Alcohol Use Disorder
Alcohol use disorder (AUD) is a problematic pattern of alcohol use causing significant impairment, defined per DSM-5 and treated per the APA Practice Guideline for the Pharmacological Treatment of Alcohol Use Disorder.
Symptoms
The same 11 DSM-5 criteria used across substance use disorders, graded mild (2-3), moderate (4-5), or severe (6 or more) -- including drinking more than intended, unsuccessful efforts to cut down, cravings, and continued use despite problems it's causing.
Causes and risk
A biopsychosocial mix with roughly 50% heritability; risk roughly doubles with a co-occurring mental illness.
How it is evaluated
The AUDIT questionnaire (WHO-endorsed, score of 8 or higher flags concern) or the shorter AUDIT-C help screen for AUD, though screening alone is not diagnostic -- DSM-5 criteria confirm the diagnosis, per current diagnostic research.
Treatment
Naltrexone or acamprosate are first-line medications per the APA guideline -- naltrexone is avoided with concurrent opioid use or significant liver disease, while acamprosate is generally safe in liver disease. Behavioral therapy alongside medication improves outcomes, per Cochrane review data.
When to seek care
Alcohol withdrawal can be medically dangerous and should never be stopped abruptly without medical supervision after heavy, regular use. Seizures, confusion, hallucinations, or significant autonomic symptoms (rapid heart rate, high blood pressure, fever) during withdrawal signal possible delirium tremens, typically appearing around 3 days after the last drink -- this is a medical emergency requiring immediate care.