Problematic Alcohol Use

What is alcohol dependence?

Drinking alcohol has both immediate and longer-term effects. The effects of alcohol and any related harm experienced from drinking depends on the amount of alcohol consumed, the age and past experience of the drinker, their social environment, as well as their genetic make-up and general health.1

Alcohol can cause dependence due to its ability to create tolerance. Tolerance is when a person requires more alcohol to get the same effects they previously got with less alcohol. Regular use of alcohol can lead to increasing tolerance and the development of an Alcohol Use Disorder (previously referred to as alcohol dependence).2 The risk of developing an alcohol use disorder varies by individual; however risk is increased in people who drink frequently and at higher levels.

Alcohol Use Disorder

Alcohol Use Disorder (AUD) is characterised by a variety of physical and psychological symptoms that develop over time; including developing a physical dependence on alcohol to function.3

Someone who is dependent on alcohol will feel a strong need or desire to drink and may put drinking ahead of everything else, including relationships, getting to work or maintaining their family commitments. Dependence can range from mild to severe. People with severe dependence drink regularly at high-risk levels, and find it hard to limit how much they drink. Someone with severe dependence will have tolerance to the effects of alcohol.2

There are some signs you can look out for that might indicate if you, or someone you care about, is experiencing alcohol dependence. These include:

  • Drinking more, or for a longer period, than intended.
  • Wanting or trying to cut back drinking but being unable to.
  • Frequently getting sick after drinking.
  • Worrying about when able to have the next drink.
  • Sweating, nausea or insomnia when not drinking.
  • Needing to drink more alcohol than previously required to get drunk.
  • Drinking alcohol, or wanting to, when waking up in the morning.
  • Consuming alcohol regularly by oneself, or trying to hide drinking.
  • Continuing to drink even though it is causing problems in the home, with family, friends, or at work.

Tolerance occurs as a person’s body comes more efficient at breaking down the alcohol, or when the nervous system becomes used to the presence of alcohol and can partially compensate for the effects of alcohol on functions such as speech and balance. For individuals who drink regularly, the immediate effects of alcohol on the brain can become less obvious as tolerance develops. Developing tolerance to alcohol often results in people drinking more. Despite an individual developing an increased tolerance, alcohol is still damaging to their long-term health.2

People who drink at high-risk levels, including those who are dependent on alcohol, are at a substantially greater risk of long-term health effects, including permanent brain damage, liver damage and disease, a range of cancers, cardiovascular disease, malnutrition, accidents and more frequent illness due to having a weakened immune system.458

While alcohol use might make some people feel better on some occasions, alcohol use increases the risk of experiencing anxiety, depression and self-harm.2

For most people, taking a break from drinking alcohol is not risky or harmful. However, for individuals who regularly drink large amounts of alcohol and have developed a physical dependence, alcohol withdrawal symptoms may be experienced if they stop or try to substantially cut down their use.6 These people may experience mild, moderate or severe symptoms and the symptoms experienced depend on the individual and their unique circumstances. Alcohol withdrawal symptoms usually begin 6-24 hours after the last drink and settle over 5-7 days.7 Symptoms can include: headache, sweating, nausea and vomiting, anxiety and agitation, shaking, fast or irregular heart beat and/or high blood pressure and seizures.7 In some very rare cases, untreated alcohol withdrawal can be a life-threatening event. Anyone who drinks daily and is considering stopping should speak to a doctor (GP) or a health care professional about the best way to go about this.6

It's not always easy to recognise that you or someone you know might need help

Could you benefit from cutting down your alcohol use?

The five minute AUDIT tool is a simple and validated assessment tool to assist you to identify if you could benefit from changing your current drinking patterns. By completing the questions you will be able to assess whether your drinking is putting you at risk of alcohol-related harm. Please try and answer the questions as accurately as possible.

On completion of the questions, personalised generated feedback will be provided. Answering the questions accurately will ensure the feedback provided is relevant to your personal circumstances. Your answers and feedback are private and confidential, and are not stored by this website upon completion.

The feedback you receive will help you recognise if you need to change your drinking patterns and provide you with further information and support service options to achieve this.

Where to get help

If you or someone you know might need help in relation to alcohol or other drug use, please speak to your GP or a health care professional. Alternatively, the Alcohol and Drug Support Line is a confidential, non-judgemental telephone counselling, information, support and referral service.

The service is free of charge and available 24/7 by calling (08) 9442 5000 or 1800 198 024 (toll-free for country callers) or emailing

Live Chat is also free of charge and available for Western Australian residents and is operated:

Monday to Friday 7.30am -9pm
Saturday 9am- 7pm
Sunday 11am - 6pm

You can access the Live Chat here.


National Health and Medical Research Council. (2009). Australian Guidelines to reduce health risks from drinking alcohol. Canberra, ACT: Commonwealth of Australia. p.20


National Health and Medical Research Council. (2009). Australian Guidelines to reduce health risks from drinking alcohol. Canberra, ACT: Commonwealth of Australia. p.24


Stone, J., Marsh, A., Dale, A., Willis, L., O’Toole, S., Helfgott, S., Bennetts, A., Cleary, L., Ditchburn, S., Jacobson, H., Rea, R., Aitken, D., Lowery, M., Oh, G., Stark, R., & Stevens, C. (2019). Counselling Guidelines: Alcohol and other drug issues (4th ed.).Perth, Western Australia: Mental Health Commission . p.96


Rehm, J. (2011). The risks associated with alcohol use and alcoholism. Alcohol Research & Health, 34 (2), 135-143.


Carguilo, T. (2007). Understanding the health impact of alcohol dependence. American Journal of Health-System Pharmacy, 64 (1), S1-S17.


Pers. Comms., Richard O’Regan, 23 January 2019


Quigley, A., Christmass, M., Vytialingam, R., Helfgott, S., & Stone, J. (2018). A brief guide to the assessment and treatment of alcohol dependence (3rd ed.). Perth, Western Australia: Mental Health Commission. Retrieved from:


Whitney, E., & Ebook Library. (2013). Understanding nutrition (2;2nd; ed.). Melbourne: Cengage Learning Australia. Pg 225.

Page last updated: 13 June 2022

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