Alcohol use disorder (formerly known as alcoholism) is a form of substance use disorder. Changes in the brain make it difficult to reduce or stop alcohol use, but treatment can help.

Alcohol use disorder is a medical and mental health condition that involves being unable to stop or reduce alcohol use despite it having negative consequences on life and daily functioning. AUD may negatively affect:

  • relationships with friends, family, coworkers, and acquaintances
  • work
  • school
  • physical and mental health

Alcohol use disorder can range from mild to severe, depending on the symptoms and impact.

If you’re experiencing (or a loved one is experiencing) alcohol use disorder, know that help is available.

Keep reading to learn about alcohol use disorder, including the symptoms and criteria, possible causes and contributing factors, and how to get help.

Why aren’t the terms “alcohol abuse” and “alcoholism” used anymore?

Alcohol use disorder has been known by a variety of terms, including alcohol abuse and alcoholism. Today, it’s referred to as alcohol use disorder.

Outdated terms can contribute stigma and judgment, and imply that it is a choice a person is making. While use of a substance may be voluntary at first, substance use disorder can impair a person’s judgment, decision making, memory, and behavior control over time.

Alcohol use disorder is a medical and mental health condition with identifiable causes and risk factors. The change in terminology reflects this. Like many other health conditions, substance use disorder disrupts the usual functioning of organs in the body, has serious harmful effects, and may be preventable and treatable.

Alcohol use, including heavy or habitual alcohol use, may not necessarily be alcohol use disorder.

According to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR), to receive a diagnosis of alcohol use disorder, a person has to have at least two of the following symptoms within 12 months:

  • Consuming alcohol in larger amounts or over a longer period than intended
  • Having a persistent desire or making unsuccessful efforts to reduce or manage alcohol use
  • Spending “a great deal of time” on activities needed to obtain alcohol, use alcohol, or recover from its effects
  • Craving alcohol, or having a strong urge to use alcohol
  • Repeated alcohol use resulting in failure to fulfill major obligations at work, school, or home
  • Continuing alcohol use despite persistent or recurrent social or relationship problems caused or exacerbated by its effects
  • Giving up or reducing important social, occupational, or recreational activities because of alcohol use
  • Repeatedly using alcohol in situations in which it is physically hazardous
  • Continuing to use alcohol despite knowledge of having a persistent or repeated physical or psychological problem likely to have been caused or worsened by alcohol
  • Having alcohol tolerance, which means having either:
    • A need for significantly increased amounts of alcohol to achieve intoxication or the desired effect
    • A significantly diminished effect with continued use of the same amount of alcohol
  • Experiencing withdrawal, which may include either:

The number of symptoms you have determines the severity:

  • Mild: 2 to 3 symptoms
  • Moderate: 4 to 5
  • Severe: 6 or more

Alcohol use disorder typically develops in stages. These include:

  • Stage 1 or binge/intoxication stage: During this stage, the brain begins to link the pleasurable and rewarding experience of alcohol with cues. This develops and strengthens alcohol use as a habit.
  • Stage 2 or withdrawal/negative effect stage: During this stage, the person feels they need alcohol use to relieve discomfort and emotional pain.
  • Stage 3 or preoccupation/anticipation stage: During this stage, a person develops deficits in their executive functioning, which is the part of the brain responsible for judgment and decision making.

Alcohol use disorder develops over time from habitual drinking.

Habitual drinking causes changes in the brain that can make it harder to stop regular alcohol use.

Some factors may increase the risk of developing alcohol use disorder. These can include:

What is binge drinking?

The National institutes of Health (NIH) defines binge drinking as a pattern of drinking alcohol that brings blood alcohol concentration (BAC) to 0.08% (or 0.08 grams of alcohol per deciliter) or higher. This typically corresponds to drinking in two hours or less:

  • 5 of more drinks for males
  • 4 or more drinks for females

The threshold is lower in females because they typically have proportionally less water in their bodies. There isn’t data available on determining BAC in people outside of the gender binary.

Alcohol use, especially the habitual and heavy alcohol use associated with alcohol use disorder, can have negative health effects.

Possible complications can include:

Sometimes it can be hard to find the line between alcohol use and misuse. The following questions may be helpful in considering your relationship with alcohol use.

  • Do you need to drink increasingly more over time to feel the effects of alcohol?
  • Do you feel guilt about your drinking habits?
  • Do you become irritable or violent when you’re drinking?
  • Do you have problems at school or work because of drinking?
  • Do you think it might be better if you reduced your alcohol use?

If you would like to reduce your alcohol use but aren’t sure where to get started, it’s best to talk with a healthcare professional. Engaging in heavy, habitual alcohol use may make withdrawal symptoms likely if you stop suddenly. Some of these symptoms can be dangerous. A doctor can help assess your situation and recommend treatment to reduce these symptoms.

What is heavy drinking?

The Centers for Disease Control and Prevention (CDC) define heavy drinking as:

  • more than eight drinks per week for females
  • more than 15 drinks per week for males

The Substance Abuse and Mental Health Services Administration (SAMHSA) defines heavy alcohol use as binge drinking on five or more days in the past month.

You don’t need a professional diagnosis to get help for alcohol use disorder.

However, a diagnosis of alcohol use disorder may provide access to additional resources to support your recovery and care, which may include:

  • support in reducing or stopping alcohol use
  • medical treatment for alcohol withdrawal syndrome, if needed
  • monitoring your overall health
  • treatment for alcohol-related health conditions

A health professional may use a questionnaire that assesses alcohol use disorder to help diagnose alcohol use disorder.

Typically, a diagnosis of alcohol use disorder doesn’t require a diagnostic test. However, a doctor may order blood work to check your liver function if you have symptoms of liver disease.

Treatment for alcohol use disorder usually involves support and medical care to help you reduce your intake of alcohol or stop drinking altogether.

Treatment may occur in stages and can include:

  • Detoxification: This involves stopping alcohol use and taking steps to prevent or manage withdrawal syndrome, if needed. It’s usually recommended to complete alcohol detoxification with medical supervision.
  • Medications: Medications can limit the pleasurable and rewarding effects of alcohol to help you reduce your alcohol use.
  • Behavioral treatment: Support groups and 12-step programs like Alcoholics Anonymous (AA) can support and reinforce your recovery from alcohol use disorder.
  • Medical treatment: Doctors help treat health problems associated with alcohol use disorder.
  • Therapy or counseling: Talk therapy, like cognitive behavioral therapy (CBT) for addiction, can help you understand and address any emotional issues or history that may contribute to developing alcohol use disorder.
  • naltrexone (ReVia), which blocks certain receptors in the brain associated with the pleasurable response to consuming alcohol; in combination with counseling, naltrexone may help decrease the craving for alcohol
  • acamprosate, a medication that can help re-establish the brain’s original chemical state before alcohol dependence
  • disulfiram (Antabuse), a drug that causes physical discomfort (such as nausea, vomiting, and headaches) whenever the person consumes alcohol
  • topiramate (Topamax), a drug that can help to decrease the rewarding effects of alcohol use; however, this use is considered off-label drug use

You may need to seek treatment at an inpatient facility if your alcohol use disorder is severe. These facilities provide 24-hour care as you detox from alcohol.

Once you’re well enough to return home, you usually continue treatment on an outpatient basis.

Recovery from alcohol use disorder may not be linear. But help is available.

Stopping or reducing heavy alcohol use suddenly and without medical support can result in withdrawal syndrome. It is a collection of symptoms that develop when the central nervous system attempts to adapt to the lack of alcohol after becoming habituated to it.

Doctors may treat withdrawal syndrome with medication or supportive care and monitoring. This may include medications like benzodiazepines or barbiturates (off-label), which require close monitoring and reassessment.

Alcohol withdrawal can cause symptoms that may include:

  • anxiety
  • tremors
  • nausea and vomiting
  • headache
  • increased heart rate
  • irritability and confusion
  • insomnia
  • high blood pressure
  • excessive sweating

Some people may experience a more serious type of withdrawal syndrome called delirium tremens (DT). It can be life threatening. It may include more severe forms of the above symptoms as well as:

If you have alcohol use disorder, help is available. The following resources may help you navigate recovery:

  • Above the Influence provides information targeted at youth and young adults regarding substance use, peer pressure, and treatment options.
  • The Substance Abuse and Mental Health Services Administration (SAMHSA) offers free resources and referrals to treatment. If you have questions or need help, call the 24/7 helpline at 800-662-HELP (4357).
  • The National Institute on Drug Abuse provides information and research for teenagers and young adults about substance use disorders.
  • The National Association for Children of Alcoholics provides information and resources for children of parents with alcohol use disorder.
  • Al-Anon provides confidential groups and meetings across the United States for adult friends and family members of people who misuse alcohol. Call 888-4AL-ANON (888-425-2666) for more meeting information.
  • Alateen provides confidential groups and meetings across the United States to help teenagers and young adults cope with a friend or family member’s alcohol use. Try Alateen chat.
  • Alcoholics Anonymous (AA) offers in-person and virtual meetings and support groups for people in recovery from alcohol addiction or misuse.
  • Narcotics Anonymous (NA) offers in-person and virtual meetings and support groups for people in recovery from narcotic addiction or misuse.

Alcohol use disorder is a medical condition. Continued habitual and heavy alcohol use can make it harder to manage, reduce, or stop.

Many factors can contribute to someone developing alcohol use disorder.

Treatment may include medical detox, medications, supportive care, and counseling to help you stop alcohol use. If you are experiencing alcohol use disorder, help is available.