Is alcohol a drug like cannabis or cocaine? Should I treat it like one or is it ‘different’? Is it safer or more dangerous? Clear to some, the fact remains that many adults in the UK have a limited understanding of the realities and dangers of heavy alcohol consumption.
First things first: Yes, alcohol is a drug – a dangerous one. Perceived as safer by many due to its legality and prevalence in popular media and binge drinking culture, alcohol is nevertheless a drug that kills thousands every year. Behind those deaths are the sad stories of families and social circles ripped apart and, in most cases, the bleak and private spiral of addiction.
This is even more worrying as nearly a third of people (29%) are reporting that they have drunk more alcohol than they normally would during COVID-19 lockdown, according to a major new study by the Policy Institute at King’s College London in partnership with Ipsos MORI.
Colin Drummond, Professor of Addiction Psychiatry from the Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King’s College London said: “There is extensive evidence that the population level of alcohol consumption is highly correlated with health harm. So, with a substantial increase in alcohol consumption during the COVID-19 pandemic as shown in the latest Ipsos MORI survey, we can expect in due course a surge in alcohol-related ill health including alcohol-related liver disease admissions and deaths.”
Understanding the basics
Alcohol is classified as a Central Nervous System (CNS) depressant. This refers to the way it operates in the body and the brain; the substance slows down how our brain operates, leading to the deterioration of other functions in the body. This happens due to the heightened production of GABA in the body. Gamma-aminobutyric acid is an inhibitory neurotransmitter and, when produced in large enough quantities when we drink heavily, it is what slows our other functions, providing the depressant effect.
Interestingly, however, alcohol also acts as a stimulant. When consumed in smaller amounts, these stimulatory effects are felt and are usually what is chased by drinkers. It’s the stimulating side of alcohol that provides the positive feelings we enjoy from the drug, such as improvements in mood, heightened confidence and natural talkativeness. It’s this aspect of the drug that also increases our blood pressure and heart rate when drinking.
The more we drink, the more we start to experience the depressant effects of alcohol over the stimulant effects. Some studies show that people who naturally experience more of the stimulant effects of the drug are more likely to become alcoholics. It’s important to remember, though, that there are a number of other genetic and environmental factors that affect your likelihood to develop addiction. These can include pre-existing conditions like depression and addiction to other substances.
Why is alcohol addictive? How does that work?
We can understand addiction simply as the uncontrollable compulsion to consume alcohol at any cost – even if we’re fully aware of the damaging consequences of doing so. Alcohol is addictive both psychologically and physically, releasing endorphins and dopamine in the brain upon use which gives us strong feelings of pleasure and euphoria.
Interestingly, our brain’s ability to react to substances, our environment and our actions ‘elastically’ makes addiction more likely; heavy alcohol use can physically change its function and chemistry, overloading the reward centres repeatedly to cause cravings that reinforce bad drinking behaviours. Studies even show that some people naturally see their brains release more endorphins and dopamine than others when drinking, which makes them more susceptible to developing alcohol addiction via heavy use.
The causes of alcohol withdrawal
Alcohol affects multiple bodily functions that result in alcohol withdrawal when attempting to stop. First and foremost, excessive alcohol consumption agitates and irritates the central nervous system. Alcohol has a sedative effect on the brain in which it suppresses certain neurotransmitters, causing people to feel at ease after drinking. It is this effect when drinking that causes people to experience initial feelings of happiness, increased sociability, and relaxation.
In heavy long-term drinking, the brain is almost continuously exposed to the depressant effects of alcohol. This causes the person to develop a physical dependence on the substance. Once the body becomes dependent on alcohol, it requires more and more of the substance to produce the same effects. When someone abruptly quits drinking, the neurotransmitters are no longer inhibited by alcohol and the brain scrambles to adjust to the new chemical imbalance. This causes the most uncomfortable signs of withdrawal symptoms such as insomnia, rapid heartbeat, changes in blood pressure, sweating, tremors and fever.
Is alcohol withdrawal dangerous like with some other drugs?
Yes. Alcohol withdrawal symptoms can occur as early as two hours after your last drink. Typically, symptoms will peak within the first 24 to 48 hours upon cessation. While some people experience very few withdrawal symptoms, others may suffer from more serious side effects. Heavy drinkers who suddenly stop drinking may experience a range of dangerous symptoms which can include heart attacks and seizures which can lead to death, so it’s important for those drinking heavily to undergo medically assisted detox.
Chris Cordell* Help Me Stop’s General Manager says “Help Me Stop offers a free service which we can do face to face, over the phone or online where we can discuss someone’s drinking and using recognised assessment tools advise if someone’s drinking levels would indicate that they may need medical assistance in managing their withdrawals. In many instances a community detox is possible, but some will need an inpatient detox”.
For many people using alcohol problematically, withdrawal involves the steady weaning off from drinking over a short period of time, making the withdrawal process safer and less likely to induce seizures, heart attacks and other dangerous symptoms.
We can help
It’s estimated that there are over 500,000 dependent drinkers in the UK. As little as 18% of them access treatment to help them quit.
Help Me Stop provides affordable and groundbreaking ‘Dayhab’ rehabilitation in London and in Winchester, and online via our Online Rehab programme. Our programmes are intensive, effective, and available at a fraction of the cost of traditional residential rehabilitation. More so, they are designed to provide treatment around a person’s work and home commitments.
*Chris is a senior associate member of the Royal Society of Medicine, Certified International Recovery Specialist, and a member of the International Society of Addiction Medicine.