Alcohol Use Disorder: Symptoms, Causes, & Treatments

What Is Alcohol Use Disorder (AUD)?

Alcohol use disorder (AUD) is a disease affecting the ability to stop alcohol consumption despite associated consequences. Excessive alcohol use impacts brain chemistry as individuals increase consumption to counteract tolerance. AUD encompasses alcohol abuse, alcohol dependence, and the informal term alcoholism.

Chronic alcohol abuse can develop into addiction when individuals rely on alcohol to function normally. The body grows dependent on the substance with prolonged consumption, and immediately stopping alcohol consumption may result in withdrawal symptoms, intense cravings, and other complications.

Alcohol addiction is common, and many individuals struggle with shame due to their condition. People may refuse to accept their addictive behavior, or misunderstand the facts about alcohol use, possibly leading to treatment avoidance and alcohol-related health problems. Some believe they can quit without realizing the psychological aspect of alcohol use disorder. As alcohol becomes engrained in their routine, simply separating from this aspect of life is challenging.

Alcohol Use Disorder Symptoms

Symptoms of alcohol abuse vary from person to person. However, individuals must exhibit at least two qualifying symptoms within 12 months to be diagnosed with alcohol use disorder.¹ Severe alcohol use disorder includes six or more manifestations of alcohol abuse.

According to diagnostic criteria, symptoms of alcohol use disorder include:

• Consuming more alcohol than planned in one session
• Time spent consuming alcohol is longer than planned
• Attempts to cut down or cease consumption fail
• Devoting excessive time to drinking, planning to drink, or planning ways to drink
• Cravings for alcohol are difficult to manage
• Problems in relationships because of alcohol (i.e., cheating, fights, sexual dysfunction)
• Problems with work because of alcohol (i.e., showing up to work, working under the influence, lost productivity)
• Social problems because of alcohol (i.e., embarrassment, rejection, impulsivity)
• Legal issues (i.e., DUI/DWI, belligerence, difficulty following rules/regulations)
• Using alcohol in physically dangerous situations (i.e., driving under the influence, blacking out or falling, waking up in unsafe locations)
• Continued alcohol consumption despite threats of further harm
• Needing to drink more alcohol to achieve the same effects
• Withdrawal symptoms causing further/repeated use
• Becoming irritable when not drinking alcohol

What Causes Alcohol Use Disorder?

Evidence suggests that genetics and environmental factors, such as traumatic life experiences, play a role in the development of alcohol use disorder.^2,3 Some individuals may turn to alcohol because it helps them relax, escape life challenges, or deal with trauma. However, individuals at higher risk of alcohol misuse do not necessarily experience the disease. Effective coping strategies and stress management skills may allow some to overcome a predisposition to alcohol use disorder.

Possible causes of alcohol use disorder include:

• Drinking at an early age: Those who begin drinking or binge drinking early are more likely to develop alcohol use disorder.
• Childhood trauma: Individuals who do not address childhood trauma may abuse alcohol to cope.
• Family history of alcohol abuse: Coming from a familial background marked by alcohol abuse may increase the risk of AUD. Parents or caregivers who model poor alcohol behavior show children such behavior is acceptable, even normal.
• Mental health conditions: Consuming alcohol to cope with debilitating depression or anxiety may calm nerves or negative emotions.
• Feelings of suicide: Individuals struggling with suicidality may use alcohol to fill a void or mask beliefs of worthlessness.
• Major life failures: Alcohol consumption allows some people to ignore their problems rather than deal with emotions.

Health Impacts of Alcohol Use Disorder

Clinical alcohol use disorder may result in short and long-term health complications, such as kidney disease, high blood pressure, and even death.⁴ Those with alcohol problems also risk physical injury due to falls, drownings, or assault. The resulting issues could be better or worse depending on the severity and duration of use. Alcohol impacts the brain causing both short-term and long-term effects that range from mild to severe.

Health impacts due to alcohol use disorder and chronic alcohol abuse may include:⁴

• Memory loss
• Digestion problems
• Alcohol-induced brain cell damage or traumatic brain injury
• Tremors
• Shakes
• Headaches
• Nausea
• Increased blood pressure
• Dehydration
• Increased anxiety
• Physical harm
• Some cancers
• Liver disease
• Heart disease
• Stroke

How Is Alcohol Use Disorder Diagnosed?

As mentioned, professionals may provide an AUD diagnosis if individuals exhibit two or more qualifying symptoms. A physician may diagnose patients with mild, moderate, or severe alcohol use disorder based on symptom manifestation. Testing for alcohol use disorder often includes personal interviews, medical history reviews, and physical exams.⁵

Alcohol Use Disorder & Co-Occurring Conditions

Alcohol use disorder can accompany other mental health conditions like depression, substance use disorder, or anxiety. Individuals experiencing trauma, mood disorders, or personality challenges may misuse alcohol to deal with emotional pain. Such maladaptive coping or avoidance strategies frequently contribute to alcohol misuse, dependence, or addiction.

Common co-occurring disorders with alcohol use disorder include:

• Anxiety disorders
• Depressive disorders
• Bipolar disorder
• Post-traumatic stress disorder or complex PTSD
• Substance use disorders
• Attention deficit/hyperactivity disorder (ADHD)
• Narcissistic personality disorder (NPD)

Symptoms of Alcohol Withdrawal

Individuals who fear alcohol withdrawal may hesitate to seek treatment. However, withdrawal symptoms can be deadly, and medical attention may be necessary to cope with the effects of alcohol abstinence. Withdrawal symptoms could last as long as two weeks (or more) based on the severity of alcohol abuse and individual.⁶

Symptoms of alcohol withdrawal may include:⁷

• Anxiety
• Nausea
• Irritability
• Shakiness
• Fatigue
• Restlessness
• Headaches or migraines
• Increased heart rate
• Delusions
• Hallucinations
• Excessive sweating
• Dehydration
• Delirium tremens (known as DT’s)
• Depression
• Hopelessness
• Suicidal Thoughts
• Death

Signs of an Alcohol Overdose

Individuals struggling with alcohol diseases risk overdose or alcohol poisoning.⁸ If overdose symptoms are present, people or loved ones should seek immediate medical attention or call 9-1-1 as these reactions can be fatal.

Symptoms of an alcohol overdose may include:⁸

• Confusion
• Vomiting
• Seizures
• Irregular breathing
• Blue, gray, or pale skin
• Low body temperature (hypothermia)
• Loss of consciousness

Treatment for Alcohol Use Disorder

Treatment for chronic alcohol use disorder often focuses on abstinence and alcohol cessation. Detox typically occurs in a hospital or alcohol use treatment center where the patient receives constant medical supervision and care. Inpatient and outpatient services are also available to aid in alcohol use disorder recovery. Developing meaningful relationships in support groups is also beneficial.

Treatment options for alcohol use disorder include:

Inpatient or Outpatient Rehab

Rehabilitation is a viable alcohol use disorder treatment, and many centers or hospitals have specialized services, physicians, and procedures available to aid recovery. Rehab can last weeks, months, or years depending on individual needs, and some patients may return to rehab after lapses or alcoholic relapses. Specialized interventions often include extensive therapy, chores, community wellness programs, and group therapy as part of rehabilitation.

Medication-Assisted Treatment

Medication-assisted treatment (MAT) for alcohol use disorder incorporates medication for alcohol use disorder to help mitigate side effects and undesired symptoms related to early or sustained recovery efforts. The Sinclair Method uses naltrexone before drinking to diminish the pleasurable effects of alcohol to help people drink less. MAT typically utilizes psychotherapy alongside medication to create a comprehensive approach to recovery.⁹ Some patients may also learn to identify the reasons for their alcohol misuse, offering them a jump start to sustained recovery.

Support Groups

Many people with alcohol use issues often participate in support groups like Alcoholics Anonymous (AA), but various other options are available. Individuals can also get involved in their communities, find mentors in business sectors, or join online support groups. These settings offer a sense of community and allow members to share progress or setbacks throughout recovery.

Behavioral Therapies

Those who wish to change their behavior and circumstances will benefit from therapy or counseling. Therapists will help clients assess their drinking habits to identify what may drive their behavior. Clients can discuss their struggles, examine pivotal events contributing to alcohol misuse, and develop healthy coping skills. For alcohol use disorders, popular therapies include cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), and acceptance and commitment therapy (ACT). Those ready to seek treatment can use an online therapist directory to locate a professional specializing in alcohol abuse problems.

How to Help Someone With Alcohol Use Disorder

Those supporting a loved one with alcohol use disorder may struggle to witness the pain of relapse and recovery. Remaining emotionally and physically supportive throughout the process is essential. Encourage them to continue treatment and offer compassion throughout their recovery. However, reaching a point where you can no longer help your loved one is okay. Remember to take care of yourself along the way, too.

In My Experience

In my experience, people who wrestle with alcohol use disorder often hit strides and challenges. Bullet-proof recoveries for alcohol use issues are rare, and individuals may encounter numerous relapses or setbacks. However, you can use failure to your advantage by learning what triggers and situations to avoid next time. If you are considering recovery, plan for the difficulties and joyous aspects of the journey.