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For many, drinking alcohol is a celebratory or social activity. Many people are able to drink small or moderate quantities of alcohol without problems. Yet, many more struggle with alcohol-related behavior.
Alcohol use disorder (AUD) is a substance-related condition defined by drinking behavior that consumes a person and impacts their life. This brain disease can cause someone to lose control over drinking and affect them on a personal, interpersonal, and professional level.
Read on to learn more about the symptoms, causes, diagnosis, and treatment of alcohol use disorder.
Alcohol use disorder may be mild, moderate, or severe. The number of symptoms a person experiences determines the type. The Diagnostic and Statistical Manual of Mental Disorders identifies the following criteria:
- Mild: Two to three symptoms
- Moderate: Four to five symptoms
- Severe: Six or more symptoms
Prevalence of AUD
Alcohol use disorder is fairly common. A 2021 study found that over 14 million adults in the U.S. meet the criteria for the condition. Rates are higher in men than in women. While affecting individuals across age groups, people between the ages of 18 and 29 have the highest prevalence.
For a diagnosis of an alcohol use disorder, at least two of the following symptoms must be present within a 12-month period:
- Cravings or urges to drink
- Consuming excessive amounts of alcohol
- Needing more alcohol or drinking over longer periods of time to achieve the same desired effect
- Excessive amounts of time spent thinking about drinking, planning to drink, or recovering from drinking
- Unsuccessful attempts to reduce, control, or stop drinking
- Consequences at work, home, or school due to alcohol consumption
- Social and interpersonal problems
- Financial or legal trouble
- Drinking in situations that may be dangerous
Factors that contribute to alcohol use disorder include:
- Co-occurring mental health conditions such as depression, attention deficient hyperactivity disorder (ADHD), bipolar disorder, or post-traumatic stress disorder (PTSD)
- Environmental factors like stress or trauma, cultural or familial attitudes about drinking, accessibility, or social pressure
- Genetics (the risk of developing alcohol use disorder is three to four times higher in those with a close relative with the condition)
Compulsive drinking and alcohol use disorder can pose other risks. There is an increased risk of suicidal behavior or dying by suicide in people with this condition.
Suicide Prevention Lifeline
If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 1-800-273-8255 or the Crisis Text line by sending ‘HOME’ to 741741 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.
Talk to your healthcare provider if you are struggling with cravings, urges, or controlling your drinking. An evaluation with a healthcare professional can lead to an accurate diagnosis. It can also help uncover any other mental health or physical conditions affecting your well-being.
A provider may ask how often and how much you are drinking. Understanding the impact on your mind, body, and life is valuable information as well.
Some providers use screening tools to help them assess drinking habits. Identifying problematic patterns allows healthcare providers to provide education, discuss concerns, and make treatment recommendations.
The AUDIT-C screening tool for alcohol use disorder involves three main factors, including:
- Drinking days per week
- Drinks per drinking day
- Frequency of heavy drinking
Upon assessing the severity of someone's drinking, a healthcare provider may suggest detox as a first step.
Withdrawal from alcohol can be intense and potentially dangerous, but it can be done safely in an inpatient or outpatient setting. Withdrawal can include symptoms like:
- Nausea or vomiting
- Heart problems
Treatment for withdrawal consists of electrolytes, vitamins, and benzodiazepines to prevent dehydration and issues with the central nervous system.
A provider may prescribe medication to help with aspects of managing drinking. Medications used in the treatment of alcohol use disorder include:
- Naltrexone (Vivitrol) to reduce cravings
- Acamprosate to maintain abstinence
- Disulfiram (Antabuse), which causes a person to feel sick when they drink
A provider will also consider other physical or mental health conditions that may be present. Depending on the situation, a provider may recommend antidepressants, anti-anxiety, or other medications. Because medications can interact with each other, talking to a provider is the safest route to developing an individually tailored treatment plan.
Research shows that interventions using motivational interviewing, cognitive behavioral therapy, and mindfulness-based techniques are successful in helping people manage their drinking.
- Motivational interviewing draws on a person's motivation for changing their behavior. Through increased awareness, individuals can make progress in short periods of time.
- Cognitive behavioral therapy can equip someone with the skills needed to evaluate their thoughts and patterns. Additionally, patients can develop coping and problem-solving skills and create a relapse prevention plan.
- Mindfulness is all about being present in the moment. Through this practice, people can treat themselves with compassion and without judgment.
Finally, support groups like Alcoholics Anonymous can be a helpful way to connect with other individuals facing similar struggles and receive support.
Help Is Available
If you or a loved one are struggling with alcohol use or addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.
For more mental health resources, see our National Helpline Database.
The course of alcohol use disorder varies by individual and can depend on the frequency and duration of drinking. Additionally, genetics or environmental stressors can complicate the diagnosis.
It's important to remember that there may be periods of remission and that relapse is a possibility. Treatment can help with navigating the setbacks and victories of recovery.
Examining the relationship a person has with alcohol can be painful. It's also the first step to making changes.
Recovery can take time and looks different for everyone. Taking care of yourself can aid in the healing process.
Some strategies to help manage alcohol use disorder include:
- Being honest about your relationship with alcohol
- Increasing awareness around limits and triggers
- Establishing a support system
- Attending therapy or self-help groups
- Seeking substance use or mental health care
- Being consistent with treatment and communicate openly with providers
- Engaging in self-care activities and hobbies
- Nurturing oneself through exercise, regular sleep, and balanced meals
- Practicing self-compassion
Alcohol use disorder is a condition characterized by compulsive and problematic drinking behaviors. The condition can be mild, moderate, or severe. Excessive drinking can lead to short-term and long-term problems that affect psychological and physical health, relationships, and other important areas in life.
Healthcare providers can treat alcohol use disorder through a variety of interventions. Medication and therapy can effectively reduce cravings and help individuals reach their goals.
A Word From Verywell
If you've been struggling with alcohol use, you're not alone. Peer and professional support are available through self-help and substance use programs. With help, you have the ability to reduce or control your alcohol use. Understanding and evaluating your relationship with alcohol can help you start the road to recovery.