Alcohol Use Disorder

A battle for physical and mental liberation

Alcohol Use Disorder, or AUD, is a physical and mental disorder we generally call “alcoholism.” Like every other substance use disorder, it can significantly impact your health, relationships, family, and livelihood.

However, it doesn’t define you. Learn more about AUD and how to recover from it.

What Qualifies as Alcohol Use Disorder?

Many people have a specific vision of an alcoholic: someone stumbling and slurring their words, unkept, quick to anger, or belligerent and remorseless.

The truth is that these stereotypes can be harmful and discourage people from getting help when needed. An AUD doesn’t typically fit in with this crafted image from movies and TV throughout the years. 

An AUD can happen to anyone with a consistent habit of excessive drinking or alcohol cravings. If alcohol causes someone harm or interrupts their life, They likely have an AUD.

Alcohol Misuse

The Centers for Disease Control and Prevention define alcohol misuse as any pattern of drinking that is more likely to cause health problems, relationship damage, or any disruption in daily life. The CDC quantifies this as an average of two or more drinks per day for men and one or more for women.

These daily averages don’t take binge drinking into account. Most often associated with young people or college parties, binge drinking is classified as five or more drinks in a sitting for men or four for women. It’s a form of alcohol abuse often, though not always, present in someone with an alcohol use disorder.

Alcohol Dependence

Alcohol dependence is more in line with what we consider “alcoholism.” Misuse and dependence aren’t mutually exclusive. Dependence can frequently follow misuse.

However, dependence is less a pattern and rather a physical addiction. When we consume any mind-altering substance (yes, alcohol is a drug), our bodies get used to it, increasing our tolerance. We need more to feel the effects of it. Eventually, we need some to avoid withdrawal or to feel “normal.”

That is a dependence. Not everyone who misuses alcohol or drinks heavily will develop an addiction. However, some people are more at risk than others and can become dependent on alcohol, even with moderate drinking. 

The Spectrum of Alcohol Use Disorder

The level of misuse falls on a spectrum ranging from mild AUD to severe AUD. The DSM-5 outlined criteria for determining where a person with AUD falls on the spectrum. 

If you’re concerned about how much alcohol you drink, your doctor will ask these questions about your habits in the last year:

  • Did you drink more, or for longer, than intended?
  • Did you try to cut down or stop drinking but couldn’t?
  • Did you spend a lot of time drinking? Or being sick or getting over other aftereffects?
  • Have you wanted a drink so badly that you couldn’t think of anything else?
  • Has drinking or being sick from drinking often interfered with caring for your home or family or caused job troubles?
  • Did you ever continue to drink even though it was causing problems with your relationships?
  • Have you had to give up or cut back on important activities or hobbies to drink?
  • Have you gotten into more than one situation during or after drinking that increased your chances of getting hurt (driving, walking in a dangerous area, or having unprotected sex)?
  • Did you ever continue to drink even though you knew it was making you feel depressed, anxious, or added to another health problem? 
  • Have you blacked out more than once? 
  • Do you find that your usual number of drinks had much less effect than before?
  • Do you get withdrawal symptoms when the effects of alcohol wear off, such as trouble sleeping, shakiness, restlessness, nausea, sweating, a racing heart, or a seizure?

The DSM-5 states that saying “yes” to two or three questions indicates a mild AUD. A yes to four or five indicates moderate, while six or more indicates severe. The more questions resonate with you, the more urgently you should seek help.

Remember that you’re allowed and encouraged to get help whenever you think you need it—no matter how many of these criteria you fit into. If you want to make a change, reach out.

When Does Drinking Become a “Problem”?

Drinking can become a problem when it keeps you from living the life that you want. Whether that means you can’t maintain relationships because of it, or you lost money because of it, or you can’t physically do the things you enjoy because of health problems that it caused—if it gets in the way of joy and fulfillment, the act of drinking becomes problematic.

Alcohol Is a Poison

The “favorite” effect of alcohol is feeling happy. Many people drink because it relaxes inhibitions and makes them more content and cheery.

But these effects come with a cost. Aside from the loss of coordination and nausea, alcohol can be incredibly physically and mentally damaging over time. Extended use can lead to the following:

  • Cirrhosis of the liver
  • High blood pressure
  • Stroke
  • Cognitive decline
  • Weakened immune system

These effects intensify over time. Most of them can improve when a person cuts out drinking. 

Reconciling How Accepted Drinking Is

Despite alcohol being a psychoactive central nervous system-depressing drug, it is legal in the United States. In fact, it’s the most widely consumed substance globally, to the point that we almost expect every person to drink alcohol.

This normalcy can make it much more challenging to seek help or even know you’re misusing alcohol. And it can make it difficult to stay sober once you start that journey. Remember that your decision to get sober is yours, and the unhealthy habits of those around you shouldn’t sway it. 

How Does Alcoholism Develop?

Like most drugs, alcohol dependence happens in your brain’s reward center. Alcohol causes your brain to release dopamine, often called the “happy hormone.” This hormone makes you feel more cheerful and relaxed when you begin drinking. 

Your brain begins to adjust to this constant rush of dopamine, so it lowers the baseline amount. Over time, your body needs more alcohol to trigger that dopamine release. This effect is called tolerance. The more frequently you drink, the higher your tolerance will become.

Who is at Risk?

Once again, misuse doesn’t guarantee an addiction. However, it is a significant risk factor. But other things might contribute to an AUD.

Those With a Family Member With an Addiction

Genetics plays an enormous role in addiction. Scientists are still researching how exactly your DNA ties into use disorders, but it’s clear there is a link. The National Institute on Alcohol Abuse and Alcoholism, the NIAA, found that addiction has a 60% heritability rate.

The NIAA also states that the family environment also plays a part. If people grow up around alcohol misuse or addiction, they’re more likely to develop it themselves.

Those Who Start Drinking Young

The environment also plays a factor in other ways—alcohol exposure when young can lead to consuming it at an early age. The NIAA found that those who started drinking at age 15 or younger were five times more likely to have an AUD than those who began at age 21.

The Connection Between Mental Health and AUD

The alcohol and dopamine relationship is just one connection between AUD and depression. Once the surge of dopamine depletes, it leads to feelings of sadness and emptiness. Not only that, but alcohol is a depressant. Though it initially triggers that reward center, it also triggers other functions in your body to slow down.

Inversely, depression is a risk factor for developing an addiction. The feelings of the dopamine rush might entice someone with a depressive disorder. However, those other depressive effects of alcohol last even after it’s out of your system.

Those with an anxiety disorder might drink to “calm the nerves,” again taking advantage of the relaxing side effects. But it’s a harmful, short-term fix for a more significant problem. Self-medicating with alcohol creates a circular relationship and can contribute to a cycle of misuse.

Treating AUD

AUD is both a physical and mental health disorder, requiring a dual approach if severe. It’s crucial to invest in treatment that you trust and create a support system that can help you along the way.

Medical Detox

The nature of long-term alcohol dependency means that some kind of detoxification might be necessary. The body has adapted to its constant presence, so returning to healthy or “normal” can be shocking.

Proper medical supervision can make this process as quick and easy as possible. It may involve several detox medications like naltrexone, acamprosate, or disulfiram.


Different methods of talk therapy can go a long way. It can help treat AUD, other related mental health disorders, and their root causes. 

Research proves that cognitive behavioral therapy (CBT) and dialectical behavioral therapy (DBT) help treat a variety of addictions. 

Call Inner Balance Counseling Today

Are you ready to get started on your journey to sobriety? We’ll guide you. The experienced staff at Inner Balance have helped many clients through AUD and other wellness concerns. Remember, you don’t have to hit rock bottom before you seek help. We’ll help you work through any obstacle, big or small.

Please schedule a consultation with us today. We’ll help you take back the life you want and deserve. All you have to do is reach out, show up, and feel better.

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