What is alcohol use disorder (AUD)?
Alcohol use disorder (AUD) or alcoholism is characterized as when an individual’s alcohol drinking behavior affects their mental or physical health or causes distress or harm to their social and personal lives.
An individual with alcohol use disorder will continue to drink even negatively impacting their life, such as losing a job or breaking up in a relationship. These alcoholics may be aware that their alcohol consumption ruins their lives, but they could not help it.
How prevalent is Alcohol Use Disorder?
According to the 2018 survey of NSDUH, almost 14.4 million adults ages 18 and older had AUD only in the United States. This includes 9.2 million men and 5.3 million women. Almost 401,000 teenagers aged 12 -17 had AUD, which consists of 173,000 males and 227,000 females of this age group.
The annual global alcohol consumption is 6.4 liters per person older than the age of 15. The share of adults who drinks alcohol is highest across Western Europe and Australia. Among European nations, alcoholic consumption is the highest in France. In 2010, almost 95 percent of adults in France had drunk alcohol in the preceding year.
Almost 88,000 people die from alcohol-related causes annually in the U.S., including approximately 62,000 men and 26,000 women. It’s the third leading preventable cause of death in the U.S.
Unfortunately, at this time, Covid-19 pandemic has just made the situation worse than before.
What are the symptoms of alcohol use disorder?
The severity of AUD can vary from moderate to severe according to the individual’s number of symptoms. Different signs and symptoms of AUD are:
- An irresistible urge to drink
- Binge drinking
- Unable to control the amount of alcohol consumption
- Negative thoughts and behavior during non-consumption times
- Spending a lot of time in drinking and purchasing alcohol
- Continue alcohol consumption, even when daily activities are affected
- Withdrawal from social activities
- Consuming alcohol in risky situations such as driving
- Increased tolerance toward alcohol. It requires a higher amount of alcohol consumption to maintain alcohol addiction.
- Consuming alcohol to start the day or to overcome a hangover
What are the causes and risk factors of alcohol use disorder?
Several factors could cause or worsen AUD that include: –
1. Genetic: Research has shown that an individual with a family history of alcoholism is more likely to adopt drinking habits, especially at a young age.
2. Environmental factor: The alcoholic’s environment plays a vital role in developing certain habits. A person is more susceptible to developing AUD due to peer pressure or socializing with other alcoholics.
3. Physical, emotional, or sexual abuse: Any person who faced physical, emotional, or sexual abuse during childhood or adulthood could turn to alcohol as a memory relief. Consuming alcohol might provide temporary relief of pain as an emotion or mental escape from negative memories.
4. Trauma: A trauma such as the death of a loved one or separation from parents or someone special can emotionally affect a person. As a result, the person could turn to alcohol to seek shelter and relief from those sad and painful memories and withdraw from society.
5. Social and cultural factors: Social and cultural factors can play an important role in adopting a habit of alcohol use. A culture where alcohol consumption is a social practice can increase the risk of AUD.
In some cultures, alcohol consumption is perceived as a symbol of the elite or upper class’s lifestyle and would negatively influence people toward alcohol as a sign of social conformity.
6. Low self-esteem: Research shows that low self-esteem or low self-image could lead to excessive alcohol use. The person may use alcohol to withdraw from social gatherings, get some confidence, or hide any nervousness. A person may adopt a drinking habit to overcome guilt feelings caused by any failure in life.
7. Emotional problems: Some people may drink to cope with negative thoughts or emotions such as anger, grief, and loneliness.
8. Drinking habits: Alcohol consumption may start from a lower amount and increased over time to a higher amount that leads to AUD development.
9. Easy access to alcohol: Unrestricted access to the purchase of alcohol is a crucial factor. Especially in countries where the law and enforcement of alcohol purchase are lax, the likelihood of AUD development increases.
10. Bariatric surgery: Post-Bariatric surgery, it’s better to avoid alcohol for some time. Studies have shown that people who undergo Bariatric surgery are more likely to adopt AUD because the surgery changes the body’s adverse reaction toward alcohol and drugs, and is more prone to getting Alcohol addiction.
What are the effects of alcohol use disorders?
AUD causes significant effects on a person’s physical, social, emotional, and mental health, even in mild cases. Some of these AUD effects are:
1. Memory loss
2. Hangover
3. Stomach ache
4. Heart problem
5. Brain damage
6. Cancer
7. Diabetes complication
8. Liver problem
9. Digestive problem
10. Erectile dysfunction in men
11. Dysfunction of the menstruation cycle
12. Permanent memory loss
13. High blood pressure
14. Suicide
15. Car accident
16. Drowning
17. Homicide
How to diagnose alcohol use disorder?
To diagnose AUD, perform a self-check before seeking a professional diagnosis.
1. Self-Testing: Perform personal checks on condition and behavior toward AUD. Ask simple questions, and if any of the answers are positive, then seek a medical professional immediately.
These questions are:
a. Do you need to consume more alcohol to feel the same effect?
b. Does alcohol consumption affect your job or personal life?
c. Do you feel irritable when you are not consuming alcohol?
d. Do you feel that you are not in control of the urge to consume alcohol?
2. Professional Diagnosis: Health professionals may use different techniques to diagnose AUD.
These tests include:
a. Screening: Screening test is used to diagnose AUD. Self-reports are the most common tool used to get information about the amount of alcohol consumption. CAGE questionnaire is an example of such a tool. If the answer to two of the questions is positive, it means further tests are required.
i. Have you ever felt you needed tocut down on your drinking?
ii. Have people annoyed you by criticizing your drinking?
iii. Have you ever felt guilty about drinking?
iv. Have you ever felt you needed a drink first thing in the morning to steady your nerves?
b. Blood and urine test: The doctor might conduct blood, urine, and liver test to judge the damage done to the liver due to alcohol consumption.
How to treat Alcohol use disorder?
The treatment of AUD may vary from person to person and according to the severity of the condition. According to diagnosis, the person may get one or more treatments, but the following treatments aim to stop alcohol consumption altogether:
1. Counseling: Therapies play an essential role in treating AUD. Different behavioral therapies, such as Cognitive Based Therapy (CBT), can be highly effective against AUD. Family therapy is also considered in treating AUD.
Another alternative can be a Support Group that gathers people with AUD to speak about their causes and efforts and explore ways to overcome AUD with a counselor’s help.
2. Medication: An individual with moderate or severe AUD may be prescribed with the following medicines:
a. Acamprosate
b. Disulfiram
c. Topiramate
d. Naltrexone
3. Residential treatment: An individual with severe AUD may be required to be hospitalized and monitored by professional medical staff. The individual will be required to take medications, be observed not to consume alcohol, and participate in psychotherapeutic treatments.
4. Mindfulness exercises: Consider some mindfulness exercises such as meditation, yoga, breathing exercises, etc., to strengthen the control against alcohol consumption.
What’s the Call To Action here for Alcohol Use Disorder?
There is NO shame in seeking treatment for AUD, which is so prevalent in so many countries. Stop procrastinating now, and explore potential treatments for the sake of your family and loved ones.
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Co-Authored by Shereen Sakhawat (M.sc Applied Psychology)