Early Warning Signs of Alcohol Use Disorder

Intervening early has many benefits and could save a life.

The earlier you seek intervention for alcohol use disorder (AUD), the easier it will be to change behavior patterns and find different ways to cope in life. By the time AUD has set in, it may be impairing your life in tragic ways that are hard to "undo," such as a divorce or the loss of a job. 

What can make AUD challenging to recognize early on is that alcohol use, and even heavy alcohol use, is common and socially acceptable in many cultures. Depending on your age, where you live, or who your friends are, drinking several drinks in one sitting—night after night—may not raise any eyebrows.   

As a result, AUD often isn’t discovered until someone suffers serious consequences, such as a car crash or suicide attempt. “We talk a lot about the opioid epidemic, but we see nine times the presentation to our hospital that are alcohol-related than are opioid-related,” says Jonathan Avery, MD, director of Addiction Psychiatry at Weill Cornell Medicine and NewYork-Presbyterian Hospital. 

“When we think of problematic alcohol use, we think of the person that's drinking every day and starts drinking in the morning,” says Dr. Avery. “They can't function without it, they're damaging their liver and brain in a daily manner, and they can't sort of survive without alcohol being a part of their body.”

Other warning signs of alcohol use disorder include:

  • Regular binge-drinking

  • Regularly drinking to the point of blacking out or not remembering things

  • Regularly drinking more than intended

  • Attempting to cut down on alcohol but not being able to

  • Continuing to drink despite negative consequences (e.g., being hungover at work or losing friendships)

  • Losing interest in other activities

  • Feeling withdrawal symptoms when you’re not drinking

“If you find yourself in black-out states or brown-out states, you should be thinking to yourself, ‘Hey, I might need to re-examine this or I'm at risk for some bad things happening,’” says Dr. Avery.

What Is Moderate Drinking?

Drinking “in moderation” is typically defined as no more than one drink per day for women and no more than two drinks per day for men. 

“We have these at-risk categories. We know if you're sort of drinking more than, say, seven or 14 drinks a week for a woman or a man, you might be more at risk to veer into sort of the addiction category,” says Dr. Avery. “But really, once it starts impairing your function, that's when you have an addiction.”

In addition to increasing your risk of AUD, excessive alcohol consumption also increases your risk of liver disease, serious injuries, certain types of cancer (especially breast cancer), cardiovascular diseases, and depression. It’s actually linked to over 200 health problems, according to the National Institute on Alcohol Abuse and Alcoholism. 

“One of my favorite expressions in recovery is that folks with addiction aren't bad people becoming good, but they're sick people becoming well, and I think that's the proper way to think about addiction and substance use disorder,” says Dr. Avery.

Jonathan Avery, MD

This video features Jonathan Avery, MD. Dr. Avery is the director of Addiction Psychiatry at Weill Cornell Medicine and NewYork-Presbyterian Hospital.

Duration: 2:34. Last Updated On: May 4, 2020, 2:56 p.m.
Reviewed by: Preeti Parikh, MD . Review date: April 29, 2020
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