A Guide to the Signs and Symptoms of Alcoholism

Signs of Severe Drinking Problems and Alcohol Use Disorder

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There are many signs and symptoms related to drinking problems. Alcoholism is considered a progressive disease, meaning that effects of drinking alcohol become increasingly more severe over time.

Those who use alcohol may begin to show early signs of a problem, then progress to showing symptoms of alcohol abuse. If drinking continues, they may later show signs of alcoholism or alcohol dependence. Take the Alcoholism Screening Quiz.

Early Signs of a Problem

Early signs of alcoholism include frequent intoxication, an established pattern of heavy drinking and drinking in dangerous situations, such as when driving. Other early signs of alcoholism include black-out drinking or a drastic change in demeanor while drinking, such as consistently becoming angry or violent.

Symptoms of Alcohol Abuse

The main symptom of alcohol abuse occurs when someone continues to drink after their drinking reaches a level that causes recurrent problems. Continuing to drink after it causes someone to miss work, drive drunk, shirk responsibilities or get in trouble with the law is considered alcohol abuse.

The "Diagnostic and Statistical Manual of Mental Disorders, IV," used to define alcohol abuse as drinking despite alcohol-related physical, social, psychological, or occupational problems, or drinking in dangerous situations, such as while driving.

The World Health Organization's "International Classification of Diseases" refers to "harmful use" of alcohol, or drinking that causes either physical or mental damage in the absence of alcohol dependence. In other words, alcohol abuse is any harmful use of alcohol.

The new DSM-5 manual no longer distinguishes between alcohol abuse and alcohol dependence, but now provides a single diagnosis of alcohol use disorder, ranging from mild, moderate or severe.

Symptoms of Alcohol Use Disorder

Previously, for someone who is alcoholic or alcohol dependent, the symptoms include all of those associated with alcohol abuse, as explained previously. But alcoholics also continue to drink in spite of all the problems it has caused in their lives.

When alcohol abuse reaches the alcohol dependence stage, the person also experiences at least three of seven other symptoms, including neglect of other activities, excessive use of alcohol, impaired control of alcohol consumption, the persistence of alcohol use, large amounts of time spent in alcohol-related activities, withdrawal symptoms, and tolerance of alcohol. See the seven symptoms of alcoholism.

Under the new alcohol use disorder, a person is diagnosed as severe if they exhibit at least six of these 11 symptoms. If they have only two or three of the symptoms, their disorder is considered mild, and if they have 4 to 5 symptoms, it is considered moderate. Learn more about diagnostic tests for alcohol use disorder.

Alcoholism Essentials

What Is Alcoholism?
The term "alcoholism" refers to a disease known as alcohol dependence syndrome, the most severe stage of a group of drinking problems which begins with binge drinking and alcohol abuse.

Diagnosis of Alcoholism
Diagnosing alcoholism can be tricky since the diagnosis depends on the drinker being willing to honestly answer a series of questions about his or her drinking patterns and attitudes.

Treatment of Alcoholism
Alcoholism is a treatable disease, and many treatment programs and approaches are available to support alcoholics who have decided to get help, but no medical cure available.


  • Diagnostic and Statistical Manual of Mental Disorders (5th Ed). Washington DC: American Psychiatric Association; 2013.