The more familiar term “alcoholism” may be used to describe a severe form of AUD, but physicians, researchers, and others in the medical community tend not to use the word.
Signs and Symptoms of Alcohol Use Disorder
Alcohol use disorder is diagnosed on the basis of criteria defined in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The DSM is a guide that describes and classifies mental disorders, published and updated regularly by the American Psychiatric Association and used as a tool by medical professionals.
- Having to drink more than normal to get the desired effect (to feel “buzzed” or drunk)
- Experiencing withdrawal symptoms after the effects of alcohol wear off
- Having occasions when you drink more or longer than intended
- Trying and failing to cut down on — or stop — drinking more than once
- Wanting to drink so much you can’t think about anything else
- Spending a lot of time drinking and experiencing the after-effects of drinking
- Noticing that drinking or the after-effects of drinking caused problems at home, work, or school
- Giving up on other activities you enjoy to drink instead
- Continuing to drink even after experiencing psychological or physical health problems (like anxiety or depression symptoms), or after having a memory blackout
- Continuing to drink even if it’s causing problems with your family and friends
- Getting into situations more than once where alcohol could have increased your risk of getting hurt (driving while under the influence, having unprotected sex, etc.)
What’s Considered Excessive Alcohol Use?
- Binge Drinking is having 4 or more drinks during a single occasion for women and 5 or more drinks for men (see below for the definition of a drink)
- Heavy Drinking is having 8 or more drinks per week for women and 15 or more drinks per week for men
- 12 ounces of beer
- 8 ounces of malt liquor
- 5 ounces of wine (this is about one glass)
- 1.5 ounces (one shot) of 80-proof distilled spirits or liquor, such as gin, rum, vodka, or whiskey
Causes and Risk Factors of Alcohol Use Disorder
Other factors that may play a role in the development of AUD include:
- History of emotional or other trauma
- Mental illnesses and mood disorders, including anxiety, depression, bipolar disorder, or schizophrenia
- Social and cultural pressure, including having a partner who drinks regularly (or a parent who does, for adolescents)
- Starting to drink — especially to binge drink — at an early age
- Regularly drinking too much over a long period of time
- Personality disorders, including antisocial personality disorder and borderline personality disorder
How Is Alcohol Use Disorder Diagnosed?
As mentioned above, the DSM-5 says an AUD diagnosis requires at least 2 of the 11 symptoms of alcoholism listed above to have occurred within the previous 12 months.
- Mild AUD 2 to 3 symptoms
- Moderate AUD 4 to 5 symptoms
- Severe AUD 6 or more symptoms
Prognosis of Alcohol Use Disorder
Alcohol can affect nearly every organ in the body. In many organs, the effects of alcohol increase over time, and the damage becomes apparent only after years of abuse.
The brain experiences the effects of alcohol right away, resulting in changes in mood, behavior, and judgment. The more alcohol you drink, the higher your blood alcohol levels and the greater your level of alcohol intoxication.
- Blurred vision
- Reduced inhibitions
- Unstable moods
- Inappropriate behavior
- Poor coordination
- Memory loss or blackouts (where you don’t remember events)
- Coma or death, in severe cases
- Increased risk of intentional or unintentional injury or death — for example, suicides, drownings, falls, and assaults and violence
- Increased risks of complications and potentially death from interactions with both over-the-counter and prescription medications
- Coma or death, in severe cases
Alcohol withdrawal after periods of excessive drinking can cause debilitating symptoms hours to days later. According to the NIAAA, symptoms may include trouble sleeping, restlessness, nausea, sweating, a racing heart, increased blood pressure, tremor (or shakiness), anxiety, feeling low, or just a general sense of malaise. Moderate and severe withdrawal syndromes can include hallucinations, seizures, or delirium tremens; the latter two can be life-threatening.
Duration of Alcohol Use Disorder
Excessive drinking or an alcohol use disorder can be successfully managed with treatments, such as therapy and medication, to help you to modify your behaviors and help your brain adapt to the absence of alcohol.
Relapsing doesn’t mean that treatment has failed, though — it takes time to change behavior. You can work with a health professional to try new treatments that may work better for you.
Receiving treatment improves your chances of recovering from AUD.
Treatment and Medication Options for Alcohol Use Disorder
There are several treatment options available for AUD, and there’s no one-size-fits-all solution.
If you think you need help with alcohol use, talk to your doctor. They can assess whether you have a risky drinking pattern, evaluate your overall health, help create a treatment plan, and refer you to programs or other healthcare providers if necessary.
Support Groups and Rehabilitation Programs
Mutual-support groups like Alcoholics Anonymous (AA) and inpatient rehabilitation are common treatments for alcohol problems.
Mutual-support groups teach you tactics to help you overcome your compulsion to drink alcohol. AA is a 12-step program that provides peer support and applies 12 spirituality-based principles. The NIAA offers a list of a number of these support groups, including secular options.
Counseling can help you identify and change behaviors that lead to drinking, build a stronger support system, develop attainable goals, learn healthy coping skills, and handle triggers that lead to relapses.
Treatment may involve standard therapies used to treat other mental illnesses, including cognitive behavioral therapy (CBT), which is commonly used to treat depression, among other disorders.
In addition to CBT, another type of therapy called Motivational Interviewing, which focuses on empowering the subject to identify their issues and take action, has also demonstrated effectiveness, according to research from 2020.
- Naltrexone (Vivitrol) helps people stop heavy drinking by blocking the euphoric effects and feelings of intoxication.
- Disulfiram (Antabuse) helps you avoid drinking alcohol by blocking the metabolism of alcohol in your body. If you do drink, it causes nausea, skin flushing, and other unpleasant symptoms.
- Acamprosate (Campral) can help you continue to abstain from drinking and is thought to work by restoring brain chemical imbalances caused by heavy drinking.
Prevention of Alcohol Use Disorder
Adolescents are also likely to binge drink, which can lead to serious consequences, including injury and death.
You can help prevent alcohol abuse in your children by setting a good example and using alcohol responsibly, talking openly with them and being involved in their lives, and setting expectations and consequences for their behavior.
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Complications of Alcohol Use Disorder
Drinking heavily over long periods of time may lead to changes in how the brain functions, from memory slips to more debilitating conditions. The impact depends on when a person started drinking, how long they’ve been drinking, and how often and how much they drink.
Wernicke-Korsakoff syndrome is a degenerative brain disorder that causes mental confusion, vision problems, lack of coordination, and memory problems, among other symptoms.
- Cardiovascular problems, such as arrhythmias, stroke, high blood pressure, or cardiomyopathy (impaired function of the heart)
- Liver problems, including steatosis (fatty liver), hepatitis, and or cirrhosis (scarring of and permanent damage to the liver)
- Pancreatitis (pancreas inflammation)
- Cancer, including of the mouth, esophagus, throat, liver, breast, and colon
- Increased risk of infections, particularly pneumonia and tuberculosis
- Bone damage, including osteoporosis, as alcohol can interfere in new bone production
- Birth defects in your baby, if you drink while pregnant, due to fetal alcohol syndrome (this applies to anyone who drinks alcohol while pregnant, and not just those with AUD)
- Reproductive problems, including erectile dysfunction in men and irregular or missed periods in women
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Research and Statistics: Who Has Alcohol Use Disorder?
Some research shows AUD is even more common than estimates suggest.
BIPOC and Alcohol Use Disorder
A number of studies have looked at alcohol use among specific racial and ethnic populations, including Black, Indigenous, and People of Color (BIPOC) communities.
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Related Conditions and Causes of Alcohol Use Disorder
As mentioned above, long-term overconsumption of alcohol has also been linked to many conditions, including cardiovascular disease; several types of cancer; neurological disorders (including Alzheimer’s disease); and stroke.
Psychological disorders including anxiety, depression, schizophrenia, and bipolar disease have been associated with AUD. They may be a contributing factor to AUD, and alcohol use itself may worsen the symptoms of these conditions.
AUD may also be associated with sleep problems, including disrupted sleep and poor sleep quality, and it may worsen sleep apnea, according to a meta-analysis from 2018.
Resources We Love
Learn more about AUD from the government organization in charge of studying alcohol use and abuse in Americans. The website offers in-depth information on the treatment for AUD, tips to find a treatment program, links to support groups, and a tool to find specialty programs, therapists, and doctors who are located near you or offer their services via telehealth.
This peer-run, international fellowship is open to anyone who wants to address a drinking problem. Research has suggested that the program can be successful in helping some people cut back on or eliminate alcohol from their lives. Check out the website to learn more about how AA works, find a chapter near you, and download e-books to help with your journey.
This blog-style website includes engaging articles, tools, tips, and more — and it’s all powered by the NIAAA and the National Institutes of Health. Helpful tools like a calculator to measure the amount of alcohol in different drinks and a free 20-page guide via download make this a highly useful, user-friendly resource.
This free service offers comprehensive support that includes meetings, programs for specific demographics, videos and podcasts, online community, and a mobile app.
Additional reporting by Joseph Bennington-Castro.