Alcohol dependence
Being dependent on alcohol has a range of harmful physical and psychological effects. Find out what they are, and where to go for help.
Alcohol dependence, which is also known as alcoholism or alcohol addiction, describes the most serious form of high-risk drinking, with a strong, often uncontrollable, desire to drink. It means drinking at a level that causes harm to your health.1
Between 2019 to 2020, there were an estimated 608,416 dependent adult drinkers in England.2
What is alcohol dependence?
Being dependent on alcohol means a person feels they’re not able to function or survive without it and that drinking becomes an important - or sometimes the most important - factor in their life.3
People who are becoming dependent on alcohol notice they need to drink more to get the same effect.4 They often give priority to drinking over other activities or obligations (such as work or family life), or continue drinking despite harmful consequences - for example, liver disease or depression caused by drinking.5 Alcohol dependence also causes physical withdrawal symptoms when you stop drinking.6,7
If you think you may be dependent on alcohol, you should consult your doctor or another medical professional before stopping drinking. You could speak to a health professional at your GP surgery, or there are also a number of national alcohol support services that you can confidentially self-refer to for advice and support.
Worried you might be dependent? Take our Drinking Check self-assessment
Signs and symptoms of alcohol dependence
An early sign of dependence is when you need more alcohol to achieve the desired effect.21 Increased tolerance is a physiological response we have to certain drugs: the more you consume, the more you need to consume to have the same effect.22
As dependence gets more established, you might find you end up spending most of your time thinking about alcohol or engaging in activities necessary to obtain, consume, or recover from the effects of drinking.23
Then, as dependence takes over, it’s possible you will find you get the shakes if you don’t have a drink, and so feel the need to keep drinking to avoid experiencing very unpleasant withdrawal symptoms.24
If you're worried you may be becoming alcohol dependent, or are concerned about someone else's drinking, warning signs to look out for include:25,26
- Often feeling the need to have a drink and give priority to drinking over other activities or obligations such as work or family life
- Getting into trouble because of drinking
- Other people warning about how much you/ they are drinking
- Thinking your/ their drinking is causing problems for example effecting your/ their physical and mental health
- Needing to drink more to get the same affect
If you’re worried that you have any of these symptoms, talk to a health professional at your GP surgery or seek further information from one of the organisations at the bottom of this page.
Other warning signs
Even if you don’t recognise the symptoms above, there are varying degrees of alcohol dependence.
If you find that you ‘need’ to share a bottle of wine with your partner most nights of the week, or always go for a few pints after work just to unwind, you’re likely to be drinking at a level that could affect your long-term health. The UK Chief Medical Officers’ (CMOs') advise, to keep health risks from alcohol low, it is safest to drink no more than 14 units a week on a regular basis.27
If you find it very difficult to enjoy yourself or relax without having a drink, you could have become dependent on alcohol.28
Health problems caused by alcohol dependence
The risk of developing a range of health problems increases the more you drink on a regular basis.
Drinking alcohol can lead to a number of different serious health problems and being dependent on alcohol is likely to increase your risk.8 These include cancers of the mouth, throat and breast, and other serious medical conditions including bowel cancer, pancreatitis, high blood pressure, stroke and coronary alcohol-related heart disease.9,10
Drinking alcohol is the most common cause of liver disease in the UK, accounting for six in 10 cases of liver disease.11 Up to one in five people in the UK drink alcohol in a way that could harm their liver.12
These alcohol-related health problems can affect people who are not dependent on alcohol too.13 That’s why, to keep health risks from alcohol low, the UK Chief Medical Officers’ (CMOs’) advise it is safest to drink no more than 14 units a week on a regular basis.14
Find out more about the physical problems caused by alcohol
Alcohol dependence and mental health
People who are dependent on alcohol often experience poor mental health.15
Anxiety, depression and suicidal feelings can all develop when you’re alcohol dependent.16 This is partly because regular, heavy drinking interferes with chemicals in our brains that are needed for good mental health.17
Being dependent on alcohol can also affect your relationships with your partner, family and friends, or affect your work and cause financial problems.18 These issues can contribute to depression and anxiety too.
Alcohol can also make you more aggressive.19 If you use alcohol to try and improve your mood, you may be starting a vicious cycle.
Find out more about the mental health problems caused by alcohol
Alcohol withdrawal
People who are seriously dependent on alcohol can also experience physical symptoms of alcohol withdrawal like shaking, sweating or nausea when their blood alcohol level drops – for example, before their first drink of the day. In this situation it can be dangerous to stop drinking completely or too quickly without medical support.
Find out more about alcohol withdrawal symptoms, and how to get help
How doctors diagnose alcohol dependence
Doctors assess whether someone is dependent on alcohol by looking for signs that show their patient can’t regulate their drinking, and that they have a strong internal drive to use alcohol. Symptoms they look for are:29
- Impaired control over alcohol use
This might mean not being able to control how long a drinking session is, how much alcohol you consume when you do drink, how frequently you drink, being unable to stop drinking once you start, or drinking on inappropriate occasions or at inappropriate places. - Giving increasing priority to alcohol
If you give precedence to drinking over other daily activities and responsibilities like family or work, if drinking is more important to you than looking after your health, or you carry on drinking despite negative consequences for your health or life. - Unwanted physical or mental effects from drinking
Showing signs of increased tolerance to alcohol (having to drink more for the same effect), experiencing withdrawal symptoms, or using alcohol to prevent or alleviate withdrawal symptoms.
A doctor may diagnose alcohol dependence if you show two or more of the above symptoms based on the ongoing pattern of how you use alcohol. Usually this is based on behaviour over the last 12 months or more, but alcohol dependence could be diagnosed based on continuous (daily or almost daily) for at least one month.30
Download the free MyDrinkaware app to track your drinking, and cut down
What causes alcohol dependence?
Usually, several different factors contribute to someone becoming alcohol dependent.31,32
The society and environment that you live in plays an important role in how likely you are to develop problems with alcohol.33 For example, how easily available alcohol is, how much it costs, and pressure from friends, family or colleagues to drink.34,35
And alcohol dependence can run in families. It’s partly down to your genes,36 but is also influenced by your family’s attitudes to alcohol and the environment you grow up in.37
Stressful events, such as bereavement or losing a job, can also trigger heavy drinking in some people, which can then lead to alcohol dependence.38
People who are alcohol dependent have higher rates of other mental health problems than the general population – particularly depression, anxiety, post-traumatic stress disorder, psychosis and drug misuse.39
Often, people drink to try and reduce symptoms (sometimes known as ‘self-medicating’), but in the long-term alcohol makes these disorders worse because it interferes with the chemical balance in our brains.40
How to reduce your risk of becoming alcohol dependent
If you drink regularly, alcohol changes the way your liver works, your brain function and creates dependence - meaning you need to drink more to have the same effect.41
How to take a break and reset your tolerance
Breaking your drinking cycle is an important way to test for – and tackle – dependence. It can prevent your body from becoming accustomed to alcohol and help to lower or ‘reset’ your tolerance.42
Taking regular breaks and having some drink-free days is the best way to lower your risk of becoming dependent on it.
With the right support and motivation many people can stop drinking, reducing their risk of alcohol harm. But remember, if you’re alcohol dependent, you should get medical advice before stopping completely, so you can do it safely. If you are able to make small reductions first, that’s a good sign.
If you choose to drink, the UK Chief Medical Officers’ (CMOs’) low risk drinking guidelines advise that to keep health risks from alcohol low, it is safest to drink no more than 14 units a week, spread over three or more days with several drink-free days, and no bingeing.
Support if you think you might be alcohol dependent
If you’re worried about your drinking, get in touch with your local GP surgery, who will be able to help.
If you’re simply looking to speak to someone on the phone or chat online for more advice on your own or someone else’s drinking, get in touch with Drinkchat or Drinkline.
Drinkchat is a free online chat service with trained advisors offering confidential advice. The service is available from 9am-2pm on weekdays.
Drinkline is a free, confidential helpline available from 9am – 8pm on weekdays, and 11am – 4pm at the weekend. Call 0300 123 1110.
Alcoholics Anonymous
If you need help to stop drinking you can phone the national Alcoholics Anonymous helpline on 0800 9177650 or email help@alcoholics-anonymous.org.uk. You can also find out more information on their website.
We Are With You (formerly Addaction)
For help and advice visit the We Are With You website. To find your nearest service in England or Scotland, visit the Service Finder section of their website.
You can also search for alcohol support services in your area using the below links:
Further advice and information
Arming yourself with strategies and tips can help you or a loved one take small steps towards big results.
References
[13] Department of Health. (2016). UK Chief Medical Officers’ low risk drinking guidelines. [Online]
[14] Department of Health. (2016). UK Chief Medical Officers’ low risk drinking guidelines. [Online]
[19] Parrott, D.J. and Eckhardt, C.I. (2018). Effects of alcohol on human aggression. Current Opinion in Psychology, 19, 1-5.
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Last Reviewed: 2nd May 2025
Next Review due: 2nd May 2028