Symptoms of Alcohol Use Disorder

There’s no exact known cause of alcohol use disorder. However, there are some factors that may make a person more likely to develop it.

Some common factors include:

Drinking patterns

Over time, heavy alcohol use and binge drinking may increase the chances of developing alcohol use disorder.

According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), heavy alcohol use is defined as consuming more than four drinks a day for men or more than three drinks a day for women.

Early alcohol use

Drinking at a young age increases the chance of alcohol use disorder in some people.

Traumatic childhood experiences, such as neglect or abuse, can also be a contributing factor.

Easy access to alcohol

Research suggests that easy access to substances, such as alcohol, can be a contributing factor to the number of high school students in the United States who live with alcohol use disorder.

A 2015 study involving more than 500,000 high school students found that more than 60% of them reported having easy access to alcohol. This was regardless of whether they lived in an urban or rural neighborhood.

Genetics and family history

Children of a parent with alcohol use disorder may be more likely to develop the condition later in life.

Multiple genes affect this likelihood. Some shape the way the body breaks down alcohol.

But genetics on their own don’t control whether a person has an alcohol use disorder. Environmental factors, such as lifestyle and role models, are also important influences.

Having a substance use disorder (SUD)

Substance use disorder and alcohol use disorder may have common contributing factors.

A 2019 study found that people with substance use disorder in their late adolescence years were four times more likely to develop alcohol use disorder in early adulthood.

Mental health

Many mental health conditions may co-occur with alcohol use disorder, such as:

• anxiety
• depression
• post-traumatic stress disorder (PTSD)

The relationship between mental health conditions and alcohol use disorder is complex. The symptoms, genetics, and brain structure related to mental health conditions can increase the risk of developing alcohol use disorder. Some people with mental health concerns may self-medicate with alcohol.

If you have attention deficit hyperactivity disorder (ADHD), for example, alcohol use disorder might make symptoms like impulsivity worse.

Symptoms of alcohol use disorder can look differently in each person.

Some people with alcohol use disorder may experience physical symptoms, such as:

• weight loss
• bloodshot eyes
• changes in physical appearance
• dry skin or brittle hair or nails
• yellowing of the eyes or skin (caused by liver damage)

Chronic (long-term) and severe alcohol misuse can cause serious health conditions, including:

• heart disease
• anemia (low iron levels)
• cirrhosis (severe liver damage)
• seizures
• high blood pressure
• nerve damage
• infectious diseases
• pancreatitis (damage to the pancreas)

Before 2013, this condition was also referred to as “alcohol abuse” and “alcohol dependence.” The most recent version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) combined these two terms into one diagnosis: alcohol use disorder with classifications for mild, moderate, and severe.

According to the NIAAA, if you meet two of the following criteria in the past year, you may receive a diagnosis of alcohol use disorder:

• At times, you drank more or longer than you intended.
• You wanted to cut down or stop drinking, or tried to, more than once, but you couldn’t.
• You spent a lot of time drinking, or a lot of time being sick or getting over the aftereffects.
• You had a strong, persistent need or urge to have a drink.
• Your drinking has affected your ability to take care of your responsibilities at home, work, or school.
• You continued to drink, even though it has affected relationships with family, friends, and loved ones.
• You avoided activities you once enjoyed so you could drink.
• You engaged in high-risk activities more than once while or after drinking. These activities can include driving, swimming, using machinery, walking in a dangerous area, or having sex without barrier protection.
• You continued to drink even though it made you feel depressed or anxious, or you blacked out with no memories afterward.
• You have to consume more drinks than before to get the same effects as in the past, as each drink has less of an effect than before.
• You had withdrawal symptoms when the effects of the alcohol was wearing off. These might have included trouble sleeping, shakiness, irritability, anxiety, depression, restlessness, nausea, or sweating. You may have also experienced hallucinations, or perceived things were there when they weren’t.

The number of criteria you meet will determine the severity of your condition:

• mild (2–3 criteria)
• moderate (4–5 criteria)
• severe (6 or more)

If you’re experiencing alcohol dependence, stopping alcohol use suddenly can cause dangerous effects, such as seizures.

Consider talking with a professional about your options to reduce the amount of alcohol you consume safely and avoid serious side effects.

The CAGE Questionnaire

Some healthcare professionals may use an older tool to screen for alcohol use disorder called the CAGE Questionnaire.

If you answer yes to two or more questions, you may use alcohol heavily or have alcohol use disorder:

• C: Have you ever felt you should cut down on your drinking?
• A: Have people annoyed you by criticizing your drinking?
• G: Have you ever felt bad or guilty about your drinking?
• E: Have you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover (eye-opener)?

If you have alcohol use disorder, or think that you do, asking for help can be hard.

There are several reasons recovery from alcohol use disorder can be challenging:

• denial, or not understanding the seriousness of their condition
• having little to no support from family, friends, and loved ones
• not understanding what alcohol use disorder is or recognizing the symptoms

Another reason is social stigma, or the idea that people with alcohol use disorder drink because they have some character flaw or they just need to “make better choices.”

No matter the reason behind the condition, there are ways you can get support. You can:

• Consider talking with a loved one. If you feel comfortable, you can open up to someone you trust about what you’re going through.
• Try talking with a mental health or primary care professional. They can recommend a treatment that best fits your lifestyle, if needed. This may involve a combination of medications, therapy, and an overall evaluation of your physical health for any effects of heavy drinking.
• Consider joining a support group. Groups like Alcoholics Anonymous and SMART Recovery offer free or low-cost meetings with peers to talk about challenges and support each other.
• Learn more. Online resources like Rethinking Drinking and NIAA Alcohol Treatment Navigator provide more information and resources.

If you think you or someone you know has alcohol use disorder, you can find help and resources.

If you want to know more about alcohol use disorder, including treatment options and what counts as a “standard drink” in the United States, you can visit the NIAAA Rethinking Drinking website.

You can visit the NIAAA Alcohol Treatment Navigator to learn more about treatment options and to find treatment near you.

A healthcare professional may also be able to recommend resources and support.