The Facts on Alcohol Use Disorder

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Alcohol abuse is the overuse or misuse of alcohol. It is defined separately from alcoholism. While they may exist together, alcohol abuse does not necessarily include some of the hallmark characteristics of alcoholism, which include an extremely strong craving for alcohol, tolerance, loss of control, or physical dependence.

If you or a loved one are struggling with substance use or addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.

Defining Alcohol Abuse

It is common for people to deny that they have an alcohol abuse problem. Furthermore, you may not recognize the signs of alcohol abuse in yourself or in someone else.

DSM-5 Definition of Alcohol Use Disorder

The 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which is produced by the American Psychiatric Association (APA) was most recently updated in May 2013. In this manual, which serves as the reference for the psychiatric and medical community, a new condition called alcohol use disorder was formally defined for the first time. Alcohol use disorder replaced the designations that had previously been separately defined as "alcohol abuse" and "alcohol dependence." Alcoholism remains a separate disorder, with its own criteria.

The DSM-5 provides a list of 11 symptoms of alcohol use disorder. Alcohol use disorder is sub-classified into mild, moderate, and severe categories.

Alcohol use disorder is considered mild if you exhibit two or three of the 11 symptoms, moderate if you display four or five symptoms, and severe if you display six or more of the symptoms on the list.

Symptoms of Alcohol Use Disorder

1. You drink more alcohol than intended to or continuing to drink for a longer period of time than you had intended.

2. You decide or trying to cut down or control your alcohol use without success. You may return to drinking after a period of abstinence.

3. A significant amount of your time is spent in obtaining alcohol, drinking alcohol, or recovering from the effects of drinking, resulting in too much of your time devoted to alcohol.

4. You have a craving for alcohol, which you might also describe as a strong desire or urge to use alcohol.

5. Your recurrent alcohol use results in a failure to fulfill some of your major obligations to your family, at home, at your job, or at school.

6. You have problems with family, friends, or co-workers as a result of your alcohol use and you continue to use alcohol use despite these persistent or recurrent social or interpersonal problems.

7. You have reduced or given up some of your social, work, or recreational activities because of your alcohol use.

This is often described as drink-seeking behavior and includes decisions such as only going to social events that will include drinking, or only hanging out with others who drink.

You may do this to avoid stigma, escape judgment from others, save your money for alcohol, or because you prefer to spend your time drinking over participating in other activities.

8. You repeatedly use alcohol in situations that are dangerous, such as swimming, driving, or using specialized equipment. Using alcohol in situations that leave you vulnerable to attack by others also fits this criterion.

9. You continue to use alcohol despite negative emotional effects, such as depression, anxiety, or memory lapses that you believe to be caused, exacerbated, or related to your alcohol use.

10. You have developed or are developing alcohol tolerance, which means having to drink increasing amounts to achieve previous effects.

Tolerance is defined by either of the following: a) A need for increased amounts of alcohol to achieve intoxication or desired effect, or b) diminished effect with continued use of the same amount of alcohol.

Some people consider tolerance as a sign of maturity or being able to "hold their alcohol." However, this is an erroneous conclusion, as tolerance is not a sign of healthy physical function.

11. If you experience either of the following, then you have problems with alcohol withdrawal: a) You have withdrawal syndrome, which includes physical symptoms, such as shaking, jitteriness, irritability, sweating, or perceptive disturbances (like hallucinations) after going a short period without drinking, or b) You may drink alcohol or use a substance such as a benzodiazepine to relieve or avoid withdrawal symptoms or to "cure" a hangover.

Alcohol Use Disorder and Alcoholism

Many effects of alcohol use disorder are also experienced by people who suffer from alcoholism, and there is a great deal of overlap between the conditions. It would not be accurate to say that one disorder is better or worse than the other, or that it is easier to recover from one or the other.

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