What is Alcohol Use Disorder, and How Should It Be Treated?

New research has found that people meeting criteria for alcohol use disorder (AUD) are frequently untreated in the United States. Could you or a family member have alcohol use disorder? Could you benefit from the newer methods of treatment for excessive or binge drinking? This article highlights the 11 symptoms of Alcohol Use Disorder based on the accepted criteria for assessing both alcohol abuse and alcohol dependence.

Alcohol Use Disorder

For years people used the term “Alcoholism” or “Alcoholic” to describe the disease state or the individual associated with excessive alcohol use.  However, recent research and treatment models have suggested that alcohol abuse is not as “black and white” as those terms suggest.  In other words, modification of alcohol use (as opposed to complete alcohol abstinence) may be possible with a viable therapeutic approach for individuals who abuse alcohol.

Alcohol use disorder is one of the most prevalent mental health disorders in the United States, and a leading cause of sickness and death in the country. Across the nation, alcohol use disorders and binge drinking have increased in recent years. Unfortunately, only 19.8 percent of adults with lifetime alcohol use disorder ever seek treatment or ask for help.

study (click link for more information) published in April 2015 reports that binge drinking in the United States is escalating. On average, heavy drinking among Americans rose 17.2 percent between 2005 and 2012.

One reason for this is a significant increase in alcohol consumption by American women. Another is the nationwide escalation of binge drinking. Combining these statistics, experts in the field suggest binge drinking among women increased more than five-fold in recent years.  Despite this fact, Alcohol Use Disorder rates are still higher among men than women.

The definition of Alcohol Use Disorder, as established by the American Psychiatric Association, was recently published in the Statistical Manual of Mental Disorders, 5th edition (for short, DSM-5).  The definition uses eleven criteria to establish the presence of Alcohol Use Disorder.  If two or more of these criteria are present, a person is considered to have at least mild Alcohol Use Disorder.

The Criteria for Alcohol Use Disorder

  • 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, i.e. driving or working near machinery.
  • 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 of the following: a) A need for markedly increased amounts of alcohol to achieve intoxication or desired effect, or b) A markedly diminished effect with continued use of the same amount of alcohol.
  • Withdrawal, as manifested by either of the following: a) The characteristic withdrawal syndrome for alcohol, or b) Alcohol (or a closely related substance, such as a benzodiazepine) is taken to relieve or avoid withdrawal symptoms.

As mentioned above, the presence of at least 2 of these symptoms indicates an alcohol use disorder (AUD). The severity of an AUD is graded mildmoderate, or severe:

  • Mild: The presence of 2 to 3 symptoms.
  • Moderate: The presence of 4 to 5 symptoms.
  • Severe: The presence of 6 or more symptoms.

Seek Help

If you or a family member meet 2 of the 11 criteria for Alcohol Use Disorder, it is appropriate to seek help.

A recent study by Bridget Grant and colleagues at the National Institute on Alcohol Abuse and Alcoholism, which is part of the National Institutes of Health (NIH) concluded, “…educating the public about AUD and its treatments, destigmatizing the disorder, and encouraging affected individuals to seek treatment” should be a national priority.

We believe that the diagnoses of Alcohol Use Disorder is not as simple as classifying a person as being an “alcoholic” or “not an alcoholic”.  We also believe that treatment goals may initially focus on reducing alcohol use, as opposed to achieving complete abstinence.  In addition, our treatment plans may include the use of physician prescribed medications. These include Naltrexone and Acamprol. They could be an important part of the management plan for individuals who meet the criteria for Alcohol Use Disorder. Please contact us for more information.

By Paul Kolodzik, MD, Medical Director

Call or text us anytime at 937-365-HELP for more information about treatment for alcohol use disorder.

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