What Is Alcohol Use Disorder?
Alcohol use disorder is considered a chronic medical condition characterized by the inability to limit the amount of alcohol consumed despite being aware that it will negatively impact the drinker’s health, relationships, or functioning.[1] There are 11 criteria outlined in the DSM-5 to determine whether someone meets the criteria for diagnosis of AUD. The severity of the condition (mild, moderate, or severe) depends on how many of those criteria a person meets.[2]
According to national surveys, approximately 29.5 million people in the United States met the criteria for an AUD in 2021.[3] However, less than 10% of those people sought treatment.[4] Alcohol use disorder is not defined by what or how much a person drinks, but by the pattern of use and the impact it has on their life.
Alcohol Addiction and Abuse
Alcohol is a central nervous system depressant.[5] It slows down brain activity and affects everything from reaction times to coordination, decision making, and mood. In moderate amounts, this means a relaxed state or lowered inhibitions.
However, when people drink large quantities of alcohol over extended periods of time, they develop tolerance to the effects of that alcohol, which will require them to continue to consume larger amounts or higher proof alcohol to have the same desired level of intoxication. This leads to dependence, where the brain requires alcohol to feel normal. When drinking stops, the brain cannot rebalance, producing withdrawal symptoms that can range from uncomfortable to life-threatening.[6] This dependence is one of the main reasons why misusing alcohol so often ends in full addiction and why quitting without professional support is both difficult and dangerous.
Why Do People Become Alcoholics?
There are numerous risk factors that can play a role in causing someone to develop an alcohol use disorder.[7] Research has identified a combination of internal and external factors. Examples include:
- Family History: A parent or relative with an alcohol use disorder increases the chances due to both genetic and environmental factors.
- Mental Health Issues: Many individuals with mental illness use alcohol to cope with psychological pain, stress, and trauma.
- Early Age of Drinking: The earlier a person begins to drink alcohol, the more their consumption leads to a higher likelihood of developing AUD later in life.
- Emotional Challenges and Environmental Stressors: Adverse childhood experiences and other ongoing environmental stressors may lead to an individual developing a problematic relationship with alcohol.
- Social Environment: Drinking with friends, having easy access to alcohol, and pressure from friends to drink all contribute to the level of an individual’s alcohol use.
- Binge Drinking: Individuals that engage in binge drinking (NIAAA defines binge drinking as having enough alcohol to reach a blood alcohol content of .08% or more) tend to develop a tolerance to alcohol as well as a physical dependency.[8]
Understanding why someone develops alcohol use disorder is an important part of building a treatment plan that addresses the real, underlying drivers of the addiction.
What Are the Signs of Alcohol Addiction?
Alcohol use disorder can be one of the most difficult conditions to detect early on due to the many warning signs that may be easily dismissed or rationalized.[9] Knowing the symptoms of alcoholism, whether it be for yourself or someone else, is a key step toward getting help.
Behavioral warning signs:
- Drinking more than you planned or for longer than you planned.
- Repeated unsuccessful attempts to quit drinking.
- Spending an excessive amount of time drinking, recovering from drinking, or trying to obtain alcohol.
- Giving up important social, work, or leisure activities to drink instead.
- Continued alcohol consumption even when knowing it is causing or worsening medical, relationship, or occupational issues.
- Drinking in unsafe situations, such as at work or while driving.
Physical warning signs:
- Needing to drink increasingly larger amounts of alcohol to feel the same effect (tolerance).
- Experiencing withdrawal symptoms (shaking, sweating, or vomiting) when not drinking
- Having periods of memory lapses or non-recall after drinking.
- Declining physical appearance or hygiene.
- Unexplained health problems, including liver issues, frequent illness, or digestive problems.
Psychological and emotional warning signs:
- Intense cravings or urges for alcohol that are difficult to resist.
- Developing anxiety, irritability, or depression when not consuming alcohol.
- Using alcohol to cope with stress, emotional pain, or hardship.
- Denial that there is a problem with alcohol use, even when there is proof of otherwise.
- Feeling guilt or shame about drinking, yet continuing to drink anyway.
Facts About Alcoholism
Understanding the causes and symptoms of Alcohol Use Disorder removes the stigma associated with the condition. Here are some important facts:
- Alcohol use disorder does not discriminate, affecting all genders, ages, races, ethnicities, and income groups.[10]
- Approximately 1/3 of individuals treated for alcohol use disorder will no longer exhibit symptoms at a 1-year follow-up.[11]
- Heavy drinking over time can lead to serious long-term health consequences, including liver damage, heart disease, certain cancers, pancreatitis, and neurological damage.[12]
- Roughly 95,000 deaths occur in the U.S. yearly due to excessive alcohol consumption.[13]
- Co-occurring mental health conditions are present in many individuals with AUD. Integrated treatment that addresses both conditions simultaneously has better outcomes than those treated for each condition separately.[14]
What Alcohol Treatment May Look Like
Alcohol addiction is difficult to overcome, but recovery is possible with evidence-based treatment that cares for both physical and emotional aspects of alcohol addiction with compassion and respect.
There are several FDA-approved medications helpful for recovery from alcohol addiction.[15] These medications have been clinically studied for treating alcohol abuse by reducing cravings, controlling withdrawals, and blocking the pleasure associated with drinking:
- Naltrexone (oral/Vivitrol): Reduces the pleasurable effects of alcohol, reducing cravings to drink alcohol so that one can maintain sobriety and avoid relapse.
- Acamprosate: Restores the chemical balance in the brain after drinking ceases and reduces the patient’s discomfort during the prolonged withdrawal period.
- Disulfiram (Antabuse): Creates an unpleasant physical reaction when the patient consumes alcohol. This creates a deterrent to drinking.
Alcohol use disorder and mental health conditions frequently occur together, and treating only one while ignoring the other leaves the door open for relapse.[16] Our dual diagnosis program provides fully integrated treatment for individuals living with both AUD and a co-occurring condition such as depression, anxiety, PTSD, or bipolar disorder. Our clinical team is experienced in navigating the complex relationship between mental health and substance use, and in building treatment plans that address both with equal seriousness.
