What is alcohol use disorder?

Alcohol use disorder means that a person drinks alcohol even though it causes harm to themselves or others. It can range from mild to severe. The more symptoms of this disorder you have, the more severe it may be. People who have it may find it hard to control their use of alcohol.

People who have this disorder may argue with others about how much they're drinking. Their job may be affected because of drinking. They may drink when it's dangerous or illegal, such as when they drive. They also may have a strong need, or craving, to drink. They may feel like they must drink just to get by. Their drinking may increase their risk of getting hurt or being in a car crash.

Over time, drinking too much alcohol may cause health problems. These may include high blood pressure, liver problems, or problems with digestion.

The physical signs of alcohol use disorder can be vague in the early stages of the disease. Some early symptoms include:

• Blackouts, which cause you to not remember what happened when you were drinking. Blackouts aren't the same as passing out. Passing out means that you lose consciousness. You don't pass out when you have an alcohol blackout. But you do lose your memories of the event.
• Accidents and illnesses you can't explain. You might have new physical problems, such as stomach cramps. Or another health problem may get worse.

As alcohol use disorder gets worse, physical symptoms of long-term heavy drinking can develop. You may:

• Not feel hungry, not eat well, and lose weight.
• Notice tiny blood vessels on your skin that look like spider webs (spider angiomas).
• See swelling or redness of the palms of your hands.
• Have redness on your face, especially your nose and cheeks.
• Keep getting infections and skin sores (abscesses).
• Have less interest in sex. You might also notice shrinkage of the testicles and impotence.
• Have a sore or upset stomach (gastritis).
• Feel numbness and tingling in your feet or hands.
• Be unsteady when on your feet.
• Have liver problems, such as cirrhosis.

Alcohol use disorder may be diagnosed at a routine doctor visit or when you see your doctor for another problem.

Your doctor will ask questions about your symptoms and past health and will do a physical exam. Your doctor also may ask questions or do tests to look for health problems linked to alcohol, such as cirrhosis.

People who drink too much also may have mental health conditions. These may include depression, anxiety disorders, or post-traumatic stress disorder (PTSD). If you have alcohol use disorder and a mental health condition, it's called a dual diagnosis. A dual diagnosis can make treatment for alcohol use disorder harder.

If your doctor thinks you have a mental health condition, your doctor may do a mental health assessment.

Getting help is up to you. But you don't have to do it alone. There are many people and kinds of treatments that can help.

Treatment for alcohol use disorder can include:

• Group therapy, one or more types of counseling, and alcohol education.
• Medicines that help to:
  • Reduce withdrawal symptoms and help you safely stop drinking.
  • Reduce cravings for alcohol.
• Support groups. These groups include Alcoholics Anonymous and SMART Recovery (Self-Management and Recovery Training).

Some people are able to stop or cut back on drinking with help from a counselor. People who have moderate to severe alcohol use disorder may need medical treatment. They may need to stay in a hospital or treatment center.

You may have a treatment team to help you. This team may include a psychologist or psychiatrist, counselors, doctors, social workers, nurses, and a case manager. A case manager helps plan and manage your treatment.