A lot of patients I see don’t really know they may meet the criteria for alcohol use disorder. I can tell you that it’s not that hard to qualify, and more and more people are entering the ranks.
From 2001 to 2012, the prevalence of alcohol use disorder (AUD) increased by 50% in the US general population (from 8.5% to 13%), affecting nearly 1 in 6 Americans. This increase disproportionately affected women, older adults, and persons of lower socioeconomic status, according to JAMA Psychiatry 2017;74:911‐923.
How Do I Know If I Have Alcohol Problems?
To be diagnosed with AUD, individuals must meet certain criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM). Under DSM–5, anyone meeting any 2 of the 11 criteria during the same 12-month period receives a diagnosis of AUD. The severity of AUD — mild, moderate, or severe — is based on the number of criteria met.
To assess whether you or a loved one may have AUD, here are some questions to ask. In the past year, have you:
- Had times when you ended up drinking more, or longer than you intended?
- More than once wanted to cut down or stop drinking, or tried to, but couldn’t?
- Spent a lot of time drinking? Or being sick or getting over the after effects?
- Experienced craving — a strong need, or urge, to drink?
- Found that drinking — or being sick from drinking — often interfered with taking care of your home or family? Or caused job troubles? Or school problems?
- Continued to drink even though it was causing trouble with your family or friends?
- Given up or cut back on activities that were important or interesting to you, or gave you pleasure, in order to drink?
- More than once gotten into situations while or after drinking that increased your chances of getting hurt (such as driving, swimming, using machinery, walking in a dangerous area, or having unsafe sex)?
- Continued to drink even though it was making you feel depressed or anxious or adding to another health problem? Or after having had a memory blackout?
- Had to drink much more than you once did to get the effect you want? Or found that your usual number of drinks had much less effect than before?
- Found that when the effects of alcohol were wearing off, you had withdrawal symptoms, such as trouble sleeping, shakiness, irritability, anxiety, depression, restlessness, nausea, or sweating? Or sensed things that were not there.
Calculate Your Alcohol Dependence
If these questions don’t convince you, you may want to complete The Audit C, a very simple tool with three questions.
- How often do you have a drink containing alcohol? A. Never
- How many standard drinks containing alcohol do you have on a typical day? A. 1 or 2
- How often do you have six or more drinks on one occasion? A. Never
B. Monthly or less
C. 2-4 times a month
D. 2-3 times a week
E. 4 or more times a week
B. 3 or 4
C. 5 or 6
D. 7 to 9
E. 10 or more
B. Less than monthly
C. Monthly
D. Weekly
E. Daily or almost daily
The AUDIT-C is scored on a scale of 0-12. Points are allotted as follows:
A = 0 points
B = 1 point
C = 2 points
D = 3 points
E = 4 points
In men, a score of 4 or more is considered positive for identifying hazardous drinking or active alcohol use disorders. In women, a score of 3 or more is considered positive. However, when the points are all from Question #1 alone (#2 & #3 are zero), it can be assumed that the patient is drinking below recommended limits and it is suggested that the provider review the patient’s alcohol intake over the past few months to confirm accuracy. Generally, the higher the score, the more likely it is that the patient’s drinking is affecting his or her safety.
Source: Substance Abuse and Mental Health Services Administration
An Easy Comfortable Alcohol Detox
At the Coleman Institute for Addiction Medicine, we help people who have decided to be abstinent from alcohol do so safely. In the privacy of our clinic, with your support person present, the patient is monitored as medication is given to reduce dangerous withdrawal symptoms. Our patients return for the following two days to assess physical and emotional response to the treatment, and to review medication effectiveness.
Please give us a call at 877-773-3869 if you are considering abstinence and want to detox off alcohol safely. Not every person who stops drinking needs a medically assisted detox in a clinical setting, and our call center can help you discern this.
Joan Shepherd, FNP
