Alcohol use disorder (AUD) affects millions of people each year. The 2021 National Survey on Drug Use and Health reported that 29.5 million people ages 12 and up had AUD in 2020.
AUD is a substance use disorder that is also a chronic neurological disorder. As with all chronic health conditions, there is a possibility of relapsing following treatment.
The relapse rate for addiction ranges between 40% and 60%, according to a 2014 study in The Journal of the American Medical Association (JAMA).
This rate is potentially lower than the relapse rates for other chronic health problems such as asthma, diabetes, and hypertension.
Like other chronic conditions, AUD cannot be cured, but management of the condition is achievable.
Why AUD Is A Chronic Brain Disease
Addiction isn’t a sign of weakness of will, contrary to outdated views. Addiction alters brain function, making it very difficult for people with AUD to stop drinking on their own.
Alcohol Addiction And The Brain
Drinking alcohol activates the brain’s reward system through a flood of dopamine, the brain’s “feel good” chemical.
This activation by use of an addictive substance is more pronounced than other behaviors that release dopamine, such as eating or having sex, encouraging continued alcohol use.
Over time, the brain adjusts by producing less dopamine and eliminating dopamine receptors.
This indicates the development of a tolerance for alcohol, which means that more alcohol is needed in order to receive the same pleasurable effects as before.
Alcohol also binds to GABA and glutamate receptors in the brain, suppressing neuron activity, which reduces feelings of distress.
Like dopamine, GABA receptors are also reduced over time with alcohol consumption, making a person more likely to drink more alcohol to achieve the same relaxing effects.
Risk Factors For Alcohol Use Disorder
A history of trauma or mental health issues, genetic and environmental influences, increased regular use of alcohol, and drinking before age 15 can all increase a person’s risk for AUD.
AUD is often comorbid (or co-occurs) with other mental health disorders, such as major depressive disorder or post-traumatic stress disorder (PTSD). People with AUD may also experience drug abuse.
How Alcohol Addiction Is Diagnosed
AUD is diagnosed using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, or DSM-5.
At least two of the following must be experienced within a year for an AUD diagnosis:
- Alcohol is often taken in larger amounts or over a longer period than was intended.
- There is a persistent desire or unsuccessful efforts to cut down or control alcohol use.
- A great deal of time is spent on activities necessary to obtain alcohol, use alcohol, or recover from its effects.
- Cravings, or strong desires or urges to use alcohol, are experienced.
- Recurrent alcohol use results in a failure to fulfill obligations at work, school, or home.
- Alcohol use continues despite persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol.
- Important social, occupational, or recreational activities are given up or reduced because of alcohol use.
- The recurrent use of alcohol in situations in which it is physically hazardous.
- 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.
Tolerance is experienced, as defined by either of the following:
- a need for markedly increased amounts of alcohol to achieve intoxication or desired effect
- a markedly diminished effect with continued use of the same amount of alcohol
Withdrawal is experienced, as manifested by either of the following:
- the characteristic withdrawal syndrome for alcohol
- alcohol (or a closely related substance, such as a benzodiazepine) is taken to relieve or avoid withdrawal symptoms
Determining The Level Of Care Required For AUD Treatment
Following diagnosis, treatment providers will determine the severity of the AUD to ensure that the appropriate level of care is received.
Severity levels include:
- mild: presence of two or three symptoms
- moderate: presence of four or five symptoms
- severe: presence of six or more symptoms
People with milder alcohol addictions and a stable living situation may benefit most from outpatient treatment programs, which offer more flexibility.
People with more severe AUD, or who lack a support system or stable living situation, will want to consider inpatient treatment.
Treatment Options For AUD
With the right support, people dealing with alcohol dependence and addiction can live healthy, fulfilling lives.
Treatment options and support for AUD include:
- individual, group, couples, or family therapy options
- medical-assisted detoxification for alcohol withdrawal
- brief intervention and other short-term counseling approaches
- different evidence-based therapy types, including cognitive behavioral therapy (CBT) and motivational interviewing (MI)
- medication-assisted treatment (MAT) using naltrexone, acamprosate, disulfiram, and in some cases topiramate
- 12-step support groups, such as Alcoholics Anonymous (AA) and SMART Recovery
- peer mentoring
- holistic treatment methods, such as mindfulness meditation or art therapy
- sober living environments and group outings
- education on addiction and treatment options
- social services, if needed
- coordinated healthcare, if needed
- dual diagnosis treatment, if needed
These treatment options may be offered through both inpatient and outpatient programs. Many treatment facilities offer customized treatment plans that include aftercare programs.
Through treatment and ongoing support, people can achieve long-term recovery from AUD.
Find Addiction Treatment Today
If you or a loved one is experiencing AUD, recovery is possible. Contact Detox Rehabs today and take the first step toward recovery.
Article Sources- American Society of Addiction Medicine (ASAM)
https://www.asam.org/quality-care/definition-of-addiction - Ark Behavioral Health
https://www.arkbh.com/alcohol/alcohol-use-disorder/dsm-5/ - Brainbook
https://www.youtube.com/watch?v=wp1U2VlJrsY - JAMA Network
https://jamanetwork.com/journals/jama/article-abstract/1883017 - NIH: National Institute on Alcohol Abuse and Alcoholism (NIAAA)
https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/understanding-alcohol-use-disorder - NIH: National Institute on Alcohol Abuse and Alcoholism (NIAAA)
https://www.niaaa.nih.gov/alcohols-effects-health/alcohol-topics/alcohol-facts-and-statistics/alcohol-use-disorder-aud-united-states-age-groups-and-demographic-characteristics - NIH: National Institute on Alcohol Abuse and Alcoholism (NIAAA)
https://www.niaaa.nih.gov/health-professionals-communities/core-resource-on-alcohol/neuroscience-brain-addiction-and-recovery - NIH: National Library of Medicine
https://pubmed.ncbi.nlm.nih.gov/33301050/