It can be painful and confusing to watch someone you care about struggle with their alcohol consumption. You may wonder if their drinking habits have crossed a line from casual use to a more serious problem. The term “alcoholic” is common, but health professionals use a more precise term: alcohol use disorder, or AUD. This is a medical condition, not a moral failing, and it’s characterized by an impaired ability to stop or control alcohol use despite negative consequences for their health, job, or relationships.
Understanding what qualifies as AUD is the first step toward helping a loved one. This guide will walk you through the symptoms of alcohol use disorder, how it is diagnosed by professionals, and what treatment options are available, so you can feel more confident in supporting them on a path to recovery.
Symptoms of Alcohol Use Disorder (AUD)
Alcohol use disorder (AUD) is a medical condition characterized by a pattern of alcohol use that leads to significant impairment or distress. The diagnosis of AUD is based on 11 specific criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). The presence of at least two of these criteria within a 12-month period can indicate an alcohol use disorder. The severity of the disorder—mild, moderate, or severe—is determined by the number of criteria met.
Intense cravings
This is more than just a passing thought or desire for a drink. It is a powerful craving that can be all-consuming, making it difficult to focus on anything else.
This intense urge is a hallmark of the psychological dependence that can develop with AUD. The individual may find themselves preoccupied with thoughts of when and how they will get their next drink, and this craving can be a significant trigger for continued alcohol use, even in the face of negative consequences.
Loss of control
A common pattern in AUD is a loss of control over alcohol consumption. An individual may start with the intention of having only one or two drinks, but frequently find that they have consumed much more.
This could also manifest as intending to drink for a short period, such as an hour at a social event, but continuing to drink for a much longer duration.
Neglecting responsibilities
The effects of alcohol use, including hangovers and the time spent drinking, can begin to interfere with a person’s ability to fulfill their major roles in life.
This may present as repeated absences from work or a decline in job performance, neglecting household chores and family responsibilities, or failing grades and a lack of attendance at school.
Drinking despite harm
A defining feature of AUD is the continued use of alcohol even when it is clearly causing or exacerbating problems in various aspects of a person’s life.
These negative consequences can be social, such as arguments with family and friends; legal, including arrests for driving under the influence; or related to physical or mental health, such as a doctor’s warning about liver damage or worsening depression.
Increased tolerance
Over time, the body can adapt to the presence of alcohol, leading to a phenomenon known as tolerance.
This means that the individual needs to consume progressively larger amounts of alcohol to achieve the desired effect of intoxication or relaxation that they once felt with smaller quantities.
Withdrawal symptoms
When a person who has developed a physical dependence on alcohol stops drinking or significantly reduces their intake, they can experience a range of uncomfortable and sometimes dangerous withdrawal symptoms.
These can include tremors (the “shakes”), anxiety, insomnia, nausea, sweating, and an elevated heart rate. In severe cases, withdrawal can lead to seizures, hallucinations, or a life-threatening condition known as delirium tremens (DTs).
Giving up activities
As alcohol use becomes more central to an individual’s life, they may begin to withdraw from social, occupational, or recreational activities that they once found enjoyable. Hobbies, sports, and time with family and friends may be sacrificed in favor of opportunities to drink.
Risky use
This criterion involves repeatedly using alcohol in situations where it is physically dangerous to do so.
The most common example is drinking and driving, but it can also include swimming while intoxicated, operating machinery, or using alcohol in other contexts that pose a risk of injury or death to the individual or others.
This demonstrates a disregard for safety that is often clouded by the compulsion to drink.
How Professionals Diagnose Alcohol Use Disorder
A formal diagnosis of AUD must be made by a qualified medical or mental health professional. They don’t just ask, “How much alcohol do you drink?” Instead, they use a comprehensive approach to understand a person’s relationship with alcohol.
1. DSM-5 Assessment
A doctor or therapist will assess a person’s symptoms against the 11 criteria for AUD. The number of criteria met within a 12-month period determines the severity of the disorder:
- Mild: 2-3 symptoms
- Moderate: 4-5 symptoms
- Severe: 6 or more symptoms
2. Physical exam and health history review
A doctor will look for physical signs of long-term alcohol misuse. Excessive drinking can lead to a wide range of health issues, including liver disease, heart problems, digestive issues, a weakened immune system, and an increased risk for certain cancers, such as breast and esophageal cancer. They will also ask about the person’s drinking habits and family history of substance abuse, as these are known risk factors.
3. Psychological evaluation
A mental health professional will talk with your loved one about their thoughts, feelings, and drinking behavior. This evaluation helps identify patterns of alcohol misuse and any co-occurring mental health conditions, like depression, anxiety, or bipolar disorder, which often accompany AUD.
How Is Alcohol Use Disorder Treated?
The good news is that alcohol use disorder (AUD) can be treated. Getting better is a process, and a good treatment plan gives you the support you need to succeed. The best plans often use a mix of different methods.
Medical Detox
For someone whose body is dependent on alcohol, quitting all at once can be very dangerous. Medical detox is the first step, where doctors and nurses help you get the alcohol out of your system safely.
This is usually done in a hospital or special clinic. Medical staff watch over you to manage withdrawal symptoms, which are the bad feelings you get when you stop drinking. This keeps you safe and as comfortable as possible.
Behavioral Treatment
This type of treatment is also known as counseling or therapy. It focuses on changing the habits and thoughts that lead you to drink. You work with a therapist, either one-on-one or in a group.
Therapy helps you understand your personal triggers, which are the feelings or situations that make you want to drink. You will learn healthier ways to cope with stress and deal with challenges without turning to alcohol.
Medication
Certain medicines can help people who are trying to stop drinking. Some medications work by reducing the strong urge to drink, while others are designed to make you feel sick if you do drink alcohol.
Disclaimer: These medications are not for everyone and can only be prescribed by a qualified medical professional, like a doctor. A doctor will determine if medicine is a safe and appropriate part of your treatment plan. Never use these medications without medical supervision.
Support Groups
In a support group, you can connect with other people who are also recovering from AUD. Sharing experiences with people who understand what you’re going through can be a huge help.
Groups like Alcoholics Anonymous (AA) and other recovery programs provide a safe community. Listening to others’ stories and getting advice helps you feel less alone and provides a structured path to follow.
Structured Treatment Programs
These programs offer a higher level of care and more focused help. There are two main types.
Residential treatment, also called inpatient care, is when you live at a treatment center for a period of time. This lets you escape your daily triggers and focus completely on getting better in a substance-free environment.
Outpatient treatment allows you to live at home while attending therapy and counseling at a clinic for several hours a week. This option is helpful for people who need strong support but also need to continue with work or school.
When Is It Time to Seek Professional Help?
It can be difficult to know when to encourage a loved one to seek help. If you notice any of the following scenarios, it is a strong sign that professional intervention is needed.
- Their drinking is causing noticeable health problems, from memory loss to signs of alcoholic hepatitis.
- They are engaging in risky behaviors, such as driving under the influence or mixing alcohol with other substances.
- They cannot fulfill major obligations at work, school, or home due to their alcohol consumption.
- Their important relationships are being damaged by their drinking.
- They have expressed a desire to stop drinking or cut back but have been unable to do so on their own.
- They experience clear alcohol withdrawal symptoms like tremors or intense anxiety when they don’t drink.
Helping a Loved One Find Support
Watching someone you love struggle with alcohol addiction can feel overwhelming, but you are not alone, and neither are they. Encouraging them to take the first step toward recovery is a profound act of care. Professional support can provide the guidance, safety, and tools they need to build a healthier future.
If you are ready to explore treatment options for your loved one, our compassionate team is here to help. Contact us today to learn more about our programs and how we can support your family on the path to healing.
Frequently Asked Questions
What is the difference between an alcoholic and alcohol use disorder?
The term “alcoholic” is commonly used, but health professionals use the formal diagnosis of alcohol use disorder (AUD). AUD is a medical condition defined by an impaired ability to control alcohol use despite negative consequences for one’s health, job, or relationships.
What are the main signs of alcohol use disorder?
The primary signs of AUD include having a strong urge to drink, drinking more than intended, and continuing to drink despite causing problems. Other key symptoms are neglecting responsibilities, developing a tolerance, and experiencing withdrawal symptoms.
How does a doctor diagnose AUD?
A professional diagnoses AUD using a comprehensive approach, not just by asking how much someone drinks. They assess a person’s symptoms against 11 official criteria, conduct a physical exam, and perform a psychological evaluation to understand drinking patterns.
Can you have a mild case of alcohol use disorder?
Yes, AUD is diagnosed on a spectrum of severity based on how many symptoms a person exhibits over a 12-month period. Meeting 2-3 of the 11 criteria is considered mild AUD, while 4-5 is moderate and 6 or more is severe.
What happens during alcohol withdrawal?
Alcohol withdrawal occurs when a person with alcohol dependence stops drinking and experiences physical and mental discomfort. Common symptoms include shaking, anxiety, nausea, and sweating, and in severe cases, withdrawal can lead to seizures.
Are there effective treatments for alcohol use disorder?
Yes, AUD is a treatable condition, and a personalized plan can lead to long-term recovery. Treatments include medically supervised detox, behavioral therapies, medications, support groups, and structured residential or outpatient programs.
When should I encourage a loved one to get help for drinking?
It is time to seek professional help if your loved one’s drinking is causing health problems, relationship damage, or risky behaviors like driving while intoxicated. If they cannot meet their responsibilities or have tried to quit on their own without success, professional intervention is needed.
Can AUD happen with other mental health conditions?
Yes, it is common for alcohol use disorder to exist alongside other mental health issues such as depression, anxiety, or bipolar disorder. A professional evaluation helps identify any co-occurring conditions so they can be treated together.