Alcohol dependence: how to spot it and what to do next

If alcohol starts deciding your day—when you drink, how you feel, who you see—that's dependence, not just a bad habit. This page gives straight answers: how to tell if you or someone you care about is dependent, what makes quitting risky, and real options that work. No fluff, just what to do first.

Common signs and immediate risks

Look for these clear signs: drinking more than intended, failed attempts to cut down, strong cravings, needing more alcohol to feel the same effect, and withdrawal symptoms when you stop (shakes, sweating, nausea, anxiety). If someone is confused, has severe tremors, high fever, hallucinations, or seizures after cutting down, get emergency medical help—those are signs of severe withdrawal like delirium tremens which can be life‑threatening.

One practical rule: don’t stop cold turkey if you’ve been drinking heavily for weeks or months. Medical supervision can prevent seizures and other serious problems. A doctor can advise whether you need inpatient detox, outpatient support, or medication to make withdrawal safer.

Treatment options that actually help

Medication can be useful. Naltrexone cuts cravings and the rewarding feeling from alcohol. Acamprosate eases longer-term withdrawal symptoms and helps maintain abstinence. Disulfiram causes unpleasant reactions if you drink while taking it—some people use it as a deterrent. These meds should be started and monitored by a clinician; they’re not one-size-fits-all.

Therapy matters. Cognitive behavioral therapy (CBT) teaches skills to handle triggers and stress. Motivational interviewing helps when you’re unsure about change. Support groups—whether 12-step groups like AA or secular options—give accountability and routine. Combining meds and therapy usually gives the best results.

Harm reduction is a smart path if abstinence isn’t realistic right now. That can mean cutting back safely, avoiding bingeing, and removing alcohol from the home. A concrete step: write a short relapse plan—who you’ll call, which situations to avoid, and one calming tool you’ll use instead of drinking (walk, call a friend, breathing exercise).

Watch for drug interactions. Alcohol interacts badly with opioids, benzodiazepines, and some antidepressants. If you’re on meds for depression or anxiety (for example, articles on Effexor or Fluoxetine are on this site), talk to your prescriber before changing your drinking. If you consider buying meds online, use trusted sources and learn how to verify pharmacies safely.

Ready to act? Start by telling a trusted clinician or calling a local addiction service. If immediate safety is a concern, go to ER. Small steps add up: set one short goal today (call a doctor, remove alcohol from your space, schedule an appointment) and build from there. You don’t have to do this alone—help exists, and treatment can be practical and effective.