Alcohol Addiction (AUD): Definition, Diagnosis & Treatment
In This Article
Alcohol use disorder (AUD) is the DSM-5’s official term for alcohol addiction. AUD includes alcohol dependence, which professionals used to consider separate from addiction.
The DSM-5 stands for Diagnostic and Statistical Manual of Mental Disorders Fifth Edition. They’re a primary resource for diagnosing alcohol and other substance addiction.2
What is Alcohol Addiction?
Alcohol addiction is a chronic progressive condition. People with AUD have trouble cutting back or quitting drinking, even when it causes problems.1
Alcohol use disorder is a common disease. In the United States, over 29.5 million aged 12+ had it in 2020.11
Is There a Difference Between Alcohol Abuse and Dependence?
Alcohol abuse is a pattern of drinking that leads to dangerous situations and failure to meet social obligations. Alcohol dependence is the physical and mental inability to quit drinking.
Those who have become dependent on alcohol lose control and continue to drink despite knowing the consequences of their actions.
Symptoms of Alcohol Use Disorder
The DSM-IV and DSM-5 set twelve signs that indicate you have AUD.4 You may have AUD if you deal with at least 2 of these:
- Drinking larger amounts or for longer periods than intended
- Unsuccessful efforts to cut down or quit
- Excessive time spent obtaining, drinking, and recovering from the effects
- Intense cravings and urges to drink
- Failure to fulfill major obligations
- Continued use despite social/interpersonal problems
- Activities/hobbies reduced or given up
- Recurrent use in physically hazardous situations (drunk driving)
- Gotten arrested or experienced legal problems due to drinking
- Recurrent use despite physical or psychological problems
- High tolerance to alcohol
- Experiencing alcohol withdrawal syndrome after quitting
Classifications of Alcohol Use Disorder
The DSM-5 removes the distinction between alcohol abuse and alcohol dependence. Instead, it classifies AUD as mild, moderate, or severe.
- Mild: 2 to 3 symptoms
- Moderate: 4 to 5 symptoms
- Severe: 6+ symptoms
If you have no more than one symptom, you may still have a drinking problem.
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Diagnosing Alcohol Addiction
Addiction specialists use the DSM-5 to diagnose AUD. You must meet at least two (2) criteria within the last 12 months to be diagnosed with AUD.
The criteria for AUD include:
- Spending a significant amount of time obtaining, using, and recovering from alcohol use
- Being unable to reduce alcohol use despite having the desire to do so
- Experiencing cravings or a strong desire to consume alcoholic drinks
- Needing to consume alcohol more frequently or in larger amounts to reach its desired effects
- Developing alcohol withdrawal symptoms when you stop drinking
- Drinking more alcohol or for longer periods than intended
- Giving up recreational, social, or occupational activities you enjoy in favor of alcohol
- Being unable to meet obligations at work, home, or school due to alcohol use
- Continuing to abuse alcohol despite its adverse effects on your relationships and social life
- Drinking alcohol in physically dangerous situations, like driving or operating heavy machinery
- Continuing to drink alcohol, despite its consequences on your physical and mental health
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What Causes Alcohol Addiction?
Alcohol use disorder develops over time. It starts with occasional binge drinking that turns into overdrinking. Eventually, this develops into alcohol addiction.10,11
Some of the most common causes of AUD include:
- Overdrinking or binge drinking
- Dealing with a mental health issue (anxiety, depression, or schizophrenia)
- Facing peer pressure during adolescence or early adulthood
- Having low self-esteem
- Family history of alcohol use disorder
- A relative or a close relationship with someone with AUD
It’s important to understand that not everyone who binge drinks has an AUD. About 90 percent of heavy or binge drinkers don’t meet the criteria for a clinical diagnosis of alcohol addiction.
Risk Factors of Alcohol Addiction
The exact cause of alcohol use disorder is unknown. However, these factors may increase your risk of developing this disease:
- Drinking 15 or more drinks per week if you’re male
- Drinking 12 or more drinks per week if you’re female
- Drinking more than five drinks per day at least once a week
- A family history of alcoholism
- Mental health problems (anxiety, depression, PTSD, etc.)
Health Consequences of Alcohol Addiction
Too much alcohol can lead to several consequences. These consequences to your physical, mental, and social health include:5,6
- Inappropriate actions or activities
- Development of chronic diseases
- Acute alcohol poisoning
- Motor accidents
- Falls and injuries
Beyond these potential issues, there are also short and long-term effects. People who quit will most likely experience withdrawal symptoms.
Alcohol can increase the amount of alcohol in the bloodstream, causing intoxication. Symptoms include:6
- Unstable moods
- Slurred speech
- Impaired attention or memory
- Impaired judgment
- Poor coordination
- Displaying inappropriate behavior
Long-term alcohol use can lead to chronic diseases and other severe problems like:5,6
- High blood pressure, heart disease, or stroke
- Liver damage
- Digestive problems
- Cancer (including breast, mouth, throat, esophagus, liver, and colon)
- Weakened immune system
- Learning and memory problems
- Mental health problems (including depression and anxiety)
- Miscarriage or stillbirth
- Fetal alcohol spectrum disorders (FASDs) in babies of mothers who drink during pregnancy
- Sexually transmitted diseases (STDs) (including HIV and hepatitis C) due to risky sexual behaviors
Who Should Not Drink Alcohol?
Moderate and low-risk drinking is safe for most people. But these people should avoid alcohol:
- People under 15 years of age: Teenagers who drink at an early age are five times more likely to develop alcoholism than people who started drinking at 21.16,17
- People with a family history of alcoholism: Having parents with alcoholism increases your risk for alcoholism.16
- Pregnant and breastfeeding women: Drinking heightens the risk of miscarriage and fetal alcohol syndrome (FAS).17
- People with medical conditions: Alcohol can worsen several pre-existing health issues, such as liver and kidney disease.
- People with trauma or mental health disorders: Drinking alcohol can trigger or worsen mental issues and increase your risk for alcoholism.
- People taking over-the-counter (OTC) and prescription medications: Alcohol can interact with drugs to reduce their effects or potentially cause an overdose.
- People who need to be alert and coordinated: This includes driving, operating machinery, and participating in other activities requiring full attention.
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What is Too Much Alcohol?
One standard drink contains around 14 grams of pure alcohol.14 The CDC says moderate drinking is:12
- Two or fewer standard drinks for men
- One or fewer standard drinks for women
Overdrinking means 12 to 15 or more drinks per week. Binge drinking refers to drinking more than five drinks on a single occasion, although they may not drink every day.
What is Moderate Drinking?
The Dietary Guidelines for Americans recommends drinking moderately or not drinking at all.13 Moderate drinking is a maximum of 1 drink per day for women or two for men.14
What is Low-Risk Drinking?
For regular drinkers, the NIAAA recommends low-risk drinking:
- No more than 3 drinks a day or 7 per week for women
- No more than 4 drinks a day or 14 per week for men
Only 2 in every 100 people who practice low-risk drinking develop alcoholism.16
0-0-1-3 Guidelines for Responsible Drinking
The Warren Air Force Base created the 0-0-1-3 program to prevent alcohol abuse among military personnel.6 However, you can use them as a guide for responsible drinking.
The 0-0-1-3 recommends limiting your alcohol consumption to:
- 0: Zero drinks for people below 21 years
- 0: Zero driving under the influence (DUI)
- 1: One drink per hour
- 3: No more than three drinks per event
What is Alcohol Withdrawal Syndrome?
Chronic drinkers who suddenly stop drinking may experience alcohol withdrawal. The symptoms may happen within several hours to a few days after the last drink, including:6
- Problems sleeping
- Rapid heartbeat
- Hand tremors
Treatment Options for Alcohol Addiction
No matter how severe the drinking problem is, treatment can help those with AUD quit alcohol and recover. Consult a health professional to determine the most suitable one for your needs.
Treatments for AUD include:
- Inpatient treatment: Involves checking yourself into a rehab facility for 24-hour medical supervision.
- Outpatient treatment: A treatment program where you can freely leave the rehab facility.
- Partial hospitalization program
- Medication-assisted treatment: Involves using medication, counseling, and therapy to treat addiction.
- Behavioral treatment: A short-term therapy technique that explores the link between thought patterns and addiction.
- Support groups: Provide a much-needed community to help maintain sobriety after treatment.
Outlook for Alcohol Addiction
How well you recover depends on different things. Mild cases get better faster. Severe cases often struggle for life.
Talk to your healthcare provider as soon as you notice a problem. Your chances of recovery are better if you address addiction sooner.
Alcohol use disorder (AUD) is a chronic condition where you constantly use alcohol despite its negative consequences. AUD can put you at risk of developing many diseases, including heart disease and cancer.
It also affects your mental health and social life. Certain people should avoid drinking alcohol, such as pregnant women and those with a family history of alcoholism or pre-existing medical conditions.
For those struggling with AUD, there are various treatment options available. Recovery may be challenging but possible with the proper support and resources. Seek help immediately if you or a loved one is facing alcohol addiction.
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- “Understanding Alcohol Use Disorder.” National Institute on Alcohol Abuse and Alcoholism, 2023.
- “Alcohol Use Disorder: A Comparison Between DSM–IV and DSM–5.” National Institute on Alcohol Abuse and Alcoholism, 2021.
- “Understanding alcohol use disorders and their treatment.” American Psychological Association, 2012.
- Hasin et al. “DSM-5 criteria for substance use disorders: recommendations and rationale.” The American Journal of Psychiatry, 2014.
- “Alcohol Use Disorder (AUD).” MedlinePlus.
- “Alcohol Use and Your Health.” Centers for Disease Control and Prevention, 2022.
- “Drinking Levels Defined.” National Institute on Alcohol Abuse and Alcoholism, 2023.
- “Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR).” American Psychiatric Association.
- “Treatment for Alcohol Problems: Finding and Getting Help.” National Institute on Alcohol Abuse and Alcoholism, 2023.
- “What Is A Standard Drink?” National Institute of Alcohol Abuse and Alcoholism.
- “Alcohol Facts and Statistics.” National Institute of Alcohol Abuse and Alcoholism, 2023.
- “CDC - Frequently Asked Questions - Alcohol.” Centers for Disease Control and Prevention, 2022.
- “Dietary Guidelines for Alcohol.” Centers for Disease Control and Prevention, 2022.
- "What Is A Standard Drink?" National Institute on Alcohol Abuse and Alcoholism.
- "2015-2020 Dietary Guidelines for Americans." U.S. Department of Health and Human Services, 2015.
- "Drinking Patterns and Their Definitions." Alcohol Research Current Reviews, 2018.
- "Alcohol Facts and Statistics." National Institute on Alcohol Abuse and Alcoholism, 2023.