[Guide] Alcohol Use, Abuse, & Dependency

[fanglike]

This is an annoyingly long alcoholism reference guide. It’s medically accurate, research and general knowledge based, created to act as an aid for your writing so that whether you’re playing a budding or experienced alcoholic, you’ll have a better understanding of how they might act, what they’ll experience internally, and the effects that drinking has on their body, mind, and social life. In no way is this guide definitive, nor is it an effort on my part to tell you how to play a character; alcoholics come in all shapes, sizes, and creeds, and what one experiences will be completely different from the next due to the external variables in their life. Consider this a quick source that you can use as a jumping-off point, or something to glance back at as your character and their addiction progresses.

 

Art by nohtora.

 

First, let’s talk a little about alcohol. Alcohol is considered to be a psychoactive drug, which means it’s a chemical substance that affects the central nervous system. This means that when using alcohol, it is going to alter your emotions and perceptions and lower your inhibitions, or how you react to and interact with the world around you. It is an extremely addictive substance both mentally and physically.

 

In low doses, alcohol produces a relaxing effect with reduced bodily tension, slow reflexes and reaction times, reduced coordination, lowered inhibitions, poor concentration, and overall slower brain activity. In medium doses, one will begin to experience slurred speech, fatigue, heightened emotions, visual difficulties (seeing double, etc), a lower core body temperature, and more blood flow to the surface of the skin, causing them to turn red and even bleed easier if injured. In high doses, alcohol consumption becomes dangerous: vomiting, breathing difficulties, and bouts of unconsciousness are common. Continuing to push past this point will almost always lead to alcohol poisoning, coma, and left untreated, death.

 

HOW TO PORTRAY DRUNKENNESS IN TEXT-BASED ROLEPLAY

As a baseline, decide what type of drunk your character is: the flirty drunk is over the top with their compliments, sweet and bubbly, and have an amorous personality; the downer drunk struggles to have a good time or overshares about their unfortunate home life; the storyteller drunk weaves exaggerated tales of true events and ensures every person is included; the happy drunk is carefree and lights up the room with their positive platitudes; the violent drunk hears what they want to hear and doesn’t have regard for their own wellbeing, so long as they can pick a fight; the daredevil drunk has forgotten the rules of life and acts out for attention and laughs; the ‘dude, I’m not even drunk’ drunk is prone to blacking out and not even realizing it; the ‘no way you’re drunk’ drunk can hold their alcohol like no others, functioning normally in the eyes of their peers despite their supposed inebriation. 

 

Whatever you choose, be it a baseline or blend of the above, there are ways to show others that your character is drunk beyond doing a /me where you tell everybody your character is drunk in the emote.

 

Slurred Speech is a way to visually portray drunkenness in roleplay. Hyphenating words and adding lengthy strings of vowels is one way to do this, although I suggest using it sparingly, as it becomes tedious to read.

• “H-h-h-heeeeey! Wheeeere d’ya think yeeeeer goin’?” he slurred, jabbing a finger into Sam’s chest. 

 

You might also cram words in your dialogue together, visually representing the pace of speech. When doing this be careful with your word choice, as too many syllables or contractions will make it confusing.

• “Iamsickofyourshit,” Dennis said, his words tumbling from his mouth in a rush.

 

Making up ‘combo’ words, such as gerroff, nuffink, and ‘boutit, is another popular method of writing drunken speech. You might also include a spoonerism – a verbal error in which the initial letters or sounds of two or more words are swapped: ‘I’m going to a pance darty!’. 

 

Descriptive Drunkenness is another route one can take when roleplaying intoxication. Not every drunk person slurs up a storm or makes up new words, after all, especially those with a tendency for alcohol abuse. To use this method, one must embroider descriptively around dialogue to make it clear that the character is hammered. Here’s an example:

 

* Collin stumbled forward and grabbed a lamppost for support. He clung there for a long time, slack-jawed and slumped over, until his red solo cup slid from his hand and fell at his feet.

 

Here we can tell that there’s something definitely wrong with Collin. He needs help from a lamppost to stay upright, so he’s either sick or drunk. By the last line of the example, the reader has pieced together the red solo cup, the universal symbol of ‘party’, and the slinky-like behaviour and concluded that Collin is probably drunk.

Drunken Physicality is pretty easy: falling, flailing, and stumbling. Drunk people also stereotypically puke, fall asleep, and shout or laugh a lot. They often have personalities that don’t coincide with that of their sober selves, and this change is a sliding scale: a calm, civil person might have a few too many and kill somebody in a bar fight, where a noisy troublemaker might become more reserved when drunk. Since alcohol loosens your inhibitions, many people reveal their ‘inner selves’ while drunk – but some don’t. Go with what you feel best progresses your plot.

 

 

ABUSE, ADDICTION, AND WITHDRAWALS

Alcohol Abuse, Addiction, and Withdrawals are something you will eventually need to factor into your character, if they’re a big drinker. Alcoholics tend to have a higher tolerance for alcohol as their tolerance builds up. They begin their day with alcohol and can't function without it, and so begins the cycle of alcohol abuse. Binge Drinking is defined as the consumption of five or more drinks in one sitting; this is most common in minors, up to the age of 22. Alcohol Dependency is a chronic and progressive disease which includes a strong need to drink despite repeated social or interpersonal problems such as losing a job or deteriorating relationships with friends and family members.

 

Alcoholics often suffer from low self-esteem, anxiety, perfectionism, feelings of guilt, self-pity, and are prone to anger and violence. High-functioning Alcoholics often also display bouts of denial (that they're not 'that bad'), the inability to maintain consistent employment or education, and the inability to maintain interpersonal relationships. One alcoholic drink is enough to set off a craving, which leads to an obsession about the next drinking opportunity. Some alcoholics may appear to be managing well to the outside world but separate or hide their drinking lives from the people in their lives.

 

There are five types of alcoholics:

The Chronic Severe Alcoholic is an individual who started drinking young and never stopped. This group commonly consists of middle-aged men who are the 'poster child' for alcoholics: they are unable to hold down jobs, lose their homes and families, suffer from health issues, and have behavorial and social issues related to their alcohol abuse. They often have a family history of alcoholism and also suffer from antisocial personality disorder, bipolar disorder, depression, or anxiety disorders. They often abuse additional substances - most commonly cocaine, opioids, marijuana, and cigarettes.

The Functional Alcoholic typically doesn’t fit the general stereotype for the disease, as alcohol does not regularly interfere with their daily life obligations. In fact, a functional alcoholic will often be middle-aged, professional, educated, married with a family, and keep up appearances as having their lives in order. They tend to drink to excess in the privacy of their home whilst hiding it from the people around them, and are often unable to stop once they start; despite this, they remain in denial of their addiction until they hit 'rock bottom' - whatever that may look like for the individual.

 

The Young Adult Alcoholic consists of people in the age range of 20-24 who do not drink alcohol as routinely as the other subtypes, but drink in a binge pattern when they do. They often have a family history of addiction and don't usually suffer from co-occurring mental health disorders. Although they don't drink every day, alcohol is still a significant influence in their life, and they rarely seek help, but rather ‘grow out of’ their addiction in their mid-20s.

 

The Young Antisocial Alcoholic began struggling with alcohol addiction earlier than the other subtypes, and tend to be in their mid-20s. About half have a family history of alcoholism and will also abuse cigarettes or marijuana, and less commonly, opioids and cocaine. This subtype is defined as specifically suffering with antisocial personality disorder, indicated by a lack of remorse for their own actions, impulsivity, a disregard for rules, and repeated violations of the rights of others. Criminal behavior and legal troubles are common.

 

The Intermediate Familial Alcoholic began drinking in their late teens, but typically won't struggle with alcohol-related issues until their mid-30s. They are often middle-aged, married with families, and have a link to another alcoholic in their immediate family who enables their addiction. 

 

If you suddenly remove alcohol from an alcoholic, they will experience one of the worst withdrawals a person can go through. This can begin as soon as 2 hours after their last drink, but more commonly between 6-24. TThe initial symptoms include shakiness, nausea, vomiting, sweating, anxiety, headache and insomnia. While these symptoms can sometimes last for several weeks, at this point they are non-life-threatening.

 

In high functioning alcoholics, between 12 and 24 hours after their last drink, visual hallucinations may begin. These usually won’t last beyond 48 hours, and your character will typically know they are hallucinations and not real. The hallucinations typically take the form of spiders, snakes, or bugs. In some alcoholics tonic-clonic (grand mal) seizures start 24-48 hours after the last drink. While the seizures are usually self-limiting, this is where the withdrawal starts to get potentially dangerous - about 3% of people who develop withdrawal-related seizures will develop brain damage due to a lack of oxygen.

 

Now, if you’re really looking to put your character in danger, Delirium Tremens is the next step. This starts at about days 3-10 after alcohol removal (peaks around day 5) and is incredibly dangerous -- untreated, 35% of people who develop DTS will die, and 10% will still die with medical treatment. Symptoms of DTS include high blood pressure, visual and/or tactile hallucinations which the person cannot distinguish from reality, tachycardia, fever, confusion, severe shaking, severe anxiety, profuse sweating, additional seizures, irregular heartbeat.

 

 

ADDICTION TREATMENT

So, your character has decided to get clean – or your loved ones have thrown you into rehab and locked the key. What now?

 

If a person does not have a full-blown substance abuse problem, the solution can be as simple as reducing the consumption of alcohol – but often, this is not enough. On average, it takes about a year to recover from chronic addiction and alcohol abuse, and 90% of those in recovery have at least one relapse before they achieve lasting sobriety. Treatments for alcoholism include:

 

Detoxification and withdrawal. Treatment for alcoholism may begin with a program of detoxification, which generally takes two to seven days. Your character may need to take sedating medications to prevent shaking, confusion or hallucinations, or other withdrawal symptoms. Detoxification is usually done at an inpatient treatment center or a hospital.
Learning skills and establishing a treatment plan. This usually involves alcohol treatment specialists. It may include goal setting, behavior change techniques, use of self-help manuals, counseling and follow-up care at a treatment center.
Psychological counseling. Counseling and therapy for groups and individuals help your character better understand their problem with alcohol and support recovery from the psychological aspects of alcoholism.
Continuing support. Aftercare programs and support groups help people recovering from problem drinking or alcoholism to stop drinking, manage relapses and cope with necessary lifestyle changes. This may include medical or psychological care or attending a support group such as Alcoholics Anonymous.
Treatment for psychological problems. Alcoholism commonly occurs along with other mental health disorders. Talking to a therapist, medications, or other such treatments may be necessary.
Medical treatment for other conditions. Common medical problems related to alcoholism include high blood pressure, high blood sugar, liver disease and heart disease. Many alcohol-related health problems will improve significantly once your character stops drinking.

 

For a serious alcohol problem, your character may need a stay at a residential treatment facility. Many residential treatment programs include individual and group therapy, participation in alcoholism support groups such as Alcoholics Anonymous, educational lectures, family involvement, activity therapy, and working with counselors, professional staff and doctors experienced in treating alcoholism. These stays typically last anywhere from one to six months.

 

 

RECOVERY & AFTERMATH

Recovery will differ for everyone. Some alcoholics will have the willpower and determination to help them overcome their addiction without relapsing, but others will not. Some alcoholics may wish to continue drinking in social settings but impose a limit on themselves to help avoid their negative behaviors. There are many different routes that recovering alcoholics might take during and after sobriety, and it's up to you to decide what route your character will go.

 

Relapsing can happen the day after, a month later, or ten years down the road. Relapsing is hard to stay away from for almost all addicts. The battle to stay clean is a constant one, and is commonly said as needed to be taken day to day.

Signs that a character is headed for relapse may include a change in attitude and the belief that participating in your recovery program isn't important anymore, an elevation in stressors in their life, the reactivation of denial thinking (I don't have a problem, I can handle things, etc), behavioral changes, and social breakdown and isolation. A character nearing relapse will similarly experience a loss in their daily routines, difficulty making healthy decisions, and irrational thinking.

 

Dry Drunk Syndrome, or post-acute withdrawal syndrome, occurs when an alcoholic's brain begins to adjust to the chemical damage that their alcohol abuse caused. Physically, they struggle with dizziness, slow reflexes, and coordination problems. The emotional symptoms are much stronger: poor impulse control, anger and negativity toward recovery and one's support system, resentment toward loved ones, isolation, increased instability, and the romanticization of their drinking days. They begin to miss the bottle after becoming sober. They believe that alcohol has never let them down, and that it has always been there for them when others weren't, providing a cradle for their problems to diminish in. Many former alcoholics go through this grieving process and, with extensive support and therapy, overcome it, going on to live healthy, sober lives.

 

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At the end of the day, no two alcoholics are alike and it's up to you to decide what best fits your character and their progression – if you stuck around 'til the end, I hope you found this guide useful!

Other drug guides coming soon.

Edited December 5, 2023 by fanglike

[Memzz]

great guide!

[Kyxi]

rattles approves