Chronic Alcohol Use Disorder: Health Risks and Treatment Options

Chronic Alcohol Use Disorder isn’t just about drinking too much. It’s a medical condition where your brain and body become wired to need alcohol-even when it’s destroying your health, relationships, or job. You might not even realize it’s happening until you’re stuck in a cycle of drinking to feel normal, then feeling worse when you stop. The truth? This isn’t a lack of willpower. It’s a brain disease, and like any other chronic illness, it needs real treatment-not judgment.

What Happens to Your Body When You Drink Too Much for Too Long

Your body doesn’t handle alcohol the way it handles water or food. Every time you drink, your liver has to break it down. But if you’re drinking heavily every day, that liver gets overwhelmed. Over time, fat builds up in liver cells-this is called fatty liver. It affects nearly 90% of heavy drinkers. At this stage, you might feel fine. No pain. No symptoms. But the damage is already there.

If drinking continues, the next stage is alcoholic hepatitis. Your liver becomes inflamed, cells start dying, and you might begin to feel nausea, fever, or jaundice-yellowing of the skin and eyes. This isn’t just uncomfortable. It’s dangerous. Left unchecked, it leads to cirrhosis. That’s when healthy liver tissue turns into scar tissue. Scar tissue doesn’t work. Once cirrhosis sets in, your liver can’t filter toxins, make proteins, or store energy like it should. Some damage can reverse if you stop drinking completely. But not all of it. The longer you wait, the less chance you have of full recovery.

It’s not just your liver. Alcohol hits your brain hard. It slows down your nervous system, which is why you feel relaxed at first. But over time, it damages nerve cells. You might start having trouble remembering things, thinking clearly, or even walking straight. Numbness or burning in your hands and feet? That’s nerve damage. Long-term drinkers are also at higher risk for dementia and memory loss. Thiamine (vitamin B1) deficiency is common-up to 80% of people with AUD are deficient. Without enough thiamine, your brain can develop Wernicke’s encephalopathy: confusion, unsteady gait, and eye movement problems. Left untreated, it can lead to permanent brain damage.

Your heart takes a beating too. Heavy drinking raises blood pressure, causes irregular heart rhythms like atrial fibrillation, and increases your risk of heart attack and stroke. Studies show heavy drinkers have a 34% higher risk of stroke and a 40% higher risk of atrial fibrillation. Even if you don’t feel it, your heart is working harder than it should.

And then there’s cancer. Alcohol is a known carcinogen. It raises your risk for mouth, throat, esophagus, liver, breast, and bowel cancers. For example, heavy drinkers are five times more likely to get mouth cancer. Just one drink a day increases breast cancer risk by 12%. There’s no safe level when it comes to cancer risk.

Alcohol Doesn’t Just Hurt Your Body-It Breaks Your Life

The physical damage is bad enough. But the ripple effects are worse. People with chronic alcohol use disorder often lose jobs, relationships, and homes. Depression and anxiety don’t just happen alongside AUD-they’re fueled by it. Alcohol messes with serotonin and dopamine, the chemicals that regulate mood. You might start drinking to feel better, but over time, you need more just to feel normal. That’s the trap.

Your immune system weakens. You’re 2.7 times more likely to get pneumonia. Simple infections become life-threatening. You’re more likely to fall, get injured, or be involved in a car crash. In the U.S., alcohol is involved in 29% of all traffic deaths. It’s also linked to domestic violence, criminal behavior, and suicide.

And the cost? In 2010, excessive alcohol use cost the U.S. $249 billion. Most of that came from lost productivity, healthcare, and criminal justice expenses. Globally, alcohol causes 3 million deaths every year. That’s more than HIV, tuberculosis, or road injuries.

Treatment Isn’t One-Size-Fits-All

The good news? AUD is treatable. And recovery doesn’t mean you have to hit rock bottom. You don’t need to be homeless or in a hospital to start getting help. Treatment works best when it’s personalized.

First step for many: detox. If you’ve been drinking heavily for months or years, stopping cold turkey can be deadly. Withdrawal can cause seizures, hallucinations, or delirium tremens-a life-threatening condition with high fever, confusion, and rapid heartbeat. That’s why medically supervised detox is critical. Doctors can give you medications like benzodiazepines to safely manage withdrawal symptoms.

After detox, the real work begins. Three FDA-approved medications help with long-term recovery:

• Naltrexone blocks the pleasurable effects of alcohol. If you drink while on it, you won’t get the same high. That reduces cravings over time.
• Acamprosate helps your brain chemistry return to normal. It’s especially helpful for people who’ve been sober for a while but still feel anxious or restless.
• Disulfiram makes you sick if you drink. It causes nausea, vomiting, and flushing. It’s not for everyone, but for some, the fear of feeling awful is enough to keep them from drinking.

Therapy Changes the Way You Think

Medications help with the body. Therapy helps with the mind.

Cognitive Behavioral Therapy (CBT) is one of the most effective. It teaches you to spot triggers-like stress, certain people, or places-and replace drinking with healthier responses. Studies show CBT reduces heavy drinking days by 60%. Motivational Enhancement Therapy (MET) helps you find your own reasons to quit. It doesn’t push you. It helps you talk through your doubts and build your own motivation.

Support groups like Alcoholics Anonymous (AA) have helped millions since 1935. The 12-step model isn’t for everyone, but the community aspect matters. People who stay connected to support groups are more likely to stay sober. AA reports about 27% of members stay abstinent after one year. That’s not perfect, but it’s better than going it alone.

New Treatments Are Changing the Game

Science is catching up. In 2022, a study in JAMA Psychiatry found that transcranial magnetic stimulation (TMS)-a non-invasive brain stimulation technique-led to 50% abstinence rates in people with severe AUD. It targets areas of the brain involved in cravings. Another breakthrough is the reSET app, an FDA-approved digital therapy tool. In clinical trials, people using reSET were nearly twice as likely to stay sober compared to those who didn’t.

The MATTERS study showed something powerful: combining medication with therapy increases abstinence rates by 24% compared to either one alone. That’s the new standard. No single treatment works for everyone. But together, they create a safety net.

Recovery Is Possible-Even After Years

Some people believe that if you’ve been drinking for decades, it’s too late. That’s a myth. Even with cirrhosis, stopping alcohol can stop further damage. Some liver function can improve. Your brain can heal. Your relationships can mend. You can get your life back.

The biggest barrier isn’t the addiction. It’s the shame. Too many people think they need to be ‘ready’ or ‘hit rock bottom’ before they deserve help. But recovery doesn’t wait. The earlier you act, the more you save-your liver, your mind, your family, your future.

You don’t need to be perfect. You don’t need to quit overnight. You just need to start. One day at a time. One step. One call to a doctor. One therapy session. One meeting. That’s how it begins.

What to Do If You or Someone You Know Is Struggling

If you’re reading this and thinking, ‘This sounds like me,’ here’s what to do next:

1. Make an appointment with your doctor. Ask for a screening for alcohol use disorder. It’s a simple checklist-no judgment.
2. Call a local addiction service. In the UK, you can contact NHS Alcohol Services or Alcoholics Anonymous. They’ll connect you to free or low-cost support.
3. Don’t try to quit alone if you’ve been drinking heavily. Detox can be dangerous without medical help.
4. Consider medication. Ask your doctor if naltrexone or acamprosate could help.
5. Find a support group-even if you’re skeptical. One meeting might change everything.

If you’re worried about someone else, don’t wait for them to ‘ask for help.’ Talk to them calmly. Say: ‘I care about you, and I’ve noticed you’ve been drinking more. I’m worried. Let’s talk to someone together.’