5 Alcohol Use Disorder Criteria Signs You May Be Overlooking

Short of inventing time travel, removing alcohol from the fabric of society is impossible (remember, we tried and failed). We now must depend on responsible alcohol use to counteract its dangerous effects. Unfortunately, alcohol use disorder (AUD) still affects over 14 million Americans. Even more concerning is that millions more overlook alcohol use disorder criteria signs. If left untreated, AUD has severe physical, emotional, social, and occupational consequences. It reduces the quality of life and lifespan. Early identification of AUD signs can help you reduce alcohol use or know when it’s time to get help. 

Alcohol: The Double-Edged Sword

Alcohol use is nothing new. For thousands of years, alcohol has been part of rituals, bonding, and socializing. Some of the world’s biggest decisions happened over a glass of wine. Its production has now become a multibillion-dollar industry that employs millions worldwide. Now your favorite celebrity has their name behind an alcohol brand. Some studies show that a glass or two of wine helps with heart health.

It’s the most used psychoactive substance worldwide. In small amounts, these intoxicants release endorphins, dopamine, and serotonin, the neurotransmitters that make us feel excited, rewarded, or warm and fuzzy inside. It can loosen us up, giving us the liquid courage to let our hair down a bit.

But alcohol has a well-documented dangerous side. In large quantities, alcohol can lead to severe impairment, memory loss, aggressive social and sexual behavior, and alcohol poisoning. Every year, one person dies every 45 minutes due to drunk driving. With excess use, the willpower to stop drinking or skip it declines, leading to a vicious cycle that seems impossible to shake. This is often the beginning of alcohol use disorder.

What is alcohol use disorder (AUD)?

Alcohol use disorder is a condition with both physical and mental aspects, and is a disorder characterized by a continuous pattern of alcohol consumption, often regardless of the social, emotional, or physical consequences.

Terms like alcohol addiction, alcoholism, and alcohol dependence also fall under alcohol use disorder. Many people with AUD can’t stop drinking, even if they try. Most require medication, counseling, and continuous support to overcome the disorder. The Diagnostic and Statistical Manual of Mental Disorders – 5th Edition (DSM-5) outlines 11 alcohol use disorder criteria. The condition can be mild, moderate, or severe, depending on the number of symptoms present. Most people think their drinking is under control. Yet, there may be initial red flags that may prove otherwise. Have you noticed these 5 alcohol use disorder criteria signs? 

1. You’re aware you’ve had too much (but you keep going anyway)

Some people go into social settings with a set limit of drinks, usually in line with social drinking criteria (1-2 drinks per day). Binge drinking or alcohol abuse starts at 4 or more drinks for women and 5 or more for men. 

If individuals are aware they’ve gone past the self-imposed limit and continue anyway – to the point of binge drinking – it sets the stage for alcohol use disorder. Repeating this behavior reduces the individual’s control over alcohol use and increases the frequency. 

2. You’ve moved on to hard liquor use

Alcohol use disorder is not predicated by the type of alcohol but by the excessive drinking of alcohol. At the same time, it’s common to build up alcohol tolerance with consistent use.

Simply put, low-alcoholic intoxicants like hard seltzers, beer, or wine do not evoke the same feelings anymore. And, like other psychoactive substances, you need stronger doses to achieve the same response. So now you skip your favorite IPA and go straight for the hard stuff. Having to drink much more or adding more potent drinks to your usual rotation is a telltale sign of AUD. 

3. You need alcohol to feel "normal"

Over time, alcohol can create a dangerous combination of negative and positive reinforcement. Perhaps someone has built a habit of a couple of glasses of wine every Friday night while watching their favorite show.

Soon, the body becomes accustomed to drinking at that time. If that person misses the timeframe, agitation, trouble sleeping, irritability, and general malaise kick in, so they drink to feel normal. This negative reinforcement, combined with the positive emotions from alcohol use, creates the basis for addiction—the person drinks for enjoyment and to take the edge off too. 

4. Skipping what matters to drink

Even mild AUD can impact interpersonal relationships, work assignments, school, and other responsibilities. Individuals struggling with alcohol use find themselves skipping weekly pickup games, missing meetings at school, or forgetting to pay the bills. The small promises missed eventually turn into bigger ones. Often, these individuals prefer alcohol-related activities like parties, bars, or mixers at work. They stick around longer than necessary, participate in excessive drinking of alcohol, and miss more important events. Like any addiction, this can start with small obligations and move to more significant responsibilities with higher stakes. 

5. Your general health is deteriorating.

Even moderate alcohol use can have adverse long-term effects on your physical health. 

The changes are mild at first:

• You keep forgetting or misplacing things

• You get sick around cold and flu season

• Low mood, including mild depression or anxiety

• Insomnia 

• Sexual dysfunction or difficulty getting pregnant

These issues can soon evolve into more chronic diseases. For instance, researchers link alcohol use to metabolic syndrome, a combination of abdominal obesity, hypertension, diabetes, and poor cholesterol levels. Alcohol use is often combined with poor diet choices, increasing the chances of these lifestyle diseases. 

So What's Next?

It’s important to understand that alcohol use disorder happens on a spectrum. Most people envision alcohol use disorder as a severe, destructive occurrence in all parts of someone’s life. However, most AUD cases involve high-functioning people. In fact, just 2 symptoms on the DSM-5 list within the past year are enough for alcohol use disorder criteria.

Have any of these 5 signs consistently occurred?

Are you concerned about the long-term effects of alcohol use?

Do you want to reduce or stop your alcohol use, but you can’t?

Then speak with a primary physician, psychiatrist, or substance abuse expert first to express any concerns. An assessment can help determine where you are on the spectrum and what help is required. Seeking help is an opportunity to catch the problem early and implement strategies to deal with stress or find fulfillment through other means. Individuals also learn if medication-assisted treatment is necessary.

Assessments from professionals are also crucial, as trying to quit alcohol use cold turkey on your own can have some unpleasant withdrawal symptoms, and can easily cause unexpected and potentially dangerous relapses.

AUD can be difficult to control, so let us be your guide. Combining telehealth communication, medication, video and available live coaching, you can discreetly yet effectively address the issue. Sign up for help from our trained specialists today.

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