Alcohol Use Disorder: When Drinking Becomes a Problem

Like other substance use disorders, alcoholism – also called alcohol use disorder (AUD) – impacts the pleasure centers of the brain. This means that when you regularly use alcohol, the brain begins to associate consuming alcohol with feelings of euphoria, relaxation, and lowered inhibitions.  Over time this can result in cravings and, in some cases physical dependency.  Alcohol Use Disorders effect people from all walks of life and manifest in a variety of ways.  Recognizing the signs and symptoms of AUD can help you seek treatment early and potentially avoid the more serious consequences associated with the disorder.

What is An Alcohol Use Disorder?

Alcohol Use Disorder (AUD) has been estimated to affect around 18% of the population at some point in their lives. Terms such as alcoholism, alcohol dependence, alcohol addiction, or alcohol abuse have been used to describe the condition.  AUD is a brain disorder which is characterized by a person’s inability to control their alcohol use despite adverse social, medical, or occupational consequences1.   Alcohol Use Disorders develop when an individual repeatedly uses alcohol, eventually developing a physical tolerance. Due to changes in the brain, increasing amounts of alcohol are required to achieve the desired effect.  Additionally, heavy drinkers may begin to experience withdrawal symptoms when use is abruptly discontinued2.  

For those who have developed a physical dependence on alcohol, cutting back or stopping all together can be very dangerous and challenging. Treatment is needed to help those struggling with an alcohol dependence to safely navigate withdrawal and recovery. 

Like other substance use disorders, AUD tends to worsen over time.  If treated early, someone with an AUD may be able to avoid major medical or social consequences. With appropriate treatment anyone can achieve and maintain recovery from an alcohol use disorder, no matter how severe it may seem.

Identifying an Alcohol Use Disorder

Problems with alcohol can be difficult to identify.  Unlike other substances, alcohol is widely used and easily accessible.  Due to its prominence in many cultures, it can be hard to tell the difference between moderate drinking and a real problem.

Qualified healthcare professionals utilize the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) to determine if a person has an AUD and to identify the level of severity if the disorder is present1. AUD can be classified as mild, moderate, or severe depending on the number of symptoms an individual reports1.  A diagnosis of AUD is typically given when two or more symptoms are present, with the level of severity being determined as follows1:

  • Mild – the presence of two to three symptoms
  • Moderate – the presence of four to five symptoms
  • Severe – the presence of six or more symptoms

The DSM-5 identifies 11 key criteria, or symptoms, to diagnose AUD by examining individual patterns of alcohol use over the past year.  The National Institute on Alcohol Abuse and Alcoholism presents these simple questions to assess a person’s symptoms3:

  • Had times when you ended up drinking more, or longer, than you intended?
  • More than once wanted to cut down or stop drinking, or tried to, but couldn’t?
  • Spent a lot of time drinking, being sick from drinking, getting over other aftereffects?
  • Wanted a drink so badly you couldn’t think of anything else?
  • Found that drinking—or being sick from drinking—often interfered with taking care of your home or family? Or caused job troubles? Or school problems?
  • Continued to drink even though it was causing trouble with your family or friends?
  • Given up or cut back on activities that were important or interesting to you, or gave you pleasure, in order to drink?
  • More than once gotten into situations while or after drinking that increased your chances of getting hurt (such as driving, swimming, using machinery, walking in a dangerous area, or engaging in unsafe sexual behavior)?
  • Continued to drink even though it was making you feel depressed or anxious or adding to another health problem? Or after having had an alcohol-related memory blackout?
  • Had to drink much more than you once did to get the effect you want? Or found that your usual number of drinks had much less effect than before?
  • Found that when the effects of alcohol were wearing off, you had withdrawal symptoms, such as trouble sleeping, shakiness, restlessness, nausea, sweating, a racing heart, dysphoria (feeling uneasy or unhappy), malaise (general sense of being unwell), feeling low, or a seizure? Or sensed things that were not there?

If any symptoms are present, it can be a cause for concern.  If multiple symptoms are present, it is crucial to seek help from a qualified professional.

Asking for Help

Treatment for AUD is available and typically includes a combination of medications, substance use treatment programs, behavioral therapies, and social support.  The best form of treatment for AUD will depend on each person’s individual needs.  Some people will need to complete a detoxification to safely stop drinking, while others may be able to enter outpatient treatment directly. 

Asking for help can be one of the most difficult steps in early recovery.  If you are concerned about your alcohol use, it’s a good idea to ask for help as soon as possible. A healthcare provider or other treatment professional can help you learn more about what treatment options are available. If you’re unsure where to begin, Contact us today to speak with one of Greenbriar’s compassionate admissions team. 

Resources

  1. https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/understanding-alcohol-use-disorder
  2. Mirijello, A., D’Angelo, C., Ferrulli, A., Vassallo, G., Antonelli, M., Caputo, F., Leggio, L., Gasbarrini, A., & Addolorato, G. (2015). Identification and management of alcohol withdrawal syndrome. Drugs, 75(4), 353–365. https://doi.org/10.1007/s40265-015-0358-1
  3. https://www.niaaa.nih.gov/sites/default/files/DSMfact.pdf