Symptoms of Alcohol Use Disorder (AUD)
In This Article
Alcohol use disorder (AUD), or alcoholism, is a chronic relapsing brain disease. AUD encompasses all forms of alcohol problems, including alcohol abuse and alcohol addiction.
Long-term alcohol misuse affects your brain function. It causes intense cravings and the compulsion to drink.
A person with AUD will struggle to control their drinking habits. They continue to drink alcohol despite its harmful effects.
11 Symptoms of Alcohol Use Disorder (AUD)
A person with AUD will exhibit signs of alcohol dependence, abuse, or addiction. The symptoms that appear depend on factors such as:
- How much alcohol was consumed
- How often someone drinks
- How long they have been drinking
There are 11 clear signs of alcohol use disorder:
- Increasing alcohol intake or drinking for longer than intended
- Failing attempts to reduce or stop alcohol consumption
- Spending more time drinking or recovering from its effects
- Having intense cravings for alcohol
- Neglecting personal responsibilities in favor of alcohol use
- Continuing to use alcohol despite social problems
- Having less time for interests, hobbies, and social activities
- Drinking in unsafe situations, such as when driving
- Consuming alcohol despite physical and psychological problems
- Increasing tolerance to alcoholic drinks
- Experiencing withdrawal symptoms when you stop drinking
How is AUD Diagnosed?
A medical professional can diagnose AUD using the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). According to the DSM-5, you must have two of the symptoms mentioned previously to be diagnosed with an alcohol use disorder.
The number of symptoms helps doctors determine the severity of your addiction.3
- Mild: 2 to 3 positive symptoms
- Moderate: 4 to 5 positive symptoms
- Severe: 6 or more positive symptoms
Causes & Risk Factors of AUD
Various internal and external factors play a role in the development of alcohol addiction. Although drinking is a personal choice, studies show that some factors are out of a person's control.
These factors include:
- Genetic factors: A family history or a genetic predisposition to AUD
- Psychological factors: Mental health conditions like depression, anxiety, or trauma
- Environmental factors: Ease of access to alcohol as well as financial status
- Social and cultural factors: Cultures that encourage drinking and peer pressure
Early Warning Signs of Heavy Alcohol Use
Early symptoms can range from mild to severe, depending on how many drinks you've had. These effects usually wear off when your blood alcohol content returns to normal, but some people may get a hangover from heavy or binge drinking.2
These symptoms include:1
- Slow reaction times
- Unsteady gait
- Slurring of speech
- Poor memory recall
- Blackouts or memory lapses
- Making poor decisions
- Engaging in risky behaviors
It's normal to have these symptoms once in a while. But if you frequently experience them or know someone who does, it may indicate early signs of an alcohol use disorder.
Physical and Psychological Symptoms of AUD
Alcohol use disorder impacts your physical and mental health. It can lead to a range of symptoms like:
- Poor hygiene: Not changing clothes or bathing as often
- Signs of malnutrition: Weight loss and hair thinning
- Physical health problems: High blood pressure, digestive problems, etc.
- Mental health problems: Depression and anxiety
Alcoholics will show a gradual decline in appearance and mental health. As their condition progresses, their physical and psychological symptoms also worsen.
Behavioral Signs of AUD
People struggling with AUD exhibit changes in their normal behavior, affecting their:
- Role in society
Here are some behavioral signs of alcoholism:
- Being more secretive about how they spend their time
- Acting defensive when confronted about their drinking
- Drinking more in private or in public with new friends
- Hiding alcoholic drinks at their home or office
- Being drunk at work, family gatherings, and meetings
- Increasing relationship problems
- Having mood swings when intoxicated
- Getting into legal and/or financial troubles
- Drinking while driving
You have to know a person well enough to notice these changes. If you know them personally, you can easily identify these behavioral signs.
What Is Alcohol Tolerance?
Alcohol tolerance happens when you no longer get the same effects of alcohol as when you started drinking.4 Developing a tolerance for alcohol often causes you to drink more to get drunk or achieve the same experience.
Alcohol tolerance typically develops due to excessive alcohol consumption. It can also lead to AUD or worsen your condition.
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Late Signs and Symptoms of Alcohol Use Disorder
Alcohol use disorder involves a persistent pattern of unhealthy drinking. Unless treated or managed, it will negatively impact your health.
The following consequences are signs of severe alcoholism:
Health Risks of Chronic Heavy Drinking
The World Health Organization (WHO) links alcohol to over 200 diseases and health issues.7 People with alcohol use disorder have a higher risk for these conditions:
- Alcohol-related liver disease: Liver cirrhosis and fatty liver
- Digestive problems: Gastritis, chronic pancreatitis, and frequent diarrhea
- Cardiovascular problems: Heart disease and anemia
- Sexual complications: Infertility and erectile dysfunction
- Degenerative bone disease: Bone thinning or osteoporosis
- Brain damage: Alcohol-related dementia
- Infections: Pneumonia and tuberculosis
- Other chronic diseases: Diabetes and certain cancers
Because alcohol prevents the gut from absorbing vitamins and nutrients, alcoholics also have a weaker immune system. Vitamin deficiencies can also lead to muscle weakness and nerve damage.9,10
Early intervention can reduce the adverse effects of alcohol on your body. It can also prevent alcohol-related problems from developing or becoming worse.
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The Dangers of Alcoholism
Chronic and excessive alcohol use damages the brain, impairing your thinking and judgment. This leads to impulsive behavior and poor decisions. As a result, you may put yourself and others around you in dangerous and life-threatening situations.
Here are some dangers of alcohol use disorder:
- Getting involved in violent crimes
- Financial problems
- Having unprotected sex with multiple partners
- Unintended pregnancy or being infected with a sexually transmitted disease
- Experimenting with other addictive substances
- Severe congenital disabilities or fetal alcohol syndrome for unborn children of pregnant women
- Reckless behavior, such as driving under the influence (DUI)
Mental Health Risks of Alcoholism
Alcohol can trigger or worsen depression because it's a central nervous system (CNS) depressant. It counteracts the effects of antidepressant medications.
Excessive drinking may also increase the risk of:11
- Suicidal ideation
Although all substances elevate the risk for suicidal behavior, alcohol is the most common substance linked to suicide. Furthermore, the rising rates of alcohol misuse are accompanied by a 35% increase in alcohol-related suicide deaths.11
For people with alcohol use disorders, suicidal behavior usually does not appear until the later stages of alcohol addiction. This is the time when they already suffer from social isolation and other side effects of a drinking problem.11
Alcohol Withdrawal Syndrome
Alcohol withdrawal is your body's reaction to a sudden decrease in alcohol after being used to its presence. It occurs within 6 hours since your last drink. Withdrawal symptoms peak within 12 to 48 hours and persist for 72 hours in more severe cases.
Signs of Alcohol Withdrawal
The signs of alcohol withdrawal include:
- Shakes or tremors
- Difficulty sleeping
- Rapid pulse
Alcohol withdrawal is potentially dangerous and requires immediate medical attention. Contact a healthcare professional if you notice any withdrawal symptoms.
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Are the Symptoms of AUD Reversible?
Yes, you can reverse some of them with substance abuse treatment. However, other conditions may require additional intervention.
Your recovery will depend on factors like:
- How long you have been drinking
- How much alcohol you drink
- How often you drink alcohol
Getting early treatment and staying sober gives you the best chances of recovering. The earlier you start treatment, the more likely you can reverse your symptoms.
Am I an Alcoholic?
The simplest way to find out if you have alcohol use disorder is to take the CAGE test. It is a screening tool that checks for the presence of substance abuse.
The test requires you to answer four questions:
- Cutting down alcohol use: Do you feel the need to cut down your drinking?
- Annoyance by criticism: Do you find it annoying when people criticize your drinking?
- Guilt: Do you feel guilty about drinking?
- Eye openers: Do you feel the need to drink first thing in the morning?
You may have an alcohol problem if you answered yes to two questions. Take note that CAGE is only used as an initial assessment. Your doctor might request a further evaluation to confirm a positive diagnosis.12
When Should You See a Doctor for AUD?
The National Institute on Alcohol Abuse and Alcoholism (NIAAA) says that the more symptoms you have, the sooner you should see a doctor.13 But remember that there is no "right time" for treatment.
If you think you have a drinking problem, you should see a doctor immediately, regardless of how many symptoms you have. You should also consider seeing a mental health professional if you have co-occurring disorders.
You will need immediate medical help if you have signs of alcohol poisoning, such as:
- Slow or irregular breathing
- Confused mental state
- Low body temperature
- Pale or blue-tinged skin
- Passing out or becoming unconscious
- Severe vomiting
What to Do if You Think Someone Is an Alcoholic
Studies show that the best way to help someone with a substance use problem is to intervene before it worsens.14 To do that, you first need to learn as much as you can about alcoholism.
Knowing the signs and symptoms of alcohol use disorder will allow you to identify its presence. If you have a loved one with AUD symptoms, you should speak to a medical professional about the next steps.
If the person is unwilling to undergo treatment, a doctor or counselor can help you plan and facilitate the intervention. They can also link you to support groups in your area, such as Alcoholics Anonymous.
Treatment for Alcohol Use Disorder (AUD)
Early addiction treatment can improve your recovery outcome. Doctors can evaluate your condition, provide treatment, and offer resources to help you cope with your drinking problem. They can also help you explore treatment options that cater to your needs.
Here are some of the best treatments for AUD:
- Inpatient programs: The most intensive and effective option for alcohol addiction; usually last 30, 60, or 90 days
- Partial hospitalization programs (PHPs): The second most intensive alcohol addiction program; allow you to return home at night after treatment
- Outpatient programs: A flexible treatment program that allows you to customize treatment sessions around your schedule
- Cognitive behavioral therapy (CBT): A short-term therapy technique that explores the link between thought patterns and addiction
- Dual diagnosis treatment: A treatment program that addresses co-occurring mental health conditions alongside addiction
- Medication-assisted therapy (MAT): Uses a combination of therapy and medication to assist you throughout detoxification and withdrawal
- Support groups: Peer-led organizations made of people dedicated to helping each other stay sober
Alcohol use disorder (AUD), or alcoholism, is a chronic relapsing brain disease. It occurs when a person frequently drinks too much alcohol.
AUD is typically associated with various mental and physical side effects that can significantly impact your life. These include long-term health problems, such as alcoholic liver disease and heart disease.
Fortunately, most of the side effects of AUD are reversible. Various treatment options are available to help you recover from addiction and maintain sobriety.
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End-Stage Alcoholism: Symptoms, Side Effects, and Recovery
Children of Alcoholics: Statistics on the Effects of Alcohol on Families
- Dasgupta, A. "Alcohol a double-edged sword: Health benefits with moderate consumption but a health hazard with excess alcohol intake." Alcohol, Drugs, Genes and the Clinical Laboratory, 2017.
- U.S. Department of Health and Human Services. "Hangovers." National Institute on Alcohol Abuse and Alcoholism, 2021.
- Hasin et al. "DSM-5 Criteria for Substance Use Disorders: Recommendations and Rationale." The American Journal of Psychiatry, 2013.
- Elvig et al. “Tolerance to alcohol: A critical yet understudied factor in alcohol addiction.” Pharmacology Biochemistry and Behavior, 2021.
- Duke University. "Content: The Blood Alcohol Concentration (BAC) Estimates the Degree of Intoxication." The Alcohol Pharmacology Education Partnership.
- "Drinking Patterns and Their Definitions." Alcohol Research Current Reviews, 2018.
- "Global status report on alcohol and health 2018." World Health Organization, 2018.
- Barve et al. “Development, Prevention, and Treatment of Alcohol-Induced Organ Injury: The Role of Nutrition.” Alcohol Research Current Reviews, 2017.
- Simon et al. “Alcoholic Myopathy: Pathophysiologic Mechanisms and Clinical Implications.” Alcohol Research Current Reviews, 2017.
- Sadowski, A., and Houck, R.C. “Alcoholic Neuropathy.” StatPearls Publishing, 2022.
- Rizk et al. “Suicide Risk and Addiction: The Impact of Alcohol and Opioid Use Disorders.” Current Addiction Reports, 2021.
- Basu et al. “Use of Family CAGE-AID questionnaire to screen the family members for diagnosis of substance dependence.” Indian Journal of Medical Research, 2016.
- Indian Journal of Medical Research. "Treatment for Alcohol Problems: Finding and Getting Help." National Institute on Alcohol Abuse and Alcoholism, 2023.
- Substance Abuse and Mental Health Services Administration (US); Office of the Surgeon General (US). “Facing Addiction in America: The Surgeon General's Report on Alcohol, Drugs, and Health.” U.S. Department of Health and Human Services, 2016.
- Nehring et al. “Alcohol Use Disorder.” StatPearls Publishing, 2023.