Alcohol Use Disorder (AUD) is a serious chronic brain disorder characterized by compulsive alcohol consumption, a loss of control over drinking, and experiencing negative emotional states when not drinking. Understanding the signs of AUD is the first step toward seeking help, as alcohol misuse accounts for a significant number of preventable deaths annually. This guide provides a straightforward overview of the indicators of AUD, divided into physical and psychological manifestations.
Defining Alcohol Use Disorder
Alcohol Use Disorder is defined as a medical condition involving a problematic pattern of alcohol use that leads to clinically significant distress or impairment. It is a complex disease that alters brain function and exists on a spectrum, with severity ranging from mild to severe.
A diagnosis is made by a healthcare professional based on criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Meeting two or more of the 11 established criteria within a 12-month period is sufficient for an AUD diagnosis.
Physical Signs of Active Addiction
One of the earliest physiological indicators of AUD is the development of tolerance, where the body adapts to the presence of alcohol. This means an individual needs to consume progressively larger amounts of alcohol to achieve the desired effect. This diminished effect signals a change in the brain’s neurochemistry in response to chronic use.
When a person who is physically dependent on alcohol suddenly stops or significantly reduces their intake, they may experience a range of physical withdrawal symptoms. Milder symptoms can include a rapid heart rate, elevated blood pressure, and noticeable hand tremors, often referred to as “the shakes.” Insomnia, excessive sweating, and gastrointestinal distress, such as nausea and vomiting, are also common during this initial phase.
More severe withdrawal can develop between 24 and 72 hours after the last drink and may involve life-threatening symptoms. This includes seizures and delirium tremens (DTs), a condition characterized by severe disorientation, fever, and hallucinations. The occurrence of these severe physical reactions indicates a significant level of physiological dependence and requires immediate medical attention.
Long-term, heavy alcohol consumption contributes to observable health deterioration that goes beyond acute withdrawal. Chronic use can cause numbness in the hands and feet, known as peripheral neuropathy, and lead to gastrointestinal problems like stomach upset or ulcers. The visible appearance may also change, with chronic alcohol misuse often leading to skin flushing, weight fluctuations, and general neglect of personal physical care.
Psychological and Behavioral Indicators
A major component of AUD is the persistent, intense craving for alcohol, which is a powerful psychological urge to consume the substance. This preoccupation can dominate a person’s thoughts and decision-making. The time spent obtaining alcohol, using it, or recovering from its effects often becomes excessive, displacing other activities.
Loss of control over the amount of alcohol consumed is a hallmark behavioral indicator. Individuals frequently drink more or for a longer duration than they originally intended, and they often make unsuccessful attempts to cut down or stop drinking entirely. This pattern demonstrates an impaired ability to regulate consumption despite the desire to do so.
A person with AUD may begin prioritizing drinking over major role obligations at work, school, or home, leading to repeated failures in these areas. They may withdraw from social circles, abandoning hobbies and recreational activities they once enjoyed in favor of drinking. This social impairment is often accompanied by continued alcohol use despite knowing it is causing relationship problems.
The psychological landscape of AUD is frequently marked by significant mood disturbances and cognitive changes. Increased anxiety, depression, and irritability are commonly associated with cycles of heavy drinking and withdrawal. Furthermore, a person may continue to drink even when they know it is worsening a pre-existing physical or mental health condition, demonstrating the compulsion associated with the disorder.
When to Seek Professional Assessment
Recognizing any of the physical or psychological indicators of AUD warrants a consultation with a healthcare professional. Early intervention is associated with better outcomes, and a formal assessment can accurately determine the presence and severity of the disorder. This assessment is typically conducted by a primary care physician, a mental health professional, or an addiction specialist.
A professional evaluation allows for an individualized treatment plan, which is especially important if severe physical dependence is suspected. Because alcohol withdrawal can be medically risky, individuals who experience tremors, seizures, or severe agitation when they stop drinking should seek medical supervision to ensure a safe detoxification process. The goal of a professional assessment is to move beyond self-diagnosis and connect the individual with appropriate care and support resources.