You may have heard the terms "alcohol dependence" and "alcohol abuse." Alcohol use disorder is a single medical diagnosis that encompasses these previously separate disorders.
Here's everything you need to know about alcohol use disorder, including symptoms, treatment options, and what to do if you suspect you or a loved one may have it.
What is alcohol use disorder?
Alcohol dependence was previously identified as at least three of the following behaviors occurring in a 12-month period:
- Need to increase amounts of alcohol to reach intoxication or increase "tolerance".
- Withdrawal symptoms.
- Drink in larger amounts.
- Trying to cut back on alcohol, but not being able to.
- Giving up social, occupational, or recreational activities because of drinking.
- Spend more time drinking, recovering from drinking, or trying to stop drinking.
- Continuing to drink despite being aware of recurring physical or psychological problems caused by the drink.
Alcohol abuse, on the other hand, was defined by experts as just one of the following behaviors over the course of 12 months:
- Recurrent use of alcohol that results in non-compliance with the main obligations of the role.
- Recurrent consumption of alcohol in situations where it could cause physical harm.
- Recurring legal problems related to alcohol consumption.
- Continued use of alcohol despite social or interpersonal problems related to alcohol use.
As of May 2013, however, both alcohol dependence and alcohol abuse have been reclassified under the diagnosis of alcohol use disorder. Simply put, this disorder is a medical condition characterized by a compulsive loss of control over alcohol consumption, leading to life problems and functional impairment.
People with this disorder often recognize the negative effects of alcohol use, but still cannot stop drinking.
What are the symptoms?
Alcohol use disorder has a prevalence of about 6 percent in the general population. Risk factors include a family history of addiction, other prior addictions, and a lifetime history of physical or emotional trauma.
The condition can range from mild to moderate to severe: more symptoms indicate greater severity. Symptoms include:
- Alcohol tolerance.
- Experiencing withdrawal symptoms.
- Cravings to drink
- Drinking alcohol in unsafe settings.
- Inability to meet work, social and family obligations.
- Repeated unsuccessful efforts to stop or control alcohol intake.
What are the most common consequences?
Here are some of the common negative results:
- Psychosocial problems or conflicts, such as poor performance at work or school.
- Inability to maintain responsibilities.
- Fights with family/friends.
- Concern from family or friends about your drinking, along with increasing conflict about your drinking.
- Psychological symptoms, such as increased anxiety, depression, and insomnia, which the person often tries to manage with even more alcohol.
- Physical symptoms, including liver damage or changes in red blood cell count (these can be identified by blood tests or a physical exam with a doctor).
- Increased risk of breast, liver, colorectal, esophageal, and head and neck cancer.
- Decreased immune system function (even a single bout of heavy drinking can reduce immune system function for 24 hours).
How is alcohol use disorder diagnosed?
This disorder is diagnosed through an interview and examination by a physician or therapist to determine if the patient meets the most recent criteria in the Diagnostic Manual of All Mental Disorders.
In some cases, if the individual consents, the doctor may also ask family or friends diagnostic questions to screen for the possible disorder. A person must meet two of the 11 criteria to receive a diagnosis.
In some situations, the disorder can be difficult to identify, because some people who have it will mask the symptoms well. The fact is that there are many people who can stay high functioning with alcohol use disorder, so much so that those closest to them may be fooled.
The 3 Steps to Treating Alcohol Use Disorder
Alcohol use disorder is treated through a combination of therapeutic approaches, peer support, and medication-assisted treatment to prevent relapse. The most important thing to understand about treatment is that it is a disease, and as such, it should be treated like any other type of chronic disease that will require ongoing treatment, monitoring, and disease management.
Treatment for alcohol use disorder generally follows three main steps:
Identify the goal of treatment
The first step in treating is for the doctor and the person seeking treatment to agree on a goal together. In most cases, the goal of treatment is complete abstinence from alcohol.
However, some patients with the less severe disorder are able to resume alcohol use. Predicting who will succeed is difficult and even in these cases I would recommend at least a temporary period of abstinence before deciding if a cautious trial of moderate drinking would be appropriate.
stop drinking alcohol
Once the goal of short- or long-term alcohol abstinence has been established, the next goal is to safely stop drinking.
Don't stop drinking suddenly. Talk to a doctor to make sure it's safe to reduce or stop your alcohol use. Withdrawal from alcohol can be very dangerous and if a well-intentioned patient quits alcohol abruptly without medical supervision, they could be harmed.
Possible withdrawal symptoms include tremors, hallucinations and seizures, according to Harvard Health Publishing. Medicines are sometimes used to prevent these symptoms. Withdrawal often occurs in a hospital or inpatient clinic. Talk to your doctor to determine which action is best for you.
Alcohol withdrawal peaks after 3-4 days without alcohol, so if a patient needs to be treated in a hospital, they can usually go home within days.
keep the results
After the “detox” period is over, it is critical that treatment continues to prevent a relapse. Physically withdrawing from alcohol does not address the underlying problems that lead a person to develop alcohol use disorder.
You can opt for the following tools to treat the disorder on an ongoing basis:
- Medication: There are several types of medications to treat this disorder, but none is a cure. The drugs have a mild to moderate effect.
- Advice: people learn strategies to help stop drinking or control triggers. If there are serious psychological problems, counseling to address them is critically important along with counseling to change drinking behaviours.
- Support for: this is the most important. Support can range from nurturing an environment through things like avoiding bars and people who provoke drinking, to social support, like joining a self-help group like Alcoholics Anonymous.