Alcohol Use Disorder | AspenRidge Recovery Center

Understanding Alcohol Use Disorder

Alcohol Use Disorder (AUD) stands as a complex and pervasive challenge, deeply rooted in the fabric of societies worldwide, and particularly resonant within the diverse communities of Colorado. This guide, crafted with a meticulous scientific approach, aims to unfold the multifaceted nature of AUD, offering a comprehensive exploration of its causes, symptoms, treatment, and prevention. The significance of this topic extends far beyond individual health; it touches the core of societal well-being and public health policy.

As we embark on this comprehensive exploration, we aim to empower readers with knowledge, challenge the stigma surrounding AUD, and ultimately contribute to a more informed and compassionate society. Whether you are personally grappling with AUD, supporting a loved one, or simply seeking to expand your understanding, this article is a step towards demystifying this complex disorder and fostering a community of support and healing.

What is Alcohol Use Disorder?

Alcohol Use Disorder (AUD) is a medical condition characterized by an inability to stop or control alcohol use, leading to adverse social, occupational, or health consequences. This disorder, also known as alcohol abuse, alcohol dependence, alcohol addiction, or colloquially alcoholism, is recognized as a brain disorder that can range from mild to severe. The development of AUD involves lasting changes in the brain due to alcohol misuse, making individuals vulnerable to relapse. However, evidence-based treatments, including behavioral therapies, mutual support groups, and medications, can assist in recovery.

Risk Factors and Symptoms of AUD

Risk factors for AUD include how much, how often, and how quickly alcohol is consumed. Early-age drinking, genetic factors, family history of alcohol problems, mental health conditions, and a history of trauma increase the risk. AUD can manifest various symptoms, and its severity is determined based on the number of criteria met by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).

Characteristics and Diagnosis of AUD

AUD is characterized by a pattern of compulsive heavy alcohol use and a loss of control over alcohol intake. This can be evident when alcohol use is continued despite adverse consequences and the availability of other rewarding activities. The definition aligns with a moderate to severe alcohol use disorder in the DSM-5 or with alcohol dependence in the ICD-11. It encompasses a range of psychological, biological, behavioral, and social consequences of alcohol use, where only some criteria need to be fulfilled to diagnose the disorder.

Prevalence and Undertreatment of AUD

The prevalence of AUD is significant, particularly in high-income and upper-middle-income countries. It is associated with high mortality and disease burden, primarily due to medical consequences like liver cirrhosis or injury. Despite its high prevalence, AUD remains one of the most undertreated mental disorders, partly due to the stigma associated with it and insufficient systematic screening in primary healthcare.

Treatment Approaches for AUD

Treatment for AUD varies and is tailored to the individual’s needs. Medications approved by the U.S. Food and Drug Administration, such as naltrexone, acamprosate, and disulfiram, can help reduce drinking and prevent relapse. Behavioral treatments focus on changing drinking behavior, and mutual support groups provide peer support. Severe cases of AUD may require medical assistance to manage alcohol withdrawal. Treatment should ideally be managed by primary healthcare, with routine screening for alcohol use. A staggered treatment response is recommended, ranging from brief advice to pharmacological treatment. Clinical interventions should be supported by alcohol control policies aimed at reducing overall consumption.

Statistics and Global Impact of AUD

The National Institute on Alcohol Abuse and Alcoholism’s 2022 National Survey on Drug Use and Health reports that 28.8 million adults aged 18 and older (11.2% of this age group) had AUD in 2021, with an estimated 753,000 adolescents aged 12 to 17 (2.9% of this age group) also affected during the same period. AUDs are among the most prevalent mental disorders globally, affecting 8.76% of the global population. This high prevalence underscores the need for effective public health strategies and interventions.

What Is Alcohol Use Disorder?

In addition to the psychological and behavioral aspects, the measurement of alcohol use in AUD is typically done through self-report. However, in clinical settings, biomarkers associated with heavy drinking are recommended. The latest generation of biomarkers, such as phosphatidylethanol, outperforms older ones in terms of specificity, sensitivity, and quantifying consumption over time. These biomarkers can provide a more accurate assessment of alcohol consumption, which is crucial for effective treatment planning.

Main characteristics of the most common alcohol-related blood biomarkers:

BiomarkerDetection window since alcohol exposurePattern/amount of alcohol drinking
Phosphatidyl ethanol (PEth) Up to three weeks after alcohol consumption 50 grams of alcohol per day
Fatty Acid Ethyl Ester (FAEE) 24–99 hours after alcohol consumption Excessive alcohol use but does not quantitatively correlate with amount of alcohol
Carbohydrate-Deficient Transferrin (CDT) Up to three weeks after alcohol consumption 5–7 standard drinks per day; recent heavy alcohol use; may be altered due to abstinence
Total Serum Sialic Acid (TSA) 2–5 weeks after alcohol consumption Excessive alcohol use, or about 60 grams per day of alcohol
Mean Corpuscular Volume (MCV) Remains high even after several (about 2–4) months of abstinence Excessive alcohol use, or about 60 grams per day of alcohol
Alanine Aminotransferase (ALT) and Aspartate Aminotransferase (AST) Elevated after alcohol use for as long as 2–3 weeks Excessive alcohol intake
Gamma Glutamyl Transpeptidase (GGT) Between 2–6 weeks after alcohol consumption Excessive alcohol intake
Cholesteryl Ester Transfer Protein (CETP) 24–48 hours after alcohol consumption Excessive alcohol intake
N-Acetyl-β-Hexosaminidase (Beta-Hex) Stays elevated until about 7–10 days after consumption Can detect acute consumption (120–160 grams of ethanol) and heavy alcohol use
Macrophage Migration Inhibitory Factor (MIF) and D-dopachrome Tautomerase (DDT) N/A N/A

In conclusion, AUD is a complex and prevalent disorder with significant health and social implications. Its treatment requires a comprehensive approach that includes medical, psychological, and social support. Understanding the nature of AUD and its effective management strategies is crucial for addressing this public health challenge. With continued research and development of effective treatments, there is hope for those affected by AUD to achieve recovery and improve their quality of life.

“Alcohol Use Disorder (AUD) is not just a personal struggle; it’s a complex medical condition requiring a comprehensive treatment approach, combining medical, psychological, and social support to address its significant health and social implications effectively.

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