Alcohol Use Disorder: Causes, Symptoms, and Treatments

What is alcohol use disorder?

Alcohol use disorder is a condition where a person has difficulty stopping or managing their alcohol use. People with alcohol use disorder prioritize alcohol over other areas of their lives, like their relationships, family, work, and health. You may also hear people refer to alcohol use disorder as alcohol dependence, addiction, or alcoholism.

Alcohol use is common, but only a portion of people who drink alcohol have alcohol use disorder. A 2023 national survey found that more than 28 million people in the U.S. ages 12 and over had alcohol use disorder within the past year. That’s about 10% of that age group.

“Moderate alcohol use” becomes a disorder when a person lacks control and has problems because of their alcohol use. These problems may include conflict with family and health issues like cirrhosis.

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What causes alcohol use disorder?

Alcohol use disorder is caused by a combination of genetic and environmental factors. 

Genetics account for about half of a person’s risk. Researchers have found several genes that play a role in alcohol use disorder. There are also certain genes that can reduce your risk of developing this condition.

Your environment, experiences, and surroundings can also impact your risk of alcohol use disorder. Another factor is the interaction between your genetics and your environment. For example, having a family member with a history of alcohol use disorder increases your risk. This could be due to genetic factors, learned behavior from being around them, or a combination of both.

Other risk factors for alcohol use disorder include:

• How much you drink: Binge drinking and heavy drinking increase the risk of alcohol addiction.

• At what age you drink: People who start drinking before age 15 are five times more likely to develop alcohol use disorder.

• Your mental health: Having a mental health condition, like depression, increases your chances of having alcohol use disorder.

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What are the symptoms of alcohol use disorder?

A person with alcohol use disorder will display certain symptoms and signs, which healthcare professionals use to diagnose a substance use disorder:

• Symptoms are feelings and experiences that indicate that a person may have an alcohol addiction. 

• Signs are observable changes in a person’s mood, behavior, or appearance that can occur while intoxicated or when misusing alcohol.

Symptoms and signs of alcohol use disorder include:

• Drinking more or for longer than planned

• Having tried unsuccessfully to quit or cut back in the past

• Spending large amounts of time drinking or recovering from alcohol use

• Cravings for alcohol

• Difficulty keeping up with responsibilities at home, work, or school because of alcohol use

• Drinking in situations that could be dangerous

• Giving up activities or interests that were once important because of alcohol

• Continuing to drink even though it has caused problems with loved ones

• Continuing to drink even though it has caused physical or mental health problems

• Needing more alcohol over time to feel the same effects

• Experiencing withdrawal symptoms, like shaky hands, rapid heart rate, and seizures when you’re not drinking

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How do you diagnose alcohol use disorder?

Diagnosing alcohol use disorder starts with a screening and evaluation. A mental health or medical professional can do this. This might be a counselor, psychologist, or doctor. 

During an evaluation, your specialist will ask questions about:

• Your current and past use of drugs and alcohol use, including how much and how often

• Whether you have a family history of addiction

• Your current psychiatric symptoms, like depression and anxiety

• Your past psychiatric history

• Things in your life that cause you stress

• Your support system

To form a diagnosis, they might also:

• Do a physical exam to figure out if you’re experiencing withdrawal or have any health issues related to alcohol

• Review laboratory results

• Screen using a tool like the Alcohol Use Disorders Identification Test (AUDIT) 

• Collect information from your family

It’s important to get a clear, accurate diagnosis. That way, you and your healthcare team can come up with a plan for treatment.

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How do you treat alcohol use disorder?

Treatment for alcohol use disorder involves a combination of therapy, medication, and support groups. Alcohol withdrawal can be life-threatening. This is why it’s important to get professional help to manage withdrawal symptoms and safely detox. But treatment for alcohol use disorder doesn’t stop with detox.

Behavioral therapies can help treat alcohol use disorder. Examples are cognitive behavioral therapy (CBT) and motivational enhancement therapy — also called motivational interviewing.

These therapies share common goals like:

• Coping with triggers

• Setting attainable goals

• Strengthening your support system

• Developing tools and strategies to prevent relapse

Medication-assisted treatment (MAT) combines medication and therapy. Medications to treat alcohol use disorder can include:

• Disulfiram (Antabuse): This stops the breakdown of alcohol and causes unpleasant side effects if you drink after taking it.

• Acamprosate (Campral): This decreases your desire to drink and can help you maintain abstinence.

• Naltrexone (Vivitrol, ReVia): This reduces urges to drink alcohol and can help prevent relapse.

Support groups like Alcoholics Anonymous (AA) and SMART Recovery can also help in the recovery from alcohol use disorder.

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Getting help for alcohol use disorder

There’s strong evidence that treatment for alcohol use disorder works. But sometimes it can be hard to know if you have a drinking problem or to recognize that it’s time to get help. You may have friends or family who talk about their concerns about your drinking. However, you may need to take the step to reach out for support. And there are many resources available. 

To get help for alcohol use disorder, you can start by speaking with your primary care provider. They’ll be able to evaluate you and provide a referral for treatment. 

If you don’t have a primary care provider, you can contact the National Institute on Alcohol Abuse and Alcoholism (NIAAA) or Substance Abuse and Mental Health Services Administration (SAMHSA) for assistance.

The NIAAA offers an Alcohol Treatment Navigator. You can use it to search for alcohol treatment programs and to get answers to common questions about treatment.

You can also contact SAMHSA’s National Helpline at 1-800-662-HELP (4357). The helpline provides information and referrals for substance use and mental health treatment. The service is free, confidential, and available 24 hours a day. You can also use the Online Treatment Locator to find treatment options in your area.

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How to cope with alcohol use disorder

Treating and managing alcohol use disorder isn’t a one-and-done type of thing. From the initial risks of alcohol withdrawal through relapse triggers, working with healthcare professionals can help you throughout your recovery. There are also steps you can take to help yourself cope with alcohol use disorder.

Know your triggers

Triggers are people, places, things, or feelings that cause urges to drink. Examples include parties, bars, and stress. You may be able to avoid some triggers, but others are unavoidable. When it comes to unavoidable triggers, come up with a coping plan. For example, you can reach out to your sober community, write in a journal, or go for a walk.

Remember that recovery is a process

Recovering from alcohol addiction may involve setbacks, like relapse. If this occurs, avoid beating yourself up. Instead, consider what you could do to change your relapse prevention plan.

Address any mental health issues

People with alcohol use disorder are over three times more likely to have another mental health condition. Getting treatment for mental health issues is important for recovery.

Use your support system

Whether you reach out to family, friends, or other people in recovery in groups like AA, make an effort to stay connected. 

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How to prevent alcohol use disorder

The only way to guarantee that you won’t develop alcohol use disorder is to abstain from alcohol (not drink at all). If you choose to drink, it’s important to understand your risk factors. Also, be aware of your drinking habits and your relationship to alcohol. These efforts can help you avoid developing an addiction. The more risk factors you have, the higher your risk of developing alcohol use disorder.

No matter your level of risk, if you choose to drink, aim to stick to the recommended guidelines for moderate drinking:

• Two drinks or less per day for men

• One drink or less per day for women

If you’re having trouble staying within those limits, seek help. Even if you don’t have alcohol use disorder, getting help early can prevent you from developing it.

When it comes to preventing underage drinking, talking to kids and teens about the risks of alcohol is important. Other helpful strategies include:

• Strengthening family bonds

• Encouraging open and healthy communication

• Knowing about their activities and who they’re friends with

• Setting rules and disciplining them appropriately

• Teaching them skills on how to refuse alcohol