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.
Symptoms of Alcohol Use Disorder
“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:
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Regular binge-drinking
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Regularly drinking to the point of blacking out or not remembering things
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Regularly drinking more than intended
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Attempting to cut down on alcohol but not being able to
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Continuing to drink despite negative consequences (e.g., being hungover at work or losing friendships)
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Losing interest in other activities
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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.
Dr. Avery is the director of Addiction Psychiatry at Weill Cornell Medicine and NewYork-Presbyterian Hospital.
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As an addiction professional, the thing I'm always thinking about
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is why are we drinking.
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Is it to self-medicate symptoms, is it to sleep,
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is it something you need to go out in a social setting?
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And you want to understand why you're using,
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pay attention to it, and just be mindful that it can quickly veer
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into problematic alcohol use.
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We talk a lot about the opioid epidemic,
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but we see nine times the presentation to our hospital
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that are alcohol-related than are opioid-related.
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And so there is a real risk, even as it so socially accepted
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and people think about what safe drinking is,
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there's still a risk for anyone who's drinking on a regular basis.
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There are a lot of negative consequences of ongoing alcohol use,
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and sometimes we think of,
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when we think of problematic alcohol use,
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we think of the person that's drinking every day
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and starts drinking in the morning
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and those are some obvious consequences.
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They can't function without it, they're damaging their liver
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and their brain in a daily manner, and they can't
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sort of survive without alcohol being a part of their body.
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When you're drinking regularly, binge-drinking,
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or drinking too much where you're blacking out
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and not remembering things, that's sort of a good sign that,
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hey, my body's having a hard time processing this,
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and that should be sort of a signal that,
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hey, I've been drinking too much, and if this is what's going on
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in my brain, I imagine other things are going on, you know,
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throughout my body, and
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when you're drinking that much, you know it's gonna cause
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other problems down the line, not just those immediate ones,
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and so if you find yourself in black-out states or brown-out states,
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you should be thinking to yourself, hey, I might need to
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re-examine this or I'm at risk for some bad things happening.
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We have these at-risk categories.
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We know if you're sort of drinking more than, say,
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seven or 14 drinks a week for a woman or a man,
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you might be more at risk to veer into sort of the addiction category,
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and so we keep sort of misuse patterns in mind,
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but really, once it starts impairing your function,
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that's when you have an addiction.
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It can feel to the person who has an addiction
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or to family members that they should just stop or get over it,
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but this really becomes a brain disease that becomes very hard
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to modulate over time, and one of my favorite expressions
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in recovery is that folks with addiction aren't bad people
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becoming good, but they're sick people becoming well,
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and I think that's the proper way to think about addiction
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and substance use disorder as not as something that we need
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to arrest our way out of or punish, but really that deserves
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sensitive, compassionate medical treatment.
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Alcohol and drug abuse statistics. American Addiction Centers, 2020. (Accessed on April 17, 2020 at https://americanaddictioncenters.org/rehab-guide/addiction-statistics.)
Alcohol use disorder. Bethesda, MD: National Institute on Alcohol Abuse and Alcoholism. (Accessed on April 17, 2020 at https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-use-disorders.)
Risky drinking and alcohol use disorder: epidemiology, pathogenesis, clinical manifestations, course, assessment,and diagnosis. Waltham, MA: UpToDate, 2020. (Accessed on April 17, 2020 at https://www.uptodate.com/contents/risky-drinking-and-alcohol-use-disorder-epidemiology-pathogenesis-clinical-manifestations-course-assessment-and-diagnosis.)
What are the risks? Bethesda, MD: National Institute on Alcohol Abuse and Alcoholism. (Accessed on April 17, 2020 at https://www.rethinkingdrinking.niaaa.nih.gov/how-much-is-too-much/whats-the-harm/what-are-the-risks.aspx.)