Alcohol use disorder

A few mild symptoms — which you might not see as trouble signs — can signal the start of a drinking problem. It helps to know the signs so you can make a change early. If heavy drinking continues, then over time, the number and severity of symptoms can grow and add up to “alcohol use disorder.” Doctors diagnose alcohol use disorder when a patient’s drinking causes distress or harm. See if you recognize any of these symptoms in yourself. And don’t worry — even if you have symptoms, you can take steps to reduce your risks.

Symptoms could be any of the following. 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?
• 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)?
• Had to drink much more than you once did to get the effect you want?
• 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?
• Continued to drink even though it was causing trouble with your family or friends?
• Found that drinking—or being sick from drinking—often interfered with taking careof your home or family? Or caused job troubles? Or school problems?
• Given up or cut back on activities that were important or interesting to you, or gave you pleasure, in order to drink?
• 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?

(Reference: https://www.rethinkingdrinking.niaaa.nih.gov/How-much-is-too-much/Whats-the-harm/What-Are-Symptoms-Of-Alcohol-Use-Disorder.aspx)

Diagnostic Criteria

A. A problematic pattern of alcohol use leading to clinically significant impairment or distress, as manifested by at least two of the following, occurring within a 12-month period:

1. Alcohol is often taken in larger amounts or over a longer period than was intended.
2. There is a persistent desire or unsuccessful efforts to cut down or control alcohol use.
3. A great deal of time is spent in activities necessary to obtain alcohol, use alcohol, or recover from its effects.
4. Craving, or a strong desire or urge to use alcohol.
5. Recurrent alcohol use resulting in a failure to fulfill major role obligations at work, school, or home.
6. Continued alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol.
7. Important social, occupational, or recreational activities are given up or reduced because of alcohol use.
8. Recurrent alcohol use in situations in which it is physically hazardous.
9. Alcohol use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by alcohol.
10. Tolerance, as defined by either of the following:
    1. A need for markedly increased amounts of alcohol to achieve intoxication or desired effect.
    2. A markedly diminished effect with continued use of the same amount of alcohol.
11. Withdrawal, as manifested by either of the following:
    1. The characteristic withdrawal syndrome for alcohol (refer to Criteria A and B of the criteria set for alcohol withdrawal, pp. 499-500).
    2. Alcohol (or a closely related substance, such as a benzodiazepine) is taken to relieve or avoid withdrawal symptoms.