About 27 million American adults, roughly the population of Texas, struggled with alcohol use disorder last year, according to the 2024 National Survey on Drug Use and Health. If you or someone you love is among them, understanding what’s happening in the brain can be the first step toward healing.

How Alcohol Changes the Brain

Alcohol addiction doesn’t happen overnight. It often begins with occasional unsafe drinking that gradually rewires the brain, turning a choice into dependence.

With repeated drinking, your brain adapts, meaning you need more alcohol to feel the same effect (tolerance). And when you stop drinking, your body may physically withdraw with tremors, anxiety, or even dangerous medical complications requiring professional care.

At the same time, psychological dependence grows. You might find yourself craving a drink to handle stress, feeling off without it, or planning your day around when you can drink next. These changes make it difficult to simply quit, even with strong willpower.

Recognizing the Signs of Alcohol Addiction

  • Physical symptoms can include:
    • Needing more alcohol to get the same effect
    • Sleep problems or appetite change
    • Shakiness, sweating, or nausea when not drinking
  • Psychological and behavioral signs may include:
    • Drinking more often or in larger amounts than intended
    • Hiding or lying about drinking
    • Neglecting work, family, or hobbies
    • Mood swings, anxiety, or depression
    • Risky behaviors such as driving under the influence

The Good News: Treatment Works

Addiction is a chronic but treatable medical condition, similar to diabetes or heart disease. Like those conditions, it may involve periods of relapse and recovery, but with proper treatment, people can and do get better.

Treatment for addiction looks different for everyone. Options range from inpatient or outpatient programs to telehealth, counseling, and support groups. 

Many people find success with a combination approach, often called Medication-Assisted Treatment (MAT):

  • Talk therapy: Licensed counselors help you build coping skills, manage triggers, and strengthen relationships. Sessions may be one-on-one, in groups, or with family.
  • Medications: Safe, non-addictive medications can reduce cravings and help prevent relapse. These are often prescribed by addiction specialists or primary care teams.

Today’s treatment programs are more flexible than ever; most allow you to continue working and caring for your family while getting help.

Taking the First Step

If you’re struggling with alcohol, start by speaking with your doctor or healthcare provider. Recovery is possible and with the right support, your brain, and your whole self, can heal.

By  Jacob Marquette, DO

Dr. Jacob Marquette is Medical Director at Barton Community Health Center and a board-certified addiction medicine specialist. The Barton Community Health Center provides medication-assisted treatment (MAT) services supporting substance use disorders, including alcohol. If you’re concerned about addiction, talk to your primary care team or visit BartonHealth.org to learn more about available treatment.