Alcoholism & Other Substance Use Disorders

It’s incredibly common for people to suffer from alcoholism and for some to develop addictions to other substances.

Sadly, the negative consequences ripple through a person’s life.

In 2020, it was reported that around 3.2 million people had taken a drug in England and Wales. [1] In relation to alcohol, there were 173,000 prescriptions provided in England in 2017 alone. [2]

What needs to be considered is how alcoholism and addiction to other drugs co-occur, what this means for the person when this happens, and what it means in relation to treatment.

The Link Between Alcoholism & Other Substance Use Disorders

Understanding a bit about alcoholism and addiction to other substances is critical for people who are living with these illnesses as well as for others.

It’s common knowledge that in relation to alcohol addiction, there are wide and varied negative repercussions. It’s a disease that destroys mental and physical health as well as families, finances, and life goals.

Coupled with other psychoactive substances, alcoholism is driven to a new level of severity. It’s not unusual for alcoholism and addiction to other substances to coexist and this in itself introduces a whole host of new challenges and risks.

So what is it that makes comorbid addictions more likely? The truth is that the underlying foundation of addiction is the same at the root.

What happens in the brain that drives alcoholism is the same for a person who is driven to use drugs. We’ll go into more detail on that soon.

It’s important to know some of the underlying factors that increase the likelihood of addiction on the whole. This not only supports people to recover by helping to facilitate a space of self-compassion but also works to break the stigma of substance addiction.

Addiction and health professionals widely agree that addiction is usually driven by a combination of the following factors:

A family history of addiction
Having a mental disorder such as bipolar disorder, anxiety, and depression.
A history of trauma.
A genetic predisposition.
Individual personality traits (i.e. having low self-esteem).
Experimenting with substances at an earlier age increases the likelihood that addiction will become a lifelong condition.

The driving factors behind addiction can lead a person to use alcohol or any other substances. The point here is that the substance itself isn’t necessarily what needs to be addressed.

If you remove all the alcohol from a person addicted to alcohol but there is cannabis in the house, they’re incredibly likely to use that instead. What needs to be addressed is the underlying causes of the person’s illness.

What is Substance Abuse?

It’s important to be clear on what substance abuse or addiction, and dependency is.

Firstly, to draw attention to the fact that “substance” refers to any substance (alcohol, illegal street drugs, and prescription drugs) that has a direct impact on the brain meaning it causes a physiological reaction.

Substance abuse is a recognised medical condition. For the person who develops it, there are huge repercussions.

Not only is it likely that the person becomes increasingly unable to maintain responsibilities (i.e. going to work or looking after the children), but they’re also likely to start using alcohol and other substances in inappropriate and even dangerous situations (i.e. at work, or while operating machinery).

Alcoholism (also known as Alcohol Use Disorder or AUD) and substance addiction are apparent when people are unable to stop or control substance use. In the treatment of addiction, they’re usually diagnosed as being mild, moderate, and severe.

What Causes Alcohol Use Disorder & Substance Addiction & Dependency?

As mentioned earlier, psychoactive substances such as alcohol and other drugs have a direct impact on the brain. When used regularly, they actually change how the brain works. In the extreme, the brain structure physically changes.

Alcohol and various other substances trigger the brain’s reward system and cause it to release dopamine. At a base level, this means you can then experience pleasurable feelings.

This can make a person return to the substance and when they do this a few times, it starts to form a neural pathway in the brain which is what underpins a habit.

As well as the neural pathways linked to addiction, substances affect your brain chemicals and hormone release and finally create serious withdrawal symptoms. All of these can be extremely distressing to face.

In the case of dependency (especially alcohol), it can be dangerous to withdraw without medical supervision.

Why Alcohol & Other Substances Commonly Co-occur

There are a number of reasons that make alcohol use with other substances more likely to occur simultaneously. It’s useful to think about this in relation to the external environment, how increased tolerance affects the body, and finally the mental health effects.

External environment

Alcohol and substance use goes through a cycle of use. People start by experimenting, some might move on to recreational use, a smaller group of these will move on to problematic or addictive use, and finally, some people will move into abstinence.

At whatever stage a person is, their external environment is extremely influential. This is because lifestyle, hobbies, who you spend time with, and how this all interacts can cause you to try substances in the first place and, indeed, go on to form triggers.

In the case of alcohol use, it’s quite likely that in some situations there is an increased exposure to other substances.

It’s common, for example, in families where addiction is present to be “initiated” into alcohol use by other family members and this can also link to trying other drugs (i.e. cannabis).

Or, for instance, if you’re a person who goes to big club nights or festivals where a lot of drinking takes place you’ll also be more likely to be offered drugs and, of course, if this is through friends then you’re more likely to say yes.

The build-up of tolerance

One aspect of addiction that people contend with is tolerance. This is where increasing amounts of the substance are required in order to feel an effect.

In the case of alcohol tolerance, a person might start to drink stronger alcohol, so for instance, they might move from beer to spirits.

However, some people will move towards other substances in order to feel a new effect. Usually, people will opt for a substance that feels similar to their original substance of choice.

In the case of alcohol, people are more likely to use other depressants.

Mental health effects

There’s a huge amount of research that demonstrates how addiction and underlying mental health conditions are linked. Actually, as well as this, there’s also the fact that the primary substance a person is addicted to can exacerbate mental health symptoms and lead to other substances.

A person might develop an alcohol addiction because they were using it to suppress or lift their mood. What eventually transpires, however, is that alcohol is a depressant and for many, it leads to depression and anxiety.

With these new symptoms, a person might then seek out a different substance to try and regulate their mental health or mood again. This is seen a lot when people become addicted to alcohol and cocaine, the first being a depressant and the second being a stimulant.

Sadly, this cycle of substance use perpetuates uncomfortable highs and lows and can be extremely hard to break without professional input.

How Alcohol & Other Substances Affect Long-term Health Consequences

Of course, where alcoholism is linked to other substance use (whether it’s drug or prescription medication) there are increased risks to your health. This can have serious implications on your mental and emotional well-being but is especially seen in the physical impact.

Alcohol consumption alone is extremely unhealthy and is linked to various diseases (including being the direct cause of certain types of cancer). As part of a co-occurring disorder, you’re put at an even greater risk because of the health risks associated with whatever other addictive drugs you’re using.

Physical health effects linked to alcohol use include:

Brain damage. Ultimately alcohol can lead to both alcohol-related dementia and Wernicke–Korsakoff syndrome.
Liver damage and disease.
Cancer includes; female breast, liver, mouth, throat, oesophagus, and bowel.
Heart failure and heart attack.
Risk of seizure when withdrawing.

It’s useful to think about what other substances are linked to and cause so you can think critically about how two substances together put your body under strain.

Cannabis is linked to anxiety, low mood, low motivation, psychosis, and schizophrenia. Alcohol is also linked to low mood, and anxiety, and can lead to hallucinations which is a symptom of psychosis and schizophrenia.

Smoking cannabis also releases toxic fumes putting your lungs at risk of damage.

Heroin puts your respiratory system under stress and reduces your blood pressure. People overdose on heroin because it can literally stop their breathing and their heart from beating.

It’s a depressant, as is alcohol. The two together can be especially fatal.

Cocaine places your heart under serious strain. It’s a stimulant. Long-term use reduces the effectiveness of your immune system and increases your risk of illnesses and diseases.

Combined with alcohol in the body, the two substances create a toxin called cocaethylene which builds up in the organs and secretes into the bloodstream. These substances together seriously increase your risk of disease.

Legal Implications of Alcoholism & Other Substance Use

It goes without saying that alcohol and substance use has legal implications. Illegal drugs in particular because – state the obvious – they’re illegal and supply, possession, and use come with various criminal penalties.

Alcohol use can have implications linked to the laws in place around it.

There’s also the fact that using alcohol and drugs greatly increases the probability that you’ll engage in unhealthy, dangerous, and/or risky behaviours that could draw the attention of the authorities.

Research reveals that “between 25% and 50% of those who perpetrate domestic abuse have been drinking at the time of the assault, although in some studies the figure is as high as 73%“. [3]

It’s also illegal to drive in England, Wales, and Northern Ireland if you have more than 80 milligrams of alcohol per 100 millilitres of blood, or if you’re under the influence of illicit drugs. Doing so can obviously lead to driving bans and imprisonment.

Research-based on the US population reveals that “85% of the prison population has an active substance use disorder or were incarcerated for a crime involving drugs or drug use”. [4]

On 20th July 2022, there were 80,819 people in prison in England and Wales.[5] In 2020/21, there were “43,255 adults in alcohol and drug treatment in prisons and secure settings” in England. [6]

That’s a huge percentage of people in prison who are affected by addiction; it’s clear that substance use, crime, and imprisonment are inextricably linked.

How to Access Treatment for Substance Use

If you or someone you know is affected by alcohol use disorder or addiction to illicit substances, then it’s important to get professional treatment for substance use.

Doing so offers you the most positive prospects in relation to your future health and well-being.

There are various options when it comes to the facilities you access. Private rehab clinics offer you a specialist service and actively work with people who are at the “action” stage of addiction where they want to become sober.

As well as treating people for addiction to one substance, clinics also treat co-occurring addictions and various other dual diagnoses where addictions might exist alongside particular mental health conditions.

To access rehabilitation treatment near you, contact Rehab 4 Alcoholism for a chat with one of our team members who can explain your options in relation to private clinics and also NHS services.

What Treatments are Available at Rehab?

At rehab, there are various treatments on offer to address addiction to alcohol and drugs. Evidence-based therapies such as cognitive behavioural therapy are an essential element of programmes as they’re proven worldwide to be successful at treating addiction.

Effective treatment programmes also include a range of other psychological (i.e. motivational enhancement therapy) and also holistic therapies, and both individual and group approaches.

Other places that offer support around addiction include Alcoholics Anonymous, self-help groups, and the NHS.

FAQS

What are the signs of alcohol use disorder?

It’s likely you have an alcohol addiction if you’re unable to control drinking, develop heavy drinking, think about it often, feel unable to face the day without it, and people who care about you are concerned about how you drink.

If you experience anxiety, low mood, shaking, and other physical symptoms when withdrawing, then you might have developed a physical dependency, which requires treatment.

How is alcoholism assessed?

A healthcare professional or addiction expert can assess you for alcohol use disorder. They’ll use the DSM-5 diagnostic tool to do this.

The assessment explores how much you drink, how often, how it affects your mental and physical health, whether you’re able to control your alcohol use, whether you have built up a tolerance, what withdrawal symptoms you experience, and how alcohol affects your life in general.