Alcohol Use Disorder | Alcohol Abuse Signs, Symptoms & Care
- Last Modified: July 27, 2023
Alcohol Use Disorder (AUD) is a complex and potentially devastating condition that affects millions of individuals worldwide. It is characterized by a persistent pattern of excessive alcohol consumption despite the negative consequences it brings to one’s health, relationships, and overall well-being. It encompasses the conditions that some people refer to as alcohol abuse, alcoholism, and alcohol dependence, among other terms.
Recognizing the signs, symptoms, and treatment options for AUD is crucial for both individuals struggling with alcohol abuse and those around them who may be seeking to help.
What Is Alcohol Use Disorder?
Alcohol Use Disorder (AUD) is a chronic relapsing brain disorder characterized by an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences. It encompasses the conditions that some people refer to as alcohol abuse, alcoholism, and alcohol dependence, among other terms. However, AUD is a medical diagnosis that aligns with the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) of the American Psychiatric Association.
AUD is more than just a behavioral problem—it involves intricate neurobiological changes. When someone consistently consumes excessive amounts of alcohol over time, it can trigger an immune response in the body. This response, facilitated by circulating cytokines and other neuroimmune mediators, leads to changes in brain function. Additionally, alcohol can directly affect the immune functions of microglia, which are the immune cells present in the central nervous system (CNS).
Is Alcohol Use Disorder a Disease?
Yes, AUD is recognized as a disease—a brain disorder that can have severe and life-threatening consequences. Just like other diseases, it exhibits predictable symptoms, follows a progressive course, and is influenced by a combination of genetic and environmental factors. Viewing AUD through the lens of a disease model highlights that it is not a moral failing or a lack of willpower but a condition that necessitates medical attention and treatment.
AUD is a complex and multifaceted disorder characterized by significant changes in key neurobiological structures responsible for executive function, memory, and stress regulation. To better understand the intricacies of AUD and other addictions, a three-stage framework of addiction (binge/intoxication, withdrawal/negative affect, preoccupation/anticipation) has proven valuable for conceptualization purposes. This framework helps shed light on the various dimensions of AUD and the complexities it entails.
How Common Is Alcohol Use Disorder?
AUD is a significant issue in the United States, affecting a considerable number of people. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), around 14.1 million adults in 2019 (5.6 percent of the adult population) had AUD, including 8.9 million men and 5.2 million women. Additionally, an estimated 414,000 adolescents (1.7 percent of the adolescent population) also experienced AUD.
Furthermore, a recent study revealed that almost one-third of the U.S. population meets the criteria for AUD at some point in their lifetime. The impact of AUD on mortality is noteworthy, with an estimated 7,043 deaths per year attributed to AUD in the United States. This translates to a cause-of-death probability of 1 in 344, or roughly 0.29 percent.
Short-Term Effects of Alcohol Abuse
Alcohol, when consumed in moderation, can have a relaxing effect and even provide some health benefits. However, when consumed excessively, it can have harmful short-term effects. These effects can range from mild to severe, depending on the amount of alcohol consumed and the individual’s tolerance level.
One of the most immediate effects of alcohol abuse is intoxication, which can lead to impaired judgment, coordination, and reaction times. This can increase the risk of accidents and injuries, including motor vehicle accidents. Alcohol can also affect the brain, causing mood swings, memory loss, and even blackouts.
Excessive alcohol consumption can also have severe physical effects. It can cause the following:
- nausea
- vomiting
- headache
- fatigue
- dehydration
In extreme cases, heavy drinking can lead to alcohol poisoning, a serious condition that can cause confusion, vomiting, seizures, slow or irregular breathing, and unconsciousness. In some cases, alcohol poisoning can be fatal.
According to a study published in the journal “Alcoholism: Clinical and Experimental Research,” individuals who consume high amounts of alcohol in a short period are more likely to experience these negative short-term effects. The study also found that these effects are more pronounced in individuals with a lower tolerance for alcohol.
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Long-Term Effects of Alcohol Abuse
The long-term effects of alcohol abuse are even more concerning. Chronic heavy drinking can lead to a host of health problems, including liver disease, heart disease, stroke, and cancer. It can also lead to mental health problems, such as depression and anxiety, and increase the risk of suicide.
One of the most serious long-term effects of alcohol abuse is alcohol dependence, also known as alcoholism. This is a chronic disease characterized by a strong craving for alcohol, the inability to limit drinking, physical dependence on alcohol, and the need to drink greater amounts to get the same effect.
Symptoms of Alcohol Use Disorder
Alcohol use disorder (AUD) is characterized by various symptoms that indicate a problematic relationship with alcohol. These symptoms can vary in severity and may include the following symptoms:
- Loss of control: People with AUD struggle to limit their alcohol intake or find it hard to stop once they start drinking
- Cravings: Strong and persistent desires to drink alcohol, which can be difficult to resist
- Tolerance: Needing to drink larger amounts to achieve the desired effect compared to before
- Withdrawal symptoms: Experiencing physical and emotional symptoms when reducing or stopping alcohol, such as shaking, sweating, or trouble sleeping.
- Neglecting responsibilities: Prioritizing drinking over important obligations like work, school, or family responsibilities
- Social and interpersonal problems: Experiencing conflicts, arguments, or strained relationships with family, friends, or colleagues due to alcohol-related behavior.
- Failed attempts to cut back or quit: Unsucessful efforts to reduce or stop drinking, leading to a return to previous levels of alcohol consumption.
It’s important to note that having a few symptoms doesn’t automatically mean someone has AUD. A thorough evaluation by a healthcare professional or addiction specialist is necessary to diagnose AUD and determine the best treatment approach.
It is crucial to seek professional help if you or a loved one is struggling with alcohol use Treatment options can include medication, behavioral therapies, and support groups, all of which can be tailored to the individual’s specific needs and circumstances.
What Are The Stages of Alcohol Addiction?
Alcohol addiction typically develops in stages, which can make it difficult to identify in the early phases. Below are the following stages of alcohol addiction :
- Pre-alcoholic stage: This stage involves the use of alcohol for stress relief or to deal with other emotional issues. There is no loss of control or physical addiction at this stage.
- Early alcoholic stage: The individual begins to drink more frequently and may experience blackouts. They may feel guilty about their drinking and may start to hide it from others.
- Middle alcoholic stage: The individual loses control over their drinking and may not be able to go any length of time without alcohol. They may start to experience health problems related to alcohol but continue to drink anyway.
- Late alcoholic stage: The individual’s health, both physical and mental, is severely affected. They may have lost their job or ruined relationships due to their drinking. At this stage, professional help is usually needed to recover from alcohol addiction.
Everyone may not go through these stages in the same way or at the same pace. Some people may progress through the stages quickly, while others may remain in one stage for a long period of time.
Signs of an Alcohol Use Disorder
Recognizing the signs of an alcohol use disorder can be challenging due to the social acceptance of drinking. However, certain behaviors can indicate a potential problem. These include:
- Drinking more or for a longer time than intended
- Being unable to cut down or stop drinking
- Spending a lot of time drinking or being sick from drinking
- Continuing to drink even when it causes problems in relationships or responsibilities at work, school, or home
- Needing more alcohol to get the same effect (tolerance)
- Having a strong urge or craving to drink
- Continuing to drink even when it makes a health problem worse
- Experiencing withdrawal symptoms when the effects of alcohol wear off
If you or a loved one is experiencing any of these signs, it may be time to seek professional help. There are many resources available, including treatment programs and support groups, that can provide the necessary tools to overcome alcohol use disorder.
Alcohol Overdose
Alcohol overdose, also known as alcohol poisoning, occurs when there is an excessive amount of alcohol in the bloodstream, leading to the shutdown of vital brain functions such as breathing, heart rate, and body temperature. It can have severe and potentially life-threatening effects. Recognizing the signs of alcohol overdose and knowing what to do in such a situation is crucial.
Alcohol intoxication can be influenced by tolerance and other factors. However, a BAC of 0.30% to 0.45% can pose a risk to vital life functions, potentially leading to unconsciousness, coma, and death. BAC levels between 0.60% and 0.80% are often fatal.
The effects of an alcohol overdose can vary depending on factors such as the individual’s tolerance, body weight, and the rate of alcohol consumption. Symptoms may include:
- Confusion and disorientation
- Vomiting
- Slow or irregular breathing
- Unconsciousness
If you suspect someone is experiencing an alcohol overdose, it is crucial to contact 911 immediately and stay with the person who may be experiencing an alcohol overdose.
Often people make assumptions that a person can simply “sleep off the effects of alcohol.” The blood alcohol concentration (BCA) can still rise even after someone stops consuming alcohol.
Management and Treatment for Alcohol Use Disorder
Treating alcohol use disorder (AUD) involves a comprehensive approach that combines medication, therapy, and support to help individuals achieve sobriety, improve their quality of life, and reduce health risks.
Medications play a valuable role in AUD treatment, helping to curb cravings, alleviate withdrawal symptoms, and prevent relapse. Drugs like naltrexone, acamprosate, and disulfiram have proven effective. In fact, a study in AMA Psychiatry suggested that varenicline, a medication typically used for quitting smoking, may also help reduce alcohol consumption in individuals with AUD.
Behavioral therapies are crucial components of AUD treatment, enabling individuals to modify their attitudes and behaviors toward alcohol, develop essential life skills, and adhere to treatment plans. Cognitive-behavioral therapy, motivational enhancement therapy, and family counseling are examples of behavioral therapies commonly used in AUD treatment.
Alcohol Detox and Medications
Alcohol detoxification is the process of removing alcohol from the body while managing withdrawal symptoms. It is an essential first step for individuals seeking to overcome alcohol dependence. During this phase, medical supervision and support are crucial to ensure safety and minimize discomfort.
Medications are often used as part of alcohol detox treatment to help individuals manage withdrawal symptoms and cravings.
Naltrexone
Naltrexone is a medication that helps reduce alcohol cravings and can be used during detox and beyond. It works by blocking the pleasurable effects of alcohol, thus reducing the desire to drink. Naltrexone can be administered orally or as a monthly injection.
Acamprosate
Acamprosate is used in the maintenance phase of alcohol recovery, following detoxification. It helps stabilize brain chemistry and reduce cravings, promoting abstinence from alcohol. Acamprosate is typically taken in tablet form.
Disulfiram
Disulfiram is another medication used to support alcohol detox treatment. It works by causing unpleasant reactions when alcohol is consumed, discouraging the individual from drinking. This effect induces symptoms like nausea, flushing of skin, and rapid heartbeat.
Benzodiazepines
Medications such as diazepam or lorazepam, help alleviate alcohol withdrawal symptoms by reducing anxiety, tremors, and seizures. They work by acting on the central nervous system to promote relaxation and prevent complications during the detox process.
Alcohol Treatment Programs
Treating Alcohol Use Disorder (AUD) isn’t a one-size-fits-all process. Everyone’s journey to recovery is unique, and it’s important to explore all available treatment options to find the best fit. Treatment approaches typically combine different strategies tailored to individual needs and preferences.
Treatment for addiction typically includes support groups, behavioral therapy, individual counseling, and a combination of stress management programs such as equestrian and art therapy.
If you or a loved one is struggling with AUD, it’s crucial to seek professional help. There are many resources available, including treatment programs and support groups, that can provide the necessary tools to overcome AUD.
- National Institute on Alcohol Abuse and Alcoholism–https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-use-disorders
- National Survey on Drug Use and Health–https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHNationalFindingsReport2018/NSDUHNationalFindingsReport2018.pdf
- DSM-5–https://www.psychiatry.org/psychiatrists/practice/dsm