Some individuals are considered alcoholics even though they drink much less than the defined amounts. Some drink only on weekends, typically classified as binge drinking; however, there is still the preoccupation with anticipation of the weekend or an uncontrolled ability to stop once started. Others are high functioning in that they maintain a job and lifestyle that does not equate with the stereotypical alcoholic as in being unable to deal with day-to-day living needs. Still, they are anticipating alcohol or overindulge when presented with alcohol. Sometimes this can be referred to as functional alcoholism or ‘dry drunk’ in that the amount of alcohol consumed on off-hours stays in the body until drinking can resume. Others keep alcohol hidden at work or home only to imagine they are drinking less than they actually are.
Intoxication often plays a role in brain injury or spinal cord injury from trauma or disease. Intoxication occurs in 50% of those at the time of traumatic brain injury. Alcohol is a risk factor for hemorrhagic stroke. If you have already had an ischemic (blood clot) or hemorrhagic (bleeding in the brain) stroke, you are at significant risk for a second stroke with alcohol use. It is estimated that one-third of individuals who sustain a spinal cord injury are intoxicated at the time of trauma. This can be from chronic alcohol abuse or a one-time binge at the wrong time.
One of the key issues in all addictions, especially alcoholism, is a lack of insight into the situation. A person may justify alcohol use based on the way it makes them feel. They may experience some euphoria at first, easing of problems, relaxation, and disregard for worries and concerns. Even though the individual has knowledge of what they are doing is extreme, the desire to escape from the reality of life may be overpowering. They may not be able to resolve their desire for alcohol with its effects on their body and their life.
Recognizing alcoholism in an individual’s life is challenging. Human bodies react differently as they metabolize alcohol. Some individuals are less able to metabolize alcohol than others. Some do not care for the taste or effects of alcohol and reject drinking it. Others crave the taste and effects. Individuals with alcoholism have difficulty controlling their drinking. It may be a consuming desire or compulsion to have another drink. They may not recognize concerns about their own behavior or how their drinking is affecting those around them.
Symptoms of alcohol abuse include mental status changes, blackouts, shakiness, sweating, aggression, agitation, poor judgment, self-abusive or self-destructive behavior, bodily or emotional harm to others, compulsiveness, guilt, loneliness, isolation, nausea and vomiting, delirium, incoordination, slurred speech, or tremor. You may have all, some, or just a few symptoms with varying degrees of intensity.
For individuals with central nervous system (CNS) injuries such as brain injury, stroke, or spinal cord injury from trauma or disease, the symptoms of alcoholism can magnify existing issues. Mental acuity can be dulled. The inability to sweat can lead to body temperature overheating. If the judgment is a concern, poor judgment is further enhanced. Seizure threshold is lowered. Movement is less controlled. Falling is increased. Tone (spasms) may or may not decrease initially but then greatly increase. Alcohol reduces your desire to care for yourself. The high sugar content in alcohol increases your risk of diabetes as well as urinary incontinence, which increases pressure injury and infection. Bowel control lessens, leading to incontinence. High calories in alcohol lead to weight gain, which makes transfers less independent. Alcohol can lead to brain injury or further injury to your brain and central nervous system.