Alcohol use disorder is a medical condition involving frequent or heavy alcohol use. People with alcohol use disorder can’t stop drinking, even when it causes problems, emotional distress or physical harm to themselves or others.
What causes alcohol use disorder?
Scientists are still trying to understand what causes alcohol use disorder. It appears to be a combination of one or more of the following:
Genetics.
Early childhood events.
Attempts to relieve emotional pain.
People are more likely to develop alcohol use disorder if they:
Consume alcohol often, in large amounts or start early in life.
Experienced trauma, such as physical or sexual abuse.
Alcohol use that turns into a use disorder develops in stages.
At-risk stage: This is when you drink socially or drink to relieve stress or to feel better. You may start to develop a tolerance for alcohol.
Early alcohol use disorder: In this stage, you have progressed to blackouts, drinking alone or in secret, and thinking about alcohol a lot.
Mid-stage alcohol use disorder: Your alcohol use is now out of control and causes problems with daily life (work, family, financial, physical and mental health). Organ damage can be seen on lab tests and scans.
End-stage alcohol use disorder: Drinking is now the main focus of your life, to the exclusion of food, intimacy, health and happiness. Despair, complications of organ damage and death are now close.
How is alcohol use disorder treated?
Treatment may include a combination of:
Behavioral therapies: Counseling, or talk therapy, with a healthcare provider like a psychologist or mental health counselor can teach you ways to change your behavior. Motivational, cognitive-behavioral, contingency and 12-step facilitation are the most commonly used techniques.
Medications: The U.S. Food & Drug Administration has approved naltrexone and acamprosate for the treatment of alcohol use disorder. Topiramate and gabapentin can also decrease cravings in some people. An older medication — disulfiram — is now used only rarely. These medications seem to help decrease the background obsessional thinking around alcohol.
Support groups: Group meetings with other people who have alcohol use disorder can help you stay sober. Alcoholics Anonymous (AA) meetings are usually free and are available in most communities. Other styles of recovery groups include: Celebrate! Recovery (Christian focus), Rational Recovery (non-spiritual) and Recovery Dharma (mindfulness/Buddhist focus).
Your treatment setting will depend on your stage of recovery and the severity of your illness. You may need inpatient medical (hospital), residential rehabilitation (rehab), outpatient intensive therapy or outpatient maintenance.
How is alcohol use disorder diagnosed?
There’s no single lab test for alcohol use disorder. Diagnosis is based on a conversation with your healthcare provider. The diagnosis is made when drinking interferes with your life or affects your health.
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