It was estimated that in 2018 around 14.8 million individuals 12 years old and up in the United States had an alcohol use disorder (AUD) in the previous year.1Alcohol use disorder is a brain disease that is chronic.2 The first and second editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM) used the term “alcoholism”.3,4
The fifth edition of the DSM includes “alcohol use disorder” as a disorder, and symptoms of alcohol use disorder include: 5
- Craving alcohol.
- Trying to control or reduce use of alcohol but not succeeding, or persistently wanting to control or decrease use of it.
- In situations where using alcohol is dangerous physically, using it repeatedly.
- Frequently using more alcohol or using alcohol for more time than intended.
- Not fulfilling important responsibilities at home, school, or work because of repeated use of alcohol.
- Spending a lot of time doing things needed for using, getting, or recovering from alcohol.
- Experiencing alcohol withdrawal.
- To evade or alleviate symptoms of withdrawal, using alcohol or a similar substance.
- Still using a consistent alcohol amount being significantly less effective.
- Significantly more alcohol being necessary to get the wanted effect or intoxicated.
- Due to use of alcohol, decreasing or stopping work-related, recreational, or social activities that are important.
- Even though knowing that alcohol probably worsened or brought on a mental or physical issue that is lasting or repeatedly occurs, still using alcohol.
- Even though alcohol worsened or brought on interpersonal or social issues that are lasting or repeatedly occur, still using alcohol.
Risk Factors for the Development of an Alcohol Use Disorder
Some of the risk factors for an alcohol use disorder may include:5-14
- Amount of alcohol consumption: Drinking that is deemed “at-risk” generally is, for healthy women, drinking an amount greater than 7 alcoholic drinks a week and/or greater than 3 in a day. Drinking that is deemed “at-risk” generally is, for healthy men, drinking an amount greater than 14 alcoholic drinks a week and/or greater than 4 in a day.
- Social network: An individual may be more likely to have a substance use disorder as an adolescent if that individual spends time with peers who act in general in deviant ways. An individual may have a higher risk of substance use disorder if the individual’s social support is poor. It contributes to the AUD risk of an individual if the individual associates with people that abuse alcohol.
- Genetics: For some genes, certain variations may impact an individual’s alcohol use disorder risk.
- Family history: Substance use in one’s family may increase a person’s risk of substance use disorder. The near relations of persons with AUD have an increased rate of AUD. There is a higher chance of alcohol problems occurring in the children of individuals with AUD. Although genetics probably contribute to this higher chance, other things family members share (such as way of living and/or environment) might play a part as well.
- Psychology: Risk of alcohol use disorder is affected by stress. Having self-esteem that is poor and being impulsive can make alcohol use disorder more likely. Mental illness (such as depression, schizophrenia, or bipolar disorder) may make alcohol use disorder more likely.
- Trauma: The likelihood of substance use disorders is higher in people who have gone through trauma.
- The age drinking starts: Drinking when younger than 21 years old may raise an individual’s risk of later alcohol use disorder.
- Parenting: Low supervision by parents may increase an adolescent’s likelihood of AUD.
A risk factor for alcohol use disorder is something that makes alcohol use disorder more likely.15
Short-Term Dangers of Alcohol Abuse
In the short-term and in the long-term, consuming too much alcohol could be harmful or even deadly.16,17
In the short-term, using too much alcohol can raise a person’s risk of problems including alcohol poisoning, violence, injury, and risky sexual activity.16,17 Death might occur, for example from alcohol poisoning or a crash involving a driver impaired by alcohol.5,14,16,17,18
The CDC conveys that individuals that intend to drive or are driving should consume no alcohol at all.16 Alcohol use starts impairing at amounts much lower than the legal limit.19 For instance, a person could have reduced visual functions and could be less capable of doing two things at once at a blood alcohol concentration of 0.02 g/dL.20
Additionally, when pregnant or attempting to conceive, using any alcohol could be dangerous— no amount is known to be safe.21 Death of the baby and lifelong disability affecting the baby can occur because of the baby’s mother using alcohol when pregnant: stillbirth, miscarriage, and a fetal alcohol spectrum disorder can result due to a woman who is pregnant using alcohol.16,21Even prior to a woman being aware of her pregnancy, alcohol is able to cause her baby problems.21 The CDC conveys that pregnant women and women who might be pregnant should consume no alcohol at all.16
Furthermore, for several other categories of individuals, the CDC indicates they should consume no alcohol at all.16
Death or lasting damage to the brain may result from alcohol poisoning, which is also called alcohol overdose.17
Alcohol poisoning symptoms and signs may include:17
- Throwing up.
- Being confused.
- 10 seconds between breaths or longer.
- Less than 8 breaths in a minute.
- Skin that is bluish and/or being pale.
- Not able to be woken up.
- Low temperature.
If you think you or someone else may have overdosed on alcohol, call 911 right away. Alcohol present in a person’s intestine and stomach keeps going into the person’s blood and moving through the person’s body even after the individual ceases drinking.17
Possible Effects of Long-term Alcohol Abuse
Using alcohol heavily for a while might bring about issues including:11,16
- Pancreatic inflammation.
- Damage to nerves.
- Muscle of heart becoming weaker.
- Liver disease.
- Issues with immune system.
- Blood pressure that is above normal.
- Heart beating irregularly.
- Raised risk of some types of cancer.
Dependence on Alcohol
Dependence may develop if a person uses too much alcohol chronically.22 Withdrawal can occur if a person who is dependent on alcohol suddenly stops or significantly decreases consumption of alcohol.5,22
Possible symptoms and signs of alcohol withdrawal include:5,23
- Trouble sleeping.
- Worsened judgment.
- Being agitated and/or irritable.
- Being disoriented.
- Difficulty concentrating.
- Being more sensitive to light, to tactile sensations, and to noises
- Worsened memory.
- Alterations in consciousness.
- Nightmares and/or intense dreams.
- Raised blood pressure.
- Faster heart rate.
- Raised temperature.
- Nausea and/or vomiting.
- Reduced appetite.
- Being restless.
- Psychomotor agitation.
Alcohol withdrawal can be deadly. If you or someone else may be experiencing alcohol withdrawal, get to an emergency department or talk to a medical provider right away. If fever, hallucinations, seizures, heartbeat that is not regular, or confusion that is severe arises, call 911 or get to an emergency department right away.24
Treatment for Alcohol Use Disorder
Do not stop drinking on your own if you could have alcohol dependence; get medical help, as withdrawal could put your life in danger.25
If you think you may have a problem with alcohol use, talk to a healthcare provider.19 An individual who has a problem with drinking should get an assessment conducted by a healthcare provider.2,26 Treatment can be beneficial for the majority of individuals with alcohol use disorder.2
AUD treatment may include behavioral treatment (also called “talk therapy” or counseling) and/or medicine.27,28
- Substance Abuse and Mental Health Services Administration. (2019). Results from the 2018 National Survey on Drug Use and Health: Detailed tables.
- National Institute on Alcohol Abuse and Alcoholism. Alcohol use disorder.
- National Institute on Alcohol Abuse and Alcoholism. (1995). Alcohol alert no. 30: Diagnostic criteria for alcohol abuse and dependence.
- Robinson, S. M. & Adinoff, B. (2016). The classification of substance use disorders: Historical, contextual, and conceptual considerations. Behavioral sciences (Basel, Switzerland), 6(3), 18.
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th). Arlington, VA: Author.
- National Institute on Drug Abuse. (2002). Risk and protective factors in drug abuse prevention.
- Rastegar, D. & Fingerhood, M. (2015). The American Society of Addiction Medicine handbook of addiction medicine. Oxford University Press.
- National Institute on Alcohol Abuse and Alcoholism. What’s “at-risk” or “heavy” drinking?.
- Thatcher, D. L. & Clark, D. B. (2008). Adolescents at risk for substance use disorders: Role of psychological dysregulation, endophenotypes, and environmental influences. Alcohol research & health : the journal of the National Institute on Alcohol Abuse and Alcoholism, 31(2), 168–176.
- Yitayih, Y., Abera, M., Tesfaye, E., Mamaru, A., Soboka, M., & Adorjan, K. (2018). Substance use disorder and associated factors among prisoners in a correctional institution in Jimma, Southwest Ethiopia: A cross-sectional study. BMC psychiatry, 18, 314.
- U.S. National Library of Medicine. (2018). Alcohol use disorder.
- Brady, K. T. & Back, S. E. (2012). Childhood trauma, posttraumatic stress disorder, and alcohol dependence. Alcohol research : current reviews, 34(4), 408–413.
- Substance Abuse and Mental Health Services Administration. (2014). A treatment improvement protocol: Trauma-informed care in behavioral health services: TIP 57.
- U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. (2018). Report to Congress on the prevention and reduction of underage drinking.
- National Cancer Institute. Risk Factor (Code C17103).
- Centers for Disease Control and Prevention. (2018). Fact sheets – alcohol use and your health.
- National Institute on Alcohol Abuse and Alcoholism. Facts about alcohol overdose (or alcohol poisoning).
- Centers for Disease Control and Prevention. (2019). Impaired driving: Get the facts.
- Centers for Disease Control and Prevention. (2018). Frequently asked questions.
- National Highway Traffic Safety Administration. Drunk driving.
- Centers for Disease Control and Prevention. (2018). Alcohol use in pregnancy.
- Becker, H. C. (2008). Alcohol dependence, withdrawal, and relapse. Alcohol research & health : the journal of the National Institute on Alcohol Abuse and Alcoholism, 31(4), 348–361.
- Center for Substance Abuse Treatment. (2015). Detoxification and substance abuse treatment: A treatment improvement protocol: TIP 45.
- A.D.A.M., Inc. (2019). Alcohol withdrawal. In A.D.A.M. Medical Encyclopedia.
- National Institute on Alcohol Abuse and Alcoholism. Self-help strategies for quitting drinking.
- National Institute on Alcohol Abuse and Alcoholism. Why do different people need different options?.
- National Institute on Alcohol Abuse and Alcoholism. What types of alcohol treatment are available?.
- National Institute on Alcohol Abuse and Alcoholism. Frequently asked questions: Searching for alcohol treatment.