Enjoying a glass of wine at dinner or a few drinks on the weekend is usually no cause for concern; many people can drink in moderation and continue to live happy, successful lives. Some people, however, can't just stop with one or two drinks — they find that alcohol interferes with their everyday life and often leads them into dangerous situations. If you fall in the latter group, you may be one of the 16 million US adults who have alcohol use disorder (AUD).
Alcohol use disorder is newly defined in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, or DSM-5, the handbook used by healthcare professionals in the United States to diagnose mental disorders. The previous edition, DSM-4, outlined two different disorders: alcohol abuse and alcohol dependence. The DSM-5, however, integrates the two into one disorder called alcohol use disorder.
To be diagnosed with AUD, you must meet two of the 11 criteria outlined in the DSM-5 and must have experienced symptoms within the last 12 months. The level of severity of the disorder depends on how many symptoms you have. The criteria are:
- Drinking more or longer than you intended.
- Trying to cut back or stop drinking more than once but couldn't.
- Spent a lot of time drinking, being sick from drinking, or getting over other aftereffects.
- Wanted a drink so badly you couldn't think of anything else.
- Found that drinking (or being sick from drinking) often interfered with taking care of your home or family, caused job troubles, or school problems.
- Continued to drink even though it was causing you trouble with family and friends.
- Given up or cut back on activities that were important or interesting to you in order to drink.
- More than once gotten into situations while or after drinking that increased your chances of being 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 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, restlessness, nausea, sweating, a racing heart, or a seizure, or seeing things that were not there.
The presence at least two of these symptoms means you have an AUD. If you have two to three symptoms, it's considered mild; four to five symptoms is considered moderate; six or more symptoms is considered severe. If you don't fall into the severe category, a mild diagnosis can still warrant concern, as it may be the start of a larger problem.
If you think you may have AUD, be sure to seek treatment from a medical professional. Your primary care physician or a psychiatrist can formally assess your condition and outline a proper course of treatment. The National Institute on Alcohol Abuse and Alcoholism also has resources for finding and getting help through its website.