Alcohol is a legal, controlled substance that lowers anxiety and inhibitions. It also has a broad range of side effects, from loss of coordination to slurred speech. Not everyone who drinks is an alcoholic, but anyone whose life is negatively affected by alcohol on a consistent basis is considered to have an alcohol use disorder or AUD.
Alcohol use disorder or 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. An estimated 16 million people in the United States have AUD. Approximately 6.2 percent or 15.1 million adults in the United States ages 18 and older had AUD in 2015. This includes 9.8 million men and 5.3 million women. Adolescents can be diagnosed with AUD as well, and in 2015, an estimated 623,000 adolescents ages 12–17 had AUD. 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 current version 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. 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.
Effects of Alcohol
Alcohol is a central nervous system (CNS) depressant, so it slows down mental and bodily processes. With the first drink of alcohol, users may experience a decrease in feelings of anxiety or stress. It is commonly touted as a social lubricant, meaning drinkers are more likely to feel confidence in meeting new people and less concerned with how they are perceived by others. Because alcohol is legal and widely accepted in society, it can be hard to tell the difference between casual use and abuse. In general, any usage of alcohol that results in negative consequences is considered abuse. Some of the negative consequences of alcohol use include:
- Physical harm or illness
- Strained relationships
- Problems at work
- Financial difficulty
Signs and Symptoms
Individuals who suffer from alcohol abuse do not always exhibit the same symptoms. The type of symptoms experienced by an individual will depend on a number of factors, such as the individual’s background and medical history. While alcohol abuse symptoms do vary, there are signs and symptoms that can indicate a problem. Signs of alcohol abuse include:
- Decreased involvement in extracurricular activities.
- Loss of interest in work or school.
- Lack of interest in family or friends.
- Preoccupation with drinking.
- Inability to control drinking.
- Erratic behavior.
- Violent behavior.
Options for Treatment
When asked how alcohol problems are treated, people commonly think of 12-step programs or 28-day inpatient rehab, but may have difficulty naming other options. In fact, there are a variety of treatment methods currently available, thanks to significant advances in the field over the past 60 years.
Ultimately, there is no one-size-fits-all solution, and what may work for one person may not be a good fit for someone else. Simply understanding the different options can be an important first step.
- Behavioral Treatments: Behavioral treatments are aimed at changing drinking behavior through counseling. They are led by health professionals and supported by studies showing they can be beneficial.
- Medications: Three medications are currently approved in the United States to help people stop or reduce their drinking and prevent relapse. They are prescribed by a primary care physician or other health professional and may be used alone or in combination with counseling. The U.S. Food and Drug Administration (FDA) has approved three medications for treating alcohol dependence, and others are being tested to determine if they are effective.
- Naltrexone can help people reduce heavy drinking.
- Acamprosate makes it easier to maintain abstinence.
- Disulfiram blocks the breakdown (metabolism) of alcohol by the body, causing unpleasant symptoms such as nausea and flushing of the skin. Those unpleasant effects can help some people avoid drinking while taking disulfiram.
It is important to remember that not all people will respond to medications, but for a subset of individuals, they can be an important tool in overcoming alcohol dependence.
- Mutual-Support Groups: Alcoholics Anonymous (AA) and other 12-step programs provide peer support for people quitting or cutting back on their drinking. Combined with treatment led by health professionals, mutual-support groups can offer a valuable added layer of support. Due to the anonymous nature of mutual-support groups, it is difficult for researchers to determine their success rates compared with those led by health professionals.
For anyone thinking about treatment, talking to a primary care physician is an important first step — he or she can be a good source for treatment referrals and medications. A primary care physician can also:
- Evaluate whether a patient’s drinking pattern is risky
- Help craft a treatment plan
- Evaluate overall health
- Assess if medications for alcohol may be appropriate
Tips for Selecting Treatment
Professionals in the alcohol treatment field offer advice on what to consider when choosing a treatment program. Overall, gather as much information as you can about the program or provider before making a decision on treatment. If you know someone who has first-hand knowledge of the program, it may help to ask about his or her personal experience.
Here are some questions you can ask that may help guide your choice:
- What kind of treatment does the program or provider offer?
It is important to gauge if the facility provides all the currently available methods or relies on one approach. You may want to learn if the program or provider offers medication and if mental health issues are addressed together with addiction treatment.
- Is treatment tailored to the individual?
Matching the right therapy to the individual is important to its success. No single treatment will benefit everyone. It may also be helpful to determine whether treatment will be adapted to meet changing needs as they arise.
- What is expected of the patient?
You will want to understand what will be asked of you in order to decide what treatment best suits your needs.
- Is treatment success measured?
By assessing whether and how the program or provider measures success, you may be able to better compare your options.
- How does the program or provider handle relapse?
Relapse is common and you will want to know how it is addressed.
When seeking professional help, it is important you feel respected and understood and that you have a feeling of trust that this person, group, or organization can help you. Remember, though, that relationships with doctors, therapists, and other health professionals can take time to develop.
The Daily Process
Overcoming an alcohol use disorder is an ongoing process, one that can include setbacks.
Because an alcohol use disorder can be a chronic relapsing disease, persistence is key. It is rare that someone would go to treatment once and then never drink again. More often, people must repeatedly try to quit or cut back, experience recurrences, learn from them, and then keep trying. For many, continued follow-up with a treatment provider is critical to overcoming problem drinking.
Relapse Is Part of the Process:
Relapse is common among people who overcome alcohol problems. People with drinking problems are most likely to relapse during periods of stress or when exposed to people or places associated with past drinking.
Seeking professional help can prevent relapse — behavioral therapies can help people develop skills to avoid and overcome triggers, such as stress, that might lead to drinking. Most people benefit from regular checkups with a treatment provider. Medications also can deter drinking during times when individuals may be at greater risk of relapse (e.g., divorce, death of a family member).
Related Links for Alcohol Use
* All information, content, and material of this website is for informational purposes only and are not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider.