Last reviewed:
12th Oct 2022
PhD, OTR/L
Alcohol use disorder (AUD) occurs when an individual drinks often and in large enough quantities for their body to become dependent and addicted to alcohol. Those with this disorder will continue to drink even when this causes negative physical, emotional, and social consequences. Treatment involves abstinence from alcohol, counseling, support group therapy, and medication.
According to the National Institute on Alcohol Abuse and Alcoholism, AUD is a "medical condition characterized by an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences. It encompasses the conditions that some people call alcohol abuse, alcohol dependence, alcohol addiction, and the colloquial term, alcoholism." [1]
AUD is the medical term for this disorder that is considered a brain disorder and may be classified as mild, moderate, or severe.
People with alcohol use disorder may engage in certain behaviors as a result of their health condition. For example, they might start drinking at different times of the day or start drinking alone. They may even begin to skip meals or eat less due to their excessive drinking. Eventually, the alcohol intake starts to affect their responsibilities, so they may take more sick days due to hangovers or because they want to be free to drink.
Their internal experiences include cravings, withdrawal symptoms, and memory lapses.
AUD can lead to liver damage, heart disease, gastrointestinal problems, and neurological damage. It can also increase the risk of accidents and injuries. Treatment for AUD often includes counseling, support groups, and medication.[2]
Alcohol use disorder is a broad term that describes a range of drinking patterns, from problematic but not physically dependent drinking to severe dependence.
Alcohol use disorder has been known as alcoholism, alcohol abuse, or alcohol addiction in the past. However, the terms' alcoholism', 'alcoholic', and ‘addiction’ are somewhat outdated, as they stigmatize the individual and they make it more difficult for people to overcome certain treatment barriers when these labels are placed on them.
The terms alcoholism/alcoholic are falling out of use and have not been considered diagnostic terms by medical professionals for some years. Doctors use diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM 5) to determine whether alcohol use disorder is present.
Some recovery groups, such as alcoholics anonymous (AA) and others still use these descriptions in their meetings. However, other support groups are starting to use the clinical and correct term AUD.
People with AUD may have difficulty controlling their drinking and continue to drink even when it causes financial, social, or physical problems. Many different symptoms can be associated with AUD, varying in severity. Occasional or moderate drinking should not lead to such symptoms.
Some of the most common symptoms include:
Other illnesses can also occur in the long term and also depend on the individual's general health:
Doctors and mental health professionals use the diagnostic criteria set out in the DSM 5 to determine whether AUD is present and to understand the severity of each case. For someone to be diagnosed with AUD, they must experience the following symptoms over 12 months:
Two or three symptoms indicate a mild case of AUD, four or five symptoms indicate a moderate case, and severe cases will present with six or more symptoms.[4]
Alcohol withdrawal symptoms can range from mild to severe and typically begin within 8 hours after the last drink. These symptoms occur in someone who has been drinking heavily for some time and suddenly stops or drastically decreases the amount of alcohol they are drinking. In some cases, symptoms may appear as early as 4-6 hours, as the alcohol in the bloodstream returns to zero. The most common symptoms include:
More severe symptoms include hallucinations, agitations, extreme tremors, confusion, disorientation, delusions, and seizures. Symptoms tend to peak on the second day after the last drink. The acute phase is usually over by day four or five.
Delirium tremens, or DT, is a specific condition caused by alcohol withdrawal, which can cause a rapid onset of confusion, hallucinations, fever, high blood pressure, and a fast heart rate.
If you experience any of these symptoms, it's essential to seek medical help immediately. Withdrawal can be dangerous, and detoxing under medical supervision is important.
The time needed to detox from alcohol depends on various factors, including how much you drink, how often you drink, and your overall health. In general, the detox process takes about a week. However, some people may experience lingering symptoms (known as post-acute alcohol withdrawal syndrome) for months or even years after stopping drinking.
If you're struggling with alcohol use disorder, there is help available. Alcohol rehab centers offer a safe and supervised environment for detoxing from alcohol. They also provide counseling and support to help you stay sober after you leave treatment.[5]
Alcohol use disorder typically develops over time. Alcohol use causes brain changes that make some people associate alcohol intake with pleasurable feelings. This makes them want to drink more often, even if they know it causes harm. With repeated use, the pleasant feelings go away. Still, the individual gets withdrawal symptoms and continues to drink to prevent these symptoms.
Some risk factors may increase the chances of developing this condition:
Even though the only sure way to prevent alcohol use disorder is to abstain, individuals can significantly reduce their risk by taking these steps.
It is essential to be aware of the signs and symptoms of alcohol use disorder and to seek help early if you or someone you know is exhibiting these signs. If you suspect (or know) that alcohol use is problematic, avoid situations that trigger drinking, such as social gatherings where alcohol is present, to prevent alcohol misuse and relapse.
A strong support system can provide individuals with the resources they need to stay sober. This includes attending therapy and support group meetings and undergoing rehabilitation when necessary.
Since going cold turkey can be dangerous in those with alcohol use disorder, a patient who has relapsed should seek professional support to get back on track.
Several treatments for AUD are available, but what works for one person might not work for another.
Detoxification helps to treat withdrawal symptoms. It is performed in an inpatient setting (hospital or a specialized center) and typically lasts one week. During this time, medications may be given to counteract severe withdrawal symptoms.
During behavioral therapy, those with alcohol addiction learn how to modify their behavior and learn skills to cope with life without reverting to alcohol. They also learn to avoid alcohol and situations that might tempt them to drink. Support groups (such as Alcoholics Anonymous) can be beneficial as individuals with alcohol use disorder are introduced to peers who understand their fears and motivate them to stay sober. Support groups also hold the person with AUD accountable.
Medications used to treat AUD are
Residential treatment is often called 'rehab', which refers to inpatient treatment at a specialized facility for alcohol use disorder. Detox, therapy, and medication all make part of rehab, and the patient stays in this residence between 30-90 days.[7]
One of the most important aspects of recovering from use disorder is taking care of yourself. This means:
Taking care of yourself can increase your chances of staying sober and healthy.
If you have a loved one struggling with alcohol misuse, you may be wondering what you can do to help. Here are five steps that can make a difference:
If your loved one relapses, don't give up on them – remind them that recovery is possible and offer your support again.
According to the National Survey on Drug Use and Health (NSDUH), in 2019, there were 14.5 million people over 12 years with AUD in the US. That amounts to 5.3% of this population group, of which 6.8% were men and 3.9% were women.
When focusing on youths aged between 12 and 17 in the same year, AUD prevalence was 1.7% of the entire population within this age group.
If you have a teenager and suspect alcohol misuse, watch out for the following signs that may indicate AUD:
Alcohol affects chemicals in the brain that regulate mood and is a depressant. Binge drinking and alcohol use disorder have been connected to symptoms of depression because the balance of chemicals is disrupted.
Even though the short-term effects of alcohol can feel relaxing in those who drink moderately/occasionally, when someone is misusing alcohol, these effects wear off quickly. In addition, individuals with depression use alcohol to mask their symptoms and start to rely on it. This creates a vicious cycle of dependence and depression.[8]
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