Alcohol Abuse and Alcoholism: Signs, Symptoms, and Diagnosis (2024)

Drinking alcohol too much or too often, or being unable to control alcohol consumption, can be a sign of alcohol misuse and, in some cases, alcohol use disorder (AUD).

AUD previously went by other names such as “alcohol abuse,” “alcohol dependence,” and “alcoholism.” To differentiate AUD from alcohol misuse and to reduce stigma around the condition, in 2013, the DSM–5 integrated these terms into a single, diagnosable disorder called alcohol use disorder (AUD).

Alcohol misuse refers to single episodes during which you might drink excessively. When this occurs repeatedly over time, and when it begins to impact your health and your life, alcohol misuse can become AUD. The disorder can also be broken down further into mild, moderate, and severe subtypes.

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) says that about 14 million adults in the United States live with AUD. These disorders can be disruptive and life threatening.

However, since alcohol affects people in different ways, recognizing AUD in yourself or in others can be subjective and challenging. Read on to learn more about the symptoms, risk factors, treatments, diagnosis, and where to get support.

Alcohol affects different people in different ways. Generally, however, the difference between alcohol misuse and AUD lies in looking at how a person drinks in the short term, as opposed to over a prolonged period of time.

In addition, AUD is an addiction disorder, which means you may have a difficult time stopping alcohol consumption, even when you want to. The definition of AUD also includes the impact that such drinking has on your health and life.

Alcohol misuse

According to the Centers for Disease Control and Prevention (CDC), moderate drinking is typically defined as two drinks or fewer for men per day, or one drink or less for women.

If you are drinking more than that at any one time, you may be misusing alcohol. Excessive drinking is defined as 15 drinks or more a week for men and eight drinks or more a week for women.

But alcohol misuse can also be about how or when you drink. For example, any alcohol consumption by a pregnant person can be considered alcohol misuse, as well as drinking under the legal age of 21.

Alcohol use disorder

AUD refers to what is colloquially known as alcoholism, which is a term that the DSM-5 no longer uses.

According to the DSM-5, you may have at least mild AUD if you’ve experienced at least two of the following in the last year:

  • had times when you ended up drinking more, or longer, than you intended
  • wanted to cut down or stop drinking, or tried to, but couldn’t
  • spent a lot of time drinking, being sick, or getting over other after effects
  • wanted a drink so badly you couldn’t think of anything else
  • found that drinking — or being sick from drinking — often interfered with taking care of your home or family, or caused job 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
  • 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
  • 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, restlessness, nausea, sweating, a racing heart, or a seizure, or you sensed things that were not there

The symptoms of alcohol misuse and AUD can overlap. But alcohol misuse, also known as excessive drinking, has a more immediate impact, whereas the symptoms of AUD will be more prolonged.

Physical symptoms of alcohol misuse

A high concentration of alcohol in the blood causes physical symptoms, such as:

  • slurred speech
  • slowing of reflexes
  • a decreased ability to control bodily movements
  • difficulty concentrating
  • gaps in memory, or brownouts
  • poor decision-making abilities
  • staying conscious but not having memory of your actions, which is called a blackout
  • hangovers

Very high concentrations of alcohol in the blood can cause breathing problems, coma, or death. It can also lead to alcohol poisoning.

Behavioral symptoms of excessive drinking

Becoming cognitively impaired from excessive drinking of alcohol can lead to risky behaviors that can result in injury or death of an affected person or of others.

Research shows a high correlation between alcohol misuse and high-risk sexual behavior, violence, crime, self-injury, and fatal injury from things like motor vehicle accidents. People with AUD represent about 20–35 percent of completed suicides.

You shouldn’t attempt to drive or operate heavy machinery while under the effects of alcohol. In the United States, the legal limit for driving under the influence of alcohol is 0.08 percent, except in the state of Utah, where it’s 0.05 percent.

Physical complications of alcohol use disorder

Many people with AUD continue to drink even as they develop health problems related to drinking. Over the long term, AUD may lead to serious health conditions, while worsening others.

These can include:

  • insomnia
  • sexual dysfunction
  • alcohol-associated liver damage or scarring (cirrhosis)
  • brain damage
  • pancreatitis
  • gastrointestinal bleeding
  • dementia

Additionally, research shows that prolonged consumption of alcohol may be associated with a rise in high blood pressure and can increase the risk of cardiovascular problems over time.

It may also lead to the development of different types of cancer. This is because when you drink, your body breaks down alcohol into acetaldehyde. This is a chemical that can damage your DNA and lead to cells growing out of control.

Another complication is alcohol withdrawal syndrome, which may occur after you stop drinking and can cause symptoms such as nausea, shaking, and sweating. It can also lead to serious symptoms like seizures, fever, or hallucinations, and can be a medical emergency.

If you have a history of withdrawal symptoms, see a health professional before quitting. You should also see a professional before quitting alcohol if you have other health conditions.

Treatment of AUD focuses on relieving symptoms of alcohol withdrawal in the short term and then suppressing alcohol cravings in the long term.

But everyone’s recovery from AUD is different. Some require medications lifelong while others do not, and some drink in moderation during their recovery while others abstain.

Treatment also often

involves

detoxification followed by medication and therapy, but everyone’s treatment plan is different where some do not require detoxification, for example, or some may opt-out of therapy.

While medication is recommended for anyone with moderate to severe alcohol use disorder, those with mild AUD may consider therapy without medications

Medications

Health professionals sometimes prescribe medications to reduce the symptoms of withdrawal. Other medications can help you quit drinking by suppressing alcohol cravings or making you feel sick when alcohol enters your body.

Medication can also help reduce cravings.

Some of the medications for AUD include:

  • naltrexone (Revia, Vivitrol)
  • acamprostate (Campral)
  • disulfiram (Antabuse)

Behavioral treatments

As you recover from AUD, you may find it helpful to see a psychotherapist who uses cognitive behavioral therapy (CBT) techniques. CBT helps you modify your thoughts and actions, while also learning alternative coping mechanisms.

For some people, alcohol misuse results from psychological or social factors. They may drink to calm down or loosen up in social settings. Others use alcohol to cope with psychological issues or stress in their daily lives.

AUD may also run in families. However, genetics doesn’t guarantee a problem with alcohol. The exact mechanism that causes people to misuse alcohol is unclear.

Alcohol misuse is more common at certain points in life. Males, college students, and people going through serious life events or trauma are more likely to experience AUD.

Other risk factors include:

  • psychiatric disorders like schizophrenia
  • mood disorders like depression or anxiety
  • personality disorders
  • impulsivity
  • loneliness
  • stress

If you have a concern that you have AUD, you can see a health professional for consultation. They may ask you about your drinking habits and health history.

They may also use blood tests to assess your overall health, paying special attention to areas of the body most impacted by alcohol, including the brain and other parts of the nervous system, as well as the heart and liver.

How do you know if you have AUD?

It can be hard to see there is a problem even if the drinking is negatively impacting your health and your life.

There is screening that may help you recognize AUD in yourself or others. According to the NIAAA, AUD may be classified based on the following:

  • Mild: experiencing two or three symptoms
  • Moderate: experiencing four to five symptoms
  • Severe: experiencing six or more of the above symptoms

Having support and seeking professional treatment increases the chances for recovery from AUD. Groups such as Alcoholics Anonymous (AA) provide support for people who are recovering.

Other support options include:

The Substance Abuse and Mental Health Services Administration (SAMSA) also offers a free national hotline for people struggling with different types of substance use disorders at 800-662-HELP (4357).

Recognizing the early signs and risk factors for AUD can help you seek early treatment and intervention to break alcohol misuse patterns. This may require a lifelong effort.

If AUD is not treated, it can increase your risk for serious health problems. After completing treatment for AUD, it’s possible to have a risk of relapse. It’s important to recognize warning signs and seek help if you’re concerned about having a relapse. Continued therapy and support help minimize this risk.

Alcohol Abuse and Alcoholism: Signs, Symptoms, and Diagnosis (2024)

FAQs

What is the diagnostic criteria for alcoholism? ›

There is a persistent desire or unsuccessful efforts to cut down or control alcohol use. A great deal of time is spent in activities necessary to obtain alcohol, use alcohol, or recover from its effects. Craving, or a strong desire or urge to use alcohol.

What are the top 10 signs of an alcoholic? ›

10 Signs Of A High-Functioning Alcoholic
  • They Frequently Blackout After Drinking. ...
  • They Always Have An Explanation For Why They Drink. ...
  • They Frequently Joke About Alcohol. ...
  • They Hide Their Alcohol. ...
  • They Experience Shame Over Their Behavior. ...
  • They Separate Sections Of Their Life. ...
  • They Try To Quit But Always Fail.
Oct 28, 2022

What are four warning signs that a person may have an alcohol use disorder? ›

Warning Signs of Substance and Alcohol Use Disorder
  • Bloodshot eyes, pupils larger or smaller than usual.
  • Changes in appetite or sleep patterns.
  • Deterioration of physical appearance, personal grooming habits.
  • Runny nose or sniffling.
  • Sudden weight loss or weight gain.
  • Tremors, slurred speech, or impaired coordination.

What are the differential diagnoses of alcoholism? ›

Panic disorder, generalized anxiety disorder, social phobia, dysthymic disorder, major depression, bipolar mania, or primary (idiopathic) insomnia: Alcohol abuse or dependence might reflect self-treatment for these conditions.

What is the ICD-10 criteria for alcoholism? ›

Alcohol dependence, uncomplicated

20 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursem*nt purposes. The 2023 edition of ICD-10-CM F10. 20 became effective on October 1, 2022. This is the American ICD-10-CM version of F10.

What is the ICD-10 diagnostic criteria for alcohol use disorder? ›

Outline of diagnostic guideline for dependence syndrome according to the ICD-10 consists of 6 items: a strong desire or sense of compulsion (strong desire), difficulties in controlling substance-taking behavior (difficulties in controlling), a physiological withdrawal state (withdrawal), evidence of tolerance ( ...

What are six indicators of alcoholism? ›

Behavioral Signs and Symptoms of Alcohol Misuse
  • Impaired judgment.
  • Inappropriate sexual behavior.
  • Aggressiveness.
  • Mood changes.
  • Depression.
  • Anxiety.
  • Poor social functioning.
  • Problems driving or operating machinery.
Apr 4, 2023

What are 3 signs you have an alcohol problem? ›

Some of the most common symptoms of alcohol abuse are: Experiencing temporary blackouts or short-term memory loss. Exhibiting signs of irritability and extreme mood swings. Making excuses for drinking such as to relax, deal with stress or feel normal.

What are the 3 types of alcoholic? ›

Alcohols bind with other atoms to create secondary alcohols. These secondary alcohols are the three types of alcohol that humans use every day: methanol, isopropanol, and ethanol.

What behavioral disorders are alcohol abuse? ›

Alcohol abuse can cause signs and symptoms of depression, anxiety, psychosis, and antisocial behavior, both during intoxication and during withdrawal.

Which signs are more likely to be alcoholics? ›

PISCES. The water signs are the zodiac signs most likely to be alcoholics Water signs have a higher proclivity for dipsomania than the other zodiac signs.

What are 3 chronic alcoholism is associated with? ›

Long-term, excessive alcohol use has been linked to a higher risk of many cancers, including mouth, throat, liver, esophagus, colon and breast cancers.

What syndromes are associated with alcoholism? ›

Korsakoff syndrome (also known as Korsakoff's amnesic syndrome) is a memory disorder that results from vitamin B1 deficiency and is associated with alcoholism. Korsakoff's syndrome damages nerve cells and supporting cells in the brain and spinal cord, as well as the part of the brain involved with memory.

What are the four states of alcoholism? ›

Despite the variation in specific causes and timeframes from person to person, the disease itself follows a pattern. If you or your loved ones need help to identify the signs of problem drinking, four stages of alcoholism have been identified: pre-alcoholic, early alcoholic, chronic alcoholic, and end-stage alcoholism.

What is the ICD for mental and Behavioural disorder due to alcohol? ›

ICD-10 code: F10. 5 Mental and behavioural disorders due to use of alcohol Psychotic disorder.

What is ICD-11 alcohol disorder? ›

6C40.20 Alcohol Dependence, current use, continuous

Alcohol Dependence with continuous consumption of alcohol (daily or almost daily) during at least the past 1 month.

What is ICD-11 alcohol use disorders? ›

6C40 Disorders due to use of alcohol - ICD-11 MMS.

What is the 2023 ICD-10 code for alcohol use disorder? ›

2023 ICD-10-CM Diagnosis Code F10. 288: Alcohol dependence with other alcohol-induced disorder.

Is alcohol use disorder a DSM diagnosis? ›

DSM–5 integrates the two DSM–IV disorders, alcohol abuse and alcohol dependence, into a single disorder called alcohol use disorder (AUD) with mild, moderate, and severe sub-classifications.

What is the 4 question alcoholic test? ›

The CAGE questionnaire consists of four questions that relate to your use of alcohol: Have you ever felt that you ought to C ut down on your drinking? Do you get A nnoyed by criticism of your drinking? Do you ever feel G uilty about your drinking?

What are the 5 most common causes of alcoholism? ›

Let's cover some of them below:
  • Stressful environments. While not every person turns to alcohol to relieve stress, some people do. ...
  • Drinking at an early age. ...
  • Mental health problems like depression. ...
  • Taking alcohol with medicine. ...
  • Family history.

What are two features of alcoholism? ›

Alcoholism is characterised by an increased tolerance to alcohol – which means that an individual can consume more alcohol – and physical dependence on alcohol, which makes it hard for an individual to control their consumption.

What are the 4 types of drinker? ›

There are four types of drinker – which one are you?
  • Social drinking. To date, nearly all the research on drinking motives has been done on teens and young adults. ...
  • Drinking to conform. ...
  • Drinking for enhancement. ...
  • Drinking to cope.

What is the one third rule for alcoholism? ›

Bogenschutz said the rule of thumb with alcohol addiction treatment is that about one-third of patients who seek treatment will get better. Another third will do about the same. An equal number will get worse.

What does a bad alcoholic look like? ›

Dishevelled appearance. If you're struggling with alcohol abuse disorder, you may start to neglect your personal hygiene and grooming, as these become less of a priority for you. You may also look exhausted as a result of dehydration and lack of sleep, which are often associated with heavy alcohol use.

How to tell if someone has an unhealthy relationship with alcohol? ›

Signs that you may have an unhealthy relationship with alcohol include:
  • If you drink more than 4 drinks on any day or 14 per week (men)
  • If you drink more than 3 drinks on any day or 7 per week (women)
  • If you drink and drive under the influence.

What is the difference between a habitual drinker and an alcoholic? ›

Problem drinking is using alcohol in a way that can negatively impact your health and your life, but the body is not physically dependent on the substance. Alcoholism, on the other hand, most likely includes the physical addiction to alcohol in addition to the problems it may cause your health and your life.

What is the most severe form of alcoholism? ›

End-Stage Alcohol Abuse

The end stage may be thought of as the most severe articulation of all the possible problems associated with alcohol use disorder. It is a circ*mstance of reversals; rather than living to drink, a person in the end stage likely drinks to live.

How much do alcoholics drink a day? ›

Heavy Alcohol Use:

NIAAA defines heavy drinking as follows: For men, consuming more than 4 drinks on any day or more than 14 drinks per week. For women, consuming more than 3 drinks on any day or more than 7 drinks per week.

What happens when you drink alcohol everyday? ›

Over time, excessive alcohol use can lead to the development of chronic diseases and other serious problems including: High blood pressure, heart disease, stroke, liver disease, and digestive problems. Cancer of the breast, mouth, throat, esophagus, voice box, liver, colon, and rectum.

Is alcoholism a mental illness or disease? ›

Yes. Since 1956, the American Medical Association (AMA) has identified alcoholism as a disease characterized by compulsive decision-making, impulsive behavior and relapse.

How do you define an alcoholic? ›

What is the definition of alcoholism?
  1. The inability to control alcohol intake after starting to drink.
  2. Obsessing thoughts about alcohol.
  3. Behaving in ways, while drunk, that is uncharacteristic of their sober personality.
  4. Repeating unwanted drinking patterns.
  5. Surrounding themselves socially with heavy drinkers.

Do alcoholics have a personality type? ›

Generally, alcoholics seem to have the same kinds of personalities as everybody else, except more so. The first is a low frustration tolerance. Alcoholics seem to experience more distress when enduring long-term dysphoria or when tiresome things do not work out quickly. Alcoholics are more impulsive than most.

What are 4 cancers associated with alcoholism? ›

Esophagus. Colon and rectum. Liver. Breast (in women).

What age does alcoholism affect the most? ›

Teenage years are the riskiest time to develop an alcohol dependence. Youth who start drinking before the age of 15 are 4 times more likely to be one who alcoholism affects later on in life. On top of that, an individual's brain is still developing well into their twenties.

Which criteria for making a diagnosis of alcoholism can be found in the DSM-5? ›

DSM-5 criteria are as follows: A maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by 2 or more of the following, occurring at any time in the same 12-month period: Alcohol is often taken in larger amounts or over a longer period than was intended.

What are the critical diagnostic criteria for addiction? ›

Consuming the substance in larger amounts and for a longer amount of time than intended. Persistent desire to cut down or regulate use. The individual may have unsuccessfully attempted to stop in the past. Spending a great deal of time obtaining, using, or recovering from the effects of substance use.

What are four of the diagnostic criteria for substance use disorders? ›

These criteria fall under four basic categories — impaired control, physical dependence, social problems and risky use: Using more of a substance than intended or using it for longer than you're meant to.

What is the DSM-5 criteria for alcohol use disorder in remission? ›

DSM-5 differentiates two phases of alcohol dependence remission. Early remission means that within 1 year a patient has not had any symptoms of dependence for at least 3 months. Sustained remission means that within a year a patient has not had any symptoms except a strong desire or urge to drink alcohol.

How is someone diagnosed with alcohol use disorder? ›

Craving, or a strong desire or urge to use alcohol. Recurrent alcohol use resulting in a failure to fulfill major role obligations at work, school, or home. Continued alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol.

What are other alcohol induced disorders DSM-5? ›

Other Alcohol-Induced Disorders
  • Depression.
  • Anxiety.
  • Bipolar.
  • Psychosis.
  • Sleep.
  • Sexual Dysfunction.
  • Neurocognitive.
Feb 28, 2021

What are the symptoms of addiction? ›

Confusion, delusions and hallucinations. Irritability, anxiety or paranoia. Changes in heart rate, blood pressure and body temperature. Nausea or vomiting with weight loss.

What are the 4 DSM-5 criteria for addiction? ›

The 11 criteria outlined in the DSM-5-TR can be grouped into four primary categories: physical dependence, risky use, social problems, and impaired control.

What are the four main characteristics present in most substance use disorders? ›

The symptoms associated with a substance use disorder fall into four major groupings: impaired control, social impairment, risky use, and pharmacological criteria (i.e., tolerance and withdrawal).

What are the 5 categories of substance abuse disorders? ›

Patients are diagnosed with a specific type of disorder based on the primary substance that they misuse, such as an alcohol use disorder, or opioid use disorder, stimulant use disorder, marijuana use disorder or sedative use disorder.

What are diagnostic tests for substance abuse? ›

Blood alcohol levels, breathalyzer test results, urine drug screens, and, less commonly, hair and saliva analysis can be used to assess patients for possible alcohol and other drug use.

What are the 9 types of addiction? ›

The DSM-5 specifically lists nine types of substance addictions within this category (alcohol; caffeine; cannabis; hallucinogens; inhalants; opioids; sedatives, hypnotics, and anxiolytics; stimulants; and tobacco).

What are the three categories of alcohol use disorder? ›

Alcohol use disorder is organized into three categories: mild, moderate and severe. Each category has various symptoms and can cause harmful side effects. If left untreated, any type of alcohol abuse can spiral out of control.

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