Drinking alcohol is romanticized and poked fun at on television and the big screen, but anyone who has been around a problem drinker knows there is nothing sexy or funny about it. Alcohol addiction, alcohol abuse, and alcohol dependence are all terms used interchangeably in American nomenclature to indicate alcoholism or someone struggling with a drinking problem.
However, according to the medical community, alcohol use disorder more accurately represents the harmful mental and physical bodily disruptions caused by excessive drinking. Alcohol use disorder is recognized as a brain disorder and is an accepted medical diagnosis.
About Alcohol Use Disorder
Alcohol use disorder (AUD) is a medical condition characterized by an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences, according to the National Institute on Alcohol Abuse and Alcoholism. AUD is considered a brain disease and affects how the brain functions.
AUD encompasses both alcohol use and alcohol dependence and allows doctors to distinguish the disorder as mild, moderate, or severe. Alcohol use disorder, as opposed to alcoholism, acknowledges that continued excessive use of alcohol is a chronic disease. AUD can go into remission but is not curable and subject to relapse. As a result, without a proper recovery program, someone with AUD who abstains from alcohol is at increased risk of returning to unhealthy drinking levels.
Heavy Drinking, Alcoholism, or Alcohol Use Disorder
Many people readily describe heavy drinkers as having alcoholism, but that is not always the case. While binge drinking (5 or more drinks for males, 4 for females, within 2 hours) and heavy drinking (more than 4 drinks on any day for men or more than 3 drinks for women), often referred to as alcohol abuse, can lead to dangerous behavior, it does not mean the person has alcoholism. Many people who abuse alcohol can stop drinking for days or months because they do not have a physical alcohol dependence.
Alcohol dependence is the distinguishing factor between alcohol abuse and alcoholism. Binge and heavy drinkers can still have relationship and job issues, but they do not have intense cravings for alcohol. Someone with alcoholism, on the other hand, physically craves alcohol, needs to drink daily to prevent withdrawal symptoms and builds up a tolerance to the amount of alcohol necessary to give them an alcohol high.
Alcoholism is the de facto, colloquial term used to indicate someone has a drinking problem, but there is a stigma attached to ‘alcoholism’ that diminishes its medical severity. Severe AUD is synonymous with the medical definition of alcoholism; however, within the medical community, the word alcoholism is considered outdated.
People with AUD experience compulsive behavior and intense cravings, preoccupation with alcohol, poor decision-making, poor insight into their addiction, or denial. AUD can lead to significant medical conditions and health problems, including liver disease or cirrhosis, heart disease, mental health disorders, and various cancers.
Diagnosing Alcohol Use Disorder
AUD is not due to a person’s weakness, moral failing, or lack of resolve. Instead, it is a brain disease that can be inherited. While not everyone who drinks will develop AUD, substance use experts have identified genetics, environmental factors, and mental health conditions as risk factors that increase a person’s susceptibility to developing an AUD.
In 2019, approximately 14.1 million people in the United States had an AUD. The Centers for Disease Control and Prevention reports excessive alcohol use leads to over 95,000 deaths in the U.S. every year and is the third-leading cause of preventable death in the country.
A healthcare provider can diagnose an alcohol use disorder. Most healthcare providers rely on The Diagnostic & Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) from the American Psychiatric Association as the standard for diagnosing AUD. Anyone meeting any 2 of the identified 11 criteria during the same 12-month period would receive a diagnosis of AUD. The number of requirements met classifies the severity level.
Here are some of the diagnostic criteria included in DSM-5. In the past year, have you:
- More than once wanted to cut down or stop drinking or tried to, but couldn’t?
- Wanted a drink so badly you couldn’t think of anything else?
- Spent a lot of time drinking? Or being sick or getting over other aftereffects?
Alcohol Use Disorder Treatment
AUD treatment aims to help the patient achieve and maintain long-lasting sobriety, which will vary based on their underlying conditions and disease severity.
Treatment services may be offered at a part- or full-time residential facility or an outpatient setting and can include:
- Doctor-directed Medication-Assisted Treatment (MAT) and medication management.
- Safe, medically supervised detoxification treatment services for alcohol withdrawal.
- Counseling and behavioral therapy.
- Support groups.
- Education around life skills, stress management, relapse prevention, and mindfulness.
- Aftercare resources and follow-up support.
- Talk to your doctor or medical provider to discuss a treatment program for you.