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What is Alcohol Use Disorder?
Alcohol Use Disorder (AUD) is classified as a mental disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), falling under the category of substance and addictive disorders.
Simply put, AUD (also known as alcoholism) is a medical and mental disorder where one is addicted to alcohol and continues to drink despite negative consequences to their health, relationships with others, work, and other aspects of their life. Although most people assume that it is the addict’s fault for repeatedly getting drunk to the point of harming their own life without regard and that they could quit if they tried to, the reality is not that simple and is tied to substantial mental health challenges.
According to the National Institutes of Health (NIH), alcohol is the second highest prevalent substance use disorder.
The Psychology Behind Alcohol Use Disorder
Mental disorders impair your cognition, including your thinking, feelings, mood, and behavior; therefore, AUD is a mental disease since it induces these same changes in the brain. Alcohol disrupts the pathways in your brain that affect how the brain functions and looks. Chronic alcohol use strongly alters brain chemistry, often leading to mental healthF issues. Chronic alcohol use also reduces the size of the neurons in your brain, or in other words, it shrinks the size of your brain.
The main reason why alcohol is so addictive is that when alcohol is downed, it causes the brain to flood the reward center of the brain with dopamine, causing a strong correlation between pleasure and alcohol consumption.
Oftentimes, when someone misuses alcohol, they will experience a blackout. A blackout is when someone who is intoxicated has gaps in their memory and cannot seem to remember what happened during the time they were under the influence. According to the National Institute on Alcohol Abuse and Alcoholism, a blackout happens because the alcohol in your bloodstream temporarily blocks the pathway in your brain that transfers short-term memories to long-term memories. The ability to remember negative and dangerous events and actions that happen during blackouts are impaired, making it hard for the individual to learn from their mistakes and find reason to become sober.
It is important to remember that AUD is a mental disease, not a moral failing. This way, it is easier to break the stigma regarding alcohol addiction and inspire people to get help and have more sympathy for others who are struggling with it.
Important Factors
According to Psychiatry, 84 percent of adults (18 and older) have drunk alcohol. Because drinking alcohol is so commonplace, it is no wonder people are often inclined to partake in drinking and are often unaware of just how dangerous the risks are. Drinking culture, peer pressure, and curiosity strongly influence people to take their first drink or continue to drink around others in social situations. Eventually, this can become a dangerous habit and turn into an addiction.
Alcohol successfully works by increasing dopamine, which increases pleasurable feelings in the beginning, and that is, unfortunately, why many people become hooked. It is, therefore, used as self-medication by many people seeking to dull their despair.
A family history of AUD or other substance use disorders also increases the risk of becoming addicted to alcohol. According to Hazelden Betty Ford, biological psychologists have found that those who are more susceptible to alcohol addiction have lower levels of dopamine in their brains compared to those of other people who are not genetically susceptible.
Symptoms and Signs
Alcohol is the most used substance in the United States, so what distinguishes simple use from addiction?
Simple use is when alcohol is consumed in moderation and without serious consequences on one’s life. On the other hand, alcohol addiction, otherwise known as AUD, involves an inability to control their drinking despite negative consequences.
Alcohol Use Disorder Exists on a Spectrum
The criteria listed in the DSM-5 consider 3 severities of AUD: mild, moderate, and severe. If a medical professional notes that you meet 2 of the criteria, that is a diagnosis of AUD. Mild AUD is characterized by the presence of 2-3 symptoms. Moderate AUD is characterized by the presence of 4-5 symptoms. Severe AUD is characterized by the presence of 6 or more symptoms.
The DSM-5 diagnosis for AUD is dependent upon whether these certain behaviors or symptoms have occurred within the past year.
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 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? 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, restlessness, nausea, sweating, a racing heart, or a seizure? Or sensed things that were not there?
Recovery to Sobriety
Treatments to help recover from AUD and gain sobriety and your life back are available. Treatment options include individual and/or group counseling sessions, outpatient programs, or a residential inpatient stay (also known as rehab). Another treatment is Alcoholics Anonymous, also known as Alcoholics Anonymous (AA). AA is a free peer-led and abstinence-focused group where those who suffered from AUD can go to for releasing their pains and feeling less alone.
AA is a free, peer-led, and abstinence-focused group for individuals with AUD. It offers a supportive environment for people to share their struggles and feel less alone.
During rehab treatment programs, detox programs help alleviate the physical ailments during the process of getting sober and managing the withdrawal symptoms.
Most cases of alcohol withdrawal are mild; however, some cases can be life-threatening. For this reason, it is advisable to have medical supervision during the detox and withdrawal phase. The most dangerous possible symptom of withdrawal is having delirium tremens, in which hallucinations and seizures can be experienced.
According to Mayo Clinic, during and after the detoxification, medications may be utilized to make the process of getting sober easier. Two of these medications are naltrexone and disulfiram which both help prevent drinking by making you feel extremely sick if you choose to drink; therefore, preventing relapse. Acamprosate, another medication, helps with dulling cravings and with easing the withdrawal process.
Post detoxification, treatment will focus on the cognitive, emotional, and behavioral aspects of addiction. New positive coping skills, therapy, and possible medication for co-existing mental health issues will be emphasized.
