Understanding the Definition of an Alcohol Use Disorder

According to the National Institute on Alcohol Abuse & Alcoholism, an estimated 18 million Americans suffer from some form of alcohol use disorder. While this number may encompass varying degrees of alcohol abuse, ongoing alcohol use brings about the same effects regardless of the stage of use.

Alcohol use disorders are medical conditions that grow progressively worse over time. Once alcohol starts to negatively impact a person’s life, the “disorder” aspect is at work. The definition of alcohol use disorder has to do with alcohol’s physical effects on the body and the subsequent changes in behavior and lifestyle that result.

Over the years, the criteria used to diagnosis alcohol use disorder have undergone some changes. What was once a distinction between alcohol abuse and alcohol dependence, has become a single diagnosis.

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Minimum Criteria for Alcohol Use Disorder

Alcohol Use Disorder

Developing a regular pattern of drinking signifies an alcohol use disorder.

According to the National Institutes of Health, the types of symptoms a person experiences and the types of consequences resulting from alcohol use determine whether he or she has an alcohol problem. For “disorder” to enter the picture, a person must maintain a regular pattern of drinking in spite of negative consequences. Likewise, uncomfortable withdrawal-type symptoms also become a regular part of a disordered lifestyle.

The four primary symptoms of alcohol use disorder include:

  • Persistent cravings
  • Inability to control intake amounts
  • Physical dependence
  • Increasing tolerance levels

These symptoms grow progressively worse the longer a person continues to abuse alcohol. Eventually, getting and drinking alcohol starts to take precedence over other daily obligations and responsibilities.

DSM-IV Criteria – Alcohol Abuse vs. Alcohol Dependence

The Diagnostic Statistical Manual of Mental Disorders or DSM is the standard by which any type of diagnosis is made. DSM-IV (the fourth edition) assigns two separate diagnoses for alcohol use disorder: alcohol abuse and alcohol dependence.

Whereas alcohol abuse refers to the negative consequences caused by alcohol use, alcohol dependence encompasses three different factors:

  • Physical dependence
  • Compulsive drinking behaviors
  • Inability to control intake amounts
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Under DSM-IV, someone who abuses alcohol isn’t necessarily alcohol dependent. On the other hand, a person diagnosed as alcohol dependent most definitely abuses alcohol on a regular basis.

For both conditions, a person must meet a certain set of criteria in order to be diagnosed with one or the other. Not surprisingly, many of these criteria overlap, as alcohol abuse inevitably becomes a stepping-stone to alcohol dependence.

DSM-V Criteria – Alcohol Use Disorder

Rather than assign two separate diagnoses for alcohol use disorder, the DSM-V (the fifth and most recent edition) combines the characteristics of both disorders into one overall diagnosis. For both alcohol abuse and alcohol dependence, a total of 11 factors or criteria are used to assign a diagnosis. Under the DSM-V guidelines, all 11 criteria are used to determine an alcohol use disorder diagnosis.

According to American Psychiatric Publishing, the new guidelines also distinguish between mild, moderate and severe conditions based on the number of criteria a person meets. For mild conditions, a minimum of two criteria must be met. From there, the higher the number of criteria met the more severe a person’s drinking problem is.

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