Alcohol use disorder (Alcohol addiction)

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at January 13, 2016
StartDiseasesAlcohol use disorder (Alcohol addiction)

Alcohol use disorder is a medical condition that the DSM-5 which is the current diagnostic and statistical manual of mental disorders, defines as having characteristics of alcohol abuse and alcohol dependence. It is characterized as a pattern of drinking that causes distress or harm.

Contents

Definition & Facts

A person with alcohol use disorder does not have control over alcohol. He or she continues to drink even when health or safety is impaired, is preoccupied with alcohol, and may binge drink. The disorder can range from mild to severe, and mild disorder may worsen over time.

Alcohol use disorder can cause accidents, poor work performance, financial problems, relationship issues and increased risk of suicide. It can also lead to other medical problems, including memory loss, liver disease, hepatitis, gastritis, bone damage, and heart problems. Because alcohol use disorder affects nearly every part of a person’s nervous system and circulatory system, any preexisting condition will most likely be aggravated by alcohol use disorder.

Symptoms & Complaints

People who suffer from alcohol use disorder will undergo alternate periods of intoxication and withdrawal. The more alcohol present in the bloodstream, the more intoxicated a person will become. Behavior and mental changes are results of intoxication, including slurred speech, poor judgment, memory problems and coordination problems. Extremely high levels of alcohol in the bloodstream can even result in blackouts, coma, or death.

Withdrawal occurs when heavy alcohol use is stopped suddenly. Symptoms of withdrawal can start occurring within a few hours of stopping, but may not occur for several days. Evidence of withdrawal includes fast heart rate, tremors, anxiety, sleeping problems, and sweating. Severe withdrawal may result in nausea and vomiting, hallucinations, seizures, and even death.

General signs that a person might be experiencing alcohol abuse disorder include the following:

  • They cannot cut off their drinking easily once they have begun, regardless of a desire to do so
  • Their urge to drink alcohol is strong, even at inappropriate times such as during the work day or when driving
  • They continue to drink even though their work is impaired, they are in danger, or their relationships are damaged
  • They experience withdrawal symptoms when they are not drinking

Causes

Alcohol use disorder can be the result of genetic as well as environmental conditions. There is evidence that the disorder runs in families, so a person with relatives who have abused alcohol should be aware of the increased risk.

Depression and mental health problems may put one at risk for developing alcohol use disorder. People with a lot of anxiety, excessive stress, depression or other mental disorders are at a higher risk of developing alcohol use disorder.

Because alcohol is an addictive substance, drinking too much over a period of time will cause certain portions of the brain to change, resulting in an inappropriate desire for alcohol in order to achieve positive feelings of well-being.

Beyond genetics, it is clear that social and cultural factors play a large role in increasing the probability of developing the disorder. Poverty and peer pressure can increase the risk for developing the disorder. People may drink to excess to feel socially accepted, a practice that can increase the risk of acquiring alcohol use disorder.

Diagnoses & Tests

Alcohol use disorder may be diagnosed by psychological evaluations that assess symptoms. In addition, complications from alcohol use disorder such as alcoholic liver disease may be observed. Blood tests and biopsies as well as imaging like CT scans and ultrasounds, may detect diseases of the liver, pancreas, brain, heart, and other organs damaged by chronic alcohol abuse.

Treatment & Therapy

Treatment will vary depending on whether the individual's disorder is mild, moderate, or severe. If the disorder is severe, a medically managed period of detoxification and treatment of withdrawal may be needed in a rehabilitation center or hospital. A doctor may also prescribe medications that can help with the detoxification.

Psychological counseling such as cognitive behavior therapy (CBT) and lifestyle skill training to cope with the behaviors and mental issues that led to the abuse can be helpful in creating alternate habits. If excess drinking was the result of, or caused relationship problems, couples and family counseling can be beneficial. Support groups such as Alcoholics Anonymous can also be constructive to those recovering from alcohol addiction as they give the patient a sense of community and encouragement from peers.

Prevention & Prophylaxis

If a person feels they or a loved one may be at risk for alcohol abuse disorder, they should be aware of common risk factors. It is important for the person at risk of alcohol use disorder to have a strong support system of friends and family to affirm their value and help them deal with physical and mental challenges properly rather than turning to alcohol as a solution. Healthy habits such as adequate sleep, exercise, and stress management are also important in preventing the disorder.