(AUD; Alcohol Dependence; Alcohol Abuse and Alcoholism)
Definition
Definition
Alcohol use disorder (AUD) is a spectrum of issues involving problem drinking. The drinking continues even though it is clearly associated with physical, mental, and social health problems.
Causes
Causes
The specific cause of AUD is unknown. It is often a complex combination of factors, including genetics and environment.
Risk Factors
Risk Factors
Factors that may increase your chance of AUD include:
- Genetic makeup that affects how your body uses alcohol
- Family members with a history of alcohol misuse
- Use of alcohol at an early age
- Use of illicit drugs or non-medical use of prescription drugs
- Easy access to alcoholic beverages
- Situations with high peer pressure and/or emotional stress
- Psychiatric disorders, such as depression or anxiety
- Smoking
Symptoms
Symptoms
Symptoms can vary between people. The most common signs and symptoms of AUD include:
- Increasing amounts of alcohol that is being consumed
- Inability to stop or limit drinking despite associated problems
- Significant amounts of time doing activities to obtain or use alcohol
- Craving or urge to use alcohol
- Repeated home, school, or work problems
- Difficulty in relationships with family members, friends, and coworkers
- Missing previously favored activities in order to drink alcohol or recover from alcohol
- Alcohol use even if it creates physically unsafe situations or leads to legal trouble
- Alcohol use that continues even when it causes or worsens health problems
Problematic alcohol use can lead to tolerance. As a result, greater amounts of alcohol are needed to reach intoxication.
A sudden withdrawal of alcohol can also cause physical symptoms in people who have developed a physical dependence. Withdrawal symptoms may include:
- Nausea
- Sweating
- Shaking
- Anxiety
- Seizures that may result from delirium tremens (DTs)
AUD is linked to the development of serious health complications and early death.
Diagnosis
Diagnosis
Your doctor will ask about your symptoms and medical history. AUD is diagnosed based on information collected from specific questions, such as number of drinks, social habits, lifestyle changes, and personal relationships. If a family member or friend is present, they may be asked questions as well.
There is no test for AUD. Further tests may be needed if there are some signs of related illness or organ damage.
Treatment
Treatment
The first and most important step is recognizing that a problem exists. Successful treatment depends on the desire to change. Denial is common in people with AUD. Support and counseling is available for family and friends who have a loved one with AUD who is in denial.
AUD treatment is aimed at teaching you how to manage the disease. Most professionals believe that this means giving up alcohol completely and permanently. A combination of approaches is most effective. Medical support may be needed to safely manage withdraw from alcohol. This could require hospitalization in a detoxification center. Support may include medications, fluid or nutrition support, and general monitoring by professional staff.
Treatment to maintain management of disorder may include:
Medications
Certain medications may help prevent relapse, such as those that:
- Block the high that contributes to alcohol craving
- Cause immediate illness after drinking alcohol
- Reduce cravings for alcohol
Counseling
AUD affects all aspects of life, including relationships, family, and work. Counseling is a large part of AUD treatment. It may be one-on-one, in a group, or with other family members. Counseling works to improve coping skills and learn other ways of dealing with stress or pain. Counseling that helps develop coping mechanisms may also be useful for family members.
Treatment and counseling take time. What works for some may not work for others. Some aspects include professional interventions, education, self-help plans, and follow-up via computers or text messaging. The length of time involved in counseling depends on how many problems are affected by AUD.
Mentoring and Community Help
Alcoholics Anonymous (AA) helps many people to stop drinking and stay sober. Members meet regularly and support each other. Your family members may also benefit from attending meetings of Al-Anon. Living with an alcoholic can be a painful, stressful situation.
Relapse is common in people who are recovering from an addiction. Treatment, like taking medication and working with a therapist, may help reduce your chance of drinking and give you the support that you need if you do have a relapse.
Medical Care
AUD affects the body’s major organs, including the brain, heart, liver, and pancreas. Treatment for AUD may also include medical treatment for life-threatening health conditions. These may include:
- Heart disease, such as heart arrhythmias, or a heart attack or stroke
- Liver disease, such as cirrhosis
- Pancreatitis
- Nutritional deficiencies
- Cognitive problems, such as dementia
- Psychiatric problems
Some of the Organs Damaged with Alcohol Use DisorderCopyright © Nucleus Medical Media, Inc.
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Prevention
Prevention
It may not be possible to prevent AUD, but it tends to run in families. If you have family members that have a history of problem drinking, be aware that you may have an increased risk for addictive behaviors.
Education and structured programs can help children and teens learn about alcohol and how it affects families and society. If you are a parent, be a good role model for your children by avoiding alcohol or drinking in moderation in a safe environment and without driving. Moderation is is one drink or less per day for women and two drinks or less per day for men.
RESOURCES:
CANADIAN RESOURCES:
Mental Health Canada http://www.mentalhealthcanada.com
References:
http://www.ebscohost.com/dynamed
Updated January 23, 2015. Accessed February 6, 2015.
American Psychiatric Association. Desk Reference to the Diagnostic Criteria from DSM-5. Washington, DC: American Psychiatric Association; 2013.
Tyburski EM, Sokolowski A, et al. New diagnostic criteria for alcohol use disorders and novel treatment approaches—2014 update. Arch Med Sci. 2014;10(6):1191-1197.
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Schinke SP, Fang L, et al. Computer-delivered, parent-involvement intervention to prevent substance use among adolescent girls. Prev Med. 2009;49;429-35.
5/14/2010 DynaMed’s Systematic Literature Surveillance
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Vivitrol (naltrexone). US Food and Drug Administration website. Available at: http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm106211.htm. Updated August 28, 2013. Accessed February 6, 2015.
Last Updated: 2/6/2015