What is alcohol use disorder?
Alcohol use disorder (AUD) is a disease where a person is not able to limit or stop using alcohol even though it is causing them problems. According to the 2021 National Survey on Drug Use and Health (NSDUH), 29.5 million people ages 12 and older had AUD in the past year. AUD is considered a mental disorder and it can be mild, moderate, or severe. AUD causes changes in the brain which makes people more likely to start drinking again. Regardless of how severe their condition is, recovery is possible with the available treatment options.
What increases the risk of AUD?
Risk of AUD depends on how often, how much, and how quickly a person drinks alcohol. Binge drinking and heavy alcohol use increases the risk of AUD. Other factors such as drinking at an early age of 15 years increases the risk. This risk of AUD is more common in females than males. Genetics and family history may increase risk of unhealthy alcohol drinking and misuse. Genetics have a larger involvement in AUD than many people believe; however, like other serious diseases, environmental factors also matter. Environmental factors include but are not limited to cultures that emphasize the use of alcohol. Childhood trauma and early exposure to alcohol in the home are all risk factors for AUD. Mental health conditions like depression, anxiety, and past trauma increase the risk as well.
What are symptoms of AUD?
Severity is based on the number of criteria a person meets based on their symptoms: mild (2-3), moderate (4-5), or severe (6 or more).
- Drinking more than intended
- Getting into unsafe situations while drinking
- Having to drink more to feel an effect
- Drinking interferes with daily living
- Symptoms when trying to stop drinking such as trouble sleeping, shakiness, restlessness, nausea, unhappiness
Answer these questions and share your responses with your doctor to assess your alcohol use and its impact on your health:
|Had times when you ended up drinking more, or longer, than you intended?|
|More than once wanted to cut down or stop drinking, or tried to, but couldn’t?|
|Spent a lot of time drinking? Or being sick or getting over other aftereffects?|
|Wanted a drink so badly you couldn’t think of anything else?|
|Found that drinking—or being sick from drinking—often interfered with taking care of your home or family? Or caused job troubles? Or school problems?|
|Continued to drink even though it was causing trouble with your family or friends?|
|Given up or cut back on activities that were important or interesting to you, or gave you pleasure, in order to drink?|
|More than once gotten into situations while or after drinking that increased your chances of getting hurt (such as driving, swimming, using machinery, walking in a dangerous area, or having unsafe sex)?|
|Continued to drink even though it was making you feel depressed or anxious or adding to another health problem? Or after having had a memory blackout?|
|Had to drink much more than you once did to get the effect you want? Or found that your usual number of drinks had much less effect than before?|
|Found that when the effects of alcohol were wearing off, you had withdrawal symptoms, such as trouble sleeping, shakiness, restlessness, nausea, sweating, a racing heart, or a seizure? Or sensed things that were not there?|
Mild: 2-3 Symptoms Moderate: 4-5 symptoms Severe: 6 or more symptoms
What are the treatments for AUD?
There are different available treatments for AUD. A treatment option that works for one person may not work for another. These treatments can be done at home or a facility. There are 3 medications available and approved by the FDA. They work to lower and stop unhealthy drinking habits.
These medications are:
- naltrexone (available as oral and injectable)
Behavioral treatments such as alcohol counseling and therapy provided by a licensed therapist are often used. Therapists will teach skills for coping and motivation to stop drinking.
Support groups are a way of providing support through peers. These group meetings can be in person or online. This approach can be combined with medications depending on severity of AUD.
Many people with AUD recover but they do face many challenges. Majority of individuals who try to stop drinking alcohol may relapse several times. This is expected considering relapse rates range from 50-80 percent. It is important to get professional help if you are struggling with AUD. Doing so can help prevent returning to drinking. For more information visit:
- Symptoms of alcohol use disorder – what is aud? [Internet]. U.S. Department of Health and Human Services; [cited 2023 Jun 23]. Available from: https://www.rethinkingdrinking.niaaa.nih.gov/How-much-is-too-much/Whats-the-harm/What-Are-Symptoms-Of-Alcohol-Use-Disorder.aspx
- Alcohol use disorder (AUD) in the United States: Age groups and demographic characteristics [Internet]. U.S. Department of Health and Human Services; [cited 2023 Jun 23]. Available from: https://www.niaaa.nih.gov/alcohols-effects-health/alcohol-topics/alcohol-facts-and-statistics/alcohol-use-disorder-aud-united-states-age-groups-and-demographic-characteristics#:~:text=Prevalence%20of%20Past%2DYear%20Alcohol%20Use%20Disorder%20(AUD)&text=According%20to%20the%202021%20National,AUD%20in%20the%20past%20year.&text=This%20includes%3A,12.1%25%20in%20this%20age%20group)
PharmD Candidate 2024
Philadelphia College of Pharmacy
St. Joseph’s University