When someone has a problematic relationship with alcohol, they may have something called alcohol use disorder (AUD). This is a condition that must be diagnosed by a doctor based on the DSM-5 criteria for alcohol use disorder. After diagnosis, targeted AUD treatment can help people get sober and improve their lives.
Learn About Alcohol Use Disorder:
How Alcoholism and AUD Are Different
When most people think about problematic alcohol use, alcoholism is the first term that comes to mind. Even those who are aware of alcohol use disorder will often use it interchangeably with alcoholism. However, the two terms are different in a few ways.
The first thing people should understand about the term alcoholism is that it is not an official medical condition. Rather, it is colloquial, and its meaning is derived not from official decisions by experts, but the natural use of everyday people. Culturally, it is used to describe a specific type of problem drinker: one who drinks often, even daily, in large amounts, struggles to function, and is often violent or otherwise problematic.
Alcohol use disorder is an official medical term and diagnosis that encompasses many types of problematic drinking behaviors.
While people would rarely use the term “alcoholic” to refer to someone who binge drinks with friends on the weekends, they might meet alcohol use disorder criteria. This broader definition makes it easier for people to seek help even when they fail to fit into the stereotype of alcoholics.
What is AUD? A basic alcohol use disorder definition is a chronic relapsing brain disease that manifests in compulsive alcohol use, loss of control over alcohol intake, and a negative emotional state when going longer between drinks than is normal for the individual. Someone can be diagnosed with the condition at any stage of alcohol addiction—though obviously, the sooner, the better.
AUD Symptoms According to the DSM-5
AUD is considered a behavioral health disorder. Like all such disorders, diagnostic criteria is determined by the Diagnostic and Statistical Manual of Mental Disorders, or DSM.
All current diagnoses must align with the criteria for alcohol use disorder in the DSM 5.
According to the DSM 5, alcohol use disorder can be diagnosed in individuals who exhibit any two or more of the following symptoms in the last year:
- Had moments of drinking more or for longer than originally intended
- More than once had a desire to reduce or stop drinking but failed
- Spent significant time drinking or recovering from drinking
- Wanted to drink so badly it took over their thoughts
- Found drinking or its aftereffects interfered with the rest of their life
- Continued drinking despite it causing problems in their life
- Cut back on or given up activities once important to them so they could drink
- Continued to drink despite mental or physical health problems caused by drinking
- On more than one occasion, been in a dangerous situation due to drinking
- Feeling the need to drink more to get the same effects
- Experienced withdrawal symptoms when going longer than normal between drinks
It is important that individuals do not attempt to use the alcohol use disorder DSM 5 criteria to diagnose themselves. Nor should they base their understanding on online alcohol use disorder identification tests. Only a trained professional can decide if someone does or does not have AUD.
Causes of AUD
Knowing AUD symptoms is important, but it leaves a big question: what causes the condition in the first place? In truth, there isn’t a clear-cut answer to this.
The causes of AUD are highly varied, and sometimes it isn’t possible to pinpoint them for a patient.
While there isn’t a single cause for all cases of mild to severe AUD, there are some that are frequently observed. These include:
- A strong biological response to alcohol
- Various genetic factors
- Having another behavioral health disorder
- Living in a culture that does not question heavy drinking
However, someone can have all of these without having AUD. Likewise, they can have none of them and still be diagnosed with the condition.
AUD Risk Factors
Perhaps more important than knowing the cause of AUD is knowing what the risk factors are for developing the condition. AUD can manifest in anyone at any time, but those with one or more risk factors are more likely to exhibit AUD symptoms. These include:
- Starting drinking early in life
- Drinking more than 15 drinks per week for men and 12 for women
- Engaging in other types of problematic drinking behaviors
- Having more than five drinks in a day once or more per week
- Being closely related to someone with AUD
- Living in the same house as someone with AUD
- Having an unstable home environment
- Having low self-esteem
- Being under a significant amount of stress
Anyone who exhibits these risk factors should be careful with their alcohol consumption.
Dangers of AUD
Heavy or frequent alcohol consumption is risky. Those who meet the diagnostic criteria for alcoholism are likely to suffer multiple problems from their drinking. Health-related consequences include:
- Injuries incurred in an inebriated state
- Violence as a result of drunken fights or due to being targeted while impaired
- Alcohol poisoning
- High blood pressure
- Heart disease
- Liver disease
- Digestive problems
- Learning disorders
- Memory impairment
On top of these, there are social consequences as well. Those with untreated AUD are likely to alienate friends and family and perform poorly at work. This can quickly turn into financial consequences. Ultimately, anyone with problematic alcohol use needs treatment before their condition can progress to dangerous levels.
How AUD Is Diagnosed
AUD can only be diagnosed by a doctor with the proper training.
Generally speaking, an AUD doctor will be a psychologist or psychiatrist, hopefully with significant experience working with those who have the disorder. They will use the DSM 5 to determine what criteria the patient meets. If they find they meet two or more criteria, an official diagnosis will be given and a treatment plan made.
Prevention and Treatment for AUD
If someone had numerous risk factors for AUD but has yet to develop the condition, they need to focus on preventing it. This means being mindful of their alcohol use and taking care to limit it.
Ultimately, the only way to prevent the condition is to actively create a positive relationship with drinking, one that includes healthy limits.
Once AUD develops, it is time to focus on treating it. Treatment for alcohol use disorder using means entering into a rehabilitation program and then following that up with routine aftercare. This could mean regular therapy sessions, attending recovery groups, or even using medications for AUD. The rehab center will help craft a treatment plan for AUD that works for the given patient.
While those with AUD should never go it alone, they can look into ways they can supplement their guided recovery. Alcoholism resources can provide needed guidance. Books about alcohol abuse recovery can offer inspiration. However, nothing is a substitute for professional treatment.
Alcohol abuse rehabilitation centers know how to help those with AUD get into recovery. By selecting the right program, users can get clean safely while developing the skills they need to continue saying no to drinking. A sober life is possible with the right team and treatment approach.
- Alcohol Use Disorder: A Comparison Between DSM–IV and DSM–5. National Institute on Alcohol Abuse and Alcoholism. https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/alcohol-use-disorder-comparison-between-dsm
- Marcelo Campos. Alcohol use disorder: When is drinking a problem? Harward Health Publishing. Harward Medical School. https://www.health.harvard.edu/blog/alcohol-use-disorder-when-is-drinking-a-problem-2018122015585
- Fact Sheets - Alcohol Use and Your Health. Centers for Disease Control and Prevention. https://www.cdc.gov/alcohol/fact-sheets/alcohol-use.htm