Alcoholism is one of the oldest documented addictions in the world. People have been drinking since the dawn of time, and, as long as people have been drinking, there have been alcoholics. Since its inception, alcohol has been present in every major civilization in one form or another. Today, 86.4% of U.S. adults report having consumed alcohol at least once in their lives, while 26.9% of adults report having engaged in binge drinking within the past month.

Like many addictions, alcoholism tends to hit men more often than women. It has long been more socially acceptable for men to imbibe than women, particularly in the consistent daily amounts which would describe him as an “alcoholic.” However, in the past decade, social norms have shifted. As a result, heavy drinking is reported to have increased across all demographics by 17% and a great deal of that increase is attributed to heavier drinking by women. For instance, binge drinking has increased by 17.5% among women in the past decade, whereas it has increased by less than 5% among men.

Alcoholism is unlike other addictions in that it does not discriminate. Poor or rich, black or white, white-collar job or no job at all, alcoholism can affect anybody. That having been said, Asians tend to be alcoholic at a lower rate than other races, and women are slightly less likely to become alcoholics than men, but that is rapidly changing. Although alcoholism can be present in all social strata, there is a slightly higher rate of alcoholism among poorer populations than among the wealthy. Alcoholism has a genetic component as well. In families where alcoholism is present, offspring are far more likely to carry the alcoholic gene than in other families. Alcoholism, however, can also occur in individuals with no family history of the addiction. In this way, alcoholism can be very difficult to predict.

Perhaps unsurprisingly, alcoholism is the most common addiction facing Americans today. More than seven percent of the American population aged 18 and up have a drinking problem; this is nearly 13.8 million Americans, and 8.1 million of them are alcoholics.

Alcoholism can be quite easy to spot if you know what you’re looking for. On the other hand, alcoholics often take great pains to cover up their drinking, which can make things tricky. Like any other addiction, alcoholics can become very good liars and tend to cover up their addiction in various ways.

Binge drinking and blackouts are often the earliest warning signs. If a person drinks to the point of intoxication every time they drink, this could be considered binge drinking. If they experience memory loss after periods of drinking, these blackouts are another early symptom. Although binge drinking can occur in individuals not prone to addiction, this pattern of drinking (especially when it occurs when the individual is alone) is often a precursor to full-blown alcoholism. In particular, alcoholics will tend to experience what is called a “black-out.” During a black-out, the alcoholic will continue to function and appear conscious, but will later be entirely unable to recall these episodes.

People who drink too much will quickly build up a tolerance. As alcoholism progresses, the addict will require more and more alcohol to achieve the same effect. As the alcoholic builds a tolerance, they will typically begin to drink more frequently and begin earlier in the day. Drinking alcohol early in the day is a common symptom of alcoholism. Similarly, alcoholics will become noticeably agitated if for some reason they are unable to acquire or ingest alcohol when they feel the need, which will become more and more frequent.

Alcohol takes quite a toll on a person’s appearance, as well. A person who has been drinking heavily for an extended period will usually be suffering from dehydration. This can lead to bloodshot eyes, puffiness in the face, and bloating, particularly in the belly. In extreme cases, liver damage will also begin, which can result in a yellowing of the skin. Alcoholics may also shake slightly, particularly in the hands.

Alcohol is a unique drug, in some ways. While it is classified as a depressant, it is the only such drug that can have inverse effects. While their nervous system is depressed, they may become highly excitable and agitated as well. What this means is that an alcoholic may appear almost manic-depressive at times, going from highly elevated moods to deeply depressed in a short time. This leads to alcoholics being extremely unpredictable, experiencing bouts of rage and suicidal episodes all on the same day.

Alcoholism is also one of the least expensive addictions possible. An alcoholic can typically acquire their daily supply of alcohol (usually a high proof substance like Vodka) for around $20. Although alcoholics frequently engage in illegal behavior, funding their addiction is not primarily the motive. Rather, the reduced inhibition caused by alcohol can lead them to do things they wouldn’t do sober.

While alcohol may not hit the pocketbook as hard as other addictions, it usually takes an extreme toll on a person’s relationships and life, in general. It is highly likely that a person suffering from alcoholism will get at least one DUI in their time, with all the related legal and alternate transportation expenses. Additionally, many alcoholics will run afoul of the law in other ways, such as fighting, public drunkenness, petty thefts, or various types of lewd behavior. Others will bear the cost of damage to their vehicle or themselves.

Alcohol has a devastating impact on a person’s physical health, even for teenagers. After a relatively brief period of daily consumption, alcoholics will no longer be able to safely quit using. Quitting or stopping the intake of alcohol “cold turkey” can be very dangerous, leading to seizures and even death. Hospitalization is typically required if an alcoholic cannot continue their daily dose of alcohol. In the long-term, damage to internal organs becomes a risk and alcoholics can suffer from pancreatitis, cirrhosis, jaundice, and even wet brain, to name just a few.

The liver is the first part of an alcoholic’s body to suffer damage. After all, this is where alcohol is processed. For alcoholics in the early stages of their addiction, they may present abnormally high levels of liver enzymes and other mild liver damage, but most of this is reversible if the progression is caught early enough. Later on, alcoholics run a high risk of cirrhosis, which can be fatal. They can also suffer damage to their kidneys or pancreas, resulting in further complications.

Alcohol also affects the chemistry of the brain, in particular the centers responsible for making decisions and registering pleasure. As time goes on, an alcoholic’s brain will produce fewer endorphins on its own, requiring alcohol to allow the alcoholic to “feel good.” This can lead to depression and bipolar mental disorders. Heavy users will also suffer from moderate impairment of intellectual functioning with problem-solving abilities and critical thinking. Most of these changes are, however, short-term, and will reverse themselves if the alcoholic is removed from the influence of the substance. In rare cases, an alcoholic may develop Wernicke Korsakoff Syndrome, or something called “wet brain”. In these cases, alcohol has so damaged the brain that the addict will never completely recover.

Alcoholism is considered by medical professionals to be a chronic condition. This means that, once alcoholism has taken hold in an individual, they will never be able to drink safely again. As a result of this and the ease of access to alcohol, there is a very high risk of relapse among alcoholics, especially if their drinking is the result of covering up inner turmoils. The National Institute on Alcohol Abuse and Alcoholism puts the relapse rate at about 90% after 4 years. It is common for alcoholics to believe themselves “cured” after a period of abstinence and think they can drink moderately again, only to find themselves once more fully addicted.

As a result, the only recoveries which have been indicated to work for alcoholics have included total abstinence, usually partnered with a program of action which allows for a complete psychological, emotional and spiritual change, like Adult and Teen Challenge programs.

The detox from alcohol can be extremely dangerous, particularly if the person has been drinking for a long time. Withdrawal symptoms are severe and can take effect within just a few hours of an alcoholic being separated from alcohol. Symptoms of alcohol withdrawal begin with depression, violent tremors (also known as the delirium tremens), and nausea. Depending upon how long the alcoholic was drinking, symptoms can progress to visual and auditory hallucinations, an itching or burning sensation in the skin, painful joints, and, ultimately, grand mal seizures. If an alcoholic is allowed to detox without supervision or medical care, this process can result in death.

Since alcohol detox is so dangerous and painful, it is always recommended that an individual seek professional care. A typical detox period lasts for 3-7 days. In a medical setting, mild doses of benzodiazepines like Ativan are commonly prescribed to lessen symptoms of withdrawal and prevent seizures.

Like other addictions, recovering from alcoholism can take months or even years. Post-acute Withdrawal Syndrome can last for up to 6 months, during which time the alcoholic may still experience foggy cognitive functions, depressed mood, and frequent urges to drink. During this period, the alcoholic will rarely have the ability to recover from their addiction. If an alcoholic is placed into the care of a year-long program where they are kept from drugs and alcohol for that entire period, there is a much greater chance of a lasting recovery. This especially so since he or she will be surrounded by a compassionate fellowship of like-minded people. The mentoring of peers who have been in the program longer, as well as seeing new how bad the new intakes look when they arrive, are key factors in recovery.