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Alcohol Use Disorder - Symptoms, Health Effects, and Management

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Alcohol use disorder (AUD) involves frequent or heavy alcohol drinking despite having adverse health effects. This article reviews alcohol use disorder.

Written by

Dr. Sameeha M S

Medically reviewed by

Dr. Vishal Patidar

Published At November 28, 2022
Reviewed AtMarch 26, 2024

Introduction

People with alcohol use disorder cannot control or stop drinking alcohol even though it affects their health, social life, and professional life. It is also known as alcohol abuse, alcohol dependence, or alcoholism. Heavy and frequent alcohol use will cause emotional distress, health problems, and brain damage. Drinking too much alcohol for an extended period of time will develop dependency and addiction. In alcohol use disorder, the person cannot stop drinking alcohol even after facing adverse effects associated with alcohol use. For them, alcohol will become an essential aspect of life, and they will lose control over drinking. Chronic alcohol addiction will cause altered daily activities and harmful health conditions.

What Is Alcohol Use Disorder?

Alcohol use disorder (AUD) involves an impaired ability to control or stop alcohol use even after having occupational, health, and social consequences. It is basically a medical condition with altered brain function. Alcohol use disorder (AUD) can be mild, moderate, and severe. Long-term alcohol use will cause chemical changes in the brain and produce pleasurable feelings during alcohol drinking. People will consume more and more alcohol to get this pleasurable feeling and end up in addiction. After some time, these pleasurable feelings will go away even after having alcohol, but the individual will not be able to stop alcohol use due to withdrawal symptoms. Withdrawal symptoms associated with alcohol use are unpleasant and dangerous. Alcohol use disorder (AUD) can be treated with the combined use of medications, behavioral therapies, and mutual support groups.

What Causes Alcohol Use Disorder?

Heavy alcohol use and misuse over a period of time will cause alcohol use disorder (AUD). Other factors which contribute to alcohol use disorder are the following:

  • Starting alcohol use at an early age in life. People who start drinking alcohol before age 15 are five times more likely to have alcohol use disorder.

  • Family history associated with alcohol addiction and problems. Parents' drinking patterns will definitely influence the child to develop the same.

  • Genetics plays an important role in developing alcohol addiction. A person's genes and environmental conditions will increase the risk of developing an alcohol use disorder.

  • Mental health conditions like depression, anxiety, grief, and post-traumatic stress disorder will increase the risk of developing alcohol use disorder (AUD).

  • Physical or mental trauma can also contribute to developing an addiction to alcohol use and dependency.

What Are the Symptoms of Alcohol Use Disorder?

  • Unable to control and limit alcohol drinking.

  • Strong urge or craving for alcohol.

  • Violent and angry behavior when questioned about alcohol drinking.

  • Irritable and cranking behavior when not allowed to drink.

  • Alcohol drinking obsession.

  • Poor professional performance due to frequent alcohol use.

  • Drinking more alcohol even after facing social, physical, and relationship problems.

  • Not remembering (blacking out) things that are happening in day-to-day life.

  • Using alcohol in situations like driving and swimming, which are normally not safe.

  • Reduced effects over the same amount of alcohol and increased consumption to produce the desired effects (tolerance).

  • Developing withdrawal symptoms like shaking, nausea, irritability, and sweating after not drinking alcohol or trying to avoid alcohol use.

What Are the Health Effects of Alcohol Use Disorder?

  • Liver Diseases - Heavy alcohol drinking will cause increased inflammation of the liver tissues (alcoholic hepatitis) and increased fat deposition in the liver (hepatic steatosis). It will also cause irreversible damage and scarring of the liver tissues, known as cirrhosis.

  • Heart Problems - Excessive alcohol drinking will cause high blood pressure and an increased risk of developing heart diseases and heart failure.

  • Immune System Problems - Excessive alcohol use will cause damage to the immune cells and increase the chances of illness and inflammation (especially pneumonia).

  • Increased Risk for Cancer - Long-term use of excessive amounts of alcohol will cause an increased risk of liver, mouth, breast, throat, and esophageal cancers.

  • Birth Defects - Alcohol use in pregnant women is associated with miscarriage, developmental disorders, and birth problems in the child, known as fetal alcohol spectrum disorders (FASDs).

  • Neurological Problems - Alcohol drinking will cause damage to the brain cells and results in short-term memory loss, confusion, pain, and numbness in the hands and feet.

  • Digestive Problems - Excessive alcohol drinking will cause stomach ulcers and gastritis (due to inflammation of the cells lining the stomach). It can also cause inflammation of the pancreas, known as pancreatitis.

  • Sexual Problems - Heavy alcohol use will cause an irregular menstrual cycle in females and erectile dysfunction in males.

  • Bone Defects - Alcohol drinking will cause damage to bone marrow and new bone formation. It will cause thinning of bones and an increased risk of bone fractures (osteoporosis).

  • Eye Problems - Heavy drinking will cause paralysis and weakness of the eye muscles.

  • Vitamin Deficiencies - Chronic alcohol use will cause altered absorption and metabolism of vitamins like vitamin B12 (folic acid) and thiamine (vitamin B1). These vitamins are needed for maintaining normal body functions and well-being.

  • Drug Interactions - Alcohol will interact with some medications and cause increased toxicity and adverse health effects.

How Can We Manage Alcohol Use Disorder?

  • Behavioral Therapies - These involve talk therapy or counseling given by a health care provider to help the individual to change drinking patterns and behavior. Reinforcement approaches, brief interventions, and motivation are the behavioral treatments used to reduce and prevent alcohol addiction and relapse. Counseling can identify the root cause associated with alcohol addiction and helps in recovery.

  • Medications - Acamprosate, Naltrexone, and Disulfiram are the three drugs approved by the United States food and drug administration for treating alcohol use disorder. Disulfiram will cause physical discomfort like vomiting, nausea, and headache after alcohol drinking and helps to stop its use. Naltrexone blocks brain receptors associated with alcohol and decreases alcohol cravings. Acamprosate helps to reestablish the chemical state of the brain before alcohol dependence and helps in the treatment.

  • Mutual Support Groups - Peer group support is used to reduce and stop alcohol drinking. Group meetings can be combined with medications and behavioral modifications to prevent relapse. Support groups are available at low cost in most regions and consist of 12-step programs like Alcoholics Anonymous (AA).

Conclusion

Alcohol use disorder (AUD) is the loss of control over alcohol drinking and alcohol dependence. It includes excessive alcohol drinking even after having physical and emotional disturbances. Individuals will not be able to stop drinking alcohol even if they wish to. Behavioral therapy coupled with medication and support groups can be used for the effective treatment of alcohol use disorder.

Frequently Asked Questions

1.

How Is Alcohol Use Disorder Defined?

Alcoholism is a medical condition characterized by troubling alcohol intake that creates clinically significant disorder or distress. It is a mild-to-severe disorder that can be identified based on the extent and number of symptoms such as drinking more or for longer than planned, persistent need to drink, unsuccessful attempts at cutting down, a significant amount of time drinking or trying to recover from alcohol, craving alcohol, continuing to drink despite knowing it causes problems, giving up critical tasks due to alcohol, physiological tolerance, and withdrawal symptoms. A healthcare provider can diagnose AUD using task sequences in the diagnostic Manual Of mental Disorders, 5th Edition (DSM-5).

2.

What Are the DSM (Diagnostic and Statistical Manual of Mental Disorders) 5 Criteria for Alcoholism?

The following are the DSM-5 requirements for alcohol addiction (AUD):
- Despite the negative consequences, drinking continues.
- Craving for alcohol. 
- Controlling drinking habits is difficult. 
- Physical alcohol tolerance.Withdrawal signs. 
- Significant time spent drinking or trying to recover from alcoholism. 
- Neglecting essential responsibilities as a result of alcohol consumption. 
- Continuing to drink despite interpersonal or social problems brought on by alcohol.

3.

Which of the Following Behaviors Is Most Likely to Indicate Alcohol Abuse?

The most common sign of alcohol abuse is drinking despite adverse consequences. This means that the person continues to consume alcohol even though it is causing negative effects in their life, such as health issues, strained relations, employee performance issues, financial troubles, or legal problems. This behavior demonstrates an absence of control over alcohol consumption and neglecting its adverse effects on the individual's life, which are characteristics of alcohol abuse.

4.

What Is the Prognosis for Someone Suffering From an Alcohol Use Disorder?

The prognosis of someone suffering from an alcohol use disorder (AUD) varies depending on several factors, including the intensity of the addictive behavior, the length of time they have been drinking, their age, overall health, and any co-occurring mental health conditions. Individuals who seek treatment, participate in therapy and support groups and make lifestyle changes may be able to achieve and sustain long-term sobriety. However, recovery from AUD is frequently a lifelong process fraught with setbacks and relapses. Left untreated, AUD can cause various physical and mental health issues, such as liver damage, brain damage, cardiovascular disease, and depression. It can even be fatal in severe cases.

5.

What Is the Prognosis for an Individual Diagnosed With Alcohol Use Disorder?

The prognosis for someone suffering from an alcohol use disorder is determined by several factors, including the severity of the addictive behavior, the individual's general health, and any co-occurring psychological or medical conditions. However, with proper treatment and support, recovery is possible, and many people achieve and maintain long-term alcoholism.

6.

What Are the Different Types of Alcoholic Consumption?

There are three types of alcoholic drinks:
- Binge drinking is described as excessive alcohol consumption in a short amount of time.
- Heavy drinking is defined as consuming excessive amounts of alcohol regularly over an extended period. 
- Alcohol dependency or addiction is defined as compulsive and uncontrollable drinking in the face of negative consequences.

7.

What Are the Contributing Factors to the Development of Alcohol Use Disorder in an Individual?

Several factors, such as :
- AUD, can run in families and may have a genetic component. Anxiousness, depressed mood, and trauma are all disorders of mental health that can raise the risk of developing AUD. 
- Binge drinking can be influenced by external factors such as cultural and social influences, social conditioning, and stress. 
- Alcohol has a biological impact on the brain, and changes in the brain's chemical reactions can make going to quit difficult. 
- Biological factors like, Alcohol affects the brain, and changes in brain chemistry can make quitting difficult. Men and young adults are more likely than women to develop AUD.

8.

What Exactly Is Excessive Alcohol Consumption?

Excessive alcohol consumption is defined as consuming more alcohol than is considered safe or moderate. This is typically prescribed for men as intaking more than fourteen standard drinks per week or four drinks in a single day. Drinking more than seven standard drinks per week or three drinks in a single day is considered excessive for women. These guidelines are based on research from of the NIAAA (National Institute on Alcohol Abuse and Alcoholism).

9.

What Are the Overall Effects of Alcohol?

Alcohol has several general effects on the body, including:
- Short-term effects, mild retardation, motor coordination, decreased reaction time, increased risk of accidents and injury, and altered mood and behavior. 
- Long-term consequences include liver, brain, heart, and other organ damage, an increased risk of cancer, a weakened immune system, and an increased risk of addiction and dependence. Personal relationships are strained, there is an increased risk of domestic violence and sexual assault, and work and academic performance suffer.

10.

Which Therapy Is Best for Alcoholism?

The best therapy for alcoholism is determined by the individual's specific needs and addiction severity. However, several evidence-based treatments for alcohol use disorder are effective, including:
- Cognitive-Behavioral Therapy (CBT): Assists people in identifying and changing problematic thoughts and behaviors associated with alcohol use.
- Motivational Enhancement Therapy (MET): Assists people in increasing their motivation to change their drinking habits. Medications such as naltrexone, acamprosate, and disulfiram can help reduce cravings and keep you from relapsing.12-step programs, such as Alcoholics. 
- Alcholics Anonymous (AA): Provides support and a structured recovery program. Individual therapy, group therapy, and support groups are part of inpatient or outpatient treatment programs, offering a comprehensive and structured approach to recovery.

11.

What Is the Most Effective Psychological Addiction Treatment?

The most effective psychological addiction treatment depends on the individual and the nature of the addiction. However, several evidence-based psychological treatments are effective in treating addiction, including:
- Cognitive-Behavioral Therapy (CBT): Aids in the identification and modification of problematic thoughts and behaviors related to substance use.
- Motivational Enhancement Therapy (MET): This type of therapy assists individuals in increasing their motivation to change their substance-use behavior. Contingency management rewards positive behavior change, such as abstaining from drugs or alcohol. Family therapy involves family members in the treatment process and addresses family dynamics that may contribute to substance use. Mindfulness-based approaches, such as meditation and yoga, can help people gain more awareness and control over their thoughts and behaviors.
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Dr. Vishal Patidar
Dr. Vishal Patidar

General Medicine

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