What To Do When You Suspect Alcohol Abuse Disorder

By Sarah Bradley

For many Americans, alcohol is a normal part of life: Many drink a glass of wine with dinner, have a beer while they watch a baseball game, or raise a glass of champagne in celebration of a milestone. 

But the number of Americans who misuse alcohol by binging or drinking heavily is not small. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) reports that in 2018, more than 14 million adults over 18 and roughly 400,000 young adults between the ages of 12 and 17 had a form of alcohol use disorder, or AUD. 

It’s not always easy to tell when someone is abusing alcohol, whether that someone is you or someone you know. Most people think AUD comes with obvious red flags and worrying behaviors, but the symptoms can be subtler and easily disguised. Here’s what you need to know about recognizing and addressing AUD in yourself or someone else.

What is alcohol abuse disorder?

You may have heard people who drink excessively referred to as alcoholics, but that’s a colloquial term, not a clinical one. The clinical diagnosis for someone who abuses or is dependent on alcohol—across a spectrum of severity—is alcohol use disorder. 

Both men and women are affected by AUD. Among adults, the disorder is more common in males; in teens, however, AUD is slightly more common in females. One of the distinct characteristics of AUD is an inability to stop using alcohol despite the consequences, whether they are personal, professional, financial, or even legal.

Common signs 

Someone with AUD might not appear to be clearly intoxicated 24/7. Here are some symptoms to look for:

• Being unable to reduce or limit the number of drinks consumed or abstain from consuming alcohol entirely

• Engaging in binge drinking, defined by NIAAA as drinking four or five alcoholic beverages in the span of a few hours at least once per month

• Spending excessive amounts of time drinking and recovering from episodes of drinking

• Craving alcohol

• Having blackout episodes

• Participating in risky behaviors while intoxicated

• Experiencing alcohol withdrawal symptoms while not drinking

• Needing to drink more and more to achieve the same effects of alcohol (a.k.a. tolerance)

If you or someone you know has exhibited any of these signs in the past 12 months, it may mean that the amount of alcohol being used is unhealthy.

Causes and risk factors

AUD is recognized as a substance addiction and chronic brain disease. It’s important to know that people affected by AUD are sick and need help getting better. No one knows for sure what causes AUD, but it has both genetic and psychological origins (i.e. it can be passed down through families or developed as a result of trauma, stress, and many other mental health conditions). 

You are more at risk of having AUD if you:

• Begin drinking at an early age;

• Have a history of depression, PTSD, or other mental health disorders;

• Have a family history of AUD or addiction;

• or have been exposed to certain social or cultural factors normalizing alcohol use.

What to do

It’s important that people with AUD not stop drinking without the supervision of a medical professional; doing so can lead to alcohol withdrawal, a potentially fatal condition. Symptoms of withdrawal may be mild—headaches, nausea, and shaking—or become severe, including seizures, hallucinations, and loss of consciousness. 

Like any other disease, AUD should be treated in conjunction with healthcare professionals. This includes both medical doctors and mental health providers. You can begin by searching the NIAAA treatment navigator, which offers resources, tips, and location services to people looking for local assistance. 

If you have AUD:

You’ve made progress just by admitting you have a problem. Now it’s time to reach out to a primary care provider or mental health provider ASAP for help. It might seem like you can’t stop using alcohol, but many people do find relief and recovery after seeking treatment. Consider asking a friend or family member to support you as you navigate this process.

If you don’t have anyone to ask for support, you can search for local alcohol abuse recovery groups here and connect with others living with AUD. 

If someone you love has AUD:

Unfortunately, you can’t force someone to get help for their alcohol use, but you can encourage them to address their drinking and offer support. Volunteer to go with them to a doctor’s office, therapy appointment, or alcohol abuse recovery meeting. Explain that they have a disease, not a weakness or failing. Try not to blame them—or yourself. Tell them that you care about them and share resources that may help, such as the national helpline for the Substance Abuse and Mental Health Services Administration (SAMHSA).

You may also want to attend an Al-Anon meeting for guidance on coping with a friend or family member’s AUD.