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Denial that an alcohol problem exists is common. Alcoholism is characterized by an extremely strong craving for alcohol, a loss of control over drinking, or a physical dependence on alcohol. In contrast, alcohol abuse is defined as a pattern of drinking that results in one or more of the following situations within a 12-month period:

  • Repeated problems at work, school, or home due to drinking
  • Risking physical safety by drinking in situations that are dangerous, such as driving or operating machinery
  • Recurring trouble with the law, such as being arrested for driving under the influence of alcohol or for physically hurting someone while drunk
  • Continuing to drink despite alcohol-related difficulties

Alcohol abuse often progresses to alcohol dependence or alcoholism. Alcoholism involves a powerful “craving,” or uncontrollable need for alcohol. This craving overrides the ability to stop drinking. This need can be as strong as the need for food or water. Symptoms of alcohol dependence include:

  • Craving a drink of alcohol
  • Inability to stop or limit drinking of alcohol
  • Needing greater amounts of alcohol to feel the same effect
  • Withdrawal symptoms if alcohol is stopped, including:
    • Nausea
    • Sweating
    • Shaking
    • Anxiety
    • Increased blood pressure
    • Seizures
  • Giving up activities in order to drink or recover from the effects of alcohol
  • Drinking that continues even when it causes or worsens health problems
  • Being unable to stop or reduce drinking despite a desire to do so

Alcoholism may also lead to physical symptoms that are due to the destructive effects of alcohol on the body, and may include:

  • High blood pressure
  • Yellowing of the whites of the eyes and/or skin ( jaundice)
  • Red palms, flushed face
  • Spidery veins showing through the skin around the umbilicus and on the face
  • Enlarged liver
  • Nausea, bloating, dyspepsia, and ulcers
  • Pancreatitis
  • Easy bruising and/or bleeding
  • Shakiness, tremor
  • Weakness of the wrists, ankles
  • Numbness and tingling
  • Impaired memory
  • Fast heart rate
  • Shrunken testicles
  • Erectile dysfunction
  • Increased susceptibility to infections and cancer


American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Text Revision. Washington, DC: American Psychiatric Association; 2000.

Helping patients who drink too much: a clinician’s guide. National Institute on Alcohol Abuse and Alcoholism website. Available at: http://pubs.niaaa.nih.gov/publications/Practitioner/CliniciansGuide2005/clinicians_guide.htm. Accessed April 14, 2007

National Institute on Alcohol Abuse and Alcoholism website. Available at: http://www.niaaa.nih.gov/.

National Institute on Alcohol Abuse and Alcoholism website. Available at: http://www.niaaa.nih.gov/.

Last reviewed March 2013 by Brian Randall, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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