Are they drinking more than they used to?
They may drink more often, pour larger measures or need more alcohol than they once did to get the same effect.
They may also start drinking earlier, continue later or regularly drink more than they intended.
Can they drink a lot without looking drunk?
Someone who drinks heavily and regularly can develop tolerance. They may consume an amount that would make another person obviously drunk while showing fewer outward signs themselves.
Being able to "hold their drink" is not evidence that alcohol is affecting them less. Judgement and other abilities can be impaired before obvious physical signs of intoxication appear.
Are they hiding their drinking?
They may hide bottles, drink before other people arrive, dispose of containers where nobody will see them or replace alcohol so the amount taken is less obvious.
They may lie about how much they have drunk, minimise it or become defensive when somebody asks.
Do they seem unable to stop once they start?
They may intend to have one or two drinks and continue drinking for much longer or consume much more than they planned.
They may repeatedly decide to cut down or stop, manage it for a while and then return to the same pattern.
Is alcohol becoming more important than other things?
More time may be spent buying alcohol, drinking or recovering afterwards. Plans may increasingly be made around whether alcohol will be available.
Activities, interests and responsibilities that once mattered may be neglected or abandoned because drinking has taken their place.
Is drinking causing problems at home or work?
Drinking may lead to missed work, neglected responsibilities, financial problems, broken plans, arguments or repeated problems with family and friends.
Continuing to drink when alcohol is repeatedly causing or worsening these problems is a significant warning sign.
Are there changes in their behaviour?
You may notice increasing irritability, secrecy, impulsive behaviour, arguments or sudden changes in mood when they have been drinking or when they cannot drink.
Behaviour alone cannot tell you whether someone is dependent on alcohol, but repeated changes that occur around drinking can be part of the pattern.
Are they forgetting what happened while drinking?
Alcohol can prevent the brain from forming new memories normally. Someone may appear awake and functioning while drinking but later have no memory of part of the evening.
These alcohol-related blackouts are different from passing out and are a sign that alcohol was significantly affecting the brain.
Do they need a drink in the morning?
Morning drinking can have different reasons, but needing alcohol after waking to stop shaking, sweating, nausea, anxiety or feeling unwell can be a sign of physical dependence.
The same can happen at other times of day when the alcohol in their body begins to wear off.
What are the signs of alcohol withdrawal?
Withdrawal symptoms can include shaking, sweating, anxiety, nausea or vomiting, disturbed sleep and a racing heart. Some people become irritable or feel generally unwell as alcohol wears off.
Severe withdrawal can cause seizures, hallucinations or severe confusion. These symptoms require urgent medical help.
Does another drink make them feel better?
If someone is physically dependent, drinking alcohol can temporarily reduce withdrawal symptoms because alcohol has been put back into the body.
If shaking, sweating, anxiety or feeling ill improves after a drink, that is an important sign that physical dependence may have developed.
Does having these signs mean they are an alcoholic?
There is no single sign that decides this. Health professionals now commonly use the term alcohol use disorder and assess a pattern of symptoms, including loss of control, tolerance, withdrawal and continued drinking despite harm.
Alcohol use disorder can range from mild to severe. A doctor or specialist alcohol service can assess what is happening rather than relying on a label.
When is medical help urgent?
Seizures, hallucinations, severe confusion, loss of consciousness, very slow or irregular breathing, or being unable to wake the person require urgent medical help.
Suddenly stopping alcohol can also be dangerous for someone who is physically dependent. They should get medical advice before stopping or sharply reducing their drinking.