What Is Alcohol Dependence?

Alcohol dependence can be understood and divided into two separate categories:

1. Psychological alcohol dependence, known as alcohol addiction or alcohol use disorder (AUD).

2. Physical alcohol dependence.

Alcohol addiction is a psychological disease defined as one’s inability to control alcohol consumption. This umbrella term illustrates a form of high-risk drinking that typically includes excessive drinking, an intense alcohol craving, and continued alcohol use despite realizing how it interferes with your daily life.

In contrast, if you are physically dependent on alcohol, you may feel like it is a central part of your life and that you are unable to function or survive without it, but those feelings do not mean your condition classifies as an AUD. The National Institute on Drug Abuse further explains that physical dependence on alcohol is a factor of addiction, but not addiction itself. However, the heavy drinking caused by physical dependence can lead to an alcohol addiction.

What Causes Physical Alcohol Dependence?

Although there are no clear-cut causes of physical alcohol dependence, there are predictors of severe alcohol dependence and withdrawal symptoms, including:

  • Heavy alcohol use (having more than two standard drinks per day)
  • A history of seizures with alcohol withdrawal
  • Being older
  • Abnormal liver function
  • Dehydration
  • Comorbid illnesses such as liver, pancreatic, neurological, circulatory, and gastrointestinal diseases.

More recent studies have also indicated certain genetic, social, psychological, or environmental factors may also impact the body’s dependency on alcohol.

How Can I Tell If I’m Dependent On Alcohol?

If you are questioning if you are experiencing physical alcohol dependence, here are some common signs to watch for:

  • Your body will begin building a tolerance to alcohol – As your body naturally builds its tolerance, you will start to notice that you may need to consume a higher volume of alcohol to feel the same effects.
  • If you suddenly stop drinking alcohol or significantly reduce your intake, your body may start to go through physical withdrawal symptoms – If you notice that the physical symptoms go away with continued drinking or that it is very difficult to stop drinking due to the symptoms, your body is most likely physically dependent on alcohol.
  • You continue to choose to drink or have a craving for alcohol even after negative consequences – These cravings present when it may not be appropriate, interrupting physical, social, or work activities.

How To Diagnose Alcohol Dependence

Although psychological and physical alcohol dependence can be understood as separate entities, the two are linked to one another. Therefore, diagnosing physical alcohol dependence is similar to the diagnosis process of an AUD. According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), to be diagnosed with AUD you must meet at least two of the following criteria within a 12-month period:

  • Drinking more alcohol than intended
  • Unsuccessful efforts to reduce alcohol drinking
  • Giving up other activities in favor of alcohol drinking
  • Craving alcohol
  • Continuing to drink despite adverse physical, work, and social effects
  • Alcohol tolerance development
  • Recurrent alcohol use in physically hazardous situations
  • Moderate to severe withdrawal symptoms

In addition to these criteria, your doctor may also run some blood tests to view your liver enzymes and electrolytes to see if there are any imbalances or abnormalities that could signal an AUD.

Health Problems Caused By Alcohol Dependence

Physical dependence on alcohol can have adverse effects on your long-term health. Continual drinking may lead to:

  • Liver diseases such as fatty liver disease, alcoholic hepatitis, and/or liver cirrhosis, which is permanent scarring of liver tissue.
  • Heart diseases, including high blood pressure, heart failure, arrhythmias (irregular heartbeat), or stroke.
  • Digestive diseases such as gastritis (inflammation of the stomach), stomach and esophageal ulcers, pancreatitis (inflammation or damage to the pancreas), diabetes, and bleeding.
  • Sexual dysfunction, including erectile dysfunction and menstrual period irregularities.
  • Neurological diseases, including fibromyalgia, brain damage, dementia, or memory loss.

How To Reduce Your Risk Of Alcohol Dependence

Physical dependence on alcohol can begin at any age, but it is commonly reported in people in their 20s and 30s and those aged 60 and older. Some risk factors, which can lead to physical dependency, include:

Based on these risks, you can reduce your physical alcohol dependence by:

  • Keeping track of your drinking habits
  • Drinking no more than one drink per day
  • Limiting your drinking to specific self-imposed criteria
  • Asking friends to look out for your drinking patterns
  • Speaking with a mental health professional or addiction specialist to create a plan to change your drinking habits

Warning Signs Of Alcohol Dependence

Experts describe alcohol dependence as a chronic, relapsing cycle. Therefore, when it comes to warning signs of physical alcohol dependence, patterns of alcohol consumption fall into different stages:

At-Risk Stage – Known as the pre-alcoholic stage, this is when you choose to drink socially or at home. You may use alcohol to feel better after a long day, to relieve stress, or to cope with certain emotions and stressors; you may also be drinking more than intended. Lastly, you may start to develop a tolerance for alcohol but may not notice it yet.

Early Stage – Though deemed the “early” stage, this stage is where a regular drinking pattern develops. Tolerance becomes noticeable, as you must drink more to reach the desired effect and feeling. In this transitional stage, as the disease becomes more severe, you may experience frequent blackouts and find that drinking and alcohol consume much of your thoughts. Due to increased tolerance, when not drinking, you may experience mild withdrawal symptoms common to physical alcohol dependence, including anxiety, shakiness, headache, insomnia, heart palpitations, and stomach problems such as nausea or vomiting.

Mid-Stage – Mid-stage alcohol dependence is marked by a loss of control over both cravings for alcohol and drinking habits. In addition, your alcohol use may significantly impact your personal, professional, and social life. You may struggle with maintaining relationships with friends or family, and personality changes may occur. Physical effects, such as organ damage and changes to your outward appearance, may also start to present.

End-Stage – This final stage, known as the late stage, is described as total alcohol dependence, where you may experience uncontrollable alcohol consumption. Health conditions, like cardiovascular and liver diseases, may be caused or exasperated by your alcohol use, and death from alcohol poisoning or long-term effects of alcohol use is imminent if treatment is not sought. Aside from intense cravings and consuming thoughts of alcohol, when not drinking, you may experience severe withdrawal symptoms, including visual or hearing disturbances or hallucinations, delirium, and possibly seizures.

If you or the people around you may notice that you compulsively use alcohol, have been drinking more excessively to feel the effects of alcohol, or exhibit these signs of withdrawal when not drinking, it’s important to take note and seek treatment before symptoms worsen.

How To Treat Alcohol Dependence

It is not advised to go “cold turkey” or suddenly stop consuming alcohol on your own to treat your physical dependency, as it can lead to dangerous withdrawal symptoms. Instead, if you think you have a physical alcohol dependence, you should seek out a medical provider, a mental health professional, or an addiction counselor regarding safe options and resources to help you detox from alcohol.

You may need a medically supervised alcohol detox if you are physically dependent on alcohol. This is due to the high risks the withdrawal effects may have on the body, which may even be fatal.

Although medical detox from alcohol dependency will help you navigate the withdrawal process safely, ongoing treatment and support may be necessary to maintain sobriety after detox. Therefore, it’s advisable to explore inpatient and residential treatment facilities that can provide support and tools to help maintain your sobriety. Explore our rehab directory to find a rehab near you.

Get Help For Physical Alcohol Dependence

Physical dependence on alcohol is a serious condition that can contribute to the development of alcohol addiction and other medical issues, but help is available. If you or a loved one thinks they are experiencing physical alcohol dependence, do not hesitate to contact a treatment provider to explore your treatment options.