What Is Alcohol Use Disorder?

Understanding Alcohol Use Disorder

What Is Alcohol Use Disorder?

Alcohol use disorder (AUD) is a medical condition characterized by an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences.

It encompasses the conditions that some people refer to as alcohol abuse, alcohol dependence, alcohol addiction, and the colloquial term, alcoholism. Considered a brain disorder, AUD can be mild, moderate, or severe.

Lasting changes in the brain caused by alcohol misuse perpetuate AUD and make individuals vulnerable to relapse.

The good news is that no matter how severe the problem may seem, evidence-based treatment with behavioral therapies, mutual-support groups, and/or medications can help people with AUD achieve and maintain recovery. According to a national survey, 14.1 million adults ages 18 and older1 (5.6 percent of this age group2) had AUD in 2019. Among youth, an estimated 414,000 adolescents ages 12–171 (1.7 percent of this age group2) had AUD during this timeframe.

What Increases the Risk for AUD?

A person’s risk for developing AUD depends, in part, on how much, how often, and how quickly they consume alcohol. Alcohol misuse, which includes binge drinking* and heavy alcohol use,** over time increases the risk of AUD. Other factors also increase the risk of AUD, such as:

  • Drinking at an early age. A recent national survey found that among people ages 26 and older, those who began drinking before age 15 were more than 5 times as ly to report having AUD in the past year as those who waited until age 21 or later to begin drinking. The risk for females in this group is higher than that of males.
  • Genetics and family history of alcohol problems. Genetics play a role, with hereditability approximately 60 percent; however, other chronic health conditions, AUD risk is influenced by the interplay between a person’s genes and their environment. Parents’ drinking patterns may also influence the lihood that a child will one day develop AUD.
  • Mental health conditions and a history of trauma. A wide range of psychiatric conditions—including depression, post-traumatic stress disorder, and attention deficit hyperactivity disorder—are comorbid with AUD and are associated with an increased risk of AUD. People with a history of childhood trauma are also vulnerable to AUD.

What Are the Symptoms of AUD?

Healthcare professionals use criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), to assess whether a person has AUD and to determine the severity if the disorder is present. Severity is the number of criteria a person meets their symptoms—mild (2–3 criteria), moderate (4–5 criteria), or severe (6 or more criteria).

A healthcare provider might ask the following questions to assess a person’s symptoms.

In the past year, have you:

  • Had times when you ended up drinking more, or longer, than you intended?
  • More than once wanted to cut down or stop drinking, or tried to, but couldn’t?
  • Spent a lot of time drinking? Or being sick or getting over other aftereffects?
  • 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 troubles? 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?
  • More than once 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 unprotected 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 sensed things that were not there?

Any of these symptoms may be cause for concern. The more symptoms, the more urgent the need for change.

What Are the Types of Treatment for AUD?

Several evidence-based treatment approaches are available for AUD. One size does not fit all and a treatment approach that may work for one person may not work for another. Treatment can be outpatient and/or inpatient and be provided by specialty programs, therapists, and doctors.

Medications

Three medications are currently approved by the U.S. Food and Drug Administration to help people stop or reduce their drinking and prevent relapse: naltrexone (oral and long-acting injectable), acamprosate, and disulfiram. All these medications are non-addictive, and they may be used alone or combined with behavioral treatments or mutual-support groups.

Behavioral Treatments

Behavioral treatments, also known as alcohol counseling or “talk therapy,” provided by licensed therapists are aimed at changing drinking behavior. Examples of behavioral treatments are brief interventions and reinforcement approaches, treatments that build motivation and teach skills for coping and preventing relapse, and mindfulness-based therapies.

Mutual-Support Groups

Mutual-support groups provide peer support for stopping or reducing drinking. Group meetings are available in most communities, at low or no cost, at convenient times and locations—including an increasing presence online.

This means they can be especially helpful to individuals at risk for relapse to drinking.

Combined with medications and behavioral treatment provided by health professionals, mutual-support groups can offer a valuable added layer of support.

Please note: People with severe AUD may need medical help to avoid alcohol withdrawal if they decide to stop drinking.

Alcohol withdrawal is a potentially life-threatening process that can occur when someone who has been drinking heavily for a prolonged period of time suddenly stops drinking.

Doctors can prescribe medications to address these symptoms and make the process safer and less distressing.

Can People With AUD Recover?

Many people with AUD do recover, but setbacks are common among people in treatment. Seeking professional help early can prevent relapse to drinking.

Behavioral therapies can help people develop skills to avoid and overcome triggers, such as stress, that might lead to drinking.

Medications also can help deter drinking during times when individuals may be at greater risk of relapse (e.g., divorce, death of a family member).

Need Help?

If you are concerned about your alcohol use and would to explore whether you might have AUD, please visit the Rethinking Drinking website.

To learn more about alcohol treatment options and search for quality care near you, please visit the NIAAA Alcohol Treatment Navigator.

For more information about alcohol and your health, please visit: https://www.niaaa.nih.gov

* The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines binge drinking as a pattern of drinking alcohol that brings blood alcohol concentration (BAC) to 0.08 percent—or 0.08 grams of alcohol per deciliter—or higher. For a typical adult, this pattern corresponds to consuming 5 or more drinks (male), or 4 or more drinks (female), in about 2 hours.

** NIAAA defines heavy alcohol use as consuming more than 4 drinks on any day for men or more than 3 drinks for women.

1 Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Behavioral Health Statistics and Quality. 2019 National Survey on Drug Use and Health. Table 5.

4A—Alcohol Use Disorder in Past Year Among Persons Aged 12 or Older, by Age Group and Demographic Characteristics: Numbers in Thousands, 2018 and 2019. https://www.samhsa.

gov/data/sites/default/files/reports/rpt29394/NSDUHDetailedTabs2019/NSDUHDetTabsSect5pe2019.htm?s=5.4&#tab5-4a. Accessed November 6, 2020.

2 SAMHSA, Center for Behavioral Health Statistics and Quality. 2019 National Survey on Drug Use and Health. Table 5.4B—Alcohol Use Disorder in Past Year Among Persons Aged 12 or Older, by Age Group and Demographic Characteristics: Percentages, 2018 and 2019. https://www.samhsa.gov/data/sites/default/files/reports/rpt29394/NSDUHDetailedTabs2019/NSDUHDetTabsSect5pe2019.htm?s=5.4&#tab5-4b

Источник: https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/understanding-alcohol-use-disorder

Alcohol Use Disorder: What It Is, Risks & Treatment

What Is Alcohol Use Disorder?

Alcohol use disorder (sometimes called alcoholism) is a medical condition. It involves heavy or frequent alcohol drinking even when it causes problems, emotional distress or physical harm.

A combination of medications, behavioral therapy and support can help you or a loved one recover. Alcohol Use Disorder

Alcohol use disorder is a medical condition involving frequent or heavy alcohol use.

People with alcohol use disorder can’t stop drinking, even when it causes problems, emotional distress or physical harm to themselves or others.

Is alcohol use disorder a disease?

Alcohol use disorder is a medical condition. It’s a disease of brain function and requires medical and psychological treatments to control it.

Alcohol use disorder can be mild, moderate or severe. It can develop quickly or over a long period of time. It’s also called alcohol dependence, alcohol addiction or alcohol abuse.

How common is alcohol use disorder?

14.5 million Americans 12 years or older have an alcohol use disorder.

How can drinking too much affect me?

Drinking too much alcohol can damage your health. It’s associated with:

  • Brain damage, including dementia.
  • Despair, depression and suicide.
  • Cancers of the breast, liver, colon and mouth.
  • Fetal alcohol syndrome (if exposed to alcohol before birth).
  • Accidents ( falls or burns) and injuries ( fractures or drowning).
  • Liver problems, such as cirrhosis, hepatitis and fatty liver.
  • Blackouts, assaults, DUIs and even homicide.

Frequent or heavy drinking can also lead to personal problems, such as trouble with:

  • Money.
  • Personal relationships.
  • Work.

Scientists are still trying to understand what causes alcohol use disorder. It appears to be a combination of one or more of the following:

  • Genetics.
  • Early childhood events.
  • Attempts to relieve emotional pain.

People are more ly to become an alcoholic if they:

  • Consume alcohol often, in large amounts or start early in life.
  • Experienced trauma, such as physical or sexual abuse.
  • Have a family history of alcohol problems.
  • Have mental health issues, such as grief, anxiety, depression, eating disorders and post-traumatic stress disorder.
  • Have had stomach bypass surgery (Roux-en-y) for weight issues.

What are the symptoms of alcohol use disorder?

Signs of alcohol use disorder include:

  • Blacking out or not remembering things that happened.
  • Continuing to drink even if it causes distress or harm to you or others.
  • Drinking more or longer than you planned.
  • Feeling irritable or cranky when you’re not drinking.
  • Frequent hangovers.
  • Getting into dangerous situations when you’re drinking (for example, driving, having unsafe sex or falling).
  • Giving up activities so you can drink.
  • Having cravings for alcohol.
  • Having repeated problems with work, school, relationships or the law because of drinking.
  • Needing to drink more and more to get the same effect.
  • Not being able to stop drinking once you’ve started.
  • Spending a lot of time drinking or recovering from drinking.
  • Wanting to cut back but not being able to.
  • Obsessing over alcohol.

A person who is alcohol dependent also might experience symptoms of withdrawal when they cut back or stop drinking, such as:

  • Anxiety.
  • Depression.
  • Irritability.
  • Nausea, dry heaves.
  • Racing heart.
  • Restlessness.
  • Shakiness.
  • Sweating.
  • Trouble sleeping.
  • Seizures.
  • Seeing things that aren’t there (hallucinations).
  • Delirium tremens.
  • Coma and death.

What are the stages of alcohol use disorder?

Alcohol use that turns into a use disorder develops in stages.

  • At-risk stage: This is when you drink socially or drink to relieve stress or to feel better. You may start to develop a tolerance for alcohol.
  • Early alcohol use disorder: In this stage, you have progressed to blackouts, drinking alone or in secret and thinking about alcohol a lot.
  • Mid-stage alcohol use disorder: Your alcohol use is now control and causes problems with daily life (work, family, financial, physical and mental health). Organ damage can be seen on lab tests and scans.
  • End-stage alcohol use disorder: Drinking is now the main focus of your life, to the exclusion of food, intimacy, health and happiness. Despair, complications of organ damage and death are now close.

There’s no single lab test for alcohol use disorder. Diagnosis is a conversation with your healthcare provider. The diagnosis is made when drinking interferes with your life or affects your health.

Treatment may include a combination of:

  • Behavioral therapies: Counseling, or talk therapy, with a healthcare provider a psychologist or mental health counselor can teach you ways to change your behavior. Motivational, cognitive-behavioral, contingency and 12-step facilitation are the most commonly used techniques.
  • Medications: The U.S. Food & Drug Administration has approved naltrexone and acamprosate for the treatment of alcohol use disorder. Topiramate and gabapentin can also decrease cravings in some people. An older medication — disulfiram — is now used only rarely. These medications seem to help decrease the background obsessional thinking around alcohol.
  • Support groups: Group meetings with other alcoholics can help you stay sober. Alcoholics Anonymous (AA) meetings are usually free and are available in most communities. Other styles of recovery groups include: Celebrate! Recovery (Christian focus), Rational Recovery (non-spiritual) and Recovery Dharma (mindfulness/Buddhist focus).

Your treatment setting will depend on your stage of recovery and the severity of your illness. You may need inpatient medical (hospital), residential rehabilitation (rehab), outpatient intensive therapy or outpatient maintenance.

To prevent alcohol problems, avoid high-risk drinking:

  • For women: No more than four or more drinks in one day or eight or more drinks per week.
  • For men: No more than five or more drinks in one day or 15 or more drinks per week.

If you drink more alcohol than that, consider cutting back or quitting. Talk to your healthcare provider about proven strategies.

Your outlook depends on many factors. Milder cases may only be problematic for a period of time. Severe cases are often a lifelong struggle.

The sooner you recognize there may be a problem and talk to your healthcare provider, the better your recovery chances.

The Substance Abuse and Mental Health Services Administration (SAMHSA) offers a hotline, 24/7, 365 days a year. Call 1-800-662-HELP (4357).

Alcoholics Anonymous is available almost everywhere and provides a place to openly and non-judgmentally discuss alcohol problems with others who have suffered from alcohol.

A note from Cleveland Clinic

No matter how hopeless alcohol use disorder may seem, treatment can help. If you think you might have a problem with alcohol, call SAMHSA or talk to your healthcare provider. They can help you cope, make a treatment plan, prescribe medications and refer you to support programs.

Last reviewed by a Cleveland Clinic medical professional on 06/02/2021.

References

Источник: https://my.clevelandclinic.org/health/diseases/3909-alcoholism

Psychologydo
Добавить комментарий

;-) :| :x :twisted: :smile: :shock: :sad: :roll: :razz: :oops: :o :mrgreen: :lol: :idea: :grin: :evil: :cry: :cool: :arrow: :???: :?: :!: