It can be fun and relaxing to go out for drinks with your friends on Friday nights after a long work week or have a cocktail before bed. Many people drink alcohol and do so regularly, but how do you know when your drinking has become a problem? When many of us think about alcoholism, we think of someone who drinks on the job, can’t keep a job or home, or can’t care for their loved ones. However, it’s crucial to recognize that problem drinking doesn’t look the same in everyone. Many people who have a problem with alcohol can hold a job and have a stable home and social life. Instead, there are various health and behavioral factors that can point to problem drinking.
Defining Alcohol Use Disorder
According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), alcohol use disorder (AUD) is a medical condition 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, alcohol dependence, and alcohol addiction. Considered a brain disorder, AUD can be mild, moderate, or severe.
There’s no quantity or frequency of alcohol use included in the definition of AUD. Diagnosing AUD is geared more towards specific features of alcohol use becoming a problem in your life, such as beginning to lose control or not being able to cope without a drink. There is no single diagnostic method for AUD. Instead, doctors and mental health professionals use a list of 11 diagnostic criteria that could signal the presence of AUD.
Signs of Alcohol Use Disorder
To assess a patient’s likelihood of AUD, doctors will ask if any of the following events have taken place in the past year:
- Have there been times when you ended up drinking alcohol more or longer than you intended?
- Have you, more than once, tried to reduce or stop drinking but couldn’t?
- Have you spent a lot of time drinking or being sick from the aftereffects?
- Have you ever wanted a drink so badly you couldn’t think of anything else?
- Have you found that drinking–or being sick from drinking–often interfered with work, family, or school duties?
- Have you continued to drink alcohol even though it was causing trouble with your family or friends?
- Have you given up or cut back on activities that were important, interesting, or pleasurable to you in order to drink?
- Have you, more than once, gotten into a situation while or after consuming alcohol that increased your chances of getting hurt (such as swimming, driving, using machinery, or having unsafe sex)?
- Have you continued to drink alcohol even though it was making you feel depressed, anxious, or adding another health problem?
- Have you had to drink more than you once did to get the effect you want? Or found that the usual number of drinks had much less effect?
- Have you found that when the effects of alcohol were wearing off, you had withdrawal symptoms, such as trouble sleeping, shakiness, restlessness, nausea, sweating, racing heart, or seizures?
These 11 criteria are used to diagnose AUD as outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). The number of “yes” answers determines the level of AUD in an individual. According to the DSM-5, a patient who answers “yes” to two to three questions is considered to have mild AUD. Those who cite four to five are moderate cases. Those who confirm six criteria or more are believed to be severely affected by their alcohol consumption.
However, just because an individual is diagnosed with a mild AUD does not mean that they don’t need help. Early intervention is often the best option, as AUD can progress from mild to severe. Depending on the severity, the level of care recommended by a treatment provider will likely be different.
Treatment for Alcohol Use Disorder
There are several evidence-based treatment approaches available for AUD. One size does not fit all, and a treatment approach that may work for one person may not work for another. Treatment can be outpatient or inpatient and be provided by specialty programs, therapists, and doctors.
Three medications are currently approved by the U.S. Food and Drug Administration (FDA) to help people stop or reduce their drinking and prevent relapse. These include naltrexone (oral and long-acting injectable), acamprosate, and disulfiram. All these medications are non-addictive and may be used alone or combined with behavioral treatments or mutual-support groups.
Behavioral treatments, also known as talk therapy, provided by licensed therapists aim to change drinking behavior. Examples of behavioral therapies are brief interventions and reinforcement approaches, treatments that build motivation and teach skills for coping and preventing relapse, and mindfulness-based therapies.
Mutual-support groups, such as 12-Step programs, provide peer support for stopping or reducing drinking. Group meetings are available in most communities, at no cost, at convenient times and locations, including an increasing presence online. Combined with medications and behavioral treatment provided by health professionals, mutual-support groups can offer a valuable added layer of support.
While all of these treatment approaches can help you recover from AUD, it is crucial to note that those with a severe AUD need medical intervention. People with severe AUD need medical help to avoid alcohol withdrawal if they decide to stop drinking. Alcohol withdrawal is a potentially life-threatening process that can occur when someone who has been drinking heavily for a prolonged period suddenly stops drinking. Doctors can prescribe medications to address these symptoms and make the process safer and less distressing.
Drinking alcohol can be fun, and it can be challenging to recognize when casual drinking has crossed the line into problem drinking. Alcohol use disorder (AUD) is characterized by 11 diagnostic criteria, with each individual meeting specific criteria for different severities of the disorder. While someone may only have a mild AUD, it is essential to recognize that early intervention is best to avoid progression into a severe AUD. Luckily, there are multiple treatment options available for those who believe they may have a drinking problem, including medications, behavioral therapy, and mutual support groups. For assistance on your journey in recovery from AUD, Hired Power is here to help. Our Personal Recovery Assistants, known as sober companions, work with clients and their families to establish a daily living plan for continued sobriety and lasting recovery. By leading clients to become active participants in their own lives, our PRAs teach them how to thrive in recovery and get the most out of each experience. To learn more about our services, call Hired Power today at (800) 910-9299.