Author: Gary Jackson

Alcohol Dependence, Withdrawal, and Relapse PMC

A convergent body of preclinical and clinical evidence has demonstrated that a history of multiple detoxification/withdrawal experiences can result in increased sensitivity to the withdrawal syndrome—a process known as “kindling” (Becker and Littleton 1996; Becker 1998). For example, clinical studies have indicated that a history of multiple detoxifications increases a person’s susceptibility to more severe and medically complicated withdrawals in the future (e.g., Booth and Blow 1993). Additional evidence indicates that behavioral measures indicating a reduced sensitivity to rewarding stimuli (i.e., anhedonia) are exaggerated in rats that experience withdrawal from repeated alcohol injections compared with rats tested during withdrawal from a single alcohol injection (Schulteis and Liu 2006). Finally, a history of multiple withdrawal experiences can exacerbate cognitive deficits and disruption of sleep during withdrawal (Borlikova et al. 2006; Stephens et al. 2005; Veatch 2006).

• They’ll do a physical exam and ask you questions about your drinking habits.
• Research shows that most people who have alcohol problems are able to reduce their drinking or quit entirely.
• Those with moderate to severe alcohol use disorders generally require outside help to stop drinking.
• One size does not fit all and a treatment approach that may work for one person may not work for another.
• Some people may drink alcohol to the point that it causes problems, but they’re not physically dependent on alcohol.

People often continue drinking to alleviate these unpleasant symptoms. The contemporary definition of alcohol dependence is still based upon early research. See your doctor if you begin to engage in behaviors that are signs of alcohol use disorder or if you think that you may have a problem with alcohol.

The Cycle of Alcohol Addiction

More direct evidence supporting increased alcohol consumption as a consequence of repeated withdrawal experience comes from animal studies linking dependence models with self-administration procedures. For example, rats exposed to chronic alcohol treatment interspersed with repeated withdrawal episodes consumed significantly more alcohol than control animals under free-choice, unlimited access conditions (Rimondini et al. 2002, 2003; Sommer et al. 2008). Similar results have been reported in mice, with voluntary alcohol consumption assessed using a limited access schedule (Becker and Lopez 2004; Dhaher et al. 2008; Finn et al. 2007; Lopez and Becker 2005).

• For example, ” abuse ” may imply that the behavior is intentional and controllable and, therefore, a personal failure rather than a disease symptom.
• More than 14 million adults ages 18 and older have alcohol use disorder (AUD), and 1 in 10 children live in a home with a parent who has a drinking problem.
• These changes also are purported to fuel motivation to reengage in excessive drinking behavior.

Alcohol dependence was originally defined as a chronic medical condition characterized by experiencing symptoms of withdrawal when the person stops consuming alcohol. To avoid experiencing withdrawal symptoms, the person has to keep consuming alcohol. The alcohol dependence syndrome was seen as a cluster of seven elements that concur. It was argued that not all elements may be present in every case, but the picture is sufficiently regular and coherent to permit clinical recognition. The syndrome was also considered to exist in degrees of severity rather than as a categorical absolute.

Medical and non-medical addiction specialists

In addition to choosing the type of treatment that’s best for you, you’ll also have to decide if that treatment is inpatient (you would stay at a facility) or outpatient (you stay in your home during treatment). Your healthcare provider can help you evaluate the pros and cons of each. Overall, gather as much information as you can about the program or provider before making a decision on treatment. If you know someone who has first-hand knowledge of the program, it may help to ask about his or her personal experience. When asked how alcohol problems are treated, people commonly think of 12-step programs or 28-day inpatient rehab but may have difficulty naming other options.

Alcohol addiction, also known as alcoholism, is a disease that affects people of all walks of life. Experts have tried to pinpoint factors like genetics, sex, race, or socioeconomics that may predispose someone to alcohol addiction. Psychological, genetic, and behavioral factors can all contribute to having the disease. As individuals continue to drink alcohol over time, progressive changes may occur in the structure and function of their brains.

Can People With Alcohol Use Disorder Recover?

Although currently few treatments are available for tackling this significant health problem and providing relief for those suffering from the disease, there is hope. Some studies using animal models involving repeated withdrawals have demonstrated altered sensitivity to treatment with medications designed to quell sensitized withdrawal symptoms (Becker and Veatch 2002; Knapp et al. 2007; Overstreet et al. 2007; Sommer et al. 2008; Veatch and Becker 2005). Moreover, after receiving some of these medications, animals exhibited lower relapse vulnerability and/or a reduced amount consumed once drinking was (re)-initiated (Ciccocioppo et al. 2003; Finn et al. 2007; Funk et al. 2007; Walker and Koob 2008). These findings have clear clinical relevance from a treatment perspective.

While no longer separate diagnoses, it can be helpful to understand the differences between the two. “Dependence” refers to being unable to stop drinking without experiencing withdrawal symptoms while “abuse” refers to continuing to consume alcohol despite adverse consequences. Alcohol abuse was defined as a condition in which a person continues to drink despite recurrent social, interpersonal, health, or legal problems as a result of their alcohol use.