Alcohol Use Disorder: Effects and Treatment

Excessive drinking has both immediate risks and dangers attributed to prolonged, chronic alcohol use.¹¹

Health hazards due to excessive drinking may include immediate dangers like:¹¹

• Falls, drownings, burns, and car collisions are more likely to occur while under the influence of alcohol. Although even moderate levels of drinking (about 2 standard drinks in a 3-hour period) have been shown to double the odds of injury, the risk increases sharply at higher levels of consumption (e.g., binge drinking). ¹²
• Acts of violence (e.g., homicide, domestic assault, sexual assault, suicide).
• Alcohol poisoning, a medical emergency resulting from high blood-alcohol concentration.
• Unintended pregnancy or sexually transmitted diseases (STDs) caused by risky sexual behavior, including unprotected sex and sex with multiple partners.

In addition to increasing the chances of developing AUD, chronic drinking over an extended period is linked to conditions like:¹¹

• Hypertension (high blood pressure).
• Weakened immune system.
• Mental health problems (e.g., depression, anxiety).
• Social problems (e.g., unemployment, family problems)
• Liver cirrhosis.
• Heart disease.
• Various forms of cancer.

When a person who engages in heavy and prolonged drinking suddenly stops drinking or significantly reduces the amount they drink, withdrawal symptoms cause significant distress and functional impairment.^3,13

Alcohol withdrawal usually begins within several hours to a few days after stopping or significantly reducing alcohol use after extended periods of heavy drinking (e.g., 8 drinks of more per day for multiple days).³

Alcohol withdrawal symptoms  include two or more of the following symptoms, which cause clinically significant distress or functional impairment:³

• Autonomic hyperactivity (sweating profusely or having a pulse rate that is higher than 100 beats per minute).
• Hand tremor.
• Insomnia.
• Nausea or vomiting.
• Transient visual, tactile, or auditory hallucinations (seeing, feeling, or hearing things that are not there).
• Psychomotor agitation.
• Anxiety.
• Generalized tonic-clonic seizures.

Medical detoxification, where a person has some form of 24-hour medical care, is generally the preferred setting for detoxification, as withdrawal symptoms can vary greatly in severity and symptoms can be unpredictable. Detox involves ensuring a person is medically stable as well as services such as correcting nutritional deficiencies caused by alcohol misuse and administering medications to help reduce the severity and likelihood of dangerous withdrawal symptoms, such as seizures.¹⁴

Delirium tremens (DT) is a severe form of alcohol withdrawal experienced by approximately 1-2% of those with a history of alcohol misuse.¹⁵ It usually lasts 3 to 4 days but sometimes up to 8 days.¹⁵ Signs and symptoms of DT include:¹⁵

• Tachycardia (rapid heart rate).
• Hypertension (high blood pressure).
• Anxiety.
• Delirium (e.g., reduced awareness of surroundings, difficulty concentrating, psychomotor disturbances, sleep disturbances).
• Visual, auditory, or tactile hallucinations (seeing, hearing, or feeling things that are not there).
• Seizures.

DT is a medical emergency and can be fatal. Death rates among those who experience DT are between 1 and 4%, which can be reduced with prompt, appropriate treatment.¹⁵