What is alcohol use disorder?
In the U.S., more than half of a population aged 12 years and more are current drinkers. A small amount of alcohol could be harmless, but how do you distinguish when your drinking is a problem? Drinking alcohol is a problem when it negatively affects your daily activities and social and professional life.
Alcohol use disorder is a medical term that healthcare professionals use to describe alcohol addiction. You or someone around you may have alcohol use disorder if two or more of the following are present: A person
- drinks more and longer than he/she planned
- wants to drink less but is not able to
- spends a lot of time finding alcohol to drink or recover from drinking
- wants badly an alcohol
- quits working, family gatherings, or other social activities
- continues drinking even when it harms his/her health or physical safety (e.g., during or before driving or swimming)
- keeps drinking despite serious health conditions
- needs more and more drink to get the same effect (this is called tolerance)
- has withdrawal symptoms when he/she quits drinking
If you think you have an alcohol use disorder, the first step is to meet your GP.
During alcohol use, people have symptoms of alcohol intoxication. The latter is caused by excessive amounts of alcohol in the bloodstream. Symptoms of alcohol intoxication are
- improper conduct or loss of judgment
- mood changes
- slurred speech
- problems with attention and memory
- problems with coordination and walking
- coma
- death
When a person with alcohol use disorder stops drinking, “withdrawal symptoms” occur. Here is the list of common “ withdrawal symptoms”:
- sweating
- problems with heart rhythm (arrhythmia)
- shaking
- insomnia (sleeping problems)
- nausea or vomiting
- hallucinations (seeing, feeling, or hearing non-existent things)
- anxiety
- agitation
- seizures
Problem drinking
Some people are not alcohol dependent but are in a high-risk group for developing alcohol use disorder or alcohol-related problems. They occasionally feel consequences of heavy alcohol drinking, e.g., accidental injuries.
When we talk about problem drinkers, first, we should outline what is called one standard drink.
In the U.S. a standard drink contains about 0.6 fluid ounces or 14 grams of “pure” alcohol and is the equivalent of
- 12 ounces (355 milliliters) of regular beer (about 5% alcohol)
- 8 to 9 ounces (237 to 266 milliliters) of malt liquor (about 7% alcohol)
- 5 ounces (148 milliliters) of wine (about 12% alcohol)
- 1.5 ounces (44 milliliters) of hard liquor or distilled spirits (about 40% alcohol)
Cocktails and alcohol mixes are not taken into account in these examples. In these cases the dose of alcohol could be more than in one drink.
Moderate drinkers have a low risk of alcohol-related problems. Moderate drinkers drink no more than one drink per day (for women and people over 65) and no more than two drinks per day (for men).
Heavy drinkers are in a high-risk group for having alcohol-related problems. A person is called a heavy drinker when:
- a woman drinks more than 7 drinks per week or more than 3 drinks per occasion
- a man drinks more than 14 drinks per week or more than 4 drinks per occasion
Binge drinkers are another group of people that have drinking problems. They only drink on occasions: within about two hours, women drink more than 4 drinks and men more than 5 drinks.
High-risk groups
Some factors increase the risk of getting alcohol use disorder.
- A habit of regular drinking over a long time period.
- The start of drinking alcohol at an early age.
- Having a family member who has alcohol use disorder.
- Having mental health issues (e.g., depression, schizophrenia, and anxiety).
- Having a history of emotional and/or physical trauma.
- Family, friends, or social media may influence daily habits and increase the risk of alcohol dependence.
Complications
Alcohol affects and depresses the nervous system. It impairs judgment, thinking, and memory and puts a drinker in immediate physical danger. The complications are also related to the devastating effects of alcohol on different organs of our body.
Dangerous situations and behaviors related to alcohol use are:
- accidental injuries, including motor vehicle accidents
- problems with family, friends, and other relationships
- inability to work or study
- legal problems, like increased risk of engagement in crimes both as a culprit or as a victim
- other substance abuse
- engaging in risky or unprotected sex or experiencing sexual abuse
- increased risk of suicide attempts
Health-related problems are diverse and include almost every organ system. Health problems that are caused by heavy drinking are :
- Liver damage that leads to fat accumulation in the liver and inflammation (alcohol-related fatty liver disease and alcoholic hepatitis). Continuous heavy drinking leads to scar formation and irreversible damage of the liver tissue called cirrhosis.
- stomach inflammation (gastritis) and ulcers
- inflammation of the pancreas (pancreatitis)
- heart rhythm problems (arrhythmia)
- atherosclerosis and hearth failure
- uncontrollable high blood pressure (hypertension)
- vision problems
- bone loss (osteoporosis)
- low blood glucose (hypoglycemia), especially in those who have diabetes and take insulin
- numbness and pain in extremities (peripheral neuropathies)
- central nervous system disorders, e.g., dementia, short-term memory loss
- increased risk of cancers (including mouth, throat, liver, pancreas, stomach and breast)
- problems with reproductive and sexual function
- Interaction with other medications decreases effectiveness or causes side effects.
- Drinking during pregnancy may lead to birth defects in a child.
Diagnosis and treatment of alcohol use disorder are discussed elsewhere.
Sources:
UpToDate
Mayo Clinic
Cleveland Clinic
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
