Alcohol Use Disorder: Signs and Treatment

Signs of Alcohol Use Disorder

Problems related to the use of alcohol can result from drinking too much, too often, or too fast. Many people have struggled to control their drinking at certain points in their lives and this has been a problem in the United States and throughout the world for a long time.

Alcohol Use Disorder Defined

Alcohol abuse that becomes severe is medically diagnosed as an alcohol use disorder (AUD). An AUD is a chronic relapsing brain disease that involves excessive and compulsive alcohol use, lack of control over alcohol use, and a negative emotional state when not drinking. In the U.S. alone, approximately 16 million people have AUD. This condition can range from severe to mild.

Diagnosing Alcohol Use Disorder

According to the 5th edition of the Diagnostic and Statistical Manual of Mental Disorder, anyone who answers yes to at least two of the following questions will be diagnosed with AUD however the number of questions that are answered ‘yes’ will determine the severity of the drinking problem.¹

Did you ever drink more or longer than you intended?
Have you wanted to cut down drinking, tried, and could not?
Do you spend a lot of time drinking?
Do you spend a lot of time feeling sick or recovering from the aftereffects of drinking?
Do you ever experience cravings or a strong need or urge to drink?
Does drinking interfere with taking care of your home or family?
Have you given up or cut back on activities that were interesting to you in order to drink?
Have you found yourself more than once in a situation where after drinking you could get hurt (i.e. using machinery, driving, swimming, having unsafe sex)?
Do you continue to drink when you feel depressed or anxious or after a memory blackout?
Do you need to drink much more than you once did to get the desired effect?
Do you find your usual number of drinks has less effect than before?
Have you found that when the effect of alcohol wears off you have withdrawal symptoms (e.g. problems sleeping, anxiety, irritability, depression, restlessness, sweating, nausea)?

Myths About Hangovers

Myth #1: Drinking coffee can prevent or cure a hangover. This is a myth and the only cure for a hangover keeping alcohol intake to a minimum and waiting it out.² Myth #2: Beer before liquor means never sicker. The truth is that the more alcohol you drink, the worse the hangover, no matter the type of alcohol.³ Myth #3: If you have a hangover and drink alcohol the morning after a night of drinking, you will avoid a hangover. This, too, is a myth. Continuing to drink the morning after can even prolong the symptoms of a hangover.⁴

Finding Help for Alcohol Use Disorder

Regardless of the severity of your alcohol use disorder, there are many ways to benefit from the treatments for alcohol use disorder. According to research, about one-third of people who are treated for alcohol problems have no further symptoms 1 year later.⁵ Others who are treated reduce their drinking and report fewer problems related to consumption of alcohol.⁶ Here is some information related to treatment for alcohol use disorders.

A 12-step program can help
A 28-day inpatient rehab can help
Many other treatment options are now available
Over the past few decades, new treatment options have been developed
What works for one person may not work for someone else
Understanding different options can be a good first step

Start With Your Primary Care Doctor

A primary care physician can be a good first step as they can provide referrals for behavioral treatments, counseling and medication. They can help you to determine whether or not your drinking is a problem, provide you with a diagnosis, create a treatment plan, evaluate your complete health and determine whether medication can help.

What Professionals Can Help?

Here are some professionals who can help. Primary care providers including MDs and doctors of osteopathic medicine can help with medications prescriptions, behavioral treatments and referrals to specialists. Assisting these primary care providers are nurse practitioners and physician assistants. Psychiatrists can help with medication prescriptions and behavioral treatments. Psychologists, social workers and alcohol addiction counsellors can all help with behavioral treatments and therapies.

Types of Treatment for Alcohol Use Disorder

Possible options are behavioral treatments, medications, and mutual support groups.

Behavior Treatment

Behavior treatment uses counseling to recognize and change thoughts, patterns, and habits around drinking. Behavioral treatments include working with a health professional and changing behaviors that can lead to heavy drinking. They help you develop the skills you need to reduce and stop drinking. They do this by setting reachable goals and learning how to cope with or avoid triggers that can cause relapse. They also help you to build a strong social support system. Studies show that these approaches are very effective for the treatment of alcohol use disorder.

Medications

Several medications are now approved in the United States to help someone to stop drinking or to reduce drinking and prevent relapse. A primary care physician or another health professional provides the prescription. Medications can work by offsetting changes in the brain as caused by alcohol abuse disorders. Some of these are newer medications. Approved medications are not addictive. The medications can be used alone or with other treatments.

Groups

Groups such as as 12-step programs or Alcoholics Anonymous (AA) can help people to feel as though they are part of a community of similar individuals who can understand their experiences. These peer support groups can help people with alcohol use disorder to obtain sobriety. A person can have a combination of support groups, counseling and even medications as part of their treatment plan.

Behavioral Treatment Types

Cognitive Behavioral Therapy

CBT can be in small groups or one on one. This therapy has a focus on identifying the feelings and situations – called cues – that lead to drinking. It also has a focus on managing the stress that leads to a relapse. Goals here include changing the thought processes leading to excessive drinking. You develop skills to cope with situations triggering problem drinking.

Motivational Enhancement Therapy

MET is held over a short period of time. The therapy has a focus on building confidence, identifying the pros/cons of seeking treatment, forming a plan for making changes in your drinking, and developing the skills you need to stick to a plan.

Marital and Family Counseling

Marital and family counseling involves spouses and other members of the family. The spouses and family members can play a role in improving family relationships. Research shows that this type of support through family therapy can often be more effective than individual counseling.

Brief Intervention Therapy

Brief intervention therapy is small group or one on one counseling. The short sessions are time limited. A counsellor gives you information about your drinking patterns and risks. Counsellors work with you to set goals and provide ideas to make a change.

Medication Treatment

Medications that FDA-approved are available to help people reduce or stop drinking and avoid relapse.

Naltrexone can reduce heavy drinking.
Acamprosate can help with abstinence.
Disulfiram can help people avoid drinking by blocking the metabolism of alcohol in the body.

What is important is to come to terms with having an AUD and choosing to get treatment. Making this decision and deciding to make a change in your life can be as important as the treatment approach. All approaches should be non-confrontational. The approaches should involve empathy and a focus on changing drinking behavior.

About Alcohol Use Disorder and Mental Health Issues

Here are some considerations.

Anxiety and depression can accompany drinking.
Someone who is alcohol dependent is two or three times more likely to have depression and anxiety.⁷
Someone who is treating alcohol should also seek treatment for accompanying mental and medical health issues.

What to Consider When Seeking Treatment for Alcohol Use Disorder

Consider inpatient or outpatient treatment and which is best for you. Inpatient facilities can be more costly and intensive as you live on site. A health care provider can help a person evaluate pros and cons of inpatient and outpatient facilities. You should also consider what your health insurance plan covers. Lower costs could be available to someone with no health insurance coverage.

Relapsing

Relapsing is a normal part of the process of battling alcohol use disorder. Relapsing does not mean failure and it is simply one of the symptoms of the disorder. When and why do relapses happen? Someone with alcohol abuse disorders can relapse during times of stress. Relapse can happen when a person is exposed to certain places or people having an association with drinking. Relapse can happen when a person is exposed to certain places or people having an association with drinking. A relapse is a temporary set-back, and not a failure. A relapse can be compared to a flare up with other disorders such as asthma and diabetes. Professional help can prevent a relapse and overcome triggers such as stress that can lead to a relapse. A regular checkup with a treatment provider can help prevent relapses. Medication can help during stressful times such as a death in the family or divorce.

How Family and Friends Can Help

Understand that caring for someone with an alcohol abuse disorder can be stressful. A caretaker must remember to also take care of themselves. Support can come from support groups and the community. Only the person with the alcohol use disorder can be responsible for his/her own treatment. Change happens best when it comes from within. Participation and support from others can make a big difference. Family and friends:

Can participate in support groups.
Should be patient as overcoming an alcohol abuse disorder is not quickly or easy.
Should consider that changing habits can take time, be hard, and require repeated effort.
Should acknowledge efforts to overcome problems related to alcohol abuse disorders.

Some Additional Statistics of Note

Please consider these statistics concerning alcohol use:⁸

In 2017…

% 86.3% of people ages 18 or older reported that they drank alcohol at some point in their lifetime % 70.1% reported that they drank in the past year % 55.9% reported that they drank in the past month

In 2015…

People ages 18+ that engaged in binge drinking within the past month 26.9% Reported heavy alcohol use in the past month 7% Adults with AUD received treatment 6.5%

In 2014…

In 2014, alcohol-impaired driving fatalities accounted for 9,967 deaths.

More Statistics…

An estimated 88,000 people die from alcohol-related causes annually (62,000 men and 26,000 women), making alcohol the third leading preventable cause of death in the United States (first and second are tobacco and diet/inactivity). In the years 2000 to 2016, it is estimated that the use of alcohol increased 0.3 percent a year and binge drinking increased at 0.7 percent per year. The increase was greatest for women, Blacks, and those aged 30-49.⁹

Article Contents

Signs of Alcohol Use Disorder
Finding Help for Alcohol Use Disorder
Types of Treatment
Behavioral Treatment Types
What to Consider When Seeking Treatment
Some Additional Statistics of Note