Key Signs and Symptoms of Alcohol Use Disorder

While it’s often dismissed or hidden behind social norms, alcohol use disorder (AUD) is a serious and widespread medical condition affecting approximately 15 million adults in the U.S., according to the National Institute on Alcohol Abuse and Alcoholism (NIAAA).

Previously divided into “alcohol abuse” and “alcohol dependence,” AUD is now understood as a spectrum, with symptoms ranging from mild to severe. And despite persistent stigma, it’s important to remember: AUD is a chronic brain disorder not a moral failing.

Here’s how to identify AUD, what it does to the body and mind, and the three evidence-based steps to start healing.

What Is Alcohol Use Disorder?

AUD is characterized by a compulsive pattern of alcohol use despite negative consequences in relationships, health, work or personal goals. Some people can appear “high-functioning,” while others experience more visible life disruptions but both fall under the same diagnosis.

Symptoms often include:

• Drinking more or for longer than intended

• Failed attempts to cut back

• Strong cravings or urges to drink

• Tolerance (needing more alcohol to feel the same effects)

• Withdrawal symptoms (shaking, sweating, irritability)

• Loss of interest in hobbies or responsibilities

• Continued drinking despite physical or mental health issues

You only need to meet two or more of these criteria in a 12-month period for an AUD diagnosis, according to the DSM-5. The more symptoms you meet, the more severe the condition.

The Consequences of AUD

Alcohol misuse impacts nearly every system in the body and its ripple effects go far beyond hangovers.

Psychological and physical effects of AUD can include:

• Heightened anxiety and depression

• Difficulty sleeping

• Liver inflammation and damage

• Increased risk of several cancers (breast, liver, esophageal, colorectal)

• Impaired immune function

• Relationship or job conflicts

• Legal and financial trouble

Importantly, many people continue drinking even when they’re aware of these consequences. That’s the nature of the disorder and why professional treatment matters.

Diagnosing Alcohol Use Disorder

AUD is diagnosed through a clinical evaluation by a licensed physician or therapist. With the person’s permission, input from family or close friends may be used to help assess the full picture.

In some cases, AUD can be difficult to spot especially among individuals who continue to work, parent or socialize. But high-functioning doesn’t mean unaffected. Behind the scenes, a person may still be mentally distressed, physically compromised or emotionally disconnected.

If you’re unsure whether your drinking is problematic, a good first step is asking:
“Is my relationship with alcohol interfering with the life I want to live?”

The 3-Step Treatment Process

Recovery from AUD isn’t about willpower it’s about understanding the condition and accessing the right tools. Here’s how treatment typically unfolds:

1. Set a Treatment Goal

In most cases, the goal is complete abstinence, especially for moderate to severe AUD. But for some individuals with mild symptoms, a controlled drinking plan might be explored under medical guidance.

Setting a clear, realistic goal with a supportive provider is the first step toward change.

2. Safely Stop Drinking

Alcohol withdrawal can be dangerous. Symptoms like tremors, hallucinations and even seizures may occur, particularly in long-term or heavy drinkers.

That’s why detox or medically supervised withdrawal is often necessary. Your doctor may prescribe medications to ease symptoms and monitor your health through this critical phase.

3. Maintain Long-Term Recovery

Detox is just the beginning. Ongoing care is essential to maintain sobriety or reduced drinking and prevent relapse.

Evidence-based tools include:

• Counseling: Cognitive behavioral therapy (CBT) and motivational interviewing help address both behavior and emotional drivers of AUD

• Medications: FDA-approved medications such as naltrexone, acamprosate and disulfiram can reduce cravings or block the euphoric effects of alcohol

• Peer Support: Groups like Alcoholics Anonymous (AA), SMART Recovery, or Women for Sobriety (WFS) offer connection, accountability and encouragement

Just like other chronic illnesses, AUD often requires a tailored, long-term treatment plan and a strong support system.

Getting Help for AUD

If you’re questioning your alcohol use or worried about someone else know that you’re not alone, and support is available.

You don’t need to hit rock bottom to seek help. In fact, early intervention can make a profound difference.

Most people with AUD are treated successfully in outpatient programs that combine therapy, medication, and support. In-patient care is reserved for those with more complex health or safety needs.

The Bottom Line

Alcohol use disorder is more common and more treatable than many people realize. With compassionate care, the right tools and ongoing support, recovery is possible at any stage of life.

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