Alcohol-Related Disorders

Alcohol-related disorders include alcohol use disorder, intoxication, and withdrawal. Many people are familiar with the symptoms of alcohol intoxication and how it can cause problematic behavioral or psychological changes, slurred speech, poor coordination, unsteady gait, impaired attention or memory, and stupor.

Alcohol Misuse

Occasional alcohol misuse can also cause serious problems as a result of its tendency to impair people’s judgement. This can result in violence, driving under the influence, engaging in risky sexual behavior, drinking to the point of blacking out, etc. According to the Center for Disease Control, there are approximately six alcohol overdose deaths every day.

Binge Drinking

In the 2015 National Survey on Drug Use and Health found that over 66 million Americans reported binge drinking in the past year. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), binge drinking for men is five or more standard alcoholic drinks in a day, and four or more for women. Binge drinking is dangerous, yet does not always meet criteria for substance use disorder. This can provide people with a false sense of safety regarding this dangerous behavior pattern.

According to the 2015-2020 Dietary Guidelines for Americans, a standard drink is considered one of the following:

• 12 ounces of 5% beer
• 8 to 9 ounces of 7% beer
• 5 ounces of 12% wine
• 1.5 ounce 80 proof distilled spirits

Alcohol Use Disorder

Alcohol use disorder is a problematic pattern of use that causes significant problems, distress, and/or impairment. The majority of people who experience an alcohol use disorder tend to start experiencing symptoms in their late teens or early to mid 20s. This condition is typically developed before age 40.

The severity of this disorder is based on how many symptoms the individual is experiencing. When two to three symptoms are experienced in the past 12 months the disorder is considered mild; four to five symptoms are moderate, and six or more symptoms are considered severe. Symptoms of an alcohol use disorder include the following:

• Larger amounts of alcohol used over a longer period than was intended
• Persistent desire or unsuccessful efforts to control use
• A great deal of time is spent obtaining, using, or recovering from alcohol
• Craving or a strong desire to use alcohol
• Recurrent alcohol use when it is physically hazardous
• Continued use despite knowledge of how it is causing or exacerbating physical and/or psychological problems
• Increased tolerance for alcohol
• Withdrawal symptoms when use is stopped

Alcohol Withdrawal

Life threatening withdrawal symptoms can occur if alcohol is stopped abruptly after prolonged heavy use. It is critical that medical attention is sought to oversee and manage withdrawal symptoms which can include the following:

• Sweating
• High pulse rate (100 bpm or more)
• Increased hand tremor
• Trouble sleeping
• Nausea or vomiting
• Hallucinations or illusions
• Difficulty sitting still
• Anxiety
• Generalized tonic-clonic seizures

Other problems associated with alcohol use disorder include:

• Bipolar disorders
• Schizophrenia
• Antisocial personality disorder
• Anxiety disorders
• Depressive disorders

Evidence Based Practices for Substance Use Disorders

• Medication Assisted Therapy
• Behavioral Couples Therapy
• Cognitive Behavioral Therapy
• Contingency Management
• Motivational Interviewing
• Family Therapy
• Psychodynamic (supportive-expressive) Psychotherapy
• 12 step facilitation therapy

**90 days of treatment or more is associated with positive outcomes