Overview
Alcohol use disorder is a medical condition in which a person has difficulty controlling their alcohol intake despite negative effects on health, relationships, and daily life. It ranges from mild to severe, and the severe end is what most people call alcoholism. It is a recognised brain disorder, not a character flaw.
How common is it?
About 1 in 8 adults meets the criteria for alcohol use disorder at some point. It is one of the most prevalent substance use conditions globally.
Causes and risk factors
Alcohol changes the brain's reward and stress circuits over time. Regular heavy drinking leads to physical dependence where the brain requires alcohol to function normally. Genetic factors account for roughly half the risk.
Common risk factors
- Family history of alcohol problems
- Starting drinking at a young age
- Mental health conditions such as depression or anxiety
- High-stress environment or trauma
- Social and cultural factors normalising heavy drinking
- Easy access to alcohol
Symptoms
- Drinking more or for longer than intended
- Unsuccessful attempts to cut down
- Spending a lot of time drinking or recovering
- Strong cravings for alcohol
- Failing to fulfil work, family, or social duties
- Continuing to drink despite relationship or health problems
- Withdrawal symptoms (shaking, sweating, nausea) when not drinking
When to see a doctor
Seek help if you or someone you know cannot stop drinking despite wanting to, experiences withdrawal symptoms, or if alcohol is causing harm. Sudden stopping after heavy dependence can be dangerous without medical supervision.
Diagnosis
Doctors use standardised questionnaires (such as AUDIT or CAGE) and clinical assessment to identify the pattern and severity. Blood tests can check for liver damage.
Treatments
Medically assisted withdrawal
Hospital or supervised withdrawal using medication (usually benzodiazepines) to prevent dangerous complications like seizures during detoxification.
Medications to prevent relapse
Acamprosate reduces cravings, naltrexone blocks the pleasurable effects of alcohol, and disulfiram causes unpleasant reactions if alcohol is consumed.
Talking therapies
Cognitive behavioural therapy (CBT) and motivational interviewing address the psychological drivers of drinking and build coping skills.
Self-care and lifestyle
- Attend a peer support group such as Alcoholics Anonymous or SMART Recovery
- Remove alcohol from the home environment
- Identify personal triggers and develop alternative responses
- Rebuild sleep, nutrition, and exercise habits progressively
Prevention
Low-risk drinking guidelines recommend no more than 14 units per week spread over several days with alcohol-free days. Addressing mental health problems early reduces the risk of using alcohol to cope.