Problem drinking that becomes severe is given the medical diagnosis of “alcohol use disorder” or AUD. AUD is a chronic relapsing brain disease characterized by:
- compulsive alcohol use,
- loss of control over alcohol intake,
- and a negative emotional state when not using.
To be diagnosed with AUD, individuals must meet certain criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM). Under DSM–5, the current version of the DSM, anyone meeting any two of the 11 criteria during the same 12-month period receives a diagnosis of AUD. The severity of AUD—mild, moderate, or severe—is based on the number of criteria met.
To assess whether you or loved one may have AUD, here are some questions to ask.
In the past year, have you:
- Had times when you ended up drinking more, or longer than you intended?
- More than once wanted to cut down or stop drinking, or tried to, but couldn’t?
- Spent a lot of time drinking? Or being sick or getting over the aftereffects?
- Experienced craving — a strong need, or urge, to drink?
- Found that drinking — or being sick from drinking — often interfered with taking care of your home or family? Or caused job troubles? Or school problems?
- Continued to drink even though it was causing trouble with your family or friends?
- Given up or cut back on activities that were important or interesting to you, or gave you pleasure, in order to drink?
- More than once gotten into situations while or after drinking that increased your chances of getting hurt (such as driving, swimming, using machinery, walking in a dangerous area, or having unsafe sex)?
- Continued to drink even though it was making you feel depressed or anxious or adding to another health problem? Or after having had a memory blackout?
- Had to drink much more than you once did to get the effect you want? Or found that your usual number of drinks had much less effect than before?
- Found that when the effects of alcohol were wearing off, you had withdrawal symptoms, such as trouble sleeping, shakiness, irritability, anxiety, depression, restlessness, nausea, or sweating? Or sensed things that were not there?
If you have any of these symptoms, your drinking may already be a cause for concern. The more symptoms you have, the more urgent the need for change. A health professional can conduct a formal assessment of your symptoms to see if AUD is present.
However severe the problem may seem, most people with AUD can benefit from treatment.
Unfortunately, less than 10 percent of them receive any treatment. You can seek treatment from a private psychiatrist who can spend some time with you to sort out the psychiatric and medical complications of alcohol use.
The first step is to get you to withdraw from alcohol. This can be done as an outpatient or in the inpatient setting. Medications are used in the withdrawal stage. For subsequent rehabilitation, the psychiatrist will engage you in therapy or refer you to a counsellor or a psychologist who has experience and interest in helping people who use alcohol.
Attending Alcohol Anonymous meetings will also provide help and emotional support.
