Alcohol Use Disorder

Alcohol Use Disorder (AUD) is a chronic illness characterized by an inability to control or stop drinking, despite its negative impact on various aspects of one’s life, including social interactions, employment, and overall health. AUD exists on a spectrum, encompassing mild, moderate, and severe cases, with the severity determined by the number of symptoms present. This article aims to provide a comprehensive understanding of AUD, its symptoms, risk factors, diagnosis, treatment options, and the impact it has on different groups. Additionally, we explore the stages of AUD and offer insights into living with and recovering from this disorder.

Defining AUD

AUD is an overarching term that includes a range of alcohol-related problems, from alcohol abuse to alcohol dependence (often referred to as alcoholism). Alcohol abuse implies the repetitive occurrence of serious consequences due to excessive drinking. In contrast, alcohol dependence signifies a loss of control over one’s drinking habits, leading to compulsive alcohol consumption.

Understanding Safe Alcohol Consumption

Experts recommend drinking in moderation to minimize the risk of developing AUD. Moderate drinking guidelines suggest no more than one drink per day for women and no more than two for men. A standard drink equates to:

• 1.5 ounces of liquor (e.g., whisky, rum, or tequila)
• 5 ounces of wine
• 12 ounces of beer

Another perspective on alcohol consumption is to assess weekly intake. “Heavy” or “at-risk” drinking for women exceeds seven drinks per week or more than three in a single day. For men, it extends beyond 14 drinks weekly or more than four in a day.

Symptoms of AUD

AUD affects an estimated 16 million people in the United States, including both adults and adolescents. Common symptoms of AUD encompass:

• Uncontrollable cravings or a strong urge to consume alcohol.
• Inability to regulate the quantity of alcohol consumed.
• Negative thoughts and feelings when not drinking.
• Drinking in situations where it poses a risk.
• Alcohol consumption interfering with one’s enjoyment of life.
• Persistently drinking despite adverse consequences.
• Neglecting or reducing participation in significant activities due to alcohol use.
• Risky behaviors while under the influence of alcohol.
• Mixing alcohol with medications.
• Alcohol use during pregnancy or while caring for small children.
• Dishonesty about the amount of alcohol consumed.
• Harming others or displaying aggression when drinking.
• Impaired memory during alcohol consumption.
• Neglecting responsibilities due to alcohol use.
• Legal problems arising from alcohol-related incidents.
• Unsuccessful attempts to cease drinking.
• Obsessive thoughts about alcohol.
• Increased tolerance, necessitating higher consumption for the same effect.
• Withdrawal symptoms upon ceasing alcohol consumption, such as shakiness, nausea, insomnia, or seizures.

Causes and Risk Factors

AUD can have various causes and risk factors, affecting different individuals. These contributing factors may include impulsivity, low self-esteem, a need for social approval, using alcohol to cope with emotional issues, peer pressure, easy access to alcohol, a history of physical or sexual abuse, a family history of alcohol problems, regular binge drinking, early initiation of alcohol use, bariatric surgery, and socioeconomic status. Recognizing these factors can aid in early intervention and prevention.

Diagnosis of AUD

Healthcare professionals assess AUD through inquiries about an individual’s drinking habits and discussions with family and friends. Physical examinations and lab tests may be conducted to gauge the impact of alcohol use on health. The Diagnostic and Statistical Manual of Mental Disorders (DSM) outlines the criteria for AUD diagnosis. If an individual meets two or more of the 11 criteria within a 12-month period, they may receive a diagnosis. The severity of AUD—mild, moderate, or severe—is determined by the number of criteria met.

Stages of AUD

AUD can evolve through various stages, beginning with at-risk drinking and progressing to severe forms. The stages include:

1. At Risk: Occasional drinking for social reasons, with the body starting to build tolerance to alcohol.

2. Early AUD: Increased drinking, often in solitude or secretly, accompanied by obsessive thoughts about alcohol. Blackouts may occur.

3. Mid-stage AUD: Loss of control over drinking, resulting in problems with work, finances, family, and health.

4. End-stage AUD: An overwhelming preoccupation with alcohol, accompanied by apathy towards food, family, friends, health, and happiness. Serious organ damage and a risk of death become imminent.

Treatment for AUD

Treatment options for AUD depend on the individual’s case. The primary goal is to abstain from alcohol and enhance the overall quality of life. Withdrawal symptoms can occur if alcohol consumption is stopped suddenly, which can be life-threatening and require medical attention.

Treatment methods include:

1. Counseling and Support: Therapy, either individually or in group settings, helps individuals comprehend their disorder’s underlying causes and offers support to stay alcohol-free.

2. Medication: For moderate or severe AUD, doctors may prescribe medications such as Acamprosate, Disulfiram, Naltrexone, or Topiramate.

3. Residential Treatment: Individuals with severe AUD may benefit from residing in treatment facilities with experienced medical professionals who provide therapy, support groups, education, and other activities.

Effects on Different Groups

In the United States, AUD affected a substantial number of people in 2021. The prevalence of AUD varied among different racial and ethnic groups. However, not everyone receives the same access to alcohol screenings. A study found that Black, Latino, and other ethnic groups, especially those with lower education levels and reliance on Medicare or Medicaid, were less likely to undergo thorough alcohol screenings. This discrepancy in access to quality screenings has significant implications for preventive care and treatment.

Effects and Complications of AUD

AUD can have both short-term and long-term effects, impacting physical and mental health. Short-term effects may include memory loss, hangovers, and blackouts. Long-term consequences involve issues such as stomach problems, heart problems, cancer, brain damage, permanent memory loss, pancreatitis, high blood pressure, and cirrhosis. Additionally, AUD increases the likelihood of engaging in risky behaviors, leading to accidents, homicides, suicides, and other adverse outcomes.

Living with AUD

Living with AUD can be challenging, but recovery is possible. Various support networks, including Substance Abuse and Mental Health Services Administration (SAMHSA) hotlines and Alcoholics Anonymous, can help individuals in their journey to recovery. In addition to formal treatment, individuals can incorporate practices like meditation, yoga, healthier socialization, new hobbies, and lifestyle changes to aid in their recovery.

Prognosis and Outlook

Recovery from AUD is attainable but often challenging, with potential setbacks. Early intervention and consistent treatment adherence are vital for successful recovery. Talk therapy can assist in learning to manage triggers, and medications can be prescribed to mitigate the risk of relapse in high-risk situations. Recognizing that recovery is an ongoing process is crucial, and with the right support, individuals can regain control over their lives and health.

Conclusion

Alcohol Use Disorder is a complex condition that affects a significant portion of the population. Understanding the symptoms, risk factors, diagnosis, treatment options, and consequences is essential for early intervention and prevention. Additionally, recognizing the unequal access to quality screenings for AUD among various ethnic groups emphasizes the need for equitable healthcare practices. Recovery is possible, and with the right support and commitment, individuals can overcome AUD and lead healthier, more fulfilling lives.