When are You Considered an Alcoholic? 11 Criteria for Substance Use Disorder
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What is an Alcoholic?
An alcoholic is known as a person who drinks alcohol beyond their ability to control it and cannot stop consuming alcohol voluntarily. This is often coupled with being habitually drunk, daily drinking, and drinking larger quantities of alcohol than most. In general, an alcoholic is someone who suffers from alcoholism.
Alcoholism, also known as alcohol use disorder, is a condition in which individuals have a craving or physical need to consume alcohol, even though it harms their lives . In the past, an individual with this condition was referred to as an “alcoholic.” However, this is increasingly seen as an unhelpful and negative label. Health professionals now say that a person has an alcohol use disorder (AUD).
According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA) , an estimated 95,000 people (approximately 68,000 men and 27,000 women) die from alcohol-related causes annually, making alcohol the third-leading preventable cause of death in the United States In 2019, alcohol-impaired driving fatalities accounted for 10,142 deaths (28.0 percent of overall driving fatalities).
NIAAA describes alcohol use disorder as a “problem drinking that becomes severe.” Alcoholism is a mental disease. Exactly how alcohol affects the brain, and the possibility of reversing the effect of heavy drinking on the brain remain hot topics in alcohol research today. Lasting changes in the brain caused by alcohol misuse perpetuate alcohol use disorder symptoms and make individuals vulnerable to relapse. The good news is that no matter how severe the problem may seem, evidence-based alcoholism treatment with cognitive-behavioral therapy, mutual-support groups, and/or medication-assisted treatment can help people with AUD achieve and maintain recovery.
Alcohol abuse can be used to talk about excessive or inappropriate consumption of alcohol, but not necessarily dependence. Moderate alcohol consumption does not generally cause any psychological or physical harm. However, if those who enjoy social drinking increase their consumption or regularly consume more than is recommended, alcoholism may eventually develop.
Classifications of Alcohol Use Disorder
Medical conditions and disorders must be carefully defined both for clinical practice and research. The most widely used definitions for alcohol use disorders (AUD) are those determined by editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM) of the American Psychiatric Association (APA) and the International Classification of Diseases (ICD) of the World Health Organization (WHO).
In May 2013, the American Psychiatric Association issued the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM–5). Although there is considerable overlap between DSM–5 and DSM–IV, the prior edition, there are several important differences:
DSM–5 integrates the two DSM–IV disorders, alcohol abuse and alcohol dependence, into a single disorder called alcohol use disorder (AUD) with mild, moderate, and severe sub-classifications.
Under DSM–5, anyone meeting any 2 of the 11 criteria during the same 12-month period would receive a diagnosis of AUD. The severity of AUD—mild, moderate, or severe—is based on the number of criteria met. Moreover, DSM–5 adds craving as a criterion for an AUD diagnosis. It was not included in DSM–IV.
11 Criteria for Substance Use Disorder
Substance use disorders are classified as mild, moderate, or severe, depending on how many of the diagnostic criteria a person meets. The 11 DSM-5 criteria for a substance use disorder are:
- Hazardous use: You have used the substance in ways that are dangerous to yourself and/or others, i.e., overdosed, driven while under the influence, or blacked out.
- Social or interpersonal problems related to use: Substance use has caused relationship problems or conflicts with others.
- Neglected major roles to use: You have failed to meet your responsibilities at work, school, or home because of substance use.
- Withdrawal: When you stop using the substance, you experience withdrawal symptoms.
- Tolerance: You have built up a tolerance to the substance so that you have to use more to get the same effect.
- Used larger amounts/longer: You have started to use larger amounts or use the substance for longer amounts of time.
- Repeated attempts to control the use or quit: You’ve tried to cut back or quit entirely, but haven’t been successful.
- Much time spent using: You spend a lot of your time using the substance.
- Physical or psychological problems related to use: Your substance use has led to physical health problems, such as liver damage or lung cancer, or psychological issues, such as depression or anxiety.
- Activities are given up to use: You have skipped activities or stopped doing activities you once enjoyed in order to use the substance.
- Craving: You have experienced cravings for the substance.
In order to be diagnosed with a substance use disorder, you must meet two or more of these criteria within a 12-month period.1 If you meet two or three of the criteria, you have a mild substance use disorder. Four to five is considered moderate, and if you meet six or more criteria, you have a severe substance use disorder.
What Causes Alcoholism?
Alcohol triggers your brain to release the reward-system chemical dopamine. This leads your brain to link positive feelings with drinking and motivates you to crave more. It also affects serotonin, which plays a role in things like mood and sleep.
As you drink more and addiction takes hold, you will experience less pleasure (develop tolerance), and you may have withdrawal symptoms when you try to stop drinking. Heavy drinkers will begin to drink even more in an attempt to keep withdrawal at bay.
Early signs of problem drinking or alcohol misuse can be subtle. For example, starting to prioritize activities that involve alcohol steadily leads to a shift in daily routines and relationships. As drinking becomes more routine, changes in sleep patterns, mood, energy, and interests can signal the onset of early alcohol use disorder. For some, this is a critical tipping point, because alcohol intake increases in an attempt to alleviate the very challenges it is creating.
What’s the Difference Between Casual Drinking and Alcohol Abuse?
A lot of people who drink end up getting drunk more often than they intended. Many people regret what they do or say when they drink. But that doesn’t mean they have the disease called alcoholism.
Different types of drinkers can be defined by the way they drink and the consequences that they experience.
The types of drinkers include:
Also known as social drinkers, casual drinkers are people who occasionally drink alcohol. They usually drink responsibly, which means they don’t get drunk or blackout regularly.
Problem drinkers consume alcohol frequently. They usually drink more than they mean to, and they regret what they do when they drink. Problem drinkers may experience some health effects, but they can quit drinking on their own.
Alcoholics cannot control how much they drink. Most alcoholics drink daily. They regularly experience problems in various aspects of life because of how much or how often they drink. These people require support groups or rehab to stay sober.
Signs You Have a Drinking Problem
There are various warning signs to help detect possible alcohol abuse. While many signs are recognizable, others may be more challenging to identify. Also, the severity of alcohol abuse may play a role in the warning signs a person exhibits. For instance, some individuals try to cover their alcohol abuse by drinking in private and isolating themselves from others. This makes it challenging for family members or friends to intervene and help their loved ones.
Mild alcohol abuse can be easily overlooked. However, what may appear as a minor issue can turn dangerous over time. These early warning signs should not be ignored. Seeking treatment sooner rather than later will allow you to get back to the things you enjoy most in life.
Some of the most common signs of alcohol abuse are:
- Experiencing temporary blackouts or short-term memory loss
- Drinking alone or in secrecy
- Exhibiting signs of irritability and extreme mood swings
- Feeling hungover when not drinking
- Making excuses for drinking such as to relax, deal with stress or feel normal
- Choosing to drink over other responsibilities and obligations
- Becoming isolated and distant from friends and family members
- Changing appearance and group of acquaintances you hang out with
No matter how minor a drinking problem may seem, alcohol abuse symptoms should not be ignored. If you or a loved one is struggling with alcoholism, call a treatment provider now to find alcohol treatment facilities nearby.
When They Want to Stop Drinking but Can’t?
Have you ever wondered what happens when you give up alcohol? Do you need help on how to reduce alcohol consumption safely? Why is it so hard to quit drinking? Is alcoholism a mental disease? These are just some of the questions that need some answers to help you better understand your condition.
Alcoholism, like other forms of substance abuse, is a disease. The problem leads to many symptoms including cravings, loss of control, physical dependence, and tolerance. These symptoms are major contributing factors to why alcoholics can’t stop drinking. Along with these problems, there is also the factor of changes in brain chemistry.
How does alcohol affect the brain? Brain chemistry plays an important role in alcoholism. Excessive drinking and positive reinforcement associated with alcohol use can eventually lead to changes in dopamine release in the brain.
Overall, there are an array of factors that contribute to alcohol dependence, not only with brain chemistry but underlying factors as well. Things like mental health, environmental influences, and genetics can all contribute to a drinking problem. However, one thing is clear: if you or a loved one has a problem with alcohol, or another substance, seeking out treatment should be a top priority.
When They are Physically Dependent on Alcohol?
According to the National Center for Biotechnology Information (NCBI) , continued excessive alcohol consumption can lead to the development of dependence that is associated with a withdrawal syndrome when alcohol consumption is stopped or substantially reduced.
Individuals who are alcohol-dependent show some or all of the following characteristics:
Alcohol tolerance: Need to drink increasing amounts over time to achieve previous effects. For example, you used to drink three cocktails every night, but now you need five to get the feeling you’re looking for.
Withdrawal symptoms: Experiencing physical symptoms, such as insomnia, tremors, and mood swings. after going for a short period without drinking.
Drinking to relieve or avoid withdrawal symptoms, such as drinking to stop the shakes or to “cure” a hangover.
Awareness of the compulsion to drink or craving for alcohol, regardless of whether you admit it to others.
Drinking larger amounts or over a longer period than intended and making unsuccessful efforts to cut down.
When Their Life is Repeatedly Being Affected by Drinking
Denial is one of the biggest obstacles to getting help for alcoholism. The urge to drink is so powerful that the mind finds many ways to justify drinking, even when the effects are obvious. By keeping you from looking honestly at your behavior and its negative effects, denial also worsens alcohol-related problems with finances, work, and relationships.
If you have a drinking problem, you may deny it by:
- Downplaying the negative consequences of your drinking
- Drastically underestimating how much you drink
- Blaming your drinking or drinking-related problems on others
- Complaining that family and friends are exaggerating the problem
For instance, you may blame an ‘unfair boss’ for trouble at work or a ‘nagging wife’ for your marital issues rather than think about how your drinking is contributing to the problem. While work, relationships, and financial stresses happen to everyone, an overall pattern of deterioration and blaming others may be a sign of trouble.
If you find yourself justifying your drinking habits, lying about them, or refusing to discuss the subject, take a moment to consider why you’re so defensive. If you truly believe that you don’t have a problem, you shouldn’t have a reason to cover up your drinking or make excuses.
When are You Considered an Alcoholic? Alcohol Abuse Risks & Complications
Drinking too much – on a single occasion or over time – can take serious risks and complications l on your health. Here’s how alcohol can affect your body:
Earlier, we asked how alcohol affects the brain? Alcohol interferes with the brain’s communication pathways and can affect the way the brain looks and works. These disruptions can change mood and behavior, and make it harder to think clearly and move with coordination.
Alcohol also causes wet brain, or Wernicke-Korsakoff syndrome (WKS), It is a brain disorder related to the acute and chronic phases of a vitamin B1 (thiamine) deficiency.
Alcoholic neuropathy is also common for people with alcohol use disorder. It is damage to the nerves that results from excessive drinking of alcohol. The cause is multifactorial, from both nutritional deficiencies and alcohol metabolism’s direct toxic impacts on neurons.
Drinking a lot over a long time or too much on a single occasion can damage the heart, causing problems including:
- Cardiomyopathy – Stretching and drooping of the heart muscle
- Arrhythmias – Irregular heartbeat
- High blood pressure
Heavy drinking takes a toll on the liver and can lead to a variety of problems and alcohol liver damage including:
Alcohol causes the pancreas to produce toxic substances that can eventually lead to pancreatitis, a dangerous inflammation and swelling of the blood vessels in the pancreas that prevents proper digestion.
There is a strong scientific consensus that alcohol drinking can cause several types of cancer—consumption of alcoholic beverages is a known human carcinogen.
Drinking too much can weaken your immune system, making your body a much easier target for disease. Drinking a lot on a single occasion slows your body’s ability to ward off infections – even up to 24 hours after getting drunk.
How to Get Help from Alcoholism? Dual Diagnosis Programs in New Jersey
Overcoming alcohol use disorder is an ongoing process, one which can include setbacks. Because alcoholism can be a chronic relapsing disease, persistence is key. It is rare that someone would go to treatment once and then never drink again. More often, people must repeatedly try to quit or cut back experience recurrences, learn from them, and then keep trying. For many, continuing to follow up with a treatment provider is critical to overcoming problem drinking.
Truth be told, relapse is common among people who overcome alcohol problems. People with drinking problems are most likely to relapse during periods of stress or when exposed to people or places associated with past drinking.
A relapse to drinking can be seen as a temporary setback to full recovery and not a complete failure. Seeking professional help can prevent relapse—behavioral therapies can help people develop skills to avoid and overcome triggers, such as stress, that might lead to drinking.
Depression and anxiety often go hand in hand with heavy drinking. Studies show that people who are alcohol dependent are two to three times as likely to suffer from major depression or anxiety over their lifetime. When addressing drinking problems, it’s important to also seek treatment for any accompanying medical and mental health issues.
Find the Right Treatment at We Level Up Inpatient Rehab New Jersey
Now that we’ve answered the question, when are you considered an alcoholic? it will give us a fresh perspective on how to deal with individuals struggling with alcohol use disorder. If you or someone you love is struggling with alcoholism, get them the safest help they need and deserve. We Level Up NJ offers a safe and medically assisted Dual Diagnosis Alcohol and Mental Health Disorder Treatment. Contact our team today!
 AA – https://www.aa.org/frequently-asked-questions-about-aa-formerly-44-questions
 NIAAA – https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/understanding-alcohol-use-disorder
 NIAAA – https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/alcohol-facts-and-statistics
 NCBI – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3860472/