Understanding Alcohol Use Disorder (AUD)
Alcohol use disorder (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 refer to as alcohol abuse, alcohol dependence, alcohol addiction, and the colloquial term, alcoholism. Considered a brain disorder, AUD can be mild, moderate, or severe.
Lasting changes in the brain caused by alcohol misuse perpetuate AUD and make individuals vulnerable to relapse. The good news is that no matter how severe the problem may seem, evidence-based treatment with behavioral therapies, mutual-support groups, and/or medications can help people with AUD achieve and maintain recovery.
According to a national survey, 14.1 million adults ages 18 and older (5.6% of this age group) and 414,000 adolescents age 12–17 (1.7% of this age group) had AUD in 2019.
What Increases the Risk for AUD?
- How much, how often, and how quickly alcohol is consumed. Drinking excessively, which includes binge drinking and heavy alcohol use, over time increases the risk of AUD.
- Drinking at an early age. A national survey found that among people ages 26 and older, those who began drinking before age 15 were more than 5 times as likely to report having AUD as those who waited until age 21 or later to begin drinking. In this group, the risk for females is higher than for males.
- Genetics. Genetics play a role, with hereditability approximately 60%. However, AUD risk is influenced by the interplay between a person’s genes and their environment.
- Family history of alcohol problems. Parents’ drinking patterns may influence the likelihood that a child will one day develop AUD.
- Mental health conditions. A wide range of psychiatric conditions—including depression, post-traumatic stress disorder, and attention deficit hyperactivity disorder—are comorbid with AUD and are associated with an increased risk of AUD.
- A history of trauma. People with a history of childhood trauma are vulnerable to AUD.
What Are the Symptoms of AUD?
Healthcare professionals use criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) to assess whether a person has AUD and to determine the severity if the disorder is present. Severity is based on the number of criteria a person meets based on their symptoms—mild (2–3 criteria), moderate (4–5 criteria), or severe (6 or more criteria).
A healthcare provider might ask the following questions to assess a person’s symptoms. In the past year, have you:
- 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? Or being sick or 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 having unprotected sex)?
- Continued to drink even though it was making you feel depressed or anxious or adding to another health problem? Or after having had a 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, or a seizure? Or sensed things that were not there?
Any of these symptoms may be cause for concern. The more symptoms, the more urgent the need for change.