What it is
Alcohol Use Disorder (AUD) is a medical condition where alcohol use causes distress or harm and is hard to cut down despite consequences. Severity ranges from mild to severe. AUD is common and treatable—many people recover with support and medications.
Common signs and symptoms
- Drinking more or longer than intended; unsuccessful attempts to cut down
- Cravings; spending a lot of time drinking or recovering
- Neglecting responsibilities; continuing to drink despite problems
- Risky situations (driving, injuries); conflicts with loved ones
- Tolerance (needing more for effect) or withdrawal (sweats, tremor, anxiety, insomnia, nausea) when cutting down
Medical risks: liver disease, high blood pressure, heart disease, cancers, depression/anxiety, sleep problems, interactions with medications. Withdrawal can be dangerous.
Why it happens
- Biology: genetics, brain reward circuits, stress systems
- Psychology: coping with anxiety, trauma, or insomnia; habit learning
- Environment: social norms, availability, stress, co-occurring mental health conditions
AUD is not a failure of willpower—it’s a treatable health condition.
What helps
- First steps
- Honest self-check: track drinks; identify triggers (stress, social settings, time of day)
- Set a goal (reduce or abstain) and share with a trusted person
- Evidence-based treatments
- Medications:
- Naltrexone (pill or monthly injection) reduces heavy drinking/cravings
- Acamprosate supports abstinence; disulfiram is an option for some
- Off-label options (e.g., topiramate, gabapentin) may help—discuss with a clinician
- Therapies:
- Motivational Interviewing, CBT, and contingency management
- Trauma-informed care when trauma is relevant
- Mutual-help and community:
- AA/12-step (works well for many), SMART Recovery, Moderation Management
- Medications:
- Safer cutting down
- If you drink heavily daily, talk to a clinician before stopping—withdrawal may need medical supervision or medication (benzodiazepines in monitored settings, gabapentin)
- Hydration, nutrition, sleep; avoid mixing alcohol with sedatives/opioids
Integrated care for co-occurring depression/anxiety, PTSD, or pain improves outcomes.
When to seek help now
- Withdrawal symptoms (shaking, sweating, high pulse/BP), seizures, confusion—seek urgent medical care
- Drinking despite pregnancy, liver disease, or dangerous situations
- Thoughts of self-harm or not wanting to live (seek urgent help)
How to talk to a clinician
- “I’m drinking more than I want and have cravings. I’d like to discuss medications like naltrexone or acamprosate and CBT or support groups.”
Outlook
Many people reduce or stop drinking and feel better within weeks—improved sleep, mood, blood pressure, and relationships. Slips can happen; each is a learning step.
Resources for readers in the USA
- Immediate help: 988 Suicide & Crisis Lifeline; Crisis Text Line text HOME to 741741
- Treatment and support:
- FindTreatment.gov (filter for AUD, detox, and medications)
- SAMHSA National Helpline: 1-800-662-HELP (4357)
- AA: aa.org; SMART Recovery: smartrecovery.org; Moderation Management: moderation.org
- Find care: Psychology Today (filter for addiction medicine/CBT); NAMI HelpLine (nami.org/help)
- Low-cost/community: Community Health Centers (findahealthcenter.hrsa.gov); 211
- Insurance tips: Check in-network detox, medication-assisted treatment, IOP/PHP, prior authorization; copay/coinsurance, deductible, out-of-pocket max; parity law appeals
- Work/school supports: FMLA, ADA accommodations, EAP; campus counseling
- Urgent options besides ER: If severe withdrawal risk, ER is appropriate; otherwise Mobile Crisis via 988 (where available), behavioral urgent care
Disclaimer: Educational information, not a diagnosis. If in crisis, use the resources above.