People with serious drinking problems may have overlapping symptoms of alcohol abuse and alcoholism, symptoms related only to non-addicted abuse or symptoms related only to alcoholism. After trying to quit, many of these individuals experience a short- or long-term relapse back into active alcohol consumption. In a study published in June 2014 in the journal Drug and Alcohol Dependence, a team of American and Spanish researchers used data gathered from a large-scale U.S. project called the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) to determine if it’s possible to predict which people affected by alcohol abuse and/or alcoholism have the highest chances of trying to quit drinking and successfully establishing drinking abstinence.
Alcohol Abuse and Alcoholism
Traditionally, doctors and researchers have considered physical dependence and alcoholism to be distinct from a dysfunctional pattern of behavior associated with non-dependent alcohol abuse. However, in reality, symptoms of each condition commonly appear together in one form or another in the same person. In response to the growing scientific consensus supporting this reality, the American Psychiatric Association (which has long defined the terms for diagnosing substance-related problems in the U.S.) eliminated separate diagnoses for alcohol abuse and alcoholism in May 2013. In their place, the organization introduced a diagnosis called alcohol use disorder, which includes all relevant symptoms for alcohol abuse and alcoholism. In addition to establishing the minimum criteria for identifying serious problems with alcohol, this new diagnosis allows doctors to count the number of symptoms present in order to determine the severity of the disorder in each affected individual.
Drinking Relapse
A person affected by alcohol abuse and/or alcoholism can’t stop drinking without experiencing serious aftereffects. Instead, he or she must begin by going through a period of detoxification where alcohol leaves the brain and body. In cases where an individual is minimally or moderately impacted by alcohol use disorder, the detox process can present a serious challenge to a sense of physical and mental well-being. However, in individuals with severe cases of the disorder, alcohol detoxification can produce major or even life-threatening side effects. Regardless of the severity of their condition, essentially all people affected by alcoholism symptoms go through a period of withdrawal when they first stop drinking and go through detoxification. In addition, people affected the symptoms of alcoholism and/or alcohol abuse must deal with the continuing presence of social and environmental triggers that they have come to associate with alcohol intake. Separately or in combination, withdrawal symptoms and drinking cues can promote ongoing cravings for alcohol consumption and lead to the onset of a relapse.
Predicting the Odds of Success
In the study published in Drug and Alcohol Dependence, researchers from the New York State Psychiatric Institute and Spain’s University of Oviedo analyzed the data from the National Epidemiologic Survey, a federal project conducted across the U.S. in two phases in the early 2000s, in order to determine how many people with alcohol use disorder tried to stop drinking over a period of three years. The researchers used the same data to determine how many people succeeded. In addition, they used the NESARC data to see if it’s possible to predict which people with the disorder will try to quit drinking and successfully quit drinking. The researchers concluded that, during the three-year period bracketed by the two phases of NESARC, roughly 18 percent of the survey participants affected primarily by alcoholism tried to quit drinking. The quit-attempt rate among the participants affected primarily by alcohol abuse was about 10 percent. Approximately 30 percent of the alcoholism-impacted individuals who tried to quit succeeded in their attempts. In contrast, the success rate among the alcohol abuse-impacted individuals who tried to quit was roughly 38 percent. The researchers determined that several factors increase the likelihood that a person affected by alcoholism and/or alcohol abuse will try to quit drinking. These factors include being unmarried, having a relatively low economic standing, being below the age of 40, having a relatively large number of alcoholism symptoms and having simultaneously occurring problems with a diagnosable mental illness. The researchers also determined that several factors help predict which alcohol abuse-impacted people who try to quit drinking will find success. These factors include being a woman, being over the age of 40 and having a spouse. The study’s authors note that, paradoxically, some of the factors that predict a likelihood of one trying to stop drinking are essentially opposite of some of the factors that predict success in quitting drinking. Unfortunately, they concluded that this curious situation likely means that some of the factors that increase an individual’s desire to stop drinking may actually diminish his or her capacity for halting alcohol use. However, the authors believe that their findings can help future researchers develop improved treatments for alcohol abuse/alcoholism.