Alcohol Use Awareness: Insights Curated by Khethani, MSc (MED)

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This personality quiz is based on The Alcohol Use Disorders Identification Test (AUDIT)1, developed by the World Health Organization (WHO) to assess alcohol consumption, behaviours, and challenges. The questionnaire was adapted from the AUDIT self-reporting version, it has been adapted into classification system which ranks responses into personalities based on severity, helping you better understand and improve your relationship with alcohol.

The questionnaire was adapted by Khethani Mathikhi, MSc (MED) in Physiology from the University of the Witwatersrand, this tool provides insights tailored to your habits and behaviours. AUDIT is a globally trusted screening tool for identifying alcohol-related risks.

  1. Williams N. The AUDIT questionnaire. Occup Med (Chic Ill). 2014;64(4):308-308. doi:10.1093/OCCMED/KQU011

 

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The Abstainer

Profile: Does not consume alcohol or does so infrequently without risks.

Possible Risk:

  • None directly related to alcohol.
  • Risks could arise if abstaining from social drinking leads to social isolation in certain cultural contexts.

 

Recommendations:

  • Maintain a healthy lifestyle.
  • Stay socially engaged and ensure overall well-being through balanced nutrition, exercise, and mental health care.

Profile: Drinks moderately, typically during social occasions, without significant issues.

Possible Dangers:

  • Minor are health risks are associated with social consumption of alcohol especially single night overconsumption in celebratory or high-pressure settings.
  • Slight chance of increased tolerance leading to higher consumption over time.1–3

 

Recommendations:

  • Continue monitoring alcohol intake and avoid exceeding recommended guidelines (14 units per week for men and women).
  • Stay hydrated and alternate alcohol with non-alcoholic beverages during events and preferably do not engage in driving following social drinks .

Profile: Drinks moderately most of the time but occasionally consumes large amounts, risking harm.

Potential Risks:

According to the CDC, binge drinking is when women have 4 or more drinks and men have 5 or more drinks within about 2 hours.4

  • This behaviour can lead to serious short-term risks, like memory blackouts, alcohol poisoning, injuries (such as falls, burns, drownings, or car accidents), poor judgment, and risky sexual behaviour.4–6
  • Alcohol doesn’t just stop at short-term effects—it impacts almost every part of the body. Even one binge drinking session can weaken your immune system7 and might trigger acute pancreatitis (painful inflammation of the pancreas) if there’s pre-existing damage.
  • Long-term dangers include liver disease, other chronic illnesses, and a higher chance of developing certain cancers like liver, breast, and colorectal cancer, among others8–10.

 

Recommendations:

  • Stick to a limit on how many drinks you have in one sitting.
  • Alternate between alcoholic and non-alcoholic drinks, like water.
  • Avoid situations or triggers that lead to over-drinking and set monthly drinking goals.
  • Drink in safe, controlled settings and know your personal limits.

Profile: Drinks frequently and may have started experiencing minor health negative consequences.

Potential Risks:

The National Institute on Alcohol Abuse and Alcoholism (NIAA) defines regular drinking as at least one drink per day for women or two drinks per day for men. This pattern can lead to alcohol tolerance, meaning you may consume more over time to achieve the same effects, significantly increasing health risks.11

  • Brain Damage: Regular alcohol use disrupts how your brain communicates, impairing mood, behaviour, coordination, and sleep quality. Poor sleep not only reduces productivity but also heightens the risk of mental health issues.11,12
  • Liver Damage: The liver bears the brunt of regular drinking, potentially developing fatty liver, inflammation, alcoholic hepatitis, or fibrosis—serious conditions that can progress to liver failure.8,10
  • Heart Risks: Regular heavy drinking can weaken the heart, causing high blood pressure, irregular heart rhythms, heart muscle damage (cardiomyopathy), or even strokes.13–15

 

Recommendations:

  • Reduce frequency and quantity of alcohol intake.
  • Take regular alcohol-free days to allow the body to recover.
  • Monitor for signs of dependence and seek guidance from a healthcare professional if needed.

Profile:

The individual shows signs of problematic drinking, which is having a clear negative impact on their daily life.

 

Potential Risks:

  • Drinking habits may include regular, binge, or a combination of both patterns4.
  • Possible liver damage, including inflammation or early signs of cirrhosis.12
  • Increased risk of developing alcohol dependence.2
  • Greater chances of accidents, strained relationships, and poor decision-making.16

 

Recommendations:

  • Seek advice from a healthcare professional to evaluate the physical and mental health effects of alcohol use.
  • Consider accessing educational resources or joining support groups to learn effective ways to reduce alcohol intake.

Develop healthier coping mechanisms for stress, such as engaging in exercise, practicing mindfulness, or exploring hobbies.

Profile:
The individual frequently consumes excessive amounts of alcohol, faces significant negative consequences, and shows signs of developing dependency.

Potential Risks:

  • Liver Damage: Excessive drinking can lead to severe liver issues such as fatty liver disease or early-stage cirrhosis9.
  • Heart and Stroke Risks: Increased likelihood of heart disease, high blood pressure, and stroke.
  • Mental Health Challenges: Alcohol use can contribute to depression, anxiety, alcohol-induced psychosis, or suicidal thoughts.
  • Weakened Immune System: Regular heavy drinking lowers immunity, increasing vulnerability to serious infections.17
  • Physical Injuries: Greater risk of injuries like falls, burns, or car accidents.18,19
  • Life Impact: Strained relationships, reduced work performance, and social difficulties.

Recommendations:

  • Seek Professional Help: Consult healthcare providers specializing in addiction for immediate assistance.
  • Structured Treatment: Enrol in a rehabilitation or treatment program tailored to your needs.
  • Therapy and Counselling: Work with a therapist to address underlying triggers and emotional challenges.
  • Safe Withdrawal: Use professional support to manage withdrawal symptoms safely and reduce intake effectively.

Profile:
The individual frequently consumes excessive amounts of alcohol, faces significant negative consequences, and shows signs of developing dependency.

Potential Risks:

  • Liver Damage: Excessive drinking can lead to severe liver issues such as fatty liver disease or early-stage cirrhosis9.
  • Heart and Stroke Risks: Increased likelihood of heart disease, high blood pressure, and stroke.
  • Mental Health Challenges: Alcohol use can contribute to depression, anxiety, alcohol-induced psychosis, or suicidal thoughts.
  • Weakened Immune System: Regular heavy drinking lowers immunity, increasing vulnerability to serious infections.17
  • Physical Injuries: Greater risk of injuries like falls, burns, or car accidents.18,19
  • Life Impact: Strained relationships, reduced work performance, and social difficulties.

Recommendations:

  • Seek Professional Help: Consult healthcare providers specializing in addiction for immediate assistance.
  • Structured Treatment: Enrol in a rehabilitation or treatment program tailored to your needs.
  • Therapy and Counselling: Work with a therapist to address underlying triggers and emotional challenges.
  • Safe Withdrawal: Use professional support to manage withdrawal symptoms safely and reduce intake effectively.

 

  1. The Alcohol Dependent

Profile: Exhibits severe alcohol use disorder, with signs of dependence and significant life disruption.

Possible Risk:

Alcohol use disorder (AUD) is defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as “a problematic pattern of alcohol use leading to clinically significant impairment or distress,” and is diagnosed as mild, moderate, or severe based on the number of symptoms, out of a possible 11, in the past 12 months 20.

AUD can lead to brain changes that make quitting alcohol very challenging. However, with sustained abstinence, some of these changes may improve over time. It’s important to note that stopping alcohol use can also result in withdrawal symptoms, which require careful management.

 

Health Risks:

  • Serious Organ Damage: AUD increases the risk of liver failure, pancreatitis, and brain damage, such as Wernicke-Korsakoff syndrome (a severe memory and coordination disorder).12
  • Cardiovascular and Immune Issues: Prolonged alcohol misuse can cause severe heart problems, suppress the immune system, and lead to gastrointestinal bleeding.14,15
  • Injuries and Mental Health Risks: Individuals with AUD are at high risk of accidents, legal problems, and suicidal thoughts.5,6,20,21
  • Social and Functional Impact: AUD can severely disrupt social, work, and personal life, making it difficult to maintain relationships, employment, or daily responsibilities.
  • The AUD Cycle:

AUD often traps individuals in a repetitive cycle with three stages21:

  1. Binge/Intoxication Stage:

Drinking becomes associated with pleasure and reward.

Environmental cues (like certain places or emotions) trigger cravings, reinforcing habitual and potentially compulsive drinking behaviour.

  1. Withdrawal/Negative Affect Stage:

Anxiety, irritability, and a sense of emotional distress dominate.

Alcohol is consumed to relieve discomfort or emotional pain, deepening dependence.

  1. Preoccupation/Anticipation Stage:

Obsessive thoughts about alcohol and difficulty resisting urges take over.

Impairments in decision-making and self-control make relapse more likely.

 

Recommendations:

  • Immediate intervention is critical—contact a healthcare professional for detox and rehabilitation.22,23
  • Consider psychosocial interventions with healthcare professionals.24
  • Use supervised medical withdrawal programs to prevent life-threatening complications.
  • Access ongoing support, such as Alcoholics Anonymous or therapy, to maintain sobriety.

Focus on rebuilding life skills and relationships with support from professionals such cognitive behavioural therapy (CBT), motivational interviewing or motivational enhancement therapy, 12-step support/self-help groups as well as 12-step facilitation, and contingency management.25–27

  1. Ostling EW, Fillmore MT. Tolerance to the impairing effects of alcohol on the inhibition and activation of behavior. Psychopharmacology (Berl). 2010;212(4):465-473. doi:10.1007/S00213-010-1972-Y
  2. Townshend JM, Duka T. Binge drinking, cognitive performance and mood in a population of young social drinkers. Alcohol Clin Exp Res. 2005;29(3):317-325. doi:10.1097/01.ALC.0000156453.05028.F5
  3. Fillmore MT, Weafer J. Acute tolerance to alcohol in at-risk binge drinkers. Psychology of Addictive Behaviors. 2012;26(4):693-702. doi:10.1037/A0026110
  4. Alcohol Use and Your Health | Alcohol Use | CDC. Accessed December 22, 2024. https://www.cdc.gov/alcohol/about-alcohol-use/index.html
  5. Albrecht-Anoschenko J, Uhl E, Gilsbach JM, Kreitschmann-Andermahr I, Rohde V. Head injury after a fall on stairs: Poorer prognosis in inebriated patients? Zentralbl Neurochir. 2005;66(2):59-62. doi:10.1055/S-2005-836487
  6. Mathias JL, Osborn AJ. Impact of day-of-injury alcohol consumption on outcomes after traumatic brain injury: A meta-analysis. Neuropsychol Rehabil. 2018;28(6):997-1018. doi:10.1080/09602011.2016.1224190
  7. Szabo G. CONSEQUENCES OF ALCOHOL CONSUMPTION ON HOST DEFENCE. Alcohol and Alcoholism. 1999;34(6):830-841. doi:10.1093/ALCALC/34.6.830
  8. Szabo G, Mandrekar P. Focus On: Alcohol and the Liver. Alcohol Research & Health. 2010;33(1-2):87. Accessed December 22, 2024. https://pmc.ncbi.nlm.nih.gov/articles/PMC3860520/
  9. Cahill A, Cunningham CC, Adachi M, et al. Effects of Alcohol and Oxidative Stress on Liver Pathology: The Role of the Mitochondrion. Alcohol Clin Exp Res. 2002;26(6):907-915. doi:10.1111/J.1530-0277.2002.TB02621.X
  10. Mann RE, Smart RG, Govoni R. The Epidemiology of Alcoholic Liver Disease. Alcohol Research & Health. 2003;27(3):209. Accessed December 22, 2024. https://pmc.ncbi.nlm.nih.gov/articles/PMC6668879/
  11. Alcohol’s Effects on the Body | National Institute on Alcohol Abuse and Alcoholism (NIAAA). Accessed December 22, 2024. https://www.niaaa.nih.gov/alcohols-effects-health/alcohols-effects-body
  12. Alcohol misuse – Risks – NHS. Accessed December 22, 2024. https://www.nhs.uk/conditions/alcohol-misuse/risks/
  13. Moushmoush B, Abi Mansour P. Alcohol and the Heart: The Long-term Effects of Alcohol on the Cardiovascular System. Arch Intern Med. 1991;151(1):36-42. doi:10.1001/ARCHINTE.1991.00400010060007
  14. Laonigro I, Correale M, Di Biase M, Altomare E. Alcohol abuse and heart failure. Eur J Heart Fail. 2009;11(5):453-462. doi:10.1093/EURJHF/HFP037
  15. Day E, Rudd JHF. Alcohol use disorders and the heart. Addiction. 2019;114(9):1670-1678. doi:10.1111/ADD.14703
  16. Schweizer TA, Vogel-Sprott M. Alcohol-Impaired Speed and Accuracy of Cognitive Functions: A Review of Acute Tolerance and Recovery of Cognitive Performance. Exp Clin Psychopharmacol. 2008;16(3):240-250. doi:10.1037/1064-1297.16.3.240
  17. Nelson S, Zhang P, Bagby GJ, Happel KI, Raasch CE. Alcohol Abuse, Immunosuppression, and Pulmonary Infection.
  18. Plurad D, Demetriades D, Gruzinski G, et al. Motor Vehicle Crashes: The Association of Alcohol Consumption with the Type and Severity of Injuries and Outcomes. J Emerg Med. 2010;38(1):12-17. doi:10.1016/J.JEMERMED.2007.09.048
  19. Fillmore MT, Vogel-Sprott M. Behavioral effects of alcohol in novice and experienced drinkers: alcohol expectancies and impairment. Psychopharmacology (Berl). 1995;122(2):175-181. doi:10.1007/BF02246092
  20. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. Diagnostic and Statistical Manual of Mental Disorders. Published online May 22, 2013. doi:10.1176/APPI.BOOKS.9780890425596
  21. Psychiatry.org – Alcohol Use Disorder. Accessed December 22, 2024. https://www.psychiatry.org/patients-families/alcohol-use-disorder
  22. Alcohol Use Disorder: From Risk to Diagnosis to Recovery | National Institute on Alcohol Abuse and Alcoholism (NIAAA). Accessed December 22, 2024. https://www.niaaa.nih.gov/health-professionals-communities/core-resource-on-alcohol/alcohol-use-disorder-risk-diagnosis-recovery
  23. Campbell EJ, Lawrence AJ, Perry CJ. New steps for treating alcohol use disorder. Psychopharmacology 2018 235:6. 2018;235(6):1759-1773. doi:10.1007/S00213-018-4887-7
  24. Reus VI, Fochtmann LJ, Bukstein O, et al. The American psychiatric association practice guideline for the pharmacological treatment of patients with alcohol use disorder. American Journal of Psychiatry. 2018;175(1):86-90. doi:10.1176/APPI.AJP.2017.1750101
  25. Day E, Copello A, Hull M. Assessment and management of alcohol use disorders. BMJ. 2015;350. doi:10.1136/BMJ.H715
  26. Haber P, Lintzeris N, Proude E, Lopatko O. Prepared for the Australian Government Department of Health and Ageing Guidelines for the Treatment of Alcohol Problems. Published online 2009. Accessed December 22, 2024. http://www.ag.gov.au/ccahttp://www.ag.gov.au/cca
  27. The American Psychiatric Association Practice Guideline for the Pharmacological Treatment of Patients With Alcohol Use Disorder. The American Psychiatric Association Practice Guideline for the Pharmacological Treatment of Patients With Alcohol Use Disorder. Published online January 5, 2018. doi:10.1176/APPI.BOOKS.9781615371969