Alcohol Addiction: Signs, Health Effects & What to Do
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Alcohol Addiction: Signs, Health Effects & What to Do
Alcohol use disorder (AUD) is a progressive condition characterized by an impaired ability to control or stop alcohol use despite adverse consequences.1
AUD is sometimes referred to as alcohol abuse, alcohol dependence, alcohol addiction, or alcoholism.1 However, these terms are not the same.
The Differences between AUD, Alcohol Addiction, Alcohol Abuse, and. Alcohol Dependence
AUD is the DSM-5’s official term for alcohol addiction. The DSM-5 stands for Diagnostic and Statistical Manual of Mental Disorders Fifth Edition, a primary resource for diagnosing alcohol and other substance addiction.2
An earlier DSM version, the DSM-IV, differentiated alcohol abuse and alcohol dependence.2
Alcohol abuse is characterized by continued alcohol use despite the drinking behavior leading to interpersonal problems, harmful situations, and neglect of major life obligations. Those who abuse alcohol also have a strong craving for alcohol.3, 4
Alcohol dependence is mainly characterized by tolerance, withdrawal, and loss of control.
People have developed alcohol tolerance if they need to drink more to get the desired effects they once got. They can experience withdrawal symptoms if they suddenly stop drinking. They are also often unable to stop drinking once they start.3, 4
In 2013, the DSM-5 replaced the terms alcohol abuse and alcohol dependence for AUD. The DSM-5 uses AUD, not alcohol addiction.2, 4
AUD has three subtypes: mild, moderate, and severe.2 Sometimes, severe AUD is referred to as alcohol dependence or alcoholism.3, 5
AUD vs. Alcohol Misuse
Drinking alcohol doesn’t automatically mean the person has AUD. Some people may only be moderate or excessive drinkers.
Moderate drinking is limiting your daily alcohol intake to two drinks or fewer for men or up to one drink for women.5, 6, 7
Excessive drinking refers to binge and heavy drinking.
Binge drinking is equivalent to consuming five drinks or more within 2 hours for men or four drinks or more for women in the same time period.5, 6, 7
Heavy alcohol use involves:5, 6, 7
- Four drinks or more per day (or 14 drinks or more per week) for men
- Three drinks or more per day (or seven drinks or more per week) for women
- Binge drinking for 5 days or more in the past month
Although binge and heavy drinking aren’t equivalent to having AUD, these drinking patterns can lead to a higher risk of developing the condition.
Alcohol misuse is another term related to alcohol abuse. You misuse alcohol if you drink excessively (either binge drinking or heavy drinking on an ongoing basis), drink while you are pregnant, or drink when you are under 21 years old.5, 6, 7
Symptoms of Alcohol Addiction
To tell whether you have AUD, you should have at least 2 of the following 11 criteria set by the DSM-5:1, 2, 5, 8
- Intense cravings and urges to drink alcohol
- Continue drinking even though it leads to hazardous situations (like drunk driving)
- Continue drinking even though it causes social or interpersonal problems
- Drinking leads to neglect of school, work, and/or home obligations
- Developing alcohol withdrawal symptoms if you suddenly stopped drinking
- Developing alcohol tolerance (the need to drink more to achieve the same effects)
- Inability to stop drinking once started
- Consuming alcohol in large amounts or for longer periods than intended
- Spending ample amounts of time obtaining or drinking alcohol or recovering from its effects
- Giving up important activities to drink
- Continue drinking even though it causes or aggravates physical or psychological problems
- Continue drinking, even after deciding not to drink, or limiting the amount you drink on specific occasions
Your level of AUD will be classified based on the number of met criteria:
- Mild: Two to three
- Moderate: Four to five
- Severe: Six or more
Health Consequences of Alcohol Addiction
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
Too much alcohol can lead to inappropriate actions or activities, development of chronic diseases, acute alcohol poisoning, overdose, coma, or death.6
Alcohol also increases the risk of death from motor accidents, falls, injuries, homicide, and suicide.5
Chronic drinkers who suddenly stopped drinking may experience alcohol withdrawal. The symptoms may happen within several hours to a few days after the last drink. They include:6
- Problems sleeping
- Rapid heartbeat
- Hand tremors
Long-term alcohol use can lead to chronic diseases and other severe problems like:5, 6
- High blood pressure, heart disease, and/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
No matter how severe the drinking problem, treatment can help people with AUD quit alcohol and recover. In order for treatment to be successful, the person has to want to recover. It’s almost impossible if they want to keep drinking.
Everyone responds differently to treatments. Consult a health professional to determine the most suitable one for your needs.
Some treatment methods for AUD include:
People live in a rehab facility to receive 24-hour care and supervision. This is ideal for people with severe AUD or co-occurring disorders. The duration varies, usually lasting from 3 to 6 months, or sometimes longer for more severe cases.9, 10, 11
This treatment approach is cheaper and less intensive than inpatient rehab. It allows people to go home at night and maintain their usual routines while undergoing treatment.9, 10, 11
Partial Hospitalization Program (PHP)
This treatment approach is more intensive than outpatient, as it requires more hours of treatment. This is less intensive than inpatient treatment because it doesn’t require 24-hour care.11
Medication-Assisted Treatment (MAT)
Medications can help people reduce cravings, prevent relapse, and reduce withdrawal symptoms. The three medications approved by the U.S. Food and Drug Administration (FDA) are for AUD:9, 10
These medications are non-addictive. They can be used alone or in combination with behavioral treatments or support groups.1 MAT is helpful for some people as an adjunct to other forms of treatment. However, it’s not useful without other forms of therapy or treatment.
Therapists offer various types of alcohol counseling or talk therapy to educate, build motivation, develop coping strategies, and prevent relapse. Examples include cognitive behavioral therapy (CBT), motivational interviewing, and family therapy.1, 9, 10
Behavioral treatment is provided in group sessions and individual therapy. Many participants find the group sessions to be particularly valuable.
Support groups like Alcoholics Anonymous (AA) and Al-Anon provide peer support for stopping or reducing drinking. Their meetings are available in most communities at low or no cost and at convenient times and locations.1 These groups are often referred to as ‘12-step’ meetings, and are readily available in person, online, and in multiple different languages.
What to Do If You’re Addicted to Alcohol
If you think you have AUD, see a medical professional for diagnosis. They can help design a treatment plan, prescribe medications, and give referrals if necessary.
You can also talk to a mental health professional or seek help from a support group.
Don’t quit suddenly, as you may experience withdrawal symptoms. Alcohol withdrawal is potentially life-threatening. A doctor can prescribe medications to make detox safer and more comfortable.
What to Do If Someone You Care About is Addicted to Alcohol
Many people with AUD hesitate to get treatment because they don't recognize the problem.
If you spot symptoms of AUD in a loved one or you think someone drinks too much, seek advice from an addiction professional.
You can become part of an intervention to help these people recognize and accept that they need professional help.
Remember: for a person with AUD to recover, they must accept they have a problem and personally decide they want to overcome it. Forcing someone into treatment rarely results in successful recovery.
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- “Understanding Alcohol Use Disorder.” National Institute on Alcohol Abuse and Alcoholism (NIAAA).
- “Alcohol Use Disorder: A Comparison Between DSM–IV and DSM–5.” National Institute on Alcohol Abuse and Alcoholism (NIAAA).
- “Understanding alcohol use disorders and their treatment.” American Psychological Association (APA). 2018.
- Hasin, Deborah S et al. “DSM-5 criteria for substance use disorders: recommendations and rationale.” The American journal of psychiatry vol. 170,8 : 834-51.
- “Alcohol Use Disorder (AUD).” MedlinePlus.
- “Alcohol Use and Your Health.” Centers for Disease Control and Prevention (CDC). April 14, 2022.
- “Drinking Levels Defined.” National Institute on Alcohol Abuse and Alcoholism (NIAAA).
- “Diagnostic and statistical manual of mental disorders (5th ed.).” American Psychiatric Association. Arlington, VA: American Psychiatric Publishing. 2013.
- “Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition).” National Institute on Drug Abuse (NIDA). January 2018.
- “Treatment for Alcohol Problems: Finding and Getting Help.” National Institute on Alcohol Abuse and Alcoholism (NIAAA).
- “Overview of Substance Use Disorder (SUD) Care Clinical Guidelines: A Resource for States Developing SUD Delivery System Reforms.” Medicaid Innovation Accelerator Program (IAP). April 2017.