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Why can’t they stop? Understanding alcohol dependence

What is alcohol dependence?

Becoming alcohol dependent means that a person has developed a strong relationship with alcohol & is unable to function without it in their lives. Drinking alcohol has become an important - or sometimes the most important factor in their life.

It also means that when a person starts drinking that they find it very difficult to control the amount or the times when they are drinking.

Depending on the level of dependence, a person can experience withdrawal symptoms if their supply of alcohol is suddenly stopped. Withdrawal symptoms can be both physical and psychological.

When someone is dependent on alcohol it usually causes chemical changes in a person’s brain which leads to all kinds of problems for them and their family. They keep drinking in spite of these problems as it is an addictive & depressant drug.

Many alcohol dependent people do not seem to be drunk (intoxicated) after drinking large amounts. Their bodies can tolerate higher continuous blood alcohol concentration without noticeable signs of becoming intoxicated.

How long does it take for someone to become dependent?

The increase in tolerance and the development of dependence are gradual processes that usually progress over a period of many years. However, some people can become dependent after only a few years or months.

How do people behave when they are dependent on alcohol?

Dependence affects different people in different ways.

Some people drink a lot of the time, some people drink first thing in the morning, some people drink every evening, some people drink every day, some don’t. Some can stop drinking for some weeks or months but when they start drinking again they lose control.

Some people stick to one type of alcohol, like vodka, beer or wine. Other people drink different types. In the late stages of dependency a person is prepared to drink any type of alcohol.

Our section Worried about a parent or carer? has information for young people living in a home where there’s an alcohol problem. It has tips on how to cope better and get help. 

For people who are dependent on alcohol, protecting their supply of alcohol, making sure they can have a drink, becomes one of the most important things in their life, or THE most important thing.

How does a person feel when they are dependent on alcohol?

Before they have a drink

A dependent person may spend a lot of time thinking and planning what and when they will be able to drink. They may feel more and more anxious, unhappy or tense until they have a drink. They may also feel unwell. Their drinking becomes the main activity around which their lives rotate.

While they are drinking

Alcohol affects the brain and the central nervous system. The alcohol acts quickly on the brain and changes feelings and behaviour for a while. Many people like the effect alcohol has on their brain and feelings and they want to keep drinking to keep getting the effect. The alcohol can make them drunk and seem like a different person.
They may do embarrassing things, get aggressive or take risks.

If they don’t drink

A person who is dependent on alcohol will suffer if they can’t get any. They will feel a lot of anxiety and upset. They may get very irritable or angry. They may not be able to sleep. They may also have physical withdrawal symptoms like shaking, seizures (fits), sweating and sickness.

Why can’t they just drink like other people?

There are lots of reasons why people start to have problems with alcohol.

Some common ones are:

  • Starting to drink at a young age
  • Drinking a lot over a long period of time
  • A family history of addiction
  • Using alcohol to cope with problems

Why can’t they stop?

It is possible to stop drinking when you are dependent on alcohol - lots of people have done it - but it isn’t easy.

Alcohol dependence can make it hard for a person to change in 2 main ways:

1)   They have a psychological dependence on alcohol. This means that they find it hard to stop their drinking habit. Psychological dependence can be hard to fight. It can make a person want to drink long after they have got rid of alcohol from their body. This can be because:

  • It is very hard to break a habit, especially something you have done for a long time
  • It can feel difficult to face the world without alcohol if it has become a big part of your life. For example, if they always used alcohol as a way to try and cope with things – to try and feel happier, relaxed, more confident or to forget something upsetting in the past.

2)   They may also have a physical dependence on the drug alcohol. This means their body needs alcohol and craves it, a bit like the way we get hungry when we don’t eat.
They could feel very ill and upset if they don’t drink alcohol. If they are physically dependent, they will get symptoms like shaking hands, feeling sick, sweating and even seizures (fits).

How do people stop?

When people change, they normally:

  • Have suffered consequences from their pattern of drinking and their drinking behaviour
  • They begin to see that drinking is causing some problems 
  • Over time they learn to accept that they are no longer in control of their drinking
  • They time to think about it or talk about it
  • Decide that they really want to stop
  • Get prepared – either by making a plan or by getting some help from a doctor or someone specially trained to help people who are dependent on alcohol.
  • Some people need medication to help them stop.

You may think it is simple, and wonder why they don’t just do this. But people who are dependent on alcohol often don’t stop to really think about what is happening. Instead they are focused on drinking.

How can I make them stop?

Unfortunately, you can’t control someone else’s behaviour or beat dependence for them. It can help to think of their alcohol dependence as an illness, which you can’t cure.

Have a look at our section Worried about a parent or carer? It has lots of advice to help you look after yourself and cope better if someone you care about has an alcohol problem.

We also have more information on dependence, if you want to read more.

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