What is Alcohol Use Disorder?

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What do typical problem drinkers look like? A tough biker thrown out of a bar for starting fights? A couple whose raucous conflicts spill into their front yard and wake the neighborhood? A homeless man dressed in rags, stumbling down the sidewalk, clutching a bottle of cheap vodka? Maybe. But they could also look like you, or your friends, or your family, or your coworkers.

The reality is that there is no “typical” appearance for someone with Alcohol Use Disorder (AUD). In fact, roughly half of the patients who come to the hospital for alcohol withdrawal are both middle-class and otherwise highly functional people.

Though the amount of alcohol consumed is a factor in screening for AUD, how people drink, their attitudes and behaviors surrounding drinking, and the point at which alcohol use begins to affect a person’s life are central to diagnosis. These people feel the urge to drink as powerfully as for water and food, sometimes even substituting alcohol for food and becoming vitamin deficient. Alcohol is the driving force in the life of an AUD sufferer. Often, it takes the risk of losing family, friends, jobs, and even life itself before they are willing to accept treatment.

Because a certain degree of alcohol use is acceptable in our society (as opposed to heroin or cocaine), problematic drinking can be difficult to spot for the untrained eye. People who have been drinking excessively may be socially uninhibited, slurring their words, and exhibit a stumbling gait. Though it is no longer part of the diagnostic criteria, legal consequences from risky behavior like drunk driving and physical altercations are another sign of uncontrollable drinking. Having a naturally high tolerance is another warning sign. People with this genetic predisposition have a higher risk of developing AUD.

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