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Alcohol Use Disorder

(AUD; Alcohol Dependence; Alcohol Abuse and Alcoholism)



Alcohol use disorder (AUD) is a spectrum of issues involving problem drinking. The drinking continues even though it is clearly associated with physical, mental, and social health problems.


Causes    TOP

The specific cause of AUD is unknown. It is often a complex combination of factors, including genetics and environment.


Risk Factors    TOP

Factors that may increase the chance of AUD include:

  • Genetic makeup that affects how the body uses alcohol
  • Family members with a history of alcohol misuse
  • Use of alcohol at an early age
  • Use of illicit drugs or non-medical use of prescription drugs
  • Easy access to alcoholic beverages
  • Situations with high peer pressure and/or emotional stress
  • Psychiatric disorders, such as depression or anxiety
  • Smoking

Symptoms    TOP

Symptoms can vary between people. The most common signs and symptoms of AUD include:

  • Increasing amounts of alcohol that is being consumed
  • Inability to stop or limit drinking despite associated problems
  • Significant amounts of time doing activities to obtain or use alcohol
  • Craving or urge to use alcohol
  • Repeated home, school, or work problems
  • Difficulty in relationships with family members, friends, and coworkers
  • Missing previously favored activities in order to drink alcohol or recover from alcohol
  • Alcohol use even if it creates physically unsafe situations or leads to legal trouble
  • Alcohol use that continues even when it causes or worsens health problems

Problematic alcohol use can lead to tolerance. As a result, greater amounts of alcohol are needed to reach intoxication.

A sudden withdrawal of alcohol can also cause physical symptoms in people who have developed a physical dependence. Withdrawal symptoms may include:

  • Nausea
  • Sweating
  • Shaking
  • Anxiety
  • Seizures that may result from delirium tremens (DTs)

AUD is linked to the development of serious health complications and early death.


Diagnosis    TOP

The doctor will ask about symptoms and medical history. AUD is diagnosed based on information collected from specific questions, such as number of drinks, social habits, lifestyle changes, and personal relationships. If a family member or friend is present, they may be asked questions as well.

There is no test for AUD. Further tests may be needed if there are some signs of related illness or organ damage.


Treatment    TOP

The first and most important step is recognizing that a problem exists. Successful treatment depends on the desire to change. Denial is common in people with AUD. Support and counseling is available for family and friends who have a loved one with AUD who is in denial.

AUD treatment is aimed at learning how to manage the disease. Most professionals believe that this means giving up alcohol completely and permanently. A combination of approaches is most effective. Medical support may be needed to safely manage withdraw from alcohol. This could require hospitalization in a detoxification center. Support may include medications, fluid or nutrition support, and general monitoring by professional staff.

Treatment to maintain management of disorder may include:


Certain medications may help prevent relapse, such as those that:

  • Block the high that contributes to alcohol craving
  • Cause immediate illness after drinking alcohol
  • Reduce cravings for alcohol


AUD affects all aspects of life, including relationships, family, and work. Counseling is a large part of AUD treatment. It may be one-on-one, in a group, or with other family members. Counseling works to improve coping skills and learn other ways of dealing with stress or pain. Counseling that helps develop coping mechanisms may also be useful for family members.

Treatment and counseling take time. What works for some may not work for others. Some aspects include professional interventions, education, self-help plans, and follow-up via computers or text messaging. The length of time involved in counseling depends on how many problems are affected by AUD.

Mentoring and Community Help    TOP

Alcoholics Anonymous (AA) helps many people to stop drinking and stay sober. Members meet regularly and support each other. Family members may also benefit from attending meetings of Al-Anon. Living with an alcoholic can be a painful, stressful situation.

Relapse is common in people who are recovering from an addiction. Treatment, like taking medication and working with a therapist, may help reduce the chance of drinking and provide the support needed in case of a relapse.

Medical Care    TOP

AUD affects the body's major organs, including the brain, heart, liver, and pancreas. Treatment for AUD may also include medical treatment for life-threatening health conditions. These may include:

Some Organs Damaged with AUD

Alcohol damaged organs right size

Copyright © Nucleus Medical Media, Inc.


Prevention    TOP

It may not be possible to prevent AUD, but it tends to run in families. If you have any family members with a history of problem drinking, be aware that it may increase your risk for addictive behaviors.

Education and structured programs can help children and teens learn about alcohol and how it affects families and society. Parents can be good role models for their children by avoiding alcohol, or drinking in moderation in a safe environment without driving. Moderation is one drink or less per day for women and two drinks or less per day for men.


Alcoholics Anonymous

Moderation Management


Canadian Centre on Substance Abuse

Mental Health Canada


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Vivitrol (naltrexone). Food and Drug Administration website. Available at: http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm106211.htm. Updated August 28, 2013. Accessed February 6, 2015.

Last reviewed March 2016 by James Cornell, MD
Last Updated: 2/6/2015

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