Alcohol Use Disorder

What is alcohol use disorder?

Disorders associated with alcohol are caused by the ingestion of alcohol over a period of time and in ways that leads to problems with health, personal relationships, school, or work. Alcohol use disorders include alcohol dependence, alcohol abuse, alcohol intoxication, and alcohol withdrawal.

What characteristics are associated with the various types of alcohol use disorder?

A person who is alcohol dependent has increased tolerance to alcohol or symptoms of withdrawal after discontinuing alcohol ingestion. People who are dependent upon alcohol may spend significant amounts of time drinking alcohol even though they are fully aware of the destructive aspects of the drug.
A person abusing alcohol begins to disregard his/her responsibilities in school, at work, or socially because of alcohol use. Also, the alcohol abuser may engage in dangerous activities while intoxicated.
Alcohol intoxication often causes a person to experience emotional changes such as moodiness or irritability. The person may also experience such physical changes as slurred speech and poor coordination. Excessive alcohol use may lead to memory loss called “blackouts”.
Alcohol withdrawal follows the discontinuation of the heavy use of alcohol. The person in alcohol withdrawal may have such symptoms as rapid pulse, sweating, nausea, vomiting, hallucinations, and seizures.

Are there genetic factors associated with alcohol use disorder?

Although alcohol abuse is seen widely in the United States, there is a higher rate of alcohol related disorders among lower socioeconomic and poorly educated groups.

Does alcohol use disorder affect males, females, or both?

In the United States males are five (5) times more likely to experience alcohol related disorders than females.

At what age does alcohol use disorder appear?

Females tend to begin drinking alcohol at a later age than males. However, once alcohol becomes a problem for women, the problems associated with alcohol progress more rapidly than in men.

How often is alcohol use disorder seen in our society?

A vast majority of adults in the United States have used alcohol. More than half of all men and about a third of all women have had some adverse effect on their lives because of the abuse of alcohol. The most common adverse events involve driving while intoxicated, domestic violence, or missing responsibilities because of severe hangovers.

How is alcohol use disorder diagnosed?

A mental health professional makes a diagnosis of alcohol use disorder by taking a careful personal history from the client/patient. It is important to the therapist to learn the details of that person’s life. It is very important not to overlook a physical illness that might mimic or contribute to a psychological disorder. If there is any question that the individual might have a physical problem, the mental health professional should recommend a complete physical examination by a medical doctor. People who have abused alcohol should have a thorough physical examination when they discontinue its use. Withdrawal of alcohol can sometimes lead to seizures if the person is not monitored carefully. Laboratory tests might be necessary as a part of the physical workup.

How is alcohol use disorder treated?

First of all, a person with alcohol use disorder has to discontinue the ingestion of all alcohol containing substances. Few people can stop drinking without the firm support of a self-help group such as Alcoholics Anonymous or another twelve-step program. The most successful people stay involved with a program of this kind over many months and years. Sometimes medications such as antidepressants, which are not addicting, can be safely used during recover to help treat the depression, which is often associated with chronic alcohol use.

What happens to someone with alcohol use disorder?

Frequently, people who abuse alcohol will drink more than they intend to drink. They often express to others that they would like to cutback their drinking, but they don’t. Their friends and activities are usually limited to those associated with alcohol.
Few people are able to discontinue alcohol use without treatment and committed peer support. Without help, many people return to drinking and alcohol use may become a lifelong habit.
There are some new medications that can be used to help people discontinue the craving for alcohol. These medications must be prescribed and monitored by a physician.

What can people do if they need help?

If you, a friend, or a family member would like more information and you have a therapist or a physician, please discuss your concerns with that person.

Developed by John L. Miller, MD
Reviewed 7/2000

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