Because drinking is socially acceptable, it can be very hard to tell whether you have a problem with alcohol. In certain situations, you may even be pressured to drink more in order to keep up with a group. And alcohol is far more accessible than most other dangerous substances. But just because it’s legal, that doesn’t mean it’s safe or healthy for everyone.
If you’re concerned about your drinking habits, you can start by taking stock of your behavior. Rather than relying on feedback from the people around you—who may drink excessively themselves—it’s important to learn the facts about this condition. With that information in hand, you’ll be ready to find treatment for alcohol use disorder (AUD).
Defining Alcohol Use Disorder (AUD)
According to the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM–V), alcohol use disorder can be diagnosed based on 11 signs and symptoms. Based on those criteria, the National Institute on Alcohol Abuse and Alcoholism (NIAA) published the following list of questions assessing the likelihood that a person has alcohol use disorder.1
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?
People with alcohol use disorder can say yes to 2 or more of these questions. Mild AUD includes 2-3 of these signs, while moderate AUD includes 4-5 of them. Severe alcohol use disorder is defined as the presence of 6 or more symptoms.
Even if you don’t officially qualify for this diagnosis, you might still exhibit signs of unhealthy behavior. It’s important to keep an eye on your drinking habits, and notice the warning signs associated with a developing addiction.
What Is Excessive Drinking?
According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), drinking in moderation means that on a day when alcohol is consumed, intake is limited to 2 drinks or less for men, and 1 drink or less for women. Drinking above this amount may be excessive, and can be categorized as binge drinking or heavy alcohol use. Both of these patterns of behaviors increase the likelihood that a person either has or will develop an alcohol addiction.
Binge Drinking
Binge drinking is a pattern of excessive drinking2 that raises blood alcohol concentration to 0.08% or higher. According to the NIAAA, an adult male can typically reach these levels after consuming 5 drinks in 2 hours. The threshold for most adult female drinkers is just 4 drinks in 2 hours.
Heavy Alcohol Use
For men, the NIAAA defines heavy alcohol use3 as “consuming more than 4 drinks on any day or more than 14 drinks per week.” For women, that number shrinks to “3 drinks on any day or more than 7 drinks per week.”
Drinking and Gender
It’s important to note that the NIAAA uses narrow definitions of sex and gender. In one article, their experts note that cis women may be more sensitive to alcohol’s effects4 than cis men. Specifically, they explain this is because “[cis] women absorb and metabolize alcohol differently than [cis] men.”
This data focuses on differences due to biological (or assigned) sex. In recent years, researchers have also begun to explore alcohol misuse in transgender and gender non-conforming populations.5 However, more research is needed on this subject. If you have questions about how your experience of sex and gender relates to drinking, speak with a doctor who understands your personal health history.
Assessing Your Situation
Many people seek treatment for alcohol addiction because of pressure from friends and family.6 While this can be a powerful motivator, it’s important to remember that advice from loved ones is no substitute for medical guidance. If you think you might have alcohol use disorder, it’s important to speak with a healthcare professional before taking any other action.
Talking to Your Doctor
If you have an ongoing relationship with a primary care provider (PCP), you can start by making an appointment with them. Your PCP may be a doctor, registered nurse, or other healthcare professional familiar with your health history. This person will be able to answer your questions, offer insight into your risk factors for addiction, and recommend a course of action that accounts for your ongoing physical health.
However, not every doctor is qualified to diagnose addiction. Depending on your provider’s expertise, you may need to ask for a referral to a specialist.
Talking to a Mental Health Professional
In addition to your PCP, you should speak with a mental health provider, like a psychiatrist or a talk therapist. If you regularly see a counselor, you can begin by getting their advice on the matter. To get properly diagnosed, it’s important to connect someone who has experience treating alcohol addiction. You may need to go through a longer referral process in order to find the right provider.
When you do speak with an addiction specialist, you can ask them to conduct a formal assessment to determine your level of dependence on alcohol. Clinicians may use a variety of assessment tools, including interview questions based on the DSM-V criteria for AUD. It’s important to get this expert’s opinion on your status, even if you’ve already answered these questions for yourself. They’ll be able to interpret your responses in a clinical context, and give you more information about your options for recovery.
Seeking Treatment for Alcohol Addiction
Once you’ve been diagnosed, you can begin planning for treatment and recovery from alcohol use disorder. For alcohol in particular—even more than many other substances—it’s absolutely vital that you begin this process with expert care.
Detox
Detoxing from alcohol is extremely dangerous without proper medical supervision.
During alcohol withdrawal,7 you may experience mild symptoms like tremors, anxiety, and irritability, or serious symptoms such as seizures, hallucinations, and delirium tremens. In severe cases, this process can even be life-threatening.
Before you stop drinking, talk to your doctor about your current alcohol intake, and learn about the risks you can expect during withdrawal. If you’re a candidate for medical alcohol detox, you can attend a residential program during this phase of recovery. Many detox centers require you to have plans for longer-term care before beginning the program.
Residential Rehab
After detox, many people in alcohol recovery benefit from residential rehab. These programs typically last 30-90 days, although exactly how long you need to stay in rehab may vary. During this time, you might participate in psychotherapy and group therapy, and get medical attention. You can also attend support groups, such as Alcoholics Anonymous or SMART Recovery groups. These groups are readily available in many rehab centers, and once you complete inpatient treatment, you can easily find a similar session in your area or online.
Long-Term Recovery From Alcohol Misuse
Recovery from alcohol addiction doesn’t end with inpatient rehab. Most people continue some form of long term treatment, which may include 1:1 talk therapy, attending support groups, or other modalities. If you decide to stop drinking completely and permanently, you may also need to restructure your social life around that choice.
This process might sound daunting, but it can also be rewarding and validating. By learning how to have fun and connect with loved ones in a new way, you can build a healthier life. These experiences can be far more meaningful—and better yet, sustainable.
If you’re concerned about your alcohol use, you can learn more about rehab facilities that treat alcohol addiction.
Reviewed by Rajnandini Rathod
- Alcohol use disorder: A comparison between dsm–iv and dsm–5 | national institute on alcohol abuse and alcoholism(Niaaa). (n.d.). Retrieved May 24, 2022, from https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/alcohol-use-disorder-comparison-between-dsm [↩]
- Drinking levels defined | national institute on alcohol abuse and alcoholism(Niaaa). (n.d.). Retrieved from https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/moderate-binge-drinking [↩]
- Drinking levels defined | national institute on alcohol abuse and alcoholism(Niaaa). (n.d.). Retrieved May 24, 2022, from https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/moderate-binge-drinking [↩]
- Are women more vulnerable to alcohol’s effects? -Alcohol alert no. 46-1999. (n.d.). Retrieved May 24, 2022, from https://pubs.niaaa.nih.gov/publications/aa46.htm#:~:text=Women%20absorb%20and%20metabolize%20alcohol,alcohol%20(5%2C6). [↩]
- Gilbert, P. A., Pass, L. E., Keuroghlian, A. S., Greenfield, T. K., & Reisner, S. L. (2018). Alcohol research with transgender populations: A systematic review and recommendations to strengthen future studies. Drug and Alcohol Dependence, 186, 138–146. https://doi.org/10.1016/j.drugalcdep.2018.01.016 [↩]
- Polcin, D. L., Korcha, R., Greenfield, T. K., Bond, J., & Kerr, W. (2012). Pressure to reduce drinking and reasons for seeking treatment. Contemporary Drug Problems, 39(4), 687–714. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3888964/ [↩]
- Saitz, R. (1998). Introduction to alcohol withdrawal. Alcohol Health and Research World, 22(1), 5–12. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6761824/ [↩]
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