Alcohol Use Disorder: Signs, Risks, and Treatment Resources

The chronic use of alcohol characterizes Alcohol Use Disorder despite consequences across all aspects of life. Alcohol addiction can feel all-consuming and impossible to quit.

There is a better way to live. Recovery is possible, and help is available.

What is Alcohol Use Disorder (AUD)?

Alcohol Use Disorder (AUD) is a chronic illness formally referred to as alcoholism. Alcohol Use Disorder affects an estimated 16 million people in the USA. It is characterized by an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences.[1]

Some signs of Alcohol Use Disorder may include:

• Uncontrollable cravings for alcohol
• Being unable to limit the amount of alcohol you drink, despite efforts to do so
• Spending a lot of time drinking, acquiring alcohol, or having frequent ‘hangovers’ from its use
• Failing to fulfill obligations at work, home, or school due to repeated alcohol use
• Continuing to drink despite proof it’s causing physical, social, psychological, and professional problems
• Putting yourself in danger while using alcohol, for example, driving while under the influence
• Experiencing withdrawal symptoms like nausea, sweating, or shaking

Alcohol Use Disorder is recognized as a Substance-Related and Addictive Disorder in the Diagnostic and Statistical Manual of Mental Disorders: Fifth Edition (DSM-5).

From Casual Drinking to Problematic Consumption

Alcohol is one of the most commonly used drugs globally and enjoys social and legal endorsement in countries and cultures on every continent. On the flip side, binge drinking, Alcohol Use Disorder, and alcohol overdose are responsible for 3 million deaths worldwide each year —5.3% of all deaths recorded.[9]

In the United States, 48.7% of the population aged 12 years and older reported drinking within the past month in 2022.[2] The same survey revealed that 21.7% of alcohol consumption took the form of binge drinking — the practice of imbibing 4-5 drinks per occasion, resulting in a higher likelihood of dangerous behavior, alcohol poisoning, Alcohol Use Disorder, and other serious health conditions.

Another recent study demonstrated a frightening truth: 1 in 8 deaths among US adults aged 20 to 64 years can be attributed to excess alcohol use.[3] These sobering truths present a reality of why it’s so crucial to recognize and treat Alcohol Use Disorder before it’s too late.

The U.S. Centers for Disease Control and Prevention (CDC) recommends that adults of legal drinking age who choose to drink do so in moderation, defining moderation as up to 2 drinks per day for men and 1 drink per day for women. The CDC also notes that while moderate alcohol consumption can be part of a healthy lifestyle for some people, no level of alcohol consumption can be considered completely safe in terms of cancer risk.[4]

Statistics on Alcohol Use, Misuse, and Addiction

Alcohol abuse is prevalent in the US, and the states of New Jersey and Tennessee are no exception.

New Jersey has reported a steady increase in drug and alcohol abuse over the past decade. Alcohol treatment facility admissions have increased significantly since 2011. According to the State of New Jersey Substance Abuse Treatment Admissions report, alcohol misuse comprised 36% of all substance abuse treatment admissions in 2021.

Tennessee ranks 10th overall in the US for the highest drug (alcohol included) use by the state. In 2016, 1 in 20 Tennessee residents abused or had physical alcohol dependence. Alcohol is the most abused substance in the state.[5]

Alcohol Quick Reference

Understanding the Effects of Alcohol

Alcohol is a nervous system depressant. From the moment you sip your drink, ethanol molecules begin their race through your bloodstream, causing a warm feeling, blushing, and a decrease in blood pressure and body temperature. Once in the brain, alcohol interferes with our ability to control our body, decreases our inhibitions, slows our thoughts, and weakens our decision-making abilities.

As you become drunk, you may slur your words or ramble incoherently. It may become difficult to walk straight, putting you at an increased risk of stumbling and falling. Coordination becomes hard, making using doors, holding drinks, or paying for purchases harder. Your mood is also heavily influenced by alcohol and may result in severe swings from happy sociability to fits of aggression and depression. Ordinary activities such as driving or cooking become dangerous due to slowed decision-making and lack of bodily control.

What are the Dangers of Alcohol Use Disorder (AUD)?

Alcohol Use Disorder (AUD) presents several physical and psychological dangers that can have lasting and lifelong consequences.

The Physical Cost of Alcohol Use Disorder

Because the ethanol in alcohol is very small, it can travel quickly throughout the body. When alcohol is consumed frequently, as is the case with Alcohol Use Disorder (AUD), many crucial systems designed to look after our bodies become damaged, sometimes permanently. These include:

• The Brain: Alcohol causes damage to both the gray and white matter in our brains. It also causes shrinkage to the hippocampus[6], an area instrumental in learning and memory. Long-term alcohol use increases the likelihood of Wernicke-Korsakoff (WK) syndrome, resulting in permanent brain damage, disability, and death.

• • The Liver: Repeated drinking puts a major strain on the liver, resulting in fibrosis, cirrhosis, liver cancer, alcoholic hepatitis, and fatty liver.
  • The Pancreas: Alcohol Use Disorder is associated with poor diet and malabsorption, resulting in vitamin deficiencies. This can result in pancreatitis, characterized by acute and severe pain and swelling.
  • The Cardiovascular System: Long-term alcohol use increases the risk of arrhythmia, high blood pressure, increased cholesterol, heart attack, and stroke.

• The Respiratory System: Frequent and excessive drinking damages the immune cells that protect the lungs and the cells that protect our airways, resulting in increased respiratory infections, damage to lung tissue, and degradation of lung function over time.

The Psychological Dangers of Alcohol Use Disorder

Alcohol directly impacts the brain, altering the function of its neurotransmitters and hormonal systems[7], including those tied to many common mental disorders. Because of this connection, individuals living with Alcohol Use Disorder often experience psychiatric symptoms both while drinking and during withdrawal.

Some common psychological symptoms of Alcohol Use Disorder include depression, anxiety, psychosis, antisocial behavior, and suicidal ideation.  It is worth noting that often people use alcohol to self-medicate for these and other existing psychological disorders.

Alcohol Poisoning

Alcohol poisoning is another name for alcohol overdose and occurs when someone drinks more than their body can handle. It is a serious and dangerous situation and can result in loss of life. If you suspect someone in your care is suffering from alcohol poisoning, seek medical care or call 9-1-1.

Some common symptoms of alcohol poisoning include:

• Confusion
• Vomiting
• Seizures
• Slow breathing, taking fewer than eight breaths a minute
• Breathing that’s not regular, with more than ten seconds between breaths
• Skin appears blue, gray, or pale
• Low body temperature
• Problems staying conscious or awake

Symptoms of Alcohol Withdrawal

Alcohol acts as a depressant. In response, our body works harder to maintain a state of wakefulness and keep our central nervous system up and running. After a period of frequent and heavy drinking, our bodies are unable to return to a baseline level of alertness in the absence of alcohol. This is what causes alcohol withdrawal.

Alcohol withdrawal symptoms will be as unique as the person experiencing them. Withdrawal symptoms may start as soon as three to four hours after a final drink and persist for 72 hours or longer. Alcohol withdrawal symptoms may include:

• Anxiety
• Depression
• Fatigue
• Headaches
• Nausea
• Tremors of the body
• Shaky hands
• Vomiting
• Sweating
• Mood swings

• Jumpiness
• Loss of appetite
• Rapid heart rate
• Pallor

More severe withdrawal symptoms may take the form of:

• Hallucinations
• Seizures

Seeking Treatment for Alcohol Use Disorder

Alcohol Use Disorder is well-understood, with many evidence-based treatment options to choose from. At its core, Alcohol Use Disorder centers around complex physical, mental, and social connections to alcohol. Treatment requires a multifaceted approach that addresses these three elements, typically involving medication, behavioral therapy, and peer support groups.

Medications for Alcohol Use Disorder

Medications are available to help with alcohol withdrawal and addiction. Those officially approved by the FDA are naltrexone (in either oral or long-acting injectable form), acamprosate, and disulfiram. All are designed to help people stop drinking and resist the urge to start again.

Behavioral Therapy

Individual counseling offered one-on-one by a licensed therapist is an important step in recovery from Alcohol Use Disorder. Some common approaches include Cognitive Behavioral Therapy (CBT), Dialectic Behavioral Therapy (DBT), and Motivational Interviewing.

Sometimes called alcohol counseling, therapy during recovery has two main focuses: to help patients identify and manage the behaviors that fuel their alcohol consumption and to address any underlying psychological challenges that lead them to use alcohol in the first place.

Peer-Support Groups

Peer support groups are anonymous places for individuals recovering from Alcohol Use Disorder to come together, share experiences, find support, and develop new sober social connections. These meetings are available in person and online and are typically free or low-cost.