“I can out-drink most people. That has to be a good sign.” Is a high alcohol tolerance a sign of alcoholism?

Not on its own. Tolerance is one of the 11 criteria used to diagnose alcohol use disorder. A tolerance that has developed over time shows that the body has adapted to regular heavy drinking. When it appears alongside signs such as withdrawal or repeated difficulty cutting down, it is a reason to seek an assessment.

“They never even look drunk.” How can you tell if someone is an alcoholic if they never seem drunk?

Look at the pattern, not how intoxicated they appear. Needing more alcohol for the same effect, rarely getting hangovers, feeling shaky or anxious without alcohol, drinking in the morning, or drinking alone or out of sight can all be warning signs.

“I never get hangovers any more.” Why don’t I get hangovers any more?

Regular heavy drinking can change how the brain responds to alcohol and can increase the liver’s capacity to process it. Fewer hangovers after heavy drinking do not mean alcohol is no longer affecting you, and alcohol may still be in your system the next morning.

“If I take a break, I’ll be able to go back to normal.” Can alcohol tolerance go back down?

Yes. The liver’s faster alcohol clearance can return towards normal after several days without alcohol, while changes in the brain can take longer to settle. That change in tolerance is another reason not to assume you can safely return to previous drinking levels after a break.

“I’ll just stop on Monday.” Is it safe to stop drinking suddenly?

For people who drink heavily every day, it may not be. Sudden withdrawal can cause symptoms ranging from tremor and anxiety to seizures. Speak to a doctor before stopping, and seek medical support where withdrawal risk is significant.

Author: Ryan Erispe

Ryan Erispe

Ryan Erispe, the Clinical Director at the Cabin’s therapeutic team, is originally from South Africa, where his career began as an addiction therapist. He has extensive experience in the addiction treatment industry, including leading teams in international treatment centres, developing programmes, and pioneering addiction treatment in a country that previously had no in-patient addiction treatment centres. Ryan has pursued studies in psychology and counselling, utilising his field experience and personal experiences to mentor teams and enhance client care. As a trauma-informed therapist, Ryan prioritises progressive, evidence-based, client-centred care. His passion lies in guiding clients to reclaim their sense of personal agency and feel empowered to effect change in their lives. Ryan’s industry knowledge and unwavering commitment to providing the best possible addiction treatment come together as he manages and mentors therapists and implements groundbreaking programmes, resulting in a service grounded in passion and values.

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