Diagnosing Alcohol Use Disorder

Do you want a drink so badly you can't think of anything else? Find out if you meet the latest criteria for an alcohol use disorder (AUD).

Diagnosing AUD can be tricky since the diagnosis depends on the person doing the drinking being willing to honestly answer a series of questions about drinking patterns and attitudes. AUD is the medical term for alcohol abuse, like binge drinking, or it can be used to mean alcohol dependence, such as your body goes into withdrawal without alcohol. Alcohol dependence is alcoholism.

Denial Makes Diagnosis More Difficult

Getting an honest answer about alcohol use and its effects on your life can be a problem because a common symptom of alcoholism is denial. An old adage about alcoholism is it's "the only disease that denies it exists and resists treatment."

A health care professional is unlikely to give an AUD diagnosis during routine visits because this condition is often misdiagnosed.

Sometimes it can be difficult to admit to a health professional about your drinking habits and patterns. There are many online alcohol screening tests you can take on your own if you are not ready to talk out loud about your drinking.

Family and Friends See the Problem

Long before a health care worker gives an AUD diagnosis, friends and family can usually recognize the problem. They may try to talk to you about the problem and encourage you to get help, but again, denial comes into play. Denial is so common in people with alcohol abuse problems that denial itself is a warning sign of alcoholism. A person who drinks a lot simply can not see or refuses to admit that alcohol use is a problem.

Diagnostic Tools for AUD

There are many diagnostic tests health professionals use to screen for and evaluate drinking problems. To overcome denial, most health professionals do not ask direct questions about the number of drinks but instead, ask questions about problems associated with drinking instead.

Short, four-to-five question alcohol screening tests, such as the FAST test, are effective in the initial screening to detect AUD, while longer, more elaborate tests do a more in-depth evaluation and assessment.

Laboratory medicine has provided us with new possibilities for biomarker-based assessment of diagnosis of health risks related to excessive alcohol use.

Alcohol Dependence Criteria

According to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, health professionals may give an AUD diagnosis if you meet two of 11 criteria within a 12-month period. Depending on the number of criteria you meet, your level of alcohol abuse or alcohol dependence can be categorized as mild, moderate or severe.

• You drink more or longer than intended
• You want to stop or tried to modify your drinking habits more than once, but cannot
• You spend a lot of your time drinking or being hungover
• You want a drink so badly that you can not concentrate on anything else
• Drinking and being hungover has interfered with your responsibilities to your family, job, and home
• You continue to drink even though it causes trouble with family and friends
• You give up important and enjoyable activities in order to drink
• You get into situations after drinking, such as driving or walking in a high-crime neighborhood, which have increased your chances of injuring yourself
• You continue to drink even though it made you feel depressed, anxious, and/or blackout
• You need to drink more than you did before to get the same effect
• You feel withdrawal symptoms, such as nausea and sweating​