Alcohol Use Disorder

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) reports that in 2014, over 16 million adults were diagnosed with alcohol use disorder, or AUD. The number of U.S. youths between 12 and 17 years old suffering AUD in 2014 reached a record 680,000. Nearly 55,000 of these youths with AUD required in-patient treatment in specialized facilities.

A drinking pattern that crosses the boundary from moderate to severe is now given a professional diagnosis of AUD instead of alcohol abuse or alcoholism.

Newly established symptoms of Alcohol Use Disorder include:

  • Drinking increasingly large amounts of alcohol over an extended period

  • Trying repeatedly to stop or cut down on drinking but failing

  • Spending many hours each day obtaining alcohol, drinking alcohol and suffering hangovers

  • Always wanting another drink or craving a drink when alcohol isn’t readily available

  • Neglecting to fulfill family, work and personal responsibilities because of chronic alcohol abuse

  • Avoiding recreational or social activities in favor of drinking or recovering from being drunk

  • Continuing to abuse alcohol even when health problems emerge or existing health issues are exacerbated by drinking (hypertension, high cholesterol, ulcers)

  • Developing a tolerance for alcohol (more and more is needed to get drunk)

  • Suffering classic alcohol withdrawal symptoms when abstaining too long from drinking

Grading Alcohol Use Disorder

Healthcare professionals grade alcohol use disorder as Mild, Moderate, or Severe based n the following criteria:

Alcohol use disorder is considered “mild” if two or more of these signs impair a person.

The presence of five symptoms means the individual is suffering “moderate” Alcohol Use Disorder.

Six or more symptoms supports a diagnosis of severe Alcohol Use Disorder.

Alcoholism Becomes Alcohol Use Disorder

man drinking alcohol consumption The fourth edition of the Diagnostic and Statistical Manual (DSM–IV), published by the American Psychiatric Association, described two distinct disorders; alcohol abuse and alcohol dependence, with specific criteria for each. The fifth edition combined the two disorders into one use disorder, naming it alcohol use disorder.

In 2013, the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM–5) was issued by the American Psychiatric Association, which contained diagnostic criteria for alcohol use disorder different from the 4th edition of the DSM.

Comparing the DSM–IV and DSM–5 regarding the definition of alcohol use disorder finds the following differences:

  • In the DSM-IV, alcohol dependence and alcohol abuse are disorders clearly distinct from each other. The DSM-5 integrates alcohol dependence and alcohol abuse into one disorder–AUD– and offers sub-classifications of AUD (mild, moderate and severe).
  • In the DSM-IV, diagnostic particulars for dependence and abuse were clearly separate, with abuse and dependence criteria based on a 12-month period. According to the DSM-V, if someone meets just two of 11 criteria in a 12- month period, they would probably be diagnosed with alcohol use disorder.
  • One of the DSM-IV’s criteria for alcohol abuse and dependence–legal problems–has been eliminated from the DSM-5. However, a new criterion–cravings–has been included in the DSM-V for diagnosing AUD.

More About Alcohol Use Disorder

This video explains the characteristics of Alcohol Use Disorder as described in the DSM-5, by Dr. Grande.

For a more in-depth examination of the DSM-V and the inclusion of alcohol use disorder, visit the Ontario Medical Association or the American Psychiatric Publishing website.

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About the author

Robert M. has been in recovery since 1988. He is a sponsor and loyal member of AA. He has been working in the drug and alcohol field for nearly 20 years. During that time, he has written industry blogs and articles for a variety of industry websites including Transitions, Malibu Horizons, Behavioral Health of the Palm Beaches and Lifeskills of Boca Raton.