Alcohol abuse, or alcohol use disorder (AUD,) is a medical condition in which a person continues to consume alcohol despite the adverse consequences. AUD can be mild, moderate, or severe.
Other names for AUD include alcohol misuse, alcohol dependence, alcohol addiction, and alcoholism. Risk factors for developing alcohol misuse disorder include a family history of alcohol misuse, mental health conditions, and starting alcohol use at a young age.
Alcohol misuse can lead to various illnesses such as heart disease. People experiencing alcohol misuse disorder should seek medical attention.
Keep reading to learn more about AUD, including who is at risk, common symptoms, treatment, and more.
Alcohol misuse is the excessive consumption of alcohol. It is the inability to control drinking, even when it negatively affects a person’s life. The person consuming alcohol may develop tolerance and experience withdrawal symptoms when trying to cut back.
A national survey published in 2019 reported that 14.1 million adults (5.6%) and 414,000 adolescents aged 12-17 years (1.7%) were experiencing AUD in 2019 in the United States.
Common definitions for alcohol misuse are below:
|Drinking in moderation||For women: 1 drink or less per day|
For men: 2 drinks or less per day
|Alcohol misuse||For women: 3 drinks or more per day OR more than 7 drinks per week|
For men: 4 drinks or more per day OR more than 14 drinks per week
|Binge drinking||For women: More than 4 drinks over 2 hours |
For men: More than 5 drinks over 2 hours
Alcohol misuse can adversely affect a person’s health, quality of life, and relationships.
- injuries (e.g. falls, workplace accidents, motor vehicle accidents)
- chronic diseases (e.g. liver cirrhosis, stroke, dementia, heart disease)
- cancers (e.g. breast, rectal, liver)
- risky sexual behaviors
- absenteeism from work or school
- adverse pregnancy outcomes (e.g. fetal alcohol syndrome)
Alcohol intoxication causes slowed speech and reflexes, difficulty in concentration and memory, and poor decision-making. A pattern of excessive use may signal alcohol misuse.
Common signs of alcohol abuse include:
- wanting to stop drinking but not managing to do so
- hiding the extent of the alcohol abuse in order to protect it
- being in denial about the extent of the alcohol abuse problem
- diverting energy from work, family, and social life in order to drink
- becoming distressed at the prospect of not having access to alcohol
- engaging in risky behaviors (eg. drunk driving)
- slurred speech and poor coordination
- impaired thinking and impaired memory
Severity of AUD is determined by the number of symptoms present.
- Mild AUD: 2-3 symptoms
- Moderate AUD: 4-5 symptoms
- Severe AUD: >6 symptoms
A health care professional will ask questions to assess a person’s symptoms and whether they have AUD. They want to determine behaviors and physical effects due to drinking. Some of the questions they might ask about symptoms include:
- Are there times when you drink more or longer than intended?
- Have you been unable to cut back or stop drinking?
- Do you get sick from drinking?
- Do you sometimes want a drink over anything else?
- Has drinking interfered with your job, school, or family life?
- Have you engaged in risky behaviors after drinking (e.g., unsafe sex, driving while under the influence)?
- Do you continue to drink even though it causes other health problems (e.g., anxiety, depression)?
- Do you need to drink more to get the effect you want?
- Do you have withdrawal symptoms when the effects of alcohol wear off (e.g., trouble sleeping, shaking, nausea, sweating)?
Making screening part of regular health visits can help with making an early diagnosis.
How much, how quickly, and how often a person uses alcohol will affect their risk of developing AUD. Other factors may also increase risk. Below is a list of some risk factors:
- Binge-drinking: Consuming large quantities of alcohol in a short period of time.
- Heavy drinking: Steady drinking over a long period of time.
- Starting to drink at a young age (before age 15 years): This risk is higher for females than males.
- A family history of misuse of alcohol: Genetics may also play a role.
- Mental health conditions: These include depression, post-traumatic stress disorder (PTSD), attention deficit hyperactivity disorder (ADHD), schizophrenia, bipolar disorder. Childhood trauma also increases the risk of developing AUD.
- Social and cultural influences: This includes experiencing peer pressure, or having role models who drink.
Following diagnosis, a healthcare professional will work with a person to determine the best course of treatment. Several options exist. People can use a combination of treatments.
Three medications are FDA-approved for alcohol dependence.
- Naltrexone (Vivitrol): This is an injection given by a healthcare professional once a month. It reduces the craving for alcohol.
- Acamprosate (Campral): This medication is taken by mouth. It is thought to act by restoring the balance of chemicals in the brain.
- Disulfiram (Antabuse): This medication is taken by mouth. It interferes with the metabolism of alcohol. Drinking even a small amount of alcohol causes very unpleasant nausea and vomiting.
Alcohol misuse may lead people to skip meals or maintain a diet that lacks balance.
Additionally, alcohol may cause inflammation in the gastrointestinal tract. This can impair absorption of essential nutrients, particularly vitamin B1 (thiamine). Thiamine is important for proper brain function. Thiamine supplements can help restore proper levels in the body.
Excessive alcohol intake can disrupt the balance of microbes in the gut. Administration of probiotics may improve intestinal function and help prevent liver disease.
As with any chronic condition, proper nutrition is an important component of any recovery plan, but so is physical activity.
People should also note that those with AUD may already be dehydrated, and further dehydration due to exercise may place people at an increased risk of seizures.
Licensed therapists work with people who are misusing alcohol to help them stop drinking. They can provide reinforcement and motivation techniques. They also help people identify and avoid their triggers for drinking. They can offer alternative ways for dealing with stress.
Peer support groups can help people reduce or stop drinking. Many communities have programs that meet frequently that may be helpful for some people. Online options are available. There are also programs for family members.
People should note that some support groups can be stigmatizing for certain individuals, and can adversely impact a treatment plan or progress towards recovery.
Mindfulness and meditation
Mindfulness techniques such as yoga, meditation, breathing exercises, and visualization may be useful to some people for focusing their thoughts away from drinking.
If a person believes that they are misusing alcohol, they should consider seeking medical help. Early intervention can help prevent some of the negative consequences of drinking.
With the support of a doctor, people can develop a treatment plan that is individualized for them. It may be in an inpatient or outpatient setting, and may require detoxification to manage withdrawal symptoms. A treatment plan may involve medication, therapy, or both.
Contacts for help
Anyone concerned about the drinking habits of themselves, or loved ones, can contact the following organizations for help:
- Substance Abuse and Mental Health Services Administration (SAMHSA): 800-662-4357
- National Institute on Alcohol Abuse and Alcoholism: 301–443–3860
- National Council on Alcoholism and Drug Dependence: 800-622-2255
Awareness of the definition and who is at risk for developing AUD can help people make better decisions about their use of alcohol.
Those people who develop AUD should seek treatment. There are treatment options available for AUD, with or without therapy, that can help guide a person’s towards recovery.