.
- MAT: Medication-assisted treatment is proven effective for the treatment of alcohol use disorder, both during detox and throughout ongoing recovery. MAT is most effective when combined with behavioral therapies.
- Behavioral therapies: Behavioral therapies like CBT (cognitive behavioral therapy) help individuals battling addiction to change their attitudes and behaviors related to alcohol use. Sessions of individual and group counseling also form a core component of treatment for chronic alcoholism.
- Support groups: Peer support groups like AA (Alcoholics Anonymous) can provide a supportive environment for those in recovery looking for encouragement and a new sober support network.
Whether you require the support and structure of an inpatient program or the flexibility and affordability of outpatient treatment, the best addiction treatment programs allow you to tackle the physical and psychological components of chronic alcoholism.
Get Treatment for Chronic Alcoholism at California Detox
If you have been struggling with acute and chronic alcohol use, we can help you initiate a sustained recovery at California Detox in Southern California.
Access our supervised medical detox program for alcohol use disorder and streamline the intensity of the withdrawal process while addressing the issue of physical dependence on alcohol. After a week, you can move directly into ongoing treatment. We offer programs at all levels of intensity, including residential rehab at our luxury beachside facility in Laguna Beach, CA.
All alcohol addiction treatments programs at California Detox utilize a combination of evidence-based interventions and holistic therapies, such as:
- MAT (medication-assisted treatment)
- Individual counseling
- Group counseling
- Family therapy
- Holistic therapy
Call 949.694.8305 for immediate assistance with a medical detox and evidence-based treatment for chronic alcoholism.