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 causing physical, mental, and social health problems.
The specific cause of AUD is unknown. It is often a complex combination of factors, including genetics and the environment.
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
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
Drinking too much alcohol can lead to tolerance. As a result, greater amounts of alcohol are needed to reach the same levels of intoxication.
Some can also develop a physical dependence. This means that a sudden withdrawal of alcohol can cause physical symptoms such as:
- Seizures that may result from delirium tremens (DTs)
AUD is linked to the development of serious health complications and early death.
You will be asked about your symptoms and medical history. AUD is diagnosed based on information collected from specific questions. This includes the 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.
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. 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. Family and friends who have a loved one with AUD who is in denial can seek advice from professionals or support groups such as Al-Anon.
Medical support may be needed to safely manage withdrawal from alcohol. This could require hospitalization in a detoxification center. Support may include medications, fluid or nutrition support, and monitoring by professional staff.
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. Treatment to maintain management of AUD may include:
Counseling is a large part of AUD treatment. Stress and physical or emotional pain are often triggers for AUD. Counseling can improve coping skills and teach healthier ways of dealing with stress or pain. Since AUD affects all aspects of life, including relationships, family, and work, counseling may also help people as they adjust to a sober life. Counseling may be one-on-one, in a group, or with other family members.
Treatment and counseling take time. What works for some may not work for others. The length of time involved in counseling depends on individual needs. For many, some form of counseling is a life long support system.
Mentoring and Community Help
Alcoholics Anonymous (AA) helps many people to stop drinking and stay sober. Members who all have drinking disorders meet regularly to share and support each other's sobriety.
Living with an alcoholic can be a painful, stressful situation. Family members may also find group support of others in a similar situation helpful. The groups may help them better deal with stresses and changes they are facing.
Certain medications may help decrease the desire to drink alcohol. Medications may be used alone or in combination with other treatments. Options include:
- Medication that decreases the pleasure signal from the brain when drinking. It may help cut cravings.
- Medication that causes immediate illness after drinking alcohol.
- Medication that reduces that physical dependence and cravings for alcohol.
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:
- Heart disease, such as heart arrhythmias, or a heart attack or stroke
- Liver disease, such as cirrhosis
- Chronic pancreatitis
- Poor nutrition
- Cognitive problems, such as dementia
- Psychiatric problems
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AUD 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. Moderation is 1 drink or less per day for women and 2 drinks or less per day for men.
Canadian Centre on Substance Abuse
Mental Health Canada
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Last reviewed March 2018 by EBSCO Medical Review Board James P. Cornell, MD Last Updated: 3/17/2017