When we talk about alcoholism, we often toss around terms such as tolerance, dependence, and addiction. Since most of us aren't experts in alcoholism or addiction, the meanings of these words can become blurred. Here, we’ll help to clarify what is meant when we talk about rising tolerance versus increasing dependence and how addiction is yet another phenomenon of its own.

When we have sorted out the specific meanings of these terms, we can more easily address alcoholism that might arise in our workplace, family, or in ourselves. Keep in mind that alcoholism is not a moral failing but a disease of body, mind, and spirit. Further, there are solutions to the alcoholic problem.

What is Tolerance?

Tolerance generally refers to an ability to deal with things that might generally be considered difficult. We tolerate things like bad weather, crying babies, foul odors, and annoying advertisements on television. However, we also talk about tolerance in terms of drugs, including alcohol.

When we have a tolerance for drugs and alcohol, that means that we can take higher doses without feeling completely impaired. From the user's point of view, higher tolerance means that you need more of the drug to get the desired effect. For some a high tolerance for drugs is a badge of honor, but that tolerance usually indicates a substance abuse problem.

What are the Types of Tolerance?

  • Acute Tolerance:
    This form of tolerance refers to the fact that your body quickly shuts off neurological receptors so as to mitigate the full impact of a drug. Acute tolerance means that a user's first hit of cocaine will produce great euphoria but ensuing doses will result in dramatically diminished effects.
  • Environment-Dependent Tolerance: This form of tolerance seems to indicate that the effects of drugs and alcohol aren't only measured in terms of precise quantities. This form of tolerance is higher in a single environment when you habitually become intoxicated in that same environment.
  • Environment-Independent Tolerance: When you persistently use alcohol or drugs over time the impact of environment will dissipate. Thus, your tolerance will show little change if you are in your regular tavern or a novel setting.
  • Learned Tolerance: This is somewhat similar to state-dependent memory. With learned tolerance, you can become accustomed to certain levels of alcohol/drugs and learn to perform certain tasks despite having taken a high dose. For example, some heavy drinkers are able to play games despite being deep in their cups.
  • Metabolic Tolerance: You are said to have metabolic tolerance when your liver enzymes rapidly eliminate toxins from your body. While this sort of tolerance also exacerbates substance abuse and addiction, it can also prove harmful when your liver's enzymes break down helpful medications.

Problems with Alcohol Tolerance

Some tolerance to alcohol is generally seen as a good thing. Since alcohol is so pervasive, it may be seen as beneficial to withstand a drink or two at a business lunch or at a birthday party. Many even see the ability to handle alcohol as a rite of passage and a gateway to adulthood.

However, when a rather innocent tolerance starts to build, it can be quite detrimental. If you need four drinks to receive the same sensation that two drinks used to provide, then you might be on a slippery slope. Increasing tolerance can result in liver damage as well as neurological problems, not to mention the myriad psychological and social problems that rise in parallel to increased tolerance.

Are We Predisposed to Tolerance Because of Genetics?

Just as we inherit hair color, height, and a winning smile, alcohol tolerance can also be genetic. This poses a very real problem in a highly alcoholic society. This is because, if you have a high tolerance for alcohol, you are prone to drink more to achieve the desired effect. Scientists have correlated this in-born high alcohol tolerance with a propensity for later alcohol abuse, if not addiction.

If your close family, especially your grandparents, have a high tolerance, you should be careful before you start drinking. That is, if you are aware that you could be a candidate for abuse and alcoholism, you might want to find non-alcoholic alternatives.

What is Dependence?

Addiction and dependence are terms we use often, but what do they mean, especially with regards to alcohol? In general, these terms indicate an inability to do without a thing, such as a drug. Indeed, if you drink enough and develop a high tolerance to alcohol, you are much more likely to become dependent on alcohol.

You'll know if you're dependent if you try to go without drinking and experience physical withdrawal symptoms. This might manifest as an inability to physically function without a drink. You might have insane cravings for sugar and digestive problems. There are other symptoms such as night sweats, shakes, and high anxiety which can all become fatal if not addressed by a medical professional.

Signs of Alcohol Dependence

  • Less variety is alcoholic beverages:
    Chronic drinkers tend to focus on a select few drinks that they can rely on to deliver the effect they need within a reliable dosage range.
  • Drink-seeking behavior: Dependent drinkers will prefer the movie theater where they can purchase a beer and may avoid events or outings where drinks won't be available. They may also avoid parties or situations where the crowd is known to exercise moderation in drinking.
  • Alcohol tolerance: A high tolerance for alcohol means the drinker will seek more and more in order to achieve their desired condition.
  • Withdrawal symptoms: When a drinker is impacted by a lack of drink, there’s definitely a problem.
  • Drinking in response to withdrawal: Drinkers who seek out a bloody mary or other alcoholic drink the morning following a heavy drinking session are not only raising their tolerance but are showing signs of alcohol dependence.
  • Craving alcohol: Cravings are a clear sign of a dependence on alcohol. Sometimes the drinker craves sugar, but all his cravings can be sated with a few drinks.
  • Failing to abstain, even when you plan to: As they say in the rooms of Alcoholics Anonymous, "it's easy to quit, but it's hard to stay quit." Drinkers who cannot maintain a sober month, or more, are likely dependent on alcohol.
  • Morning drinking: Drinkers who start the day with a drink are likely dependent on their booze. The real test is if they can reach evening without withdrawal symptoms.

Risks of Alcohol Dependence

Heavy drinking and alcohol dependence present a dire problem in themselves, but they can lead to greater secondary problems if you don't stop drinking. Drinking does more than cause you to fall down or slur your words.

It is also a heavy contributor to physical problems such as:

  • Heart Disease
  • Stroke
  • Liver Disease
  • Dementia
  • Pancreatitis
  • Brain Damage

Drinking also poses a threat to your physical well-being in that it impairs your judgment and coordination. Drinkers have been known to fall from balconies, stumble into ditches, or slip and fall down stairs. Real tragedy can ensue if your judgment fails and you end up driving while intoxicated. Drunk drivers are a threat to themselves and every other car on the road with them.

Alcoholic dependence also runs roughshod over your personal and professional lives. Though many heavy drinkers are known to be so-called functional alcoholics, their drinking eventually causes trouble somewhere in their lives, often in their relationships. In fact, as dependence progresses, alcoholics discover that they have a very hard time maintaining a regular work schedule. Some are able to make it to retirement without any major mishaps. However, once those external restraints are gone the real trouble can begin.

Alcohol Withdrawal Symptoms

Many problem drinkers are unaware of their problem until they try to stop drinking. For some, their abstinence is involuntary, sometimes imposed by a family member or by the judicial system. Regardless of the reason for cessation, if you experience consequences as a result of abstinence, it’s time to seek help.

Alcohol withdrawal symptoms include, but are not limited to:

  • Tremors
  • Shakes
  • Cravings for Alcohol or Sugar
  • Hallucinations
  • Delusions
  • Memory Problems
  • Seizures
  • Depression
  • Anxiety
  • Sweats
  • Insomnia

Treatment of Withdrawal

If you are a very heavy drinker who has passed from problem-drinking to alcohol dependency, you should consider abstinence. However, the consequences of withdrawal from alcohol can be fatal. Therefore, if you are experiencing regular withdrawal symptoms such as shakes, tremors, or anxiety you should check in to a medical detoxification facility. When you are in the care of medical professionals, they will ensure that you are fully hydrated, fed, and monitored for more extreme symptoms. The doctors and nurses will provide an IV drip to maintain your fluid levels, blood pressure monitoring to ensure that you don't experience a heart attack, and moral support to help you get through your struggle. The doctors will also be able to prescribe an appropriate dose of anti-anxiety or withdrawal suppression medications.

Only once you detox in a medical facility can you consider moving forward with your treatment. You will need a clear head to begin sorting out the consequences of your drinking, which may have left your personal or professional life in ruin.

What is Alcohol Addiction?

Alcohol addiction may seem hopeless when you are in it. Very often alcoholics have gastrointestinal problems, suffer memory lapses, and may experience neurological problems such as shakes and tremors. Where the tolerance and dependence issues are physical in nature, addiction is a behavioral change. Addiction keeps its sufferers returning to the bar or liquor store for another drink. Some say that addiction is the bizarre idea that you can handle just one or two drinks or that you can quit any time you want, despite a mountain of evidence to the contrary.

Addiction is often built on a mountain of denial. Alcoholics might experience a blackout or be charged with DUI but then return to drink as soon as they are able. They will claim their drinking is a non-issue or minimize the damage as a fluke or a random mistake. Facts do not matter to the alcoholic, who has the curious ability to make the true false, and the false true. It's also common for alcoholics to find a friend who drinks more or who has hit a new low and point to them as the real alcoholic.

Typical Warning Signs and Symptoms of Alcoholism

Since alcohol is everywhere in our culture, it's important to know the warning signs of alcoholism. The problem is so widespread in our society that you'll be hard-pressed to find a person who has not been impacted by drug or alcohol addiction. If they don't have an issue themselves, then they likely know of a co-worker, neighbor, or acquaintance who has or had a problem. Furthermore, considering the terrible medical problems that result from drinking, everyone's insurance rates have been impacted by heavy drinkers.

Some common warning signs and symptoms of alcoholism include, but are not limited to the following:

  • Daily drinking, especially when it begins at breakfast
  • Drinking to drunkenness and seldom in moderation
  • Dislike for moderate drinking
  • Avoiding non-drinking events or establishments
  • Memory problems such as alcoholic blackouts
  • Physical damages resulting from drinking
  • Relationship problems that stem from drinking
  • Problems with work including poor performance, tardiness, or emotional outbursts
  • Difficulty eating and then digestive problems after a meal
  • Ever-worsening depression that alcohol never solves but always exacerbates
  • Obsession with alcohol and drinking
  • A return to drinking after an embarrassing event that centered on alcohol
  • Shakes or tremors the morning after drinking
  • Prioritizing drinking over family or work responsibilities

Reasons Why Alcoholics Drink

Alcoholics always have a reason to drink. They often joke that they can start drinking at 10 AM because "it's 5 o'clock somewhere."

There are other reasons that may be a bit more serious, including:

  • To medicate trauma from childhood
  • The idea that alcohol will ease depression
  • To medicate or even enhance bipolar disorder
  • Loss of a loved one
  • Genetic predisposition
  • Acculturation
  • To soothe the psychological pain from sexual trauma
  • To soothe feelings of inadequacy
  • The belief that alcohol can produce a good night's sleep
  • To ease social anxiety
  • Soothe physical pain
  • Problems at work, which often stem from drinking
  • Peer Pressure
  • The belief that drinking is necessary for socialization
  • The belief that alcohol is necessary for romance
  • The belief that alcohol is necessary in order to enjoy life
  • To stave off tremors, shakes, and other withdrawal symptoms
  • To satisfy an impulsive personality
  • The idea that alcohol can stimulate creativity
  • The mistaken idea that quitting will crumble one's personality and way of life

Final Thoughts

Tolerance is a key driving force in the physical and medical aspects of alcoholic dependence and addiction. When drinkers pursue more and more drinks, they typically incur more and more reasons to drink. They begin to experience problems at work, in their relationships, and with family members. Since drinkers often have very raw feelings, they continue drinking to help nurse their resentments, run from difficult realities, or to hide unwanted feelings.

Alcoholic cycles are all tragic. It is of vital importance to realize that a growing tolerance indicates real trouble ahead. As alcohol takes a larger role in their life, it will do nothing but cause harm to the drinker, and all of those around him. Though they may try to slow down and may even reduce their tolerance for a bit, the Big Book of Alcoholics Anonymous says, "Over any considerable period of time we get worse, never better."

If you or a loved one is spiraling out of control, please consult with an addictions specialist before real trouble arises.