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Alcoholism, substance abuse, and addictive behavior


Alcohol abuse is a pattern of drinking that is harmful to the drinker or others. The following situations, occurring repeatedly in a 12-month period, would be indicators of alcohol abuse:

  • Missing work or skipping child care responsibilities because of drinking
  • Drinking in situations that are dangerous, such as before or while driving
  • Being arrested for driving under the influence of alcohol or for hurting someone while drunk
  • Continuing to drink even though there are ongoing alcohol-related tensions with friends and family

Alcoholism is a disease. It is chronic, or lifelong, and it can get worse over time and be life-threatening. Alcoholism is based in the brain. These are some of the typical characteristics of alcoholism:

  • Craving: a strong need to drink
  • Loss of control: the inability to stop drinking
  • Physical dependence: withdrawal symptoms, such as nausea, sweating, shakiness, and anxiety, when alcohol use is stopped after a period of heavy drinking
  • Tolerance: the need for increasing amounts of alcohol to get "high"

Know the risks

Research suggests that a woman is more likely to drink too much if she has any of the following:

  • Parents and siblings (or other blood relatives) with alcohol problems
  • A partner who drinks too much
  • The ability to "hold her liquor" more than others
  • A history of depression
  • A history of childhood physical or sexual abuse

The presence of any of these factors is a good reason to be especially careful with drinking.

How do you know if you have a problem?

Answering the following four questions can help you find out if you or someone close to you has a drinking problem.

  • Have you ever felt you should cut down on your drinking?
  • Have people annoyed you by criticizing your drinking?
  • Have you ever felt bad or guilty about your drinking?
  • Have you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover?

One "yes" answer suggests a possible alcohol problem. If you responded "yes" to more than one question, it is very likely that you have a problem with alcohol. In either case, it is important that you see your health care provider right away to discuss your responses to these questions.

Even if you answered "no" to all of the above questions, if you are having drinking-related problems with your job, relationships, health, or with the law, you should still seek help.

Treatment for alcohol problems

Treatment for an alcohol problem depends on its severity. Routine doctor visits are an ideal time to discuss alcohol use and its potential problems. Health care professionals can help a woman take a good hard look at what effect alcohol is having on her life and can give advice on ways to stop drinking or to cut down.

Alcoholism treatment works for many people. But like other chronic illnesses, such as diabetes, high blood pressure, and asthma, there are varying levels of success when it comes to treatment. Some people stop drinking and remain sober. Others have long periods of sobriety with bouts of relapse. And still others cannot stop drinking for any length of time. With treatment, one thing is clear, however: the longer a person stops drinking alcohol, the more likely he or she will be able to stay sober.

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Substance abuse

Many people do not understand why people become addicted to drugs. The truth is: drugs change the brain and cause repeated drug abuse. Drug addiction is a brain disease. Drug use leads to changes in the structure and function of the brain. Although it is true that for most people the initial decision to take drugs is voluntary, over time, the changes in the brain caused by repeated drug abuse can affect a person's self control and ability to make sound decisions. At the same time, drugs cause the brain to send intense impulses to take more drugs.


Drug abuse is a treatable disease. There are many effective treatments for drug abuse. Some important points about substance abuse treatment include:

  • Medical and behavioral therapy, alone or used together, are used to treat drug abuse.
  • Sometimes treatment can be done on an outpatient basis.
  • Severe drug abuse usually requires residential treatment, where the patient sleeps at the treatment center.
  • Treatment can take place within the criminal justice systems, which can stop a convicted person from returning to criminal behavior.
  • Studies show that treatment does not need to be voluntary to work.

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Addictive behavior

Why do some people become addicted, while others do not?

Nothing can predict whether or not a person will become addicted to drugs. But there are some risk factors for drug addiction, including:

  • Biology. Genes, gender, ethnicity, and the presence of other mental disorders may increase risk for drug abuse and addiction.
  • Environment. Peer pressure, physical and sexual abuse, stress, and family relationships can influence the course of drug abuse and addiction in a person's life.
  • Development. Although taking drugs at any age can lead to addiction, the earlier that drug use begins, the more likely it is to progress to more serious abuse.

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Content last updated: August 13, 2015.

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