Alcohol Awareness Month: When Does Alcohol Use Become a Problem and What Can We Do About It?
By: Julia T. Maleky, A.S.W
Camino a Casa Clinician I
Alcohol use, misuse, or abuse has touched almost all of our lives in one way or another. Alcohol Awareness Month is a national public health campaign that takes place every April, and its purpose is to increase awareness and understanding of the causes and treatment of alcoholism. The month of April highlights the importance of learning about the widespread and pervasive nature of alcoholism, including the signs, effects, and, most importantly, what we can do to help.
Alcohol is one of the most used substances by youth and adults in the United States. According to the National Institute of Health’s (NIH) 2020 Monitoring the Future Survey, 55.3% of high school seniors used alcohol in the past year. In 2019, about 25% of 14- to 15-year-olds reported having at least 1 drink (SAMHSA, 2019). The National Survey on Drug Use and Health (NSDUH) showed that an estimated 414,000 adolescents ages 12-17 currently have an alcohol use disorder. Furthermore, Partners in Prevention reports that alcohol is the third leading cause of preventable death in the United States, with about 95,000 Americans dying from alcohol-related causes every year.
The effects of alcohol use are widespread and can last a lifetime. According to research done by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), alcohol use during teenage years can interfere with adolescent brain development and can contribute to a range of consequences such as increased risk of hospitalization, risky sexual behaviors, physical and sexual assault, criminal activity, fatalities, and reduced academic performance. Research also shows that people who start drinking before the age of 15 are at a higher risk for developing alcohol use disorders later in life (SAMHSA, 2019).
The DSM-5 defines alcohol use disorder as a problematic pattern of alcohol use leading to clinically significant impairment or distress, as manifested by at least two of the following, occurring within a 12-month period:
- Alcohol is often taken in larger amounts or over a longer period of time than intended.
- There is a persistent desire or unsuccessful efforts to cut down or control alcohol use.
- A great deal of time is spent in activities necessary to obtain alcohol, use alcohol, or recover from its effects.
- Craving, or a strong desire or urge to use alcohol.
- Recurrent alcohol use resulting in a failure to fulfill major role obligations at work, school, or home.
- Continued alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol.
- Important social, occupational, or recreational activities are given up or reduced because of alcohol use.
- Recurrent alcohol use in situations where it is physically dangerous.
- Alcohol use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by alcohol.
According to the DSM-5, two to three of these symptoms indicate a mild alcohol use disorder. How many people do you know who express a craving for alcohol and need to drink more alcohol to feel like they did when they first started to drink (tolerance)? Or who continue to drink despite waking up the next morning feeling absolutely terrible? If we thought of alcohol the same way we thought of heroin or cocaine, would we still be okay with having a glass or two of wine every night? Food for thought…
For many people, getting help for alcohol use, misuse, or abuse can pose significant challenges. For one, alcohol is often seen as a lesser evil and a normal rite of passage for youth; therefore, alcohol use may not even appear to be problematic until later in life. Alcohol use has become so normalized in our society that few people think twice about the negative consequences that may be associated with adolescents having an occasional drink. There are also social stigmas associated with alcohol abuse or addiction which hinders individuals of all ages from seeking the help they deserve. Finally, there can be a lot of shame and anger associated with acknowledging a substance use disorder and asking for help. Many people may not feel that their usage is problematic; they may even feel that it truly improves their lives. They may think they have complete control over their usage. Whatever the reason may be, whether it is social, emotional, or financial, there may be a lot of hesitation in getting help for alcohol use, misuse, or abuse.
How Camino a Casa plays a role in recovery
Camino a Casa addresses co-occurring disorders and identifies youth that demonstrate substance use, abuse, or dependence issues. While treatment at Camino a Casa primarily focuses on mental health issues such as self-harm and depression, we recognize the added difficulties associated with having co-occurring substance use disorders, and the toll that substance use can take on the mental health of our youth. For many teens and adolescents, alcohol use, abuse or misuse develops due to an underlying mental health issue as a form of coping. Pathways to Recovery is a weekly group that helps youth understand their triggers for using substances and learn more adaptive coping strategies to use in place of substances. We engage the youth in experiential activities to facilitate discussion around triggers, stigma, relapse, and self-compassion. Our goal is to provide youth with a safe space to explore the reasons why they use substances, and to work toward being able to use more appropriate strategies to deal with their emotions.
For more information about the Camino a Casa program, please visit www.caminoacasa.org.
SAMHSA’s National Helpline: 1-800-622-HELP (4357)
This is a confidential, free, 24-hour-a-day, 365-day-a-year, information service, in English and Spanish, for individuals and family members facing mental and/or substance use disorders. This service provides referrals to local treatment facilities, support groups, and community-based organizations.