WHAT IS ALCOHOL USE DISORDER (AUD)?
When a person has uncontrolled and problematic drinking, he or she may have a health condition called alcohol use disorder (AUD), commonly known as alcoholism. Health professionals use a list of symptoms to diagnose AUD. Depending on how many symptoms the person has, AUD can be mild, moderate, or severe. Even a mild disorder can lead to problems, so treatment is important.
What Are The Symptoms?
Alcohol use disorder (AUD) is a condition that health care professionals diagnose when a patient’s drinking pattern causes significant distress or harm. Previously known as alcohol abuse or alcoholism, AUD can be mild, moderate, or severe. AUD can cause lasting changes in the brain that make patients vulnerable to relapse. The good news is that no matter how severe the problem may seem, most people with AUD can benefit from treatment with behavioral therapies, medications, or both.
AUD is diagnosed when a person answers “yes” to two or more of the questions below.
In the past year, have you:
- Had times when you ended up drinking more, or longer, than you intended?
- More than once wanted to cut down or stop drinking, or tried to, but couldn’t?
- Spent a lot of time drinking? Or being sick or getting over the aftereffects?
- Experienced craving—a strong need, or urge, to drink?
- Found that drinking—or being sick from drinking—often interfered with taking care of your home or family? Or caused job troubles? Or school problems?
- Continued to drink even though it was causing trouble with your family or friends?
- Given up or cut back on activities that were important or interesting to you, or gave you pleasure, in order to drink?
- More than once gotten into situations while or after drinking that increased your chances of getting hurt (such as driving, swimming, using machinery, walking in a dangerous area, or having unsafe sex)?
- Continued to drink even though it was making you feel depressed or anxious or adding to another health problem? Or after having had a memory blackout (i.e., forgetting, after drinking, where you were or what you did while drinking)?
- Had to drink much more than you once did to get the effect you want? Or found that your usual number of drinks had much less effect than before?
- Found that when the effects of alcohol were wearing off, you had withdrawal symptoms, such as trouble sleeping, shakiness, irritability, anxiety, dysphoria, depression, restlessness, nausea, or sweating? Or sensed things that were not there?
Any of these symptoms may be cause for concern. The more symptoms, the more urgent the need for change. A health professional can look at the number, pattern, and severity of symptoms to see whether AUD is present and help set a good course of action back to health.
The latest science shows that AUD can cause lasting changes in the brain. That's why AUD is best treated by a health professional. The good news is that effective treatment can help the brain heal, while giving people with alcohol problems the skills and support they need to recover.
Some people who drink heavily may not have AUD, but their drinking patterns put them at risk for AUD and other problems.
What Are The Treatments?
Health care professionals provide two types of treatment for alcohol use disorder:
- Talk therapy. A licensed therapist can help people build coping strategies and skills to stop or reduce drinking. Treatment can include one-on-one, family, or group sessions.
- Medications. A primary care clinician or a board-certified addiction doctor can prescribe non-addicting medications. These can help people stop drinking and avoid relapse.
Three medications have been approved by the US Food and Drug Administration to help people with alcohol use disorder (AUD) stop or reduce their drinking and avoid relapse:
- Naltrexone works by blocking the receptors in the brain that are involved in craving alcohol or the rewarding effects of drinking. It comes either as a pill that is taken daily, or as an injection that can be given once per month.
- Acamprosate is prescribed to help people with AUD maintain abstinence from alcohol by alleviating some negative symptoms of prolonged abstinence. It is a pill that is taken three times per day.
- Disulfiram is a pill that causes unpleasant symptoms such as nausea and flushing of the skin when a person drinks. Wanting to avoid those unpleasant effects can help some people refrain from drinking.
All of these medications are designed to help manage a chronic disease, just as someone might take medications to keep their asthma or diabetes in check.
Not all people will respond to medications, but for some individuals, they can be an important tool in overcoming alcohol use disorder.