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Can An Alcoholic Become A Social Drinker?

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One of the most common questions people who try to quit drinking ask is whether they have to stop forever. Can they learn how to drink in moderation? Can they learn to become social drinkers? The answer is much more complex than the question would suggest. With recent global statistics reporting 2.8 million premature deaths per year due to alcohol consumption, it is more important than ever to take a closer look at alcohol and patterns of drinking behavior. The impact that alcohol has on societies and individuals is substantial as the alcohol facts and statistics below highlight. 

  • People have been alcohol for over 12,000 years
  • In 2010, alcohol addiction cost the US $249 billion
  • 32% of heavy drinkers also use illegal drugs
  • Alcoholism is the third leading cause of death in the US
  • Alcoholics Anonymous (AA) has over 2 million members in the world.
  • More than 10% of children in America have at least one parent with an alcoholism problem
  • Over 50% of adults have blacked out at least once in their lifetimes.
  • 3.3 million deaths on a global level were caused by alcohol abuse.
  • People who start drinking before the age of 15 have a higher chance of becoming dependent on alcohol than people who start drinking at the age of 21
  • Alcoholism will affect 17% of men and 8% of women.

What Exactly is Alcoholism? 

“Alcoholism” is a level of malfunction that is included in the overarching diagnosis of Alcohol Use Disorder (AUD). Most experts believe that “alcoholism” or AUD is on a spectrum which means that there are different phases of addiction that people experience during their life. This is supported by the Diagnostic Statistical Manual of Mental Disorders, 5th Edition (DSM-5), which asserts that AUD has 3 diagnostic levels which include ‘Mild, Moderate and Severe’. If you have at least 2 symptoms from the list, then your AUD diagnosis will be ‘Mild’, 4-5 symptoms is ‘Moderate’ and 6+ is ‘Severe’. The simple truth is that most addicts oscillate between these different stages of addiction depending on their particular circumstances and stressors. 

Stages of Problem Drinking

Whether a person with an alcohol addiction will be able to become a social drinker in the future greatly depends on the severity of the addiction and the symptoms that they have. There are several stages that a person may go through before they reach the level of being diagnosed with AUD. These basic stages are: 

Moderate Drinker: A person who does not frequently drink, but may be a binge drinker and experience negative effects due to their behavior. 

Problem Drinker: A person who is not an alcoholic but whose alcohol use creates psychological and social problems for himself and others.

Heavy Drinker: Anyone who drinks frequently or in large amounts. They tend to have a high tolerance for alcohol, will experience blackouts and often have severe consequences to their drinking like incarceration and loss of employment and/or relationships.  

Medication for AUD

Although there is no cure for alcoholism, there are a handful of medications approved by the Food and Drug Administration (FDA) for the treatment of alcoholism. These include Disulfiram (Antabuse), Acamprosate (Campral) and Naltrexone (Revia). They each have different benefits and drawbacks, so it is best to consult a medical professional to find out what is appropriate and safe to use before starting any medication regime to treat alcohol addiction.  

Disulfiram (Antabuse): One of the oldest medications on the market, Disulfiram is used to discourage people from drinking due to its effects. The drug inhibits the enzyme used to metabolize alcohol and causes a severe reaction that makes most people violently sick even when a small amount of alcohol is consumed. When used as prescribed, the effects may begin in as little as 10 minutes after consuming alcohol and include anxiety, headache, flushing of the face, sweating, blurred vision, nausea, and vomiting with its effects lasting for 1 hour or more. 

Naltrexone (Vivitrol, Revia): Originally used to treat people with opiate use disorders, naltrexone was approved in 1994 by the FDA as a treatment for alcohol dependence. Naltrexone works to decrease drinking behavior as a dopamine blocker and reports from patient’s who’ve successfully been treated with the drug report a reduction in cravings, and the urge or desire to drink. It also interferes with their desire and pleasure associated with drinking leading to a person drinking less when they do consume alcohol. People who take Naltrexone will not experience severe reactions like those who take disulfiram, but it may cause liver damage when taken in large doses and should not be given to people with hepatitis or liver disease.

Acamprosate (Campral): Used alongside counseling and social support, acamprosate is thought to restore a balance in the central nervous system between the glutamate and gamma-aminobutyric acid (GABA), excitatory and inhibitory neurotransmitters, respectively. In contrast to naltrexone and disulfiram), acamprosate is not metabolized by the liver and does not adversely interact with alcohol so that it can be used by people with liver disease or hepatitis, as well as in those who continue to drink. 

Can Alcoholics Go Back To Moderate Drinking? 

Many alcoholics have tried to return to social drinking. Those who did so successfully were probably problem drinkers, to begin with, and not necessarily alcoholics. The Moderation Management program has helped many learn to drink safely, but it’s not for everyone.

However, those who have quit drinking because of past problems, and then attempt to go back to controlled or moderate drinking, fail to do so. They simply cannot drink one or two and stop, or at least not for any sustained period.

Most experts agree that if you are someone who has been diagnosed with AUD, the most effective treatment involves abstinence with social drinking no longer being a viable option. It’s important to remember that alcoholism aka AUD, is a chronic and incurable disease. There is no amount of willpower or bargaining that one can do to make it go away, and seeking help from a medical professional, substance abuse treatment center, or a support group such as Alcoholics Anonymous (AA) is often the best course of action. The good news is that it is possible to break the cycle of addiction and start on the path to recovery. If you are currently suffering and would like more information about addiction or a free assessment by a counselor to then please contact the professionals at The River Rehab to explore what treatment options are available.