Alcohol Use Disorder
My name is William Conway, MD. I am a general internist with a subspecialty in addiction medicine. I have practiced addiction medicine since 2012, and I come from a place of understanding and respect. Your improved quality of life is my priority. My current addiction treatment practice is Suboxone+Primary Care™ in Nashville. My current practice of general internal medicine is Nashville Concierge Medicines.
My promise, as a healthcare professional committed to helping people move from a place of pain to a place of peace, is to be your go-to point person each and every time we meet. When you make an appointment with me in my clinic, I will be the person to shake your hand and look you in the eye, and together we will move forward to a place of healing.
Executive Summary
- Alcohol Use Disorder (AUD) affects millions of Americans every year.
- The risk factors of developing AUD include family history, drinking at an early age, mental health challenges, frequent heavy drinking, and life stressors.
- Some signs that you or your loved ones might notice include a decreased interest in non-drinking activities, frequent hangovers or withdrawal symptoms, and an increased alcohol tolerance over time.
- When drinking becomes a problem, there is hope and there is help!
Case Study in Nashville
Marnie, a long term resident of Nashville, never expected to be drinking alone. But widowhood had caught her unawares, and here she was. That drink before dinner that she and Henry had shared almost every night for forty years… well, now she had it alone. Before long, she was drinking Henry’s share as well. It made everything feel less lonely. Then came the drink after dinner- granted not a common occurrence when Henry had been around, but still- it was easier to face the rest of the long, lonely evening without him with a glass in her hand.
At some point, Marnie switched from buying bottles to buying boxes. It was easier on her fixed-income budget. Her evening ritual developed, over just a few short months, into a four-serving habit. It wasn’t immediately obvious to her just how much more she was drinking since there were no tell-tale bottles lining up to be counted. She knew she was drinking more than she had, but loneliness reached out and told her it was for comfort, and she believed it. Who was it hurting, anyway?
Maybe Marnie’s story is relatable to you, or maybe your story looks wildly different. As a specialist in addiction medicine, I’ve known a few Marnies. But I’ve known hundreds of others, because there are as many paths to AUD as there are people who walk that path. The most important part of your story is what you decide to do next. Unfortunately, Nashville is known as a “party town,” and we have more than our fair share of people who struggle with alcohol issues.
What is Alcohol Use Disorder?
It doesn’t necessarily start with a dramatic crisis.
A drinking problem usually begins… just as drinking. It’s an activity that becomes a habit that eventually becomes a need. And wants are nice to have, but needs can get you into trouble.
To begin to understand something, it helps to have a proper definition of it.
Alcohol Use Disorder is a medical condition whereby someone is unable to control or stop their drinking in spite of it causing problems in their life. Some of the characteristics of the disorder include an increasing tolerance to alcohol, withdrawal symptoms when not drinking, and continuing to drink even when negative consequences come from it. It is a problem for millions of people in the USA alone.
What are Some of the Risk Factors of Developing Alcohol Use Disorder?
It’s impossible to tell who will be able to keep up a long-term habit of “social drinking” without it becoming a problem. Some people seem to be able to nurse a drink for an entire evening, or to just drink occasionally at a party, but others won’t be able to do this.
So, while nobody can predict whether or not they’ll develop a drinking problem, there are some known risk factors. These include:
- A family history of problem drinking,
- Depression or anxiety,
- Using alcohol at an early age,
- Drinking heavily for a long time, and
- Going through stressful life changes.
Often, the catalyst for alcohol use becoming problematic is a major stressor in life that causes someone to rely more and more heavily on alcohol for relief from anxiety or other negative feelings. This can be relationship difficulties, trouble at work or school, a major move, difficulty with adolescent children, or even retirement. Responding to stress by trying to silence it with a drink (or two, or three…) can turn a previously benign habit into a real problem.
What are Some of the Signs of Alcohol Use Disorder?
Americans in particular have created a culture of social drinking that makes it hard to know when alcohol use has become a problem. We drink at every social event, every holiday, every celebration; from football games to birthday parties to cookouts, there’s always alcohol available. It’s almost as if someone who isn’t drinking is the outlier.
So what are some signs of Alcohol Use Disorder? Think “alcoholism” and certain stigmatized images spring readily to mind: car accidents, job loss, divorce, estrangement from friends and family. But look closer and it might look a bit different. It might be something like a slow dulling of the joy you used to experience in life, the enjoyment you once had of certain favorite activities that now feels flat. These are signs that alcohol is now required by your brain to make everyday things feel pleasant or enjoyable. Without it, things are just starting to fall flat.
This dulling or flattening feeling means that the rewards system in your brain has been disrupted. Any drug can cause this- in fact, any addiction can cause this, from heroin to the screen time we all find ourselves getting sucked into every day. The brain, being so wonderfully adaptable, will rewire itself to crave those activities or drugs that give us easy pleasure. And alcohol, being that perfect fit for certain brains, will gladly sneak in and take control of your reward system, eventually pushing out the simple enjoyment of things like a walk in nature or a quiet conversation. Sometimes this is what AUD looks like: “I don’t enjoy anything anymore unless I have a glass in my hand and another one on the way.”
So how can you tell when this seemingly normal, socially acceptable behavior has become a problem?
How to Know When You’re Developing a Problem
While some signs that your drinking has become a problem are obvious, others can kind of sneak up on you. We all know that it’s a problem when we do something truly dangerous like driving after we’ve been drinking, but sometimes alcohol can be a little more devious than that.
If you find that you drink more than you had planned on drinking, or for longer, or that you’ve spent more money on alcohol than you wanted to, that might be a sign that it’s a problem. If you only enjoy activities when drinking is involved, that’s another. And again, it can be hard to tell because drinking is such a part of so many social gatherings. So sometimes, you also have to listen to what your friends and family have to say about it. A partner or best friend might be the first to notice a change in you. They might be the first to point out that you drink more than you used to, or that you can’t seem to have any fun unless there’s alcohol involved.
If it’s someone you trust, it might be time to listen.
What to do When Drinking Becomes a Problem
Once you’ve been able to acknowledge that your drinking has become a problem, the next step is to find help. This might be where I come in. With my subspecialty in addiction medicine, I can walk with you all the way through to the other side of this. There are many effective treatments! We can talk about which kind would be the best fit for you, personally.
Reasons to Hope: A Pathway to Recovery
There’s always good news. And the good news here is that AUD is treatable. I hope it’s comforting for you to know that fully half of adults who have struggled with AUD eventually recover. There are many different roads to recovery, but they all start with a decision. It is within your control to decide that you want to step away from alcohol. As a doctor, I have sat with people in the darkness of addiction and walked with them through to the other side of it!
Recovery doesn’t look the same for everyone. Some people respond best to group or individual therapy; others prefer medication or support programs. There’s going to be something that works for you. The fact that you’re here, reading this, might be just the push you need. Reach out to me today and get ready to live life to the fullest!
Conclusion
If you find yourself needing help with your drinking, I, Dr. Conway, am here for you. Whether you need medication, emotional support, or a referral for some other kind of support, I’m here for that. There is a strong and loving community of people out there, and you aren’t alone.
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