Understanding alcohol abuse - symptoms and signs

What are the symptoms and signs of alcohol abuse?

The NHS suggests these questions for a person concerned they may be drinking too much alcohol:

• Do you feel you should cut down on your drinking?
• Do other people criticise your drinking, which may annoy you?
• Do you feel feeling guilty or bad about your drinking?
• Do you need a drink first thing in the morning to "steady your nerves" or clear a hangover?
• Do you sometimes forget what happened the night before because of drinking?
• Do you fail to do what's expected of you due to drinking, such as missing an appointment or not turning up for work because of being drunk or hungover?
• Do you regularly exceed the recommended daily limit for alcohol? The recommended daily limits are no more than three to four units a day for men and two to three for women. A unit of alcohol is equivalent to around half a pint of normal strength lager, a small glass of wine or a single measure of spirits.

The following symptoms and signs are also associated with alcohol abuse:

• Temporary blackouts or memory loss.
• Recurrent arguments or fights with family members or friends.
• Continuing use of alcohol to relax, cheer up, sleep, deal with problems or feel "normal".
• Headache, anxiety, insomnia, nausea and other unpleasant symptoms when you stop drinking.
• Flushed skin and broken capillaries on the face, a husky voice, trembling hands, chronic diarrhoea and drinking alone in the mornings or in secret. These symptoms are specifically associated with chronic alcoholism.

Bear in mind that alcohol abuse is different from alcohol dependence.

• With alcohol abuse, a person uses alcohol to excess but may not have regular cravings. These cravings include the need to drink daily, and/or withdrawal symptoms during periods when they suddenly stop.
• If a person is dependent on alcohol, they need to drink regularly. This could mean drinking daily and they will need to drink more and more to get the same effects. They also experience withdrawal symptoms if they stop drinking.

Seek medical advice about alcohol abuse if:

• You have any of the symptoms listed above and are unable to stop drinking on your own. You need medical intervention to treat alcoholism. You may also be susceptible to ailments such as cirrhosis, alcoholic hepatitis and heart disease.
• You drink regularly and experience chronic or periodic depression. You may be at risk of suicide.
• You have tried to stop drinking and experienced withdrawal symptoms such as headaches, anxiety, insomnia, nausea or delirium tremens (DTs). You need medical attention from a doctor or a treatment centre.

Ask yourself if you have a problem. Use the acronym “CAGE”. You may have a problem if you answer yes to any of the following:

• C - tried but failed to “cut” down
• A - annoyed by criticism from others
• G - guilt about consequences of drinking (e.g. loss of job or relationship)
• E - eye-opener (car accident or drinking and driving charge etc)