Understanding the Definition of an Alcohol Use Disorder

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Calendar icon Last Updated: 05/13/2019

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An estimated 18 million Americans suffer from some form of alcohol use disorder. While this number may encompass varying degrees of alcohol abuse, chronic heavy drinking brings about negative effects regardless of the stage of use.

Alcohol use disorders are medical conditions that grow progressively worse over time. Once alcohol starts to impact a person’s life negatively, 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.

Minimum Criteria for Alcohol Use Disorder

The types of symptoms a person experiences and the types of consequences resulting from their 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. Also, the individual experiences uncomfortable withdrawal symptoms when not drinking or when drinking less.

The four primary symptoms of alcohol use disorder include:

  • Persistent cravings
  • Inability to control amounts consumed
  • 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 mental health diagnosis is made. DSM-IV (the fourth and prior 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

Under DSM-IV criteria, 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 had to meet a certain set of criteria to be diagnosed. Not surprisingly, many of these criteria overlapped, 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. Treatment professionals distinguish between mild, moderate and severe cases of alcohol use disorder based on the number of criteria a person meets. For mild disorders, a minimum of two criteria must be met. From there, the higher the number of criteria met, the more severe the alcohol addiction is.

The current DSM-V Criteria for Alcohol Use Disorder

  1. Drinking more or more often than you intend to.
  2. Wanting to cut down or stop drinking but being unable to.
  3. Spending a great deal of time getting alcohol, drinking, or recovering from drinking.
  4. Experiencing alcohol cravings.
  5. Failing to meet expectations at home, school, or work because of your drinking.
  6. Continuing to drink even when it is causing relationship problems.
  7. Forgoing important social, recreational, or professional activities because of drinking.
  8. Continuing to drink even when it is putting you in danger.
  9. Continuing to drink even when you know you have a mental or physical health problem that is caused by or worsened by alcohol.
  10. Developing a tolerance so that you have to drink more to feel the same effect.
  11. Experiencing withdrawal symptoms that can be relieved by drinking alcohol.