6 Signs You’re Self-Medicating With Alcohol

It’s possible you might be using alcohol to relieve some of the burden you’re carrying, whether that’s physical, emotional, or a combination of the two. In which case, you might want to understand more about self-medicating with alcohol. Before we dive into the details of how to recognize this behavior, it’s important to know that there is no shame in seeking relief.

While alcohol is not the best tool for addressing discomfort, it may have been what was available to you at the time. You deserve better tools, whether that includes community support, online alcohol treatment, or other healthier coping mechanisms. With a deeper understanding of why you’re using alcohol to self medicate, true healing is within reach.

What ‘self medicating with alcohol’ really means 

The self-medication hypothesis was first introduced in 1985 by Edward J Khantzian, MD, at Harvard Medical School. The hypothesis stated that individuals begin using a specific substance as a coping mechanism when they discover that it can provide short-term relief to their particular source of pain, such as a mental health condition like depression, generalized anxiety disorder, or post traumatic stress disorder. The hypothesis also suggests that continued substance use can worsen symptoms while doing very little to lessen the underlying physical or mental health condition

Coping with past traumas, emotional pain, stressful situations, and relationship issues can be painful and overwhelming. It’s human nature to try and feel better. However, using alcohol as a coping mechanism can have harmful long-term effects. While drinking can provide temporary relief from physical or emotional pain, it also avoids working through the underlying issues. 

Additionally, given how alcohol and depression interact and how alcohol intensifies anxiety symptoms, drinking can make underlying issues feel even more all-consuming. This feeling of helplessness and discomfort can lead to more self medicating’ which creates an unhealthy cycle of using alcohol to cope. This cycle can be broken, and awareness is an important step in that journey.

Woman sitting and thinking in her living room

Signs that you’re self-medicating with alcohol 

1. Using alcohol to feel ‘normal’ 

One sign of self-medicating with alcohol is using alcohol to feel better or to even feel ‘normal.’ As a therapist, I’ve heard many patients share, “the only time I feel like myself is when I drink.” Oftentimes, this means patients are looking to escape from feelings of anxiety or stress

When you drink alcohol, dopamine is released in your brain, which can relieve temporary feelings of anxiety. Anxiety is a normal emotion that occurs daily when faced with new situations. In most cases, anxiety reaches a certain level after a stressful event and then subsides. 

In some cases, anxiety does not go away and becomes an everyday and constant feeling. While alcohol can temporarily relieve anxiety, it ultimately increases it over time. Turning to alcohol when you feel overwhelmed, angry, depressed, and anxious are common signs of self-medicating by drinking.

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2. Patterns of intense alcohol cravings 

Another sign of using alcohol as self medication is drinking to soothe or stop alcohol cravings, which are caused by chemical reactions in the brain. This pattern of alcohol use occurs when the brain comes to believe that alcohol is necessary to maintain control and balance.

When alcohol is consumed, certain neurotransmitters in the brain are significantly increased. These neurotransmitters include dopamine, GABA, serotonin, and glutamate, acting at the NMDA receptor. After heavy and long-term alcohol use, these neurotransmitters increase, and then rapidly decrease as the alcohol wears off. As a result, the brain attempts to restore balance and compensate for the depressive effects of alcohol. 

With short-term and low-level alcohol use, the brain can recover fairly well and regain balance relatively easily. After long-term and excessive use, the brain experiences withdrawal and has difficulty maintaining its balance. This causes the brain to seek more of the neurotransmitters which are increased by alcohol use. This is also what causes the brain to crave alcohol. 

Over time, the brain is conditioned to understand that dopamine, GABA, serotonin, and glutamate are necessary for survival, and that without it, you’re in danger. This chemical interaction in your brain can reinforce the pattern of drinking to self medicate. However, with tools like therapy, medication, and peer accountability, you can take steps to ‘rewire’ your brain.

 3. Adverse biological side effects

If you’re consistently experiencing negative physical side effects related to alcohol consumption, it’s likely your alcohol use has become unhealthy. Similar to some medications, alcohol can provide short-term relief. However, unlike many FDA-approved prescription drugs, alcohol’s side effects can make the underlying issues worse. Usually when we consider taking prescription medication, we will read over the side effects and evaluate whether or not it’s the right decision. Imagine considering a medication that has a proven 98% chance of causing the following symptoms:

  • Emotional issues
  • Significant neurochemical imbalance
  • Poor judgement
  • Slurred speech
  • Shrinking brain
  • Nightmares
  • Insomnia
  • Blackouts
  • Dizziness
  • Impulse control issues
  • Lethargy
  • Hallucinations
  • Confusion
  • Amnesia
  • Anger
  • Depression
  • Addiction
  • Vomiting
  • Diarrhea
  • Anxiety
  • Organ failure
  • Liver failure
  • Renal failure
  • Seizures 
  • Memory loss
  • High blood pressure 
  • Heart damage
  • Cancer 
  • Infertility
  • Birth defects
  • Liver damage
  • Pancreatitis 
  • Malnutrition 
  • Diabetes
  • Inflammatory issues
  • Decreased immune response 
  • Brain damage
  • Kidney issues
  • Loss of sensation
  • Difficulty in breathing
  • Death

Would you consider taking this medication? Alcohol is advertised, glorified and marketed as a socially accepted and exciting behavior. However, the effects of alcohol can be dangerous and even life-threatening. No one ever seeks to develop a dependence on alcohol or intentionally attempts to experience the above symptoms. It’s important to be aware of these potential side effects, and understand that they’re indicators that you can benefit from making a change. 

4. Adverse emotional and social consequences. 

Many of us have experienced more than one hangover and know how difficult it is to try to manage our day after we drink too much. Excessive drinking can affect our job performance, productivity, ability to drive a car, and so many other aspects that contribute to our daily routine. This can also negatively impact our personal and professional relationships. 

Moreover, a pattern of use can cause job loss, financial problems, and even legal problems. If your alcohol use is getting in the way of your daily responsibilities and routines, that could be a sign that you are self-medicating with alcohol to escape from your day-to-day reality. The good news is, when removing alcohol from your life, you can create the space to discover things to do instead of drinking

You also don’t have to go through that alone. Engaging in alcohol therapy can help you identify your core values, understand what brings you authentic joy, and build an alcohol-free life you love. It can also help you heal from past experiences and mend relationships affected by alcohol use.

Person walking in a fall coat by a river

5. Thinking about alcohol during the day and looking forward to it.

You may notice that you’re spending more and more time thinking about drinking. When alcohol consumes your mental energy, that can be a sign that you’ve become increasingly reliant on alcohol to help you feel better. This might look like planning your day around alcohol, skipping events and responsibilities to drink, and always thinking about when you can have your next alcoholic beverage.

You may start to bargain with yourself when thinking about alcohol. That might sound like: “I can enjoy a few drinks tonight because I worked hard today,” or, “I can enjoy a few drinks because I had a bad day.” You may notice that just about any reason turns into a reason to drink. 

You might also observe that you feel most alive and excited right before you’re about to start drinking, which is due to the science of alcohol cravings. If you’re in this stage, it’s likely your loved ones may have noticed your drinking habits and even showed concern that you’re self-medicating with alcohol. If this sign rings true to you, it’s important to know that with support and commitment, alcohol can become less important to you.

6. Drinking to escape painful experiences and memories 

If you’ve ever watched a horror movie, you may have noticed in certain scenes, your heart rate increases, your temperature and blood pressure increases, and you feel afraid and overwhelmed. This is because your fight or flight glands (called the amygdala and hippocampus), can’t tell the difference between reality and perceived reality. 

In other words, the amygdala and hippocampus can’t tell if you’re in the movie or observing it. Therefore, your body reacts to try and protect you. These same fight or flight glands also process information in your subconscious in the same way. 

Sometimes, they can’t tell if your harmful or fearful memories are currently happening or if they’re experiences from the past. This is especially relevant when it comes to alcohol, trauma, and PTSD.

Many individuals who have experienced trauma turn to alcohol to escape the resulting anxiety and discomfort that recur over time. Drinking to soothe anxiety symptoms is a sign of self-medicating with alcohol. If you’ve experienced past traumas, that does not define you. You deserve to feel safe without using alcohol as a coping mechanism. Healing is possible.

How to stop self-medicating with alcohol  

There is no shame in identifying with any of these signs. It can be difficult to notice that your drinking habits have become unhealthy. This phenomenon is sometimes referred to as “gray area drinking.” If you’re self-medicating by drinking, there is likely underlying distress driving your decision-making. You deserve relief that supports your overall health and wellness. Even if you’ve been using alcohol to cope for years or decades, it’s not too late to change your drinking habits, and change your life. You are not powerless over alcohol, and there are a variety of treatment resources to choose from.

At Monument, you get access to online alcohol therapy, which is among the best tools to help you stop self-medicating with alcohol. Therapy can help you address the underlying issues that drive you to drink. Additionally, therapy can help you build healthier coping mechanisms to persevere through challenges without alcohol. Hard times are inevitable, and there are therapy tools that can help you through them. You can check out the Monument treatment plan roadmap for a deeper understanding of why therapy is such a crucial component of this journey.

In addition to therapy, medication to stop drinking is an effective tool to treat alcohol use disorder. Medications such as naltrexone can reduce cravings for alcohol and help break the cycle of using alcohol to cope. And last but certainly not least, peer support can play a crucial role.

We are all faced with challenges that can be tempting to hide from, but with the right support, we can build the courage to tackle them head-on and become a more resilient version of ourselves. Joining an alcohol support group can provide extra accountability and encouragement to stop self-medicating with alcohol. You can do this, and we’re with you along the way.


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Disclaimer: Our articles and resources do not constitute clinical or licensed therapy or other health care services. If you need counseling or therapy services please contact a licensed provider. If this is a medical emergency, call 911.

About the Author

Mark Zauss TherapistMark is a double board-certified licensed mental health counselor in Florida with over 12 years of experience. He is a board Clinical Mental Health Counselor by the NBCC – (National Board for Certified Counselors), a Nationally Certified Counselor by the NBCC as well as a Board Certified Telehealth counselor for online counseling.