Alcohol Use Disorder

This section is adapted from the American Psychiatric Association website.

Problem drinking that becomes severe is given the medical diagnosis of “alcohol use disorder” or AUD.  AUD is a chronic relapsing brain disease characterized by compulsive alcohol use, loss of control over alcohol intake, and a negative emotional state when not using.

Approximately 6 percent or 15 million adults in the United States ages 18 and older had AUD in 2015.  To be diagnosed with AUD, individuals must meet certain criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM). Under DSM–5, the latest edition of the DSM, anyone meeting any two of the 11 criteria during the same 12-month period receives a diagnosis of AUD. The severity of AUD—mild, moderate, or severe—is based on the number of criteria met.

To assess whether you or loved one may have AUD, here are some questions to ask.  In the past year, have you:

• 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 the after effects?
• Experienced craving — a strong need, or urge, to drink?
• 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, irritability, anxiety, depression, restlessness, nausea, or sweating? Or sensed things that were not there? Beyond If you have any of these symptoms, your drinking may already be a cause for concern. The more symptoms you have, the more urgent the need for change. A health professional can conduct a formal assessment of your symptoms to see if AUD is present.

However severe the problem may seem, most people with AUD can benefit from treatment. Unfortunately, less than 10 percent of them receive any treatment.

Ultimately, receiving treatment can improve an individual’s chances of success in overcoming AUD.

A LITTLE GOES A LONG WAY: KNOW THE AMOUNTS

Knowing how much alcohol constitutes a “standard” drink can help you determine how much you are drinking and understand the risks. One standard drink contains about 0.6 fluid ounces or 14 grams of pure alcohol. In more familiar terms, the following amounts constitute one standard drink:

• 12 fluid ounces of beer (about 5% alcohol)
• 8 to 9 fluid ounces of malt liquor (about 7% alcohol)
• 5 fluid ounces of table wine (about 12% alcohol)
• 5 fluid ounces of 80-proof distilled spirits (40% alcohol)

Research demonstrates “low-risk” drinking levels for men are no more than 4 drinks on any single day AND no more than 14 drinks per week. For women, “low-risk” drinking levels are no more than three drinks on any single day AND no more than seven drinks per week. To stay low-risk, you must keep within both the single-day and weekly limits.

Even within these limits, you can have problems if you drink too quickly, have health conditions, or are over age 65. Older adults should have no more than three drinks on any day and no more than seven drinks per week.

Based on your health and how alcohol affects you, you may need to drink less or not at all. People who should abstain from alcohol completely include those who:

• Plan to drive a vehicle or operate machinery
• Are pregnant or trying to become pregnant
• Take medications that interact with alcohol
• Have a medical condition that alcohol can aggravate