Alcohol Use Disorder (AUD)

Alcohol use disorder (AUD) is the clinical term for alcohol addiction or alcoholism. It is a chronic, relapsing medical condition that requires long-term care. AUD is a multi-faceted disorder with physical, behavioral, social and spiritual elements. Addressing each part of this complicated disease is essential to successful treatment.

Diagnosis

Diagnosing AUD, according to The Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) is the presence of at least 2 of the following symptoms occurring within a 12-month period.

Symptoms

Alcohol is taken in larger amounts over a longer period of time than intended.
There is a persistent desire or unsuccessful effort to cut down or control alcohol use.
A great deal of time is spent in activities necessary to obtain alcohol, use alcohol, or recover from its effects.
Craving, or a strong desire or urge to use alcohol.
Recurrent alcohol use resulting in a failure to fulfill major role obligations at work, school, or home.
Continued alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol.
Reduction of social, occupational, or recreational activities because of alcohol use.
Recurrent alcohol use in situations where it is physically dangerous.
Alcohol use is continued despite knowing that a persistent or recurrent physical or psychological problem that is likely to have been caused or made worse by alcohol.
Increased tolerance, defined as a need for markedly increased amounts of alcohol to achieve intoxication or desired effect.
Experience of withdrawal from alcohol and taking alcohol to relieve or avoid withdrawal symptoms.

The severity of AUD is defined as:
Mild: 2-3 symptoms
Moderate: 4-5 symptoms
Severe 6 or more symptoms

Screening Tools

There are a number of methods a health care provider can use to screen for AUD.

SBIRT (Screening, Brief Intervention, and Referral to Treatment) is an evidence-based clinical tool designed to facilitate early intervention and treatment for people who are experiencing or are at risk of developing alcohol and substance use disorders. Administered by physicians and other healthcare professionals, SBIRT screening consists of questions that quickly assess the severity of substance use and identify the appropriate level of treatment when needed.

https://www.samhsa.gov/sbirt

Health Consequences

AUD is a serious illness. Drinking too much and too often is connected to negative health conditions, some of which can be fatal.

Heavy alcohol use is linked to short and long term consequences to one’s health. According to the Center for Disease Control, motor and cognitive impairment from intoxication can cause short-term effects such as:

Injuries from accidents such as motor vehicle crashes, falls, drownings, and burns
Violence, including homicide, suicide, sexual assault, and intimate partner violence
Alcohol poisoning
Risky sexual behavior leading to higher rates of sexually transmitted infections
Miscarriage, stillbirth, or fetal alcohol spectrum disorders among pregnant women

Over time, excessive use of alcohol can lead to the development of chronic diseases and other serious problems that can significantly reduce the quality of life and ultimately lead to death.

Significant health consequences from long-term heavy alcohol use include:

Alcoholic Liver Disease: cirrhosis of the liver, fatty liver, alcoholic hepatitis
Alcoholic neuropathy
Anemia
Brain damage leading to learning, memory, and motor problems and dementia
Cancer of the mouth, breast, throat, esophagus, liver, and colon
Cardiovascular disease such as high blood pressure, cardiomyopathy, stroke, and heart attack
Digestive problems
Gout
Mental health problems including depression and anxiety
Pancreatitis
Seizures
Social problems such as damaged relationships, lost productivity, family problems, and unemployment
Suppressed immune response