no alcoholAlcohol Use Disorder

Alcohol use disorder (which includes a level that’s sometimes called alcoholism) is a pattern of alcohol use that involves problems controlling your drinking, being preoccupied with alcohol, continuing to use alcohol even when it causes problems, having to drink more to get the same effect, or having withdrawal symptoms when you rapidly decrease or stop drinking.

Unhealthy alcohol use includes any alcohol use that puts your health or safety at risk or causes other alcohol-related problems. It also includes binge drinking — a pattern of drinking where a male consumes five or more drinks within two hours or a female downs at least four drinks within two hours. Binge drinking causes significant health and safety risks.

If your pattern of drinking results in repeated significant distress and problems functioning in your daily life, you likely have alcohol use disorder. It can range from mild to severe. However, even a mild disorder can escalate and lead to serious problems, so early treatment is important.

Symptoms

Alcohol use disorder can be mild, moderate or severe, based on the number of symptoms you experience. Signs and symptoms may include:

  • Being unable to limit the amount of alcohol you drink
  • Wanting to cut down on how much you drink or making unsuccessful attempts to do so
  • Spending a lot of time drinking, getting alcohol or recovering from alcohol use
  • Feeling a strong craving or urge to drink alcohol
  • Failing to fulfill major obligations at work, school or home due to repeated alcohol use
  • Continuing to drink alcohol even though you know it’s causing physical, social or interpersonal problems
  • Giving up or reducing social and work activities and hobbies
  • Using alcohol in situations where it’s not safe, such as when driving or swimming
  • Developing a tolerance to alcohol so you need more to feel its effect or you have a reduced effect from the same amount
  • Experiencing withdrawal symptoms — such as nausea, sweating and shaking — when you don’t drink, or drinking to avoid these symptoms

Alcohol use disorder can include periods of alcohol intoxication and symptoms of withdrawal.

  • Alcohol intoxication results as the amount of alcohol in your blood stream increases. The higher the blood alcohol concentration is, the more impaired you become. Alcohol intoxication causes behavior problems and mental changes. These may include inappropriate behavior, unstable moods, impaired judgment, slurred speech, impaired attention or memory, and poor coordination. You can also have periods called “blackouts,” where you don’t remember events. Very high blood alcohol levels can lead to coma or even death.
  • Alcohol withdrawal can occur when alcohol use has been heavy and prolonged and is then stopped or greatly reduced. It can occur within several hours to four or five days later. Symptoms include sweating, rapid heartbeat, hand tremors, problems sleeping, nausea and vomiting, hallucinations, restlessness and agitation, anxiety, and occasionally seizures. Symptoms can be severe enough to impair your ability to function at work or in social situations.

What is considered one drink?

The National Institute on Alcohol Abuse and Alcoholism defines one standard drink as any one of these:

  • 12 ounces (355 milliliters) of regular beer (about 5 percent alcohol)
  • 8 to 9 ounces (237 to 266 milliliters) of malt liquor (about 7 percent alcohol)
  • 5 ounces (148 milliliters) of unfortified wine (about 12 percent alcohol)
  • 5 ounces (44 milliliters) of 80-proof hard liquor (about 40 percent alcohol)

When to see a doctor or counsellor

If you feel that you sometimes drink too much alcohol, or it’s causing problems, or your family is concerned about your drinking, talk with your doctor. Other ways to get help include talking with a mental health provider or seeking help from a support group such as Alcoholics Anonymous or a similar type of self-help group.

Because denial is common, you may not feel like you have a problem with drinking. You might not recognize how much you drink or how many problems in your life are related to alcohol use. Listen to relatives, friends or co-workers when they ask you to examine your drinking habits or to seek help. Consider talking with someone who has had a problem drinking, but has stopped.

If your loved one needs help

Many people with alcohol use disorder hesitate to get treatment because they don’t recognize they have a problem. An intervention from loved ones can help some people recognize and accept that they need professional help. If you’re concerned about someone who drinks too much, ask a professional experienced in alcohol treatment for advice on how to approach that person

Genetic, psychological, social and environmental factors can impact how drinking alcohol affects your body and behavior. Theories suggest that for certain people drinking has a different and stronger impact that can lead to alcohol use disorder.

Over time, drinking too much alcohol may change the normal function of the areas of your brain associated with the experience of pleasure, judgment and the ability to exercise control over your behavior. This may result in craving alcohol to try to restore good feelings or reduce negative ones.