Alcoholism and drug addiction are the same disease. Alcohol is a drug just like every other substance under that broad umbrella. So why do drugs and alcohol always seem to be classified differently? Why do opiates, pills, stimulants, and marijuana get lumped together as drugs but alcohol does not? People that I meet in recovery identify as an alcoholic or a drug addict or both. The two biggest anonymous fellowships are Narcotics Anonymous and Alcoholics Anonymous. Rehab websites offer treatment for addiction to drugs and alcohol.
I think there are a few reasons for the distinction. Alcohol is legal in most places around the world. It does not have the same stigma attached to it as other drugs. It is not considered inherently bad like heroin or meth. Alcohol is socially acceptable. People drink beer during sports games. Celebrations are toasted with champagne. Wine is paired with food. Television programming breaks are filled with alcohol commercials.
There is a misconception that alcoholism is not as serious as addiction to drugs like meth and heroin. There is the term “functioning alcoholic” that refers to people who have a drinking problem but are able to hold down jobs, families, and other responsibilities. As opposed to using hard drugs, when someone drinks heavily it is easier to chalk it up to a fondness for partying rather than a problem. Alcoholism tends to progress more slowly than addiction to other drugs and people can drink for years and years before they start suffering serious negative consequences to their health and livelihoods. It can be easier to hide. The people in an alcoholic’s life may be more willing to cut them slack and give them chances than if they were using drugs. Obviously these situations are not always the case but in general, in my experience, they seem to hold true.
This misconception that alcohol is less dangerous than other drugs could not be further from the truth. It impairs inhibitions, judgment, and motor skills in such a way that when people are extremely drunk, they can put themselves and others in real danger. Violence and vehicular accidents are common and often there’s no recollection of them. Because alcoholism often progresses slowly over a long period it can be harder to break that cycle and people have a long time to suffer increasingly negative consequences. Alcohol withdrawals can cause seizures and even death. It is easier to overdose on other drugs but alcoholic death is usually slow and extremely painful. Alcohol works on the body and mind in unique ways and in this blog I’ve written about some serious medical complications that accompany chronic alcohol abuse and alcoholism.
Cirrhosis of the liver is a common problem related to serious alcoholism. Too much alcohol inflames the tissue of the liver and as the liver tries to heal itself, scar tissue is formed. When this is repeated over and over, more scar tissue accumulates and weakens the ability of the liver to function. Cirrhosis takes years to develop from constant inflammation and damage. Unfortunately, most symptoms don’t begin to show until the later stages when the damage may be irreversible. There are too many complications to list all of them but many are severe as they are a result of the liver shutting down: edema, jaundice, mobility problems, memory problems, and confusion. If drinking continues and cirrhosis is left untreated it can develop into liver cancer and turn fatal if the liver completely shuts down.
Excessive alcohol consumption can cause or contribute to other kinds of cancer in addition to liver cancer: esophageal, laryngeal, colon, and breast cancer in women. The risks of developing one of these types of cancers increases directly with the amount one drinks. Binge drinkers and heavy drinkers are at the highest risk; you don’t necessarily have to be an alcoholic. One of my uncles died of liver cancer. He had been a heavy drinker and drug user for years. It was sad to see his quick decline in the later stages of the disease. He needed a liver transplant but was unable to get one in time. I was able to speak with him on the phone a few hours before he passed away but he was mostly incoherent because of all the pain medication he was on. He was in a lot of pain.
Chronic heavy drinking can cause a host of physical problems including:
- Gastrointestinal problems
- Heart disease
- Immune system problems
It can be equally damaging to the brain. Most of us are familiar with the short-term effects that alcohol has, as listed above. Rapid consumption of alcohol also causes blackouts. This occurs when alcohol interferes with the transference of short-term memories to long-term memories. Technically it creates a form of alcohol induced amnesia as the drinker is able to participate in activities and events that will not be remembered later on.
Long-term heavy drinking causes different types of alcohol related dementia (ARD) related to frontal lobe damage in the brain. The symptoms are similar to those of other dementia disorders like Alzheimer’s: memory loss, confusion, and difficulty with motor tasks. The most well-known form of ARD is probably Wernicke-Korsakoff’s syndrome, colloquially known as “wet brain”. This occurs in two stages and is a result of thiamine deficiency in the brain. Without thiamine, the brain cannot convert sugar to energy like normal and functioning is impaired. The first stage is Wernicke encephalopathy in which the dementia-like symptoms occur. These symptoms worsen during Korsakoff syndrome and can degrade into hallucinations and psychosis. Long-term memory may also be affected. This is a serious condition that can be lasting if not treated immediately.
Getting through the initial acute withdrawals when stopping the use of any substance can be the biggest hurdle to overcome on the road to recovery. The temptation to use again to alleviate the terrible physical and psychological pain is difficult to resist. Alcohol is one of the hardest and most dangerous substances to withdraw from. In extreme cases, alcohol withdrawal can cause seizures, death, and a terrifying condition called Delirium Tremens. This usually only occurs in people who have been daily heavy drinkers for years and sets in anywhere from one to four days after cessation of drinking. Sufferers experience racing hearts, tremors, and fever. They will experience extreme anxiety, agitation, confusion, and fear. They have delusions and frightening hallucinations. Some people see rats or spiders crawling on them or in the room. Delirium Tremens is considered a medical emergency and requires treatment. Benzodiazepines are often used to sedate patients and prevent seizures.
This was a more difficult topic to write about than I anticipated. There are so many complications arising from alcohol abuse that affect different parts of the body. I tried to focus on the conditions that seemed the most serious and frightening.
These days there seems to be much more going on with drug addiction in the public eye and in the media than alcoholism. The opioid epidemic, the opioid spending bill, fentanyl, increasing overdoses, methamphetamine, Mexican drug cartels, etc. It is understandable given the scope and severity of these problems. Giant drug seizures and kingpin arrests make sensational stories. Those kinds of things don’t happen with alcohol.
In writing this blog I found it easy to start going down the rabbit hole of alcoholism vs. drug addiction but that isn’t the point I was trying to make. I believe them to be symptoms of the same disease. What I want to get across is that alcohol is a drug and alcoholism is extremely dangerous. Alcohol abuse causes life-threatening physical and psychological problems and tends to kill people slowly over a number of years. Alcohol’s wide acceptance in society can make it seem deceptively harmless. The aggressive marketing of it paints a picture of sophistication and innocuous fun.
Some of the hardest cases that I’ve seen during my time in recovery have been alcoholics. Hard drinkers for years who lost everything that they held dear and are suffering from alcoholic complications. Many of them are chronic relapsers who keep going out after periods of sobriety. After drinking for so long and relapsing so many times, some alcoholics give up on believing that they can stop. It never gets easier to see people you care about repeatedly putting themselves through the wringer.
But I have seen more people in recovery staying sober. Seeing treatment and Alcoholics Anonymous working in the lives of others is a beautiful thing. Hearing these people share about getting their families and lives back together. People who had a spiritual awakening at the diagnosis of the early stages of wet brain or cirrhosis and got themselves on the path out of active alcoholism and into recovery.