What it is
Alcohol Use Disorder is a medical condition where drinking leads to impaired control, social or work problems, risky use, and/or physical dependence. Severity ranges from mild to severe based on how many criteria are met. AUD is common and highly treatable—many people recover and live well.
AUD isn’t defined by daily drinking alone; it’s about patterns and impact on life and health.
Common signs and symptoms
- Control and time
- Drinking more or longer than intended; unsuccessful attempts to cut down
- A lot of time spent obtaining, using, or recovering from alcohol
- Impact
- Cravings; missed obligations; conflicts or isolation; risky situations (driving, mixing with sedatives)
- Dependence and health
- Tolerance (needing more for effect) and/or withdrawal (shakes, sweating, anxiety, insomnia, nausea)
- Sleep problems, depression/anxiety, GI upset; long-term risks: high blood pressure, liver disease, cancers, heart disease, cognitive changes
Red flags for dangerous withdrawal: past severe withdrawal, seizures, delirium tremens, heavy daily use, or benzodiazepine use.
Why it happens
- Genetics, stress, trauma, and mental health conditions increase risk
- Alcohol’s short-term relief of stress/anxiety reinforces use
- Social norms and availability; learned coping patterns
What helps
- Evidence-based treatments
- Medications for AUD:
- Naltrexone (oral or monthly injection) reduces heavy drinking and cravings
- Acamprosate supports abstinence after detox
- Disulfiram creates aversive reaction if drinking (use selectively)
- Off-label: topiramate, gabapentin in some cases
- Therapies:
- Motivational Interviewing (MI) to clarify goals
- Cognitive Behavioral Therapy (CBT) to manage triggers and cravings
- Contingency Management; Community Reinforcement Approach
- Mutual-help groups (AA, SMART Recovery) as optional supports
- Medications for AUD:
- Harm reduction and safety
- Set alcohol-free days; standard drink tracking; avoid driving; don’t mix with opioids/benzos
- For those choosing abstinence: plan for withdrawal safety; consider medical detox if moderate–severe
- Levels of care
- Outpatient therapy/medication management
- Intensive Outpatient (IOP) or Partial Hospitalization (PHP)
- Inpatient/residential or medical detox when withdrawal risk or instability is high
- Whole-health supports
- Treat co-occurring depression, anxiety, PTSD, ADHD
- Sleep, nutrition, exercise; rebuild routines and sober social networks
Recovery often improves within weeks: better sleep, mood, energy, blood pressure, and relationships.
When to seek help now
- Morning drinking to steady hands; prior severe withdrawal; seizures; confusion—seek medical evaluation before quitting
- Mixing alcohol with opioids, benzodiazepines, or sleep meds
- Thoughts of self-harm or severe depression—urgent help
How to talk to a clinician
- “I’m concerned about my drinking. I’d like to discuss starting naltrexone (or acamprosate), a therapy referral, and a plan for safe reduction or abstinence.”
Resources for readers in the USA
- Immediate help: 988 Suicide & Crisis Lifeline; 911 for medical emergencies
- Find treatment: SAMHSA Helpline 1-800-662-HELP (4357); FindTreatment.gov; Psychology Today (filter for AUD/CBT/MI/medication-assisted treatment)
- Mutual-help: AA (aa.org), SMART Recovery (smartrecovery.org), Moderation Management (moderation.org)
- Low-cost/community: Community Health Centers (findahealthcenter.hrsa.gov); 211
- Insurance tips: Ask about coverage for AUD medications, IOP/PHP, detox/residential; copay/coinsurance, deductible, out-of-pocket max
Disclaimer: Educational information, not a diagnosis. If in crisis, use the resources above.