Alcohol addiction signs: what families hide, and the effects on body and mind

What are the signs of alcohol addiction, and when does drinking become an illness?

The main alcohol addiction signs appear when a person loses control over their drinking: they drink more, or for longer, than they meant to, they try to stop and can't, they keep going despite the problems drinking causes for their health, work and family, and they get symptoms such as shaking, sweating and poor sleep as the alcohol wears off. Doctors call this "alcohol use disorder". It is a treatable illness, not a moral weakness. It covers every kind of alcoholic drink, including local drinks such as araqi and merissa in Sudan.

It helps to think of three levels, which sometimes overlap:

• Social or occasional drinking: drinking now and then that doesn't seem to cause an obvious problem. Even so, the World Health Organization stresses that no level of alcohol use is risk-free, and that small amounts can still cause harm.
• Harmful drinking: drinking that is already causing real damage, such as accidents, trouble at work or in a marriage, or health problems, but without the signs of dependence described next.
• Dependence (addiction): weakened control over drinking, such as drinking more than intended or failing to cut down, even if the person still manages to hold back at times, along with strong urges to drink, needing more to get the same effect, withdrawal symptoms on stopping, and drinking that comes before everything else.

Doctors use a list of 11 signs, summarized by the U.S. National Institute on Alcohol Abuse and Alcoholism (NIAAA) in its 2025 update, and they count the signs that have appeared during the past 12 months: two or three signs suggest a mild disorder, four or five a moderate one, and six or more a severe one. The list helps you notice what is happening, but only a doctor can make the diagnosis after seeing the person.

This is not a small problem. In its fact sheet updated in 2024, the WHO estimates that about 400 million people worldwide aged 15 and over were living with alcohol use disorders in 2019, and 209 million of them had alcohol dependence.

Alcohol addiction signs families notice first

A person with an alcohol addiction rarely says "I have a problem". Much more often a wife, mother or child notices the change first. Watch for these signs:

• Drinking in the morning or soon after waking to calm the nerves or stop the shakes. The NHS describes waking up and needing a drink as a sign of craving.
• Shaking hands, sweating and irritability when some time passes without a drink, which settle once they drink again.
• Secrecy: the family may find hidden bottles, a smell they try to cover, many excuses to go out, and lies about where they were and where the money went.
• Broken promises: "this is the last time" again and again, and attempts to stop that don't last.
• Neglecting responsibilities: missing work, coming home late, caring less for the children, and dropping hobbies and friendships they used to enjoy.
• Mood changes: irritability, withdrawal or sadness, and more arguments at home.
• Not remembering what happened while drinking, driving under the influence, or carrying on even after a doctor's warning.

If you are a wife asking "my husband drinks, what do I do?", know that this confusion is very common, and that there are practical steps to protect yourself and your children and to encourage your husband toward treatment. You will find some of them in our guide if your husband is using drugs.

Effects of alcohol on the body: liver, stomach, heart and brain

Alcohol does not only harm the liver; its effects reach the whole body. Among the main harms described by NIAAA and the NHS:

• Liver: damage starts with fat building up, then inflammation can follow, then scarring (cirrhosis), and it can lead to liver cancer.
• Stomach and digestive system: alcohol damages the lining of the gut, can cause inflammation and bleeding, and is linked with acid reflux.
• Pancreas: long-term heavy drinking is one cause of pancreatitis, which can become chronic and raise the risk of diabetes.
• Heart: high blood pressure, an irregular heartbeat, a weakened heart muscle, and a higher risk of stroke.
• Brain and memory: thinking and balance are affected, and many people with alcohol addiction run low on vitamin B1 (thiamine). This can cause Wernicke-Korsakoff syndrome: confusion and problems with movement and eyesight, then difficulty forming new memories that may not fully come back, as the MedlinePlus medical encyclopedia explains. If someone who drinks heavily develops new confusion, unsteady walking, or unusual eye movements or double vision, take them to an emergency department straight away or call an ambulance on 123 (or your local emergency number), whether or not they have stopped drinking: without quick treatment this condition gets steadily worse and can be life-threatening.
• Immunity and cancer: heavy drinking weakens the immune system, and alcohol is a cancer-causing substance linked with cancers of the mouth, throat, esophagus, liver, bowel and breast.

In its 2024 fact sheet, the WHO estimates that alcohol caused about 2.6 million deaths worldwide in 2019. The reassuring news is that stopping drinking, with medical supervision, prevents further harm. The NHS explains that early-stage fatty liver usually recovers after stopping, while cirrhosis usually does not go away.

Alcohol and depression, anxiety and sleep: a cycle that feeds itself

Many people drink "to forget" or "to sleep", but in the long run alcohol makes the problem worse. NIAAA's professional resource, updated in 2025, explains that alcohol may ease anxiety for a moment, but heavy drinking and repeated withdrawal increase both anxiety and drinking, and that alcohol shortens dreaming (REM) sleep and worsens breathing problems during sleep.

• The same resource says that between 27% and 40% of people with major depression also develop alcohol use disorder at some point in their lives.
• Low mood or anxiety may be caused by the drinking itself, or may be a separate illness that needs its own treatment. A doctor tells the two apart by following the symptoms during drinking and after stopping.
• The resource notes that stopping drinking often improves the mental health conditions that come with it, while sleep may need 30 days or more without alcohol to recover.

That is why good treatment looks after mind and body together. If you notice lasting sadness and a loss of enjoyment, read about the symptoms of depression.

Why do Arab families hide alcohol addiction?

In our societies drinking alcohol carries a heavy religious and social stigma. The person fears scandal, and the family fears for its reputation, for the daughters' marriage prospects and for the father's job, so the matter stays secret for years. In a study of substance use, including alcohol, at a psychiatric rehabilitation center in Al Qassim, Saudi Arabia, published in 2018, the researchers wrote that stigma and fear of being found out make treatment harder, and that cases do not reach specialists in time.

Hiding it protects no one; it only delays treatment while the damage to the liver, the family and work keeps growing. Treatment in the right place is confidential, and the doctor deals with the illness, not with judging the person. Asking for help does not go against faith; it is taking the means to protect yourself and your family.

Why must a medical assessment come before stopping drinking?

Deciding "I'll stop tomorrow" may sound brave, but it can be dangerous for someone who drinks heavily and regularly. The NHS warns that stopping suddenly can be very dangerous if you are dependent on alcohol, and advises getting medical help before you stop. MedlinePlus explains that withdrawal symptoms usually start within hours of the last drink, are at their worst over the next two or three days, and can include seizures and a severe confusional state (delirium tremens) that can be life-threatening.

So the doctor first assesses how much and for how long the person has been drinking, any past withdrawal, the state of the liver and heart, and any mental health conditions alongside, and then decides whether outpatient treatment with close follow-up is enough, or whether the person needs medically supervised detox at the center. To understand when alcohol withdrawal becomes life-threatening and when a stay at a center is needed, read alcohol withdrawal symptoms and delirium tremens.

Alcohol addiction treatment: how it starts and what it includes

NIAAA describes alcohol use disorder as a long-term condition that can relapse, and a relapse as a temporary setback rather than a failure. Treatment usually follows these steps:

1. Doctor's appointment and assessment: it starts with an outpatient appointment and physical health checks, open to men and women.
2. Safe withdrawal when needed: done under continuous medical supervision until the withdrawal phase passes safely. Inpatient stays at Oxygen Center are for males aged 15 and over (under 18 with a guardian's consent).
3. Psychological therapy: such as cognitive behavioral therapy, motivational work, and learning skills to cope with stress and triggers.
4. Medicines a doctor decides on: NIAAA lists medicines that help reduce the urge to drink or help people stay alcohol-free, such as naltrexone and acamprosate. Availability may differ from country to country, and only the doctor chooses what suits each person.
5. Rehabilitation and involving the family: the rehabilitation and aftercare program includes family counseling, aftercare and relapse prevention.

If the person you love refuses to come, you can come alone first to understand the options and how to talk with them. If you are looking for treatment through the state, you can call the hotline of Egypt's Fund for Drug Control and Treatment of Addiction on 16023 for confidential treatment through its partner centers at no cost.

When should you seek help?

• If two or more of the signs above have been present for a while, it is a good time for an appointment and assessment.
• If shaking, sweating, poor sleep or anxiety appear when a drink is delayed, this means physical dependence, and stopping needs medical supervision.
• If you see yellowing of the eyes or skin, a swollen belly, vomiting blood, or black stools, get urgent medical care.
• If there are repeated accidents, violence, or driving under the influence.
• If there is deep sadness or talk of death, follow the emergency box above straight away.

You can contact Oxygen Center in Damanhour on mobile and WhatsApp +20 101 687 0711 or the landline +20 45 320 0011. Recovery from alcohol addiction is possible, and many people have got their health and their families back after a first step like the one you are thinking about now.