Alcohol Use Disorder

Alcohol consumption is a common element of social gatherings, meals, and celebrations. In many situations, alcohol use is far from being a disorder, but is instead a means for relaxation and enjoyment. Yet everyone has a different tolerance and response to alcohol. Factors such as age, family history, gender, quantity and frequency of consumption influence our relationship to alcohol. When alcohol use exceeds healthy levels, or combines with other underlying issues, it can lead to alcohol abuse and dependency. Using alcohol excessively to cope with or avoid stressful situations can signal a greater problem with alcohol use. Moreover, alcohol use disorder can have devastating consequences for the drinker as well as his or her family and friends. 

Knowing the difference between alcohol abuse and alcohol dependence is important in clarifying our understanding of problematic drinking. Alcohol dependence, often referred to as “alcoholism,” occurs when an individual is physically or psychologically dependent on drinking alcohol. Alcohol abuse, which includes binge drinking, is present when there is recurrent harmful use of alcohol despite negative consequences. Both conditions are now classified by the DSM-5 as alcohol use disorder. 

A third or more of American families are directly affected by an alcohol problem at one time or another. The impact has both personal and social repercussions. Family dynamics change in ways that negatively impact relationships with spouses, children, and siblings. Finances may suffer when the drinker loses his or her job or engages in acts of recklessness, such as gambling or driving under the influence. Alcohol uses disorders take a toll on everyone involved in the drinker’s life. 

According to the U.S. Department of Health and Human Services and U.S. Department of Agriculture, Dietary Guidelines for Americans 2015–2020, moderate drinking is up to one drink per day for women and up to two drinks per day for men. In the United States, one standard drink contains roughly 14 grams of pure alcohol, which is found in: 

• 12 ounces of regular beer, which is usually about 5% alcohol 

• 5 ounces of wine, which is typically about 12% alcohol  

• 1.5 ounces of distilled spirits, which is about 40% alcohol

A third or more of American families are directly affected by an alcohol problem at one time or another.

Symptoms of Alcohol Use Disorder

Alcohol abuse exists across gender, race, and ethnicity. As reported by the 2015 National Survey on Drug Use and Health (NSDUH), 15.1 million adults are dependent on alcohol or have an alcohol-related problem. If you or a loved one is struggling with drinking, it can help to know what symptoms are used to identify an AUD. Keep in mind that professionals working with alcohol use disorder will assess severity accordingly. 

• Drinking more or for a longer period than intended.
• On more than one occasion, feeling the need or attempting to cut down or stop drinking.
• Spending a lot of time drinking, or recovering from the after-effects of alcohol.
• Craving or thinking about wanting a drink or having the urge to use alcohol.
• Failing to fulfill major work, school, or home responsibilities due to drinking.
• Continuing to drink even though it is causing relationship trouble with your family or friends.
• Prioritizing drinking by giving up or cutting back other activities that were important to you or gave you pleasure.
• Drinking before or during situations that are physically dangerous—while driving a car, operating machinery, swimming, or having unsafe sex.
• Continuing to drink even though drinking is making you feel depressed or anxious, is linked to another health problem, or results in having memory blackouts.
• Developing a tolerance for drinking—needing much more than you once did to get the desired effect from alcohol, or not experiencing the same effect when drinking the same amount of alcohol.
• Withdrawal, characterized by trouble sleeping, shakiness, restlessness, nausea, sweating, a racing heart, a seizure, or imagining things.

When to Seek Help

Seeking professional help for alcohol use disorder can been difficult for many reasons. Many people are in denial that there is a problem and will find ways to justify or normalize their drinking behaviors. Families, often with benign intention, can be complicit in allowing the problem to continue. Typically, alcohol problems don’t resolve on their own and, when left untreated, can lead to a host of physical and psychological problems. In the most severe cases, the drinker’s life will end prematurely. If you, or someone you care about, is showing signs of an alcohol use disorder, it is important to get treatment as soon as possible. A marriage and family therapist who specializes in addiction can be a valuable resource and works systemically with the drinker and his or her family. 

Resources

Alcoholics Anonymous

Alcohol Rehab Guide

Hazelden Betty Ford Foundation

SMART Recovery