What is Alcohol Use Disorder?
Alcohol Use Disorder (AUD) is a chronic medical condition characterised by an individual's inability to control or stop their drinking despite adverse consequences. It is a severe form of problem drinking. It is diagnosed based on a set of criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which mental health professionals use for diagnostic purposes.
The DSM-5 criteria for diagnosing Alcohol Use Disorder include:
Impaired control
The person often drinks more or for a more extended period than intended, and there is a persistent desire to cut down or control drinking.
Social impairment
Drinking interferes with work, school, or home responsibilities. It may also lead to social problems or withdrawal from the person once enjoyed activities.
Risky use
The person continues to drink despite knowing it's causing physical or psychological problems, and there's a pattern of engaging in hazardous activities while intoxicated.
Tolerance
There is a need for increased amounts of alcohol to achieve the desired effect and a diminished effect with continued use of the same amount.
Withdrawal
The person experiences withdrawal symptoms when not drinking or drinking to avoid withdrawal symptoms.
AUD can range from mild to severe, depending on the number of criteria met. It is essential to note that AUD is a medical condition, and individuals struggling with it may benefit from professional help, such as counselling, medication, or participation in support groups. Treatment approaches can vary based on the severity of the disorder and individual needs. Seeking help from healthcare professionals is crucial for an accurate diagnosis and appropriate intervention.
Symptoms of Alcohol Use Disorder
A variety of symptoms characterises Alcohol Use Disorder (AUD), and the severity of the disorder can range from mild to severe. These symptoms are outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). To be diagnosed with AUD, an individual must meet specific criteria. The symptoms include:
Impaired Control
Drinking more or for a more extended period than intended. A persistent desire or unsuccessful efforts to cut down or control drinking.
Social Impairment
Drinking interferes with responsibilities at work, school, or home. Continuing to drink despite it causing problems in relationships. Giving up or reducing activities due to alcohol use.
Risky Use
Drinking in situations where it is physically hazardous, such as while driving or operating machinery. Continued drinking despite knowledge of physical or psychological problems related to alcohol use.
Tolerance
Needing to drink increasingly more significant amounts to achieve the desired effect. Not experiencing the same effect with the same amount of alcohol as before.
Withdrawal
Experiencing withdrawal symptoms when not drinking or drinking to relieve withdrawal symptoms. Withdrawal symptoms may include anxiety, tremors, sweating, nausea, and insomnia.
Time Spent on Alcohol
A great deal of time is spent obtaining, using, or recovering from the effects of alcohol.
Loss of Interest
Reduction or abandonment of important social, occupational, or recreational activities in favour of drinking.
Unsuccessful Attempts to Quit or Control Use
Persistent desire to cut down or control alcohol use, with unsuccessful efforts to do so.
Craving
Strong urges or cravings to drink alcohol.
It's important to note that an individual does not need to exhibit all of these symptoms to be diagnosed with AUD. The number of criteria determines the severity of the disorder. Seeking professional help is recommended for individuals experiencing symptoms of AUD, as it is a medical condition that can have severe consequences if left untreated. Treatment may involve counselling, medication, and support groups tailored to the individual's needs.
Treating Alcohol Use Disorders
Treating Alcohol Use Disorder (AUD) typically involves a multifaceted approach that addresses both the physical and psychological aspects of the condition. The appropriate treatment plan can vary based on the severity of the disorder and individual needs. Here are common approaches to treating AUD:
Detoxification (Detox)
For individuals with severe alcohol dependence, supervised detoxification may be necessary to manage withdrawal symptoms. This is often done in a medical setting to ensure the person's safety.
Medication-Assisted Treatment (MAT)
Medications may be prescribed to help reduce cravings and manage withdrawal symptoms. Examples include disulfiram, naltrexone, and acamprosate. MAT is often combined with counselling and support.
Counselling and Psychotherapy
Individual counselling or psychotherapy can help individuals explore the underlying issues contributing to their alcohol use and develop coping strategies. Behavioural therapies, such as cognitive behavioural therapy (CBT) and motivational enhancement therapy (MET), are commonly used.
Support Groups
Participation in support groups, such as Alcoholics Anonymous (AA) or SMART Recovery, can provide a sense of community and encouragement. These groups often follow a 12-step or similar program.
Inpatient or Outpatient Rehabilitation Programs
Inpatient programs provide a more intensive and structured environment for individuals with severe AUD. Outpatient programs offer flexibility for those with milder forms of AUD.
Family Therapy
Involving family members in the treatment process can be beneficial. Family therapy helps improve communication and understanding, addressing the impact of AUD on relationships.
Lifestyle Changes
Encouraging healthy lifestyle changes, such as regular exercise, improved nutrition, and stress management, can support recovery.
Continued Monitoring and Aftercare
Long-term recovery often involves ongoing monitoring and aftercare. This may include regular check-ins with healthcare providers, ongoing counselling, and participation in support groups.
It's important to note that treatment plans should be tailored to each individual's unique circumstances. Seeking professional help is crucial, and healthcare providers, including addiction specialists, can assist in determining the most appropriate course of action. Support from friends and family is also essential for the individual's recovery journey. It's often a lifelong process, and maintaining a commitment to sobriety requires ongoing effort and support.
Dr Clem Bonney
Treatment of Alcohol Use Disorder, in the context of workplaces, requires an understanding of the driver of the disorder and the ability to engage with the employer and worker to develop a plan to assist with remaining at the workplace. This ensures a safe and effective transition for the employer and the employee. Dr Clem Bonney, as an occupational physician and Medical Review Officer, assists both parties with such issues.