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.