Alcohol: how to avoid the pitfalls of addiction

The hangover that can occur after a night of drinking is caused by alcohol inhibiting the secretion of the hormone vasopressin—also called antidiuretic—which regulates water and electrolyte balance in the kidneys. After drinking several glasses of alcohol, we need to use the bathroom, and as a consequence, our body loses a significant amount of fluid, including minerals. This deficiency disrupts the activity of nerve cells in the brain, causing headaches the day after a night of excessive drinking.

Excessive or regular consumption creates a risk of addiction. It is believed that Switzerland has 250,000 people with alcohol dependency. “Like other drugs, alcohol overstimulates the reward system, a neural network established in the limbic system,” explains Jean-Bernard Daeppen, Head of Department at CHUV’s Service of Medicine of Addictions. This part of the brain includes functions that maintain life. Basic behaviors, such as feeding or breeding, generate pleasure. But by stimulating this reward system, alcohol is able to “hack the system,” triggering a domino effect leading to the compulsive need to consume, paired with a kind of discomfort in the absence of the substance.

Jeanne*, 57, no longer consumes any alcohol today. Yet, just a few years ago, she was drinking nearly two bottles of wine a day. “I was laid off practically overnight after 12 years in the same company—an incomprehensible decision. At the same time, my only daughter left home. I felt very lonely and, for the first time in my life, completely useless. I started drinking to lift my spirits.” 

First one glass here and there, then two, then three. "I quickly got to one bottle a day, then two. Since I live in a small village where everyone knows each other, I avoided buying so much wine at the supermarket. I was driving to town to get my supply. Then, since I always had brain fog, I thought about getting it delivered. It is worth noting that it is regarded unfavorably for a woman to drink so much. It was definitely the hardest period of my life: I didn’t want anyone to find out about my secret, so I went out as little as possible, which amplified my loneliness.” This situation lasted for more than a year until one day, her daughter came to visit her unannounced. “She found me in a pitiful state. She helped me get back on track by being there. Later, I had the support of other family members. And when my daughter told me she was pregnant, it hit me: I had to be a good grandmother. That was my biggest motivation to stop drinking.”

Strong social roots

With these potential risks, how can we explain that alcohol is always associated with conviviality and that sobriety may be misunderstood? “Alcohol is connected to the idea of opening up to sociability, says Markus Meury, spokesman for the Addiction Switzerland foundation. The vision of the day or work week that requires to let off steam in the evening or on the weekend is tenacious: it is easier to let oneself go or forget everything with alcohol.”

The prevalence of alcohol consumption can also be explained by the fact that it is easily accessible and cheap, unlike other narcotic substances. According to Addiction Switzerland, 83% of people aged 15 and over in Switzerland admit to drinking alcohol “more or less regularly.” In contrast, cocaine, the second most common illegal drug after cannabis, is consumed by only 1-2% of the population.

Gender differences

It is estimated that 7 to 8% of men are dependent on alcohol versus 2 to 3% of women. Without even talking about addiction, men tend to drink more, especially for cultural reasons, says Jean-Bernard Daeppen. "Men seem to enjoy the effects of alcohol more than women. They are more specifically interested in its disinhibition effect." What about young people, do they drink more since the health crisis? “The statistics do not show an overall increase, says Markus Meury. However, consumption among girls (11-15 years) has increased, catching up with that of boys in different categories.” The CHUV has developed a prevention app that targets this population group.

Recovering from addiction

It can be difficult to cope alone when alcohol consumption has led to addiction. “About 10% of those affected seek professional help”, says Jean-Bernard Daeppen. People who come to see us are those with a serious addiction or an associated mental illness. The main approach to treat such addiction is psychotherapeutic, with the few existing drugs proving ineffective to date.

Once you’ve got rid of the addiction, how can you not give in again, since alcohol remains omnipresent, from the shops to the restaurants? If the offer of “sober” drinks has increased considerably, those who turn down a drink often face looks of incomprehension.

“In urban areas, not drinking or reducing consumption is increasingly accepted today because it may be easier to choose friends or the environment you are in, observes Markus Meury. However, in some environments, not drinking is still very much frowned upon. For instance, it is difficult for a farmer to ask for a cup of herbal tea instead of a glass of white wine for the aperitif.” 

Better social acceptance of refusal to drink emerged with Dry January. This phenomenon from the UK involves not drinking alcohol during the whole month of January. Of course, the effects of such a diet differ depending on one’s initial consumption. However, this decrease in alcohol consumption cannot (yet) be seen in the statistics. The number of people who self-identify as abstinent has not yet increased, according to the latest data from the Swiss Health Survey carried out in 2022.

^*Pseudonym