Alcoholism - Part 2

The First Warning Signs of Problematic Drinking

I am continuing the series on alcoholism.

In the first part, we looked at where addiction begins and how a person's relationship with alcohol can gradually change. This time, we will focus on the first warning signs that do not necessarily mean a fully developed addiction but should not be overlooked.

Today, professional terminology more commonly uses the term alcohol use disorder instead of the general label "alcoholism." It is a health condition in which a person gradually loses the ability to stop or control their drinking, even though it causes health, work, family, or social problems. The disorder can be mild, moderate, or severe.

Why Is It Important to Notice the Early Signs?

Problematic drinking usually does not begin with a person needing alcohol every morning or immediately losing their job and family.

At first, alcohol may simply seem like a normal part of celebrations, relaxation, or spending time with friends. Gradually, however, the reason a person drinks may begin to change.

Alcohol stops being just a complement to a social occasion.

It begins to be used to calm down, suppress anxiety, forget problems, improve mood, or make it easier to fall asleep.

A person may tell themselves:

"I need to switch off."

"After today, I've earned a drink."

"I can't relax without alcohol."

It is at this point that alcohol may begin to turn into a tool for regulating emotions.

From a psychological perspective, drinking can be reinforced because it temporarily relieves unpleasant feelings.

A person experiences stress, anxiety, sadness, or emotional tension, drinks alcohol, and feels relief.

The brain begins to remember this connection:

unpleasant feeling → alcohol → temporary relief.

This pattern is known in psychology as negative reinforcement.

It does not mean that alcohol provides something genuinely beneficial.

It means that it temporarily removes or reduces something unpleasant, making it more likely that the person will reach for it again.

With repeated drinking, a vicious cycle may develop.

Alcohol provides short-term relief, but it does not solve the underlying problems.

Once the alcohol wears off, stress, guilt, or anxiety often return—sometimes even more intensely.

As a result, the person may turn to alcohol again and gradually learns to cope with more and more life situations by drinking.

This mechanism is considered one of the key processes involved in the development and maintenance of addiction.
One of the First Warning Signs: Increasing Tolerance

One of the warning signs may be increasing tolerance.

The amount of alcohol that once produced relaxation or intoxication may gradually no longer be enough. The person needs to drink more to achieve the same effect.

For this reason, the ability to "hold your alcohol well" is not proof that alcohol is harmless. On the contrary, it may indicate that the body is adapting to repeated drinking.

However, tolerance alone does not automatically mean addiction. It is, nevertheless, a reason to pay closer attention—especially if it is accompanied by loss of control, a strong desire to drink, or continued drinking despite negative consequences.

Then Comes the Loss of Control

A person may plan to have only one or two drinks but repeatedly ends up consuming much more.

They may decide not to drink for a certain period but fail to stick to their plan.

Or they may try to reduce their drinking, only to return to their previous pattern after a few days or weeks.

What matters is not only how much a person drinks.

The real warning sign is the difference between how much they intended to drink and how much they actually drank.

Repeated unsuccessful attempts to reduce alcohol consumption are among the symptoms professionals consider when assessing alcohol use disorder.

However, a single symptom is not enough to establish a diagnosis. The diagnosis is based on several symptoms occurring over a specific period of time and should be made by a qualified healthcare professional.

Thinking About Alcohol More and More Often

Another change may be thinking about alcohol more frequently.

A person plans when they will have a drink, checks whether there is enough alcohol at home, or looks forward mainly to the part of the day when they will be able to pour themselves a drink.

Craving may also appear—a strong urge or compelling desire to drink.

This is more than simply wanting a drink.

Craving may be accompanied by tension, irritability, and the feeling that the person will not be satisfied until they drink.

Another sensitive warning sign is hiding alcohol consumption.

A person conceals how much they have drunk, hides bottles, drinks alone, or tries to prevent others from noticing their drinking habits.

Often, they already realize that their drinking has crossed a line they would no longer be able to openly justify to others.

Memory Blackouts

After consuming larger amounts of alcohol, memory blackouts may occur.

During these periods, the person may talk to others or perform various activities but later be unable to remember them.

These "blackouts" should never be dismissed as a funny party story.

Repeated memory blackouts are a serious warning that alcohol is being consumed in a way that significantly affects brain function and increases the risk of accidents, conflicts, and dangerous decisions.
When Responsibilities and Relationships Begin to Fade

The problem may not become visible only through drinking itself.

It may also become apparent through the things that gradually begin to disappear because of alcohol.

A person may become less reliable, arrive late to work, neglect household responsibilities, or cancel planned activities.

They may lose interest in hobbies and increasingly seek environments where they can drink.

Within the family, arguments, blame, and a loss of trust may begin to appear.

One of the most important warning signs is continuing to drink despite already seeing its consequences.

The person knows that alcohol is damaging their health, relationships, or work performance, yet they are unable—or unwilling—to change their drinking habits.

Alcohol Use Disorder Has No Single Cause

Alcohol use disorder does not arise from a single cause, nor can it be explained simply as a lack of self-discipline.

Modern science understands it as the result of the interaction between biological, psychological, and social factors.

Genetic vulnerability, the functioning of the brain's reward system, impulsivity, past trauma, chronic stress, mental health difficulties, family patterns, the social environment, and the availability of alcohol may all play a role.

Scientific estimates suggest that genetic differences may account for approximately half of a person's vulnerability to alcohol use disorder.

This does not mean that someone with a family history of addiction will inevitably develop the disorder.

Likewise, it does not mean that someone with no family history is protected from it.

Genetic predispositions always interact with a person's environment and life experiences.

Addiction is a treatable chronic condition in which biological processes, psychological factors, environmental influences, and an individual's personal life story all come together.

Understanding addiction in this way does not remove personal responsibility for one's behavior.

Instead, it helps replace the oversimplified belief that the solution is simply:

"Just stop drinking."

What Is the Situation in Slovakia?

A survey conducted in 2023 by Pilulka and Behavio, involving a sample of one thousand adult respondents in Slovakia, found that 14% of those surveyed consumed alcohol every day or several times a week.

When extrapolated to the adult population, this figure has sometimes been described as representing more than half a million people.

However, this number should be interpreted with caution.

The frequency of drinking alone does not determine whether someone has an addiction or another form of alcohol use disorder.

Therefore, the survey should not be understood as meaning that 14% of Slovaks have diagnosed alcoholism.

It does, however, indicate that regular alcohol consumption affects a significant proportion of the population and that prevention and the early identification of problems are important.

The seriousness of alcohol-related harm is also reflected in data from the National Health Information Centre (NCZI).

In 2024, 13,863 hospitalizations related to alcohol-associated conditions were completed in Slovakia.

Although these figures do not include people in the early stages of alcohol-related problems, they clearly demonstrate where long-term risky drinking can eventually lead.
Which Signs Should Concern Us?

We should pay particular attention when a person:

• uses alcohol to cope with stress, anxiety, sadness, or loneliness,
• gradually needs larger amounts of alcohol to achieve the same effect,
• drinks more than they originally intended,
• repeatedly fails in attempts to cut down on drinking,
• frequently thinks about alcohol or experiences a strong urge to drink,
• hides the amount of alcohol they consume or drinks alone,
• experiences memory blackouts,
• neglects responsibilities, relationships, or personal interests,
• continues drinking despite health, family, or work-related problems.

None of these signs alone necessarily means that a person has developed a full alcohol addiction.

However, the more of these signs appear and the longer they persist, the greater the likelihood that the problem has progressed beyond occasional drinking.

Recognizing the Problem Early Is Not a Sign of Shame

Admitting that your relationship with alcohol is beginning to change is not a sign of weakness.

It is an opportunity to intervene before alcohol gains greater control over your life.

Perhaps the most important question is not:

"Am I already addicted?"

Sometimes it is more helpful to ask yourself:

• Why do I drink?
• Can I relax without alcohol?
• Can I stick to the amount I planned to drink?
• What in my life is beginning to change because of my drinking?

The early warning signs do not necessarily mean that a fully developed addiction is already present.

However, they are a sufficient reason to pause, take an honest look at your own behavior, and, if necessary, seek professional help.

– JK –