Alcohol Use Disorder

Alcohol use disorders are a category of conditions in which a person regularly consumes alcohol in a way that is compulsive, and has harmful consequences at least some of the time.

Many people drink alcohol regularly without abusing it or becoming addicted. For example, looking forward to getting a drink at happy hour doesn’t mean you’re an alcoholic.

However, when you frequently consume alcohol in a way that feels compulsive or that interferes with your day-to-day life, it may be worth considering whether you’re facing an alcohol use disorder.


Prevalence of alcohol use disorders

Alcohol use disorders are very common in the United states.

According to the 2014 National Survey on Drug Use and Health:

  • About 17 million people in the United States ages 12 and older had an alcohol use disorder
  • About 60.9 million reported having engaged in binge drinking at least once in the past month

Additionally, American Addiction Centers indicate that men are about twice as likely as women to have an alcohol use disorder.

Symptoms of alcohol use disorders

Symptoms of alcohol use disorders can vary from person to person. They also depend on whether you’re experiencing alcohol dependency or alcohol abuse. However, some common indicators across alcohol use disorders include:

  • Compulsive use of alcohol: Individuals struggling with alcohol use disorders may wish to drink less or stop altogether, but they find it difficult to do so. Cravings for alcohol may be intense enough to interfere with other activities or thoughts.
  • Risky use and/or harmful consequences: You might continue to drink even when it is dangerous – driving a car after drinking, for instance – or when it has a negative impact on you, or those around you. Examples of such consequences might include problems at work, conflicts with friends or family, or excessive spending on alcohol.
  • Lack of enjoyment: Where drinking was once fun and pleasurable, it might now be a source of stress, pain, or conflict.
  • Memory impairment: If you sometimes drink so much that you forget what happened, you might be dealing with an alcohol use disorder.
  • Tolerance: You might need to drink more in order to feel the same effects that you once experienced from a smaller amount of alcohol.
  • Withdrawal: If you stop drinking or go too long without a drink, you experience painful physical and/or psychological symptoms.

Note that you don’t have to experience all of the above symptoms to have an alcohol use disorder. Anytime that drinking is causing problems in your life, it’s worth considering whether to seek treatment.

Find therapists who treat alcohol use disorder and alcoholism on Zencare below.

Types of alcohol use disorder

Most diagnosable alcohol use disorders fall into one of two categories:

Alcohol Dependence

  • Alcohol dependence is an addiction to alcohol.
  • You may wish to stop drinking, but feel powerless to do so.
  • Dependence is characterized by the compulsive need to drink, whether you enjoy it or not.
  • It also usually includes symptoms or withdrawal and/or tolerance.

Alcohol Abuse

  • If you’re dealing with alcohol abuse, you aren’t addicted but you still get into consistent trouble because of drinking.
  • Alcohol abuse usually doesn’t include compulsion, withdrawal, or tolerance.
  • Alcohol abuse can still have very serious consequences including behaving dangerously, neglecting responsibilities, or getting into conflicts with others.

Binge drinking (consuming excessive amounts of alcohol over a short period of time) is also a common pattern of problematic alcohol use, even though it may not qualify as dependence or abuse.

Again, you don’t need to be experiencing alcohol dependence or abuse to seek help. You might pursue treatment anytime that you’re worried about your drinking and its impact on your life, especially if you have a family history of alcohol use disorders.


What to do if you’re experiencing an alcohol use disorder

Alcohol use disorders are generally considered highly treatable. If you may have an alcohol use disorder, you can explore the following options:

  • Therapy: Find a therapist who can help you understand your alcohol use patterns and take steps toward changing them. (See more tips below on selecting a therapist.)
  • Recovery groups: Recovery groups, where you can meet others facing the same challenges that you are, are a very common treatment option, especially for people who wish to stop drinking altogether. You can look for local chapters of Alcoholics Anonymous online.
  • Rehabilitation programs: Rehabilitation programs for alcohol use disorders come in many forms, from long-term residential programs to outpatient programs. These programs often include a variety of services, such as counseling, group therapy, and medical treatment. Look for options in your area, or consult the national directory provided by The Substance Abuse and Mental Health Services Administration.
  • Medical treatment: Treatment for alcohol addiction sometimes begins with a medically managed withdrawal process, sometimes followed by treatment with pharmaceutical tools or other medical supports. Contact your primary care doctor or an addiction treatment center to discuss these options.
  • Hotlines: If you’re having thoughts of suicide or need immediate support, you can always call the National Suicide Prevention Hotline at at 1-800-273-8255. The Substance Abuse and Mental Health Services Administrationhotline at 1-800-622-4357 can also help you locate resources and treatment options.

How to look for a therapist for alcohol use disorder

Look for a therapist who has a specialty in treating alcohol use and addiction  

Several different kinds of therapy have been shown to be effective for alcohol use disorders. Here are some of the most common types; click the links to learn more about each one:

You may also want to work with a therapist who has specific credentials, such as a Credentialed Alcoholism and Substance Abuse Counselor (CASAC).

Know what questions you need to ask potential therapists

These questions may prove helpful when interviewing potential therapists:

  • What therapy type (possibly one of the examples above) do you use when treating alcohol use disorder?
  • Do you have a harm reduction or abstinence-based philosophy?
  • Are you able to help me transition to a higher level of care, if necessary? What might that look like?

Prioritize personal fit

While personality fit is a nuanced factor, it is critical to your success in therapy. Multiple studies have revealed the importance of this factor, often referred to as “therapeutic alliance.”

On your initial phone call with the therapist, ask yourself:

  • Could I see myself forming a connection with this therapist?
  • Does their approach suit my personality?
  • Do I feel like I will be heard and respected by this therapist?

Additionally, consider these factors:

  • Some therapists are more reflective and spend most of the session listening and drawing insights about your patterns and coping styles.
  • Some therapists are more directive, establishing weekly agendas and assigning tasks to complete between sessions.
  • Some utilize specific techniques or tools (exposure exercises, eye movements, tapping, breath work, guided imagery, art and music, etc.).
  • Some use a combination of multiple approaches.

Consider cost, location, and scheduling

Therapy will only work if it works for you. Before making an appointment, ask yourself honestly:

  • Can I afford these session fees? The cost of therapy for addiction depends on location, practitioner, and whether you’re using insurance.
  • Can I commit to attending sessions regularly? Remember to account for travel time, and other demands in your schedule.
  • Do the therapists’ available times work for me? Some therapists offer evening and weekend appointments if you have an otherwise limited schedule.

How will you pay for therapy?

  • Does the therapist take your insurance?
  • Does the therapist offer rates that will work with your budget?

When and where will you attend sessions?

  • Does the therapist offer treatment at a location that is convenient for you?
  • Do they have times open that work with your schedule?

Do you feel comfortable talking to this therapist?

New to therapy? Learn about how to find a therapist here.