Addiction Alcohol Use Your Relationship With Alcohol Guide Your Relationship With Alcohol Guide Overview Where to Start Take a Quiz What Is Alcohol Use Disorder? Understanding Risks Types of Alcohol Problems How Much Is Too Much? Risks of Binge Drinking What Is a Problem Drinker? Myths About Alcohol Modification Tips What Is Sober Curious? How to Be Social While Quitting Drinking How to Say No to Alcohol Sobriety Support What Is Recovery? Benefits of Recovery Tips to Stay Sober What Is Alcohol Use Disorder? By Buddy T Buddy T Facebook Twitter Buddy T is an anonymous writer and founding member of the Online Al-Anon Outreach Committee with decades of experience writing about alcoholism. Learn about our editorial process Updated on July 22, 2020 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by John C. Umhau, MD, MPH, CPE Medically reviewed by John C. Umhau, MD, MPH, CPE John C. Umhau, MD, MPH, CPE is board-certified in addiction medicine and preventative medicine. He is the medical director at Alcohol Recovery Medicine. For over 20 years Dr. Umhau was a senior clinical investigator at the National Institute on Alcohol Abuse and Alcoholism of the National Institutes of Health (NIH). Learn about our Medical Review Board Print Table of Contents View All Table of Contents What Is Alcohol Use Disorder? Symptoms Diagnosis Causes and Risk Factors Types Treatment Coping Next in Your Relationship With Alcohol Guide Types of Drinking Habits to Avoid What Is Alcohol Use Disorder? According to the National Institutes of Health, an alcohol use disorder (AUD) is defined as a “chronic relapsing brain disease” that causes a person to drink compulsively despite adverse consequences to daily life and overall health. Alcohol use disorder replaced the designations that had previously been separately defined as "alcohol abuse" and "alcohol dependence." Symptoms It is common for people to deny that they misuse alcohol. Furthermore, you may not recognize the signs of an alcohol use disorder in yourself or in someone else. The "Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition," (DSM-5), published in 2013, has created a list of 11 symptoms that indicate an alcohol use disorder. The more symptoms you have, the more urgent the need for help. Alcohol is often taken in larger amounts or over a longer period than was intended. There is a persistent desire or unsuccessful efforts to cut down or control alcohol use. A great deal of time is spent in activities necessary to obtain alcohol, use alcohol, or recover from its effects. Craving, or a strong desire or urge to use alcohol. Recurrent alcohol use resulting in a failure to fulfill major role obligations at work, school, or home. Continued alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol. Important social, occupational, or recreational activities are given up or reduced because of alcohol use. Recurrent alcohol use in situations in which it is physically hazardous. Alcohol use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by alcohol. Tolerance, as defined by either a need for markedly increased amounts of alcohol to achieve intoxication or desired effect, or a markedly diminished effect with continued use of the same amount of alcohol. Withdrawal, as manifested by either the characteristic withdrawal syndrome for alcohol, or alcohol (or a closely related substance, such as a benzodiazepine) taken to relieve or avoid withdrawal symptoms. Signs of Severe Drinking Problems and Alcohol Use Disorder Diagnosis Roughly 15 million people in the United States were diagnosed with an AUD in 2018, including 19.2 million men, 5.3 million women, and 401,000 adolescents ages 12–17. If you suspect that you or someone you love has an alcohol use disorder, your healthcare provider can conduct a formal assessment of your symptoms. To be diagnosed with an AUD, individuals must experience two of the 11 criteria of AUD as outlined by the DSM-5 during the same 12-month period. Here's a quick summary of the above criteria: Drinking more than intendedTrying to quit without successIncreased alcohol-seeking behaviorMissing work or school due to drinkingInterference with important activitiesCraving for alcoholDrinking despite social or personal problemsContinued use despite health problemsDrinking in hazardous situationsBuild up of toleranceWithdrawals when trying to quit What an Alcohol Use Disorder Diagnosis Means Causes and Risk Factors An alcohol use disorder can result from a combination of genetic, environmental, psychological, and social factors, many of which are still being researched. Some of the most common risk factors include: Heavy, chronic drinking: Drinking too much alcohol has been found to alter the parts of the brain responsible for pleasure, judgment, and self-control, which can cause alcohol cravings.Family history: Children of parents with an alcohol use disorder are two to six times more likely than the general public to develop an AUD. This increased risk is likely due genetics as well as environmental and lifestyle influences shared by members of the family.History of trauma: Childhood trauma, including emotional abuse, sexual abuse, physical abuse, emotional neglect, and physical neglect, have all been linked to an increased risk for an AUD in adulthood.Psychiatric disorders: People with a mental health disorder such as anxiety, depression, schizophrenia, and bipolar disorder have been found to have higher rates of misusing alcohol or other substances. In fact, studies show that over one-third of patients with schizophrenia meet the criteria for an AUD diagnosis.Social and cultural influences: Having parents, peers, partners, and other role models who drink regularly may increase a person’s risk of developing an AUD, especially if the person is exposed to heavy drinking at a young age. Another important factor that influences the risk of alcohol on the body is nutrition. Alcohol and nutrition can interact in a number of ways—heavy alcohol use can interfere with nutrition while alcohol/nutrition interacts can impact gene expression. Types Alcohol use disorder is sub-classified into mild, moderate, and severe categories. Mild: If you have two to three of the 11 symptoms on the list, you could be diagnosed with a mild disorder.Moderate: If you have four to five symptoms, you are likely to have a moderate alcohol use disorder.Severe: If you have six or more of the symptoms, you have a severe alcohol use disorder. Treatment The good news is that most people with AUD can benefit from treatment, which often includes a combination of behavioral treatment, medication, and support. The bad news is that less than 10% of people actually receive treatment , often due to fear of stigma or shame, denial or lack of problem awareness, skepticism about treatment, and lack of accessibility to affordable treatment. If left untreated, alcohol use disorders can be harmful to your health, relationships, career, finances, and life as a whole. They can even be fatal, so it's important to get help as early as possible. A good first step is talking to your primary care physician, who can assess your overall health, evaluate the severity of your drinking, help craft a treatment plan, refer you to an addiction specialist or treatment program, and determine if you need any medications for alcohol. Detox and Withdrawal Depending on the severity of your AUD, you may need to undergo medical detox to help treat the symptoms of alcohol withdrawal, which can range from mild to severe. Detox can be done on an in-person or outpatient basis and include intravenous (IV) fluids to prevent dehydration and medications to minimize symptoms and treat seizures or other complications of alcohol withdrawal. How to Gauge the Severity of Alcohol Withdrawal Symptoms Behavioral Treatment A big part of AUD recovery is working with a trained professional to better understand your relationship with alcohol and to learn how to cope with daily living without alcohol. Behavioral treatment can also help with any co-occurring mental illnesses contributing to the AUD. Cognitive behavioral therapy: aims to teach you to recognize and avoid the situations in which you are most likely to drink and to cope with other problems and behaviors that may lead to alcohol misuse. Motivational enhancement therapy: aims to help you build your confidence and motivation to stop drinking. Family therapy: aims to help families become aware of their own needs and prevents substance misuse from moving from one generation to another. Brief interventions: aims to get the person to reduce their level of drinking or change their harmful pattern of drinking. Medications There are currently three medications approved by the FDA for the treatment of an alcohol use disorder. While not all people will respond to medication, many find it helpful in reducing cravings and maintaining abstinence, especially when combined with behavioral treatment and support. Naltrexone (Revia, Depade, Vivitrol): reduces the craving for alcohol Acamprosate (Campral): reduces post-acute withdrawal symptoms during the early stages of alcohol abstinence Disulfiram (Antabuse): causes unpleasant symptoms such as flushing, nausea, vomiting, and headache when you drink alcohol Support Groups Online and community-based recovery groups can also be helpful during alcohol withdrawal and addiction treatment. A support group, like Alcoholics Anonymous or SMART recovery, can help you feel less isolated and provide an opportunity to learn from and connect with others with similar problems and shared experiences. 12 Step Recovery Programs Guide New, Addiction-Free Lives Coping In addition to getting appropriate AUD treatment, there are things that you can do on your own that will make it easier to cope with and sustain your recovery. Get Advice From The Verywell Mind Podcast Hosted by Editor-in-Chief and therapist Amy Morin, LCSW, this episode of The Verywell Mind Podcast shares strategies for coping with alcohol cravings and other addictions, featuring addiction specialist John Umhau, MD. Follow Now: Apple Podcasts / Spotify / Google Podcasts Recognize Your Triggers Understanding what might trigger you to relapse and having a plan in the place for such triggers is important for staying sober during and after treatment for an AUD. Some common triggers may include: StressEmotional distressEnvironmental cues that result in cravingsPeople who are still using drugs or drinkingRelationship troublesJob or financial problems 5 Triggers of Relapse and How to Avoid Them Practice Self-Care A big part of recovery is building resilience toward life stressors without turning to alcohol, and practicing self-care (focusing on your physical, social, mental, and spiritual well-being) can help. Taking steps to care for your mind and body will better equip you to live your best sober life. Seek Support Social support from friends and family as well as online or in-person support groups can help prevent feelings of isolation and shame and provide a sense of security and hope about your sober future. Family members and loved ones can also benefit from this type of support and may consider groups like Al-Anon and Alateen. Support for Mental Health and Addiction Issues During COVID-19 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. 7 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. National Institute on Alcohol Abuse and Alcoholism. Alcohol Use Disorder. U.S. National Library of Medicine. Alcohol use disorder. Schwandt ML, Heilig M, Hommer DW, George DT, Ramchandani VA. Childhood trauma exposure and alcohol dependence severity in adulthood: mediation by emotional abuse severity and neuroticism. Alcohol Clin Exp Res. 2013;37(6):984-92. doi:10.1111/acer.12053 Yang P, Tao R, He C, Liu S, Wang Y, Zhang X. The risk factors of the Alcohol Use Disorders-through review of its comorbidities. Front Neurosci. 2018;12:303. doi:10.3389/fnins.2018.003 Barve S, Chen SY, Kirpich I, Watson WH, Mcclain C. Development, prevention, and treatment of alcohol-induced organ injury: the role of nutrition. Alcohol Res. 2017;38(2):289-302. National Institute on Alcoholism and Alcohol Abuse. Treatment for Alcohol Problems: Finding and Getting Help. Probst C, Manthey J, Martinez A, Rehm J. Alcohol use disorder severity and reported reasons not to seek treatment: a cross-sectional study in European primary care practices. Subst Abuse Treat Prev Policy. 2015;10:32. doi:10.1186/s13011-015-0028-z Additional Reading Kendler KS, Ohlsson H, Bacanu S, Sundquist J, Sundquist K. The risk for drug abuse, alcohol use disorder, and psychosocial dysfunction in offspring from high-density pedigrees: its moderation by personal, family, and community factors. Mol Psychiatry. 2020;25(8):1777-1786. doi: 10.1038/s41380-018-0111-8 By Buddy T Buddy T is an anonymous writer and founding member of the Online Al-Anon Outreach Committee with decades of experience writing about alcoholism. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit Get Treatment for Addiction Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.