How to Address a Drinking Problem

It can be tough to determine if a person’s consumption is unhealthy — and even harder to get him or her to talk about it. Why having the conversation is crucial.

7:00 AM

Author | Landon Hudson

With its presence splashed across TV screens, billboards and pop music lyrics, alcohol is everywhere. It's common, then, to assume that everyone consumes beer and liquor on a regular basis.

But when does "having a few" become a problem?

LISTEN UP: Add the new Michigan Medicine News Break to your Alexa-enabled device, or subscribe to our daily audio updates on iTunes, Google Play and Stitcher.

People unable to manage their intake may have alcohol use disorder, a medical condition that doctors diagnose using 11 criteria.

The three levels of severity — mild, moderate and severe — are each defined by the number of symptoms cited.

"I think the easiest way to think about this illness is that someone with alcohol use disorder often exhibits behaviors indicating difficulty controlling their alcohol use, often has cravings or urges to drink, and has had his or her life impacted by drinking in a negative way," says Allison Lin, M.D., a psychiatrist at University of Michigan Addiction Treatment Services.

With signs that include a reduced ability to work and waning interest in social activities, alcohol use disorder doesn't just affect one individual. It can cause problems within that person's home, workplace and school.

And quitting isn't always easy: Nausea, sweating or shaking may occur from withdrawal and may require medical treatment. Withdrawal symptoms can be life-threatening if not medically managed.

"Like other chronic illnesses, we expect that people can have relapses after periods of doing well, and one of the goals of treatment is often to prevent or lessen the impacts of relapses," Lin says. "I also think of it as quite a complex illness influenced by both biological and psychosocial factors."

Sometimes people are afraid of talking about addiction, but I think it's important to try to talk openly about it in a caring way.
Allison Lin, M.D.

Warning signs and treatment options

Because many people drink in social settings, it might be tough to tell if someone has an issue and, if one is suspected, to approach the person about it.

"One challenge is that, especially early in the illness, many people with an alcohol use disorder have a hard time recognizing the problems that it's causing them," Lin says. "Oftentimes, family members and friends are the first to recognize the problems."

MORE FROM MICHIGAN: Subscribe to our weekly newsletter

Some common warning signs: personal problems or negative interactions with environment or peers.

Complicating recovery is that alcohol use disorder, while more common than the overuse of other drugs such as opioids, is less frequently addressed.

"I think opioid use disorders have received more recent national attention because the health care system has contributed to the problem, but also because there are effective interventions," Lin says.

But, she notes, there also are targeted, effective interventions for people who want to stop drinking.

Treatment can include medications or psychotherapy. Some medications, such as naltrexone, have shown to be effective in reducing alcohol use. Psychotherapy options, including cognitive behavioral therapy and motivational interviewing (a clinical approach rooted in making lifestyle changes), can work, too.

Abstinence from alcohol is strongly recommended after the detox period.

Conversation and compassion are key

Those in need aren't alone: Alcohol use disorder affects 16 million U.S. adults and 623,000 youths ages 12 to 17, according to the National Institutes of Health.

The first step to recovery is getting the conversation started even if multiple attempts are needed.

SEE ALSO: How to Spot Signs of Opioid Addiction

"Sometimes people are afraid of talking about addiction, but I think it's important to try to talk openly about it in a caring way," Lin says. "Often when we work with folks struggling with alcohol and other substance use disorders in a treatment setting, it takes several tries and different approaches until the person agrees to treatment."

Openness to receiving treatment can fluctuate day to day, but providing consistent support is crucial.

Many people with alcohol use disorder can recover, Lin notes.

"I think the challenge is that when someone is struggling, it can feel really terrible, especially because the illness can also worsen other things like depression and anxiety," Lin says. "But over time, we know many people get better often with the help of family, friends and also with treatment."

University of Michigan Addiction Treatment Services offers a comprehensive range of services and outpatient care to help treat mild to severe substance use disorders. To schedule an appointment, call 734-764-0231.

For U-M students, the Collegiate Recovery Program is a nontreatment program that offers support for those who may be struggling with a substance use disorder.


More Articles About: Health Management Addiction and Substance Abuse Mental Health Assessment Mental Health
Health Lab word mark overlaying blue cells
Health Lab

Explore a variety of healthcare news & stories by visiting the Health Lab home page for more articles.

Media Contact Public Relations

Department of Communication at Michigan Medicine

[email protected]

734-764-2220

Stay Informed

Want top health & research news weekly? Sign up for Health Lab’s newsletters today!

Subscribe
Featured News & Stories Illustration of doctor pictured outside a pill bottle that houses a bent-over figure with pills lying on the ground
Health Lab
It’s easier now to treat opioid addiction with medication -- but use has changed little
Buprenorphine prescribing for opioid addiction used to require a special waiver from the federal government, but a new study shows what happened in the first year after that requirement was lifted.
marijuana leaf drawing blue lab note yellow badge upper left corner
Health Lab
Data shows medical marijuana use decreased in states where recreational use became legal 
Data on medical cannabis use found that enrollment in medical cannabis programs increased overall between 2016 and 2022, but enrollment in states where nonmedical use of cannabis became legal saw a decrease in enrollment
Mothers Babies Postpartum
Health Lab
Rapid rise seen in mental health diagnosis and care during and after pregnancy
Perinatal mental health research shows more pregnant people and those who have recently given birth are getting diagnosed and treated for depression, anxiety and PTSD, but disparities remain.
Older woman checks her face in the mirror
Health Lab
Does trying to look younger reduce how much ageism older adults face?
How do ageism and positive age-related experiences differ for people who have tried to look younger, or feel they look younger, than they actually are? A new study examines this and the relationship with health
Illustration of girl with blue water line, depicting a figure drowning, as girl contemplates pill in hand
Health Lab
Antidepressant dispensing to adolescents and young adults surges during pandemic
Rate of antidepressant dispensing to young people rose faster after March 2020, especially among females
Breaking Down Mental Health on blue background and text inside a yellow head graphic
Breaking Down Mental Health
Depression and Sleep
In this episode, learn to understand the interplay between depression and how cognitive behavioral therapy can improve sleep.