Alcoholism
What Is Alcohol Use Disorder?
Alcohol Use Disorder spans from mild to severe and includes what many refer to as alcohol abuse, dependence, or addiction. It reflects lasting changes in brain circuits that perpetuate compulsive drinking and vulnerability to relapse, even after periods of abstinence.
Signs and Symptoms
Clinicians use DSM-5 criteria to diagnose AUD and determine severity (mild: 2–3 symptoms; moderate: 4–5; severe: ≥6) based on behaviors over the past year:
| Symptom Domain | Examples |
|---|---|
| Loss of Control | Drinking more or longer than intended; unsuccessful attempts to cut down |
| Time Spent | Significant time obtaining, using, or recovering from alcohol |
| Cravings | Strong desire or urge to drink |
| Role Interference | Neglecting family, work, or school responsibilities |
| Social or Interpersonal | Continued use despite relationship problems |
| Risky Use | Using in dangerous situations (e.g., driving) |
| Withdrawal & Tolerance | Needing more to feel effects; experiencing withdrawal symptoms |
Common withdrawal symptoms include tremor, sweating, nausea, insomnia, anxiety, and in severe cases, seizures or delirium tremens, which can be life-threatening without medical management.
What Causes Alcoholism?
AUD arises from an interplay of factors:
Genetic Predisposition: Family history contributes up to 60% of risk.
Neurobiological Changes: Alterations in brain reward and stress circuits reinforce drinking.
Psychological & Social: Coexisting mental health conditions (depression, PTSD, ADHD), childhood trauma, and peer influences.
Drinking Patterns: Early age of first drink, binge drinking, and high-volume consumption increase risk.
How Is AUD Diagnosed?
Dr. Budhwar will conduct:
Clinical Interview: Detailed history of drinking patterns, consequences, and attempts to quit.
Screening Tools: Questionnaires like AUDIT (Alcohol Use Disorders Identification Test).
Physical & Laboratory Evaluation: To assess liver function, screen for complications, and rule out other conditions.
Treatment Options
Effective AUD treatment is personalized and may include:
1. Medications
Three FDA-approved agents aid recovery:
Naltrexone (oral & injectable XR): Reduces cravings by blocking opioid receptors.
Acamprosate: Restores neurotransmitter balance, reducing protracted withdrawal symptoms.
Disulfiram: Creates unpleasant reactions when alcohol is consumed, deterring relapse.
Additional options with growing evidence include gabapentin and topiramate; emerging therapies (e.g., psilocybin) are under study.
2. Behavioral Therapies
Cognitive Behavioral Therapy (CBT): Teaches coping skills, relapse prevention, and problem-solving.
Motivational Enhancement Therapy (MET): Builds readiness and commitment to change.
Contingency Management: Uses incentives to reinforce abstinence.
Mutual-Support Groups: AA, SMART Recovery, and others provide peer encouragement and accountability.
3. Integrated Care
Combining medication with counseling and peer support yields the best outcomes. Inpatient detoxification may be required for severe withdrawal risks; outpatient treatment suits mild-moderate AUD.
Self-Help Strategies
Set Clear Goals: Define whether to cut down or quit entirely.
Track Drinking: Use a journal or app to monitor intake and identify triggers.
Develop Alternatives: Replace drinking with healthy activities—exercise, hobbies, social outings.
Build Support: Engage friends, family, or sponsor for encouragement and accountability.
Manage Cravings: Use relaxation techniques (deep breathing, mindfulness) and delay tactics (wait 15 minutes).
When and How to Seek Help
If drinking causes significant distress or you meet any AUD criteria, seek professional support:
Contact us for guidance
Visit our home page for resources
Recovery from Alcoholism is possible. With a comprehensive treatment plan, medical supervision, and ongoing support, patients can achieve long-term sobriety and reclaim a healthier, fulfilling life.