What is considered Alcohol Use Disorder?
According to the National Institutes of Health the definition of Alcohol Use Disorder is:
Alcohol use disorder (AUD) is a medical condition characterized by an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences. It encompasses the conditions that some people refer to as alcohol abuse, alcohol dependence, alcohol addiction, and the colloquial term, alcoholism. Considered a brain disorder, AUD can be mild, moderate, or severe. Lasting changes in the brain caused by alcohol misuse perpetuate AUD and make individuals vulnerable to relapse. The good news is that no matter how severe the problem may seem, evidence-based treatment with behavioral therapies, mutual-support groups, and/or medications can help people with AUD achieve and maintain recovery. According to a national survey, 14.1 million adults ages 18 and older1 (5.6 percent of this age group2) had AUD in 2019
Disordered use of alcohol is defined by the CDC as: Excessive alcohol use includes binge drinking, heavy drinking, any alcohol use by people under the age 21 minimum legal drinking age, and any alcohol use by pregnant women. For men, heavy drinking is typically defined as consuming 15 drinks or more per week. For women, heavy drinking is typically defined as consuming 8 drinks or more per week. Keep in mind, a standard drink is defined as:
- 12 ounces (355 milliliters) of regular beer (about 5% alcohol)
- 8 to 9 ounces (237 to 266 milliliters) of malt liquor (about 7% alcohol)
- 5 ounces (148 milliliters) of wine (about 12% alcohol)
- ounces (44 milliliters) of hard liquor or distilled spirits (about 40% alcohol)
In the past year, if you have experienced as few as two of these concerns, you may be diagnosed with Alcohol Use Disorder.
• Being unable to limit the amount of alcohol you drink
• Wanting to cut down on how much you drink or making unsuccessful attempts to do so
• Spending a lot of time drinking, getting alcohol or recovering from alcohol use
• Feeling a strong craving or urge to drink alcohol
• Failing to fulfill major obligations at work, school or home due to repeated alcohol use
• Continuing to drink alcohol even though you know it’s causing physical, social, work or relationship problems
• Giving up or reducing social and work activities and hobbies to use alcohol
• Using alcohol in situations where it’s not safe, such as when driving or swimming
• Developing a tolerance to alcohol so you need more to feel its effect or you have a reduced effect from the same amount
• Experiencing withdrawal symptoms — such as nausea, sweating and shaking — when you don’t drink, or drinking to avoid these symptoms
• Family history of alcohol use disorder and other substance use disorders
• Availability of alcohol
• Heavy alcohol use
• Binge drinking
• Permissive societal attitudes towards alcohol use
• History of childhood abuse
• History of conduct or mood disorder in childhood
• Having mental health conditions such as depression or post-traumatic stress disorder
Excessive alcohol use has immediate effects that increase the risk of many harmful health conditions. These include the following:
• Injuries, such as motor vehicle crashes, falls, drownings, and burns.
• Violence, including homicide, suicide, sexual assault, and intimate partner violence.
• Alcohol poisoning, a medical emergency that results from high blood alcohol levels.
• Risky sexual behaviors, including unprotected sex or sex with multiple partners. These behaviors can result in unintended pregnancy or sexually transmitted diseases, including HIV.
• Miscarriage and stillbirth or fetal alcohol spectrum disorders (FASDs) among pregnant women.
Over time, excessive alcohol use can lead to the development of chronic diseases and other serious problems including:
• High blood pressure, heart disease, stroke, liver disease, and digestive problems.
• Cancer of the breast, mouth, throat, esophagus, voice box, liver, colon, and rectum.
• Weakening of the immune system, increasing the chances of getting sick.
• Learning and memory problems, including dementia and poor school performance.
• Mental health problems, including depression and anxiety.
• Social problems, including family problems, job-related problems, and unemployment.
• Alcohol use disorders, or alcohol dependence.
Sage Prairies’ approach to alcohol use disorder is evidence-based, integrated, and individualized. Our specialists and partners utilize a range of medication and behavioral methods with demonstrated efficacy for helping individuals meet their individual recovery goals. Care is often integrated with patients’ other needs to improve treatment outcomes, reduce costs, and promote better physical
and mental health.
Effective treatments for alcohol use disorder generally include: alleviation of withdrawal symptoms, stopping or reducing alcohol use, and offering patients behavioral skills and knowledge to help them meet their recovery goals of abstinence or attempt to establish a healthy level of alcohol use.
If an individual has great difficulty stopping drinking, or they suffer withdrawal symptoms, Sage Prairie partners with detox of withdrawal management programs to initiate treatment. Often individuals stay at a withdrawal management facility for two to five days to stabilize physically. During this process, individuals often experience unpleasant and potentially serious symptoms of alcohol withdrawal syndrome. These may include increased heart rate, sweating, anxiety, tremors, nausea and vomiting, heart palpitations, and insomnia.
In more severe cases, people may also have seizures or hallucinations. In severe cases of alcohol withdrawal, an individual can suffer delirium tremens, which typically includes confusion, high blood pressure, neurological agitation and seizures.
Delirium tremens can be fatal in some cases.
Treatment for withdrawal symptoms often include medications, intravenous fluids, vitamins and other medications to treat hallucinations or other symptoms. Once an individual is stabilized, they are often evaluated for therapy and counseling needs, medication needs and other individualized needs based on a recovery continuum. If they are offered therapy and counseling. The following methods are most often effective and used by Sage Prairie:
Cognitive-Behavioral Therapy (CBT)
This form of therapy is based on the principle that one’s thoughts, feelings, and behaviors can all influence one another. The goal is to help patients reduce or stop alcohol use by adjusting patterns of thinking and feeling that can lead to consumption of alcohol.
This therapy helps people identify and accept ambivalent feelings about drinking with the goal of strengthening a commitment to their recovery goals.
For people with alcohol use disorder and their families, this form of therapy helps all involved to identify and face consequences of alcohol use in order to support reduction in or abstinence from alcohol consumption.
The Food and Drug Administration (FDA) has approved three medications for the treatment of alcohol
use disorder. In general, these medications aim to reduce cravings and consumption of alcohol:
1. Naltrexone. By blocking alcohol from interacting with certain receptors in the brain, naltrexone reduces the pleasurable feelings brought on by alcohol consumption and lessens cravings for alcohol. Naltrexone is often provided as a monthly injection.
2.Acamprosate. Consumption of alcohol can disturb the balance of certain chemicals in the brain. By helping to re-balance these chemicals, acamprosate lessens the craving for alcohol.
3. Disulfiram. This medication discourages alcohol use by causing uncomfortable symptoms including nausea, diarrhea, and vomiting when alcohol is consumed.
These include 12-step groups, SMART recovery, Al-Anon Family groups, All Recovery groups, and others. Sage Prairie also has developed a partnership with local Recovery Community Organizations to offer other peer services. These programs are designed to offer participants active help and support for one another in their recovery.
Sage Prairie has partnered with Recovery Properties to offer patient housing. I the housing, there are only current and former Sage Prairie patients. This helps patients to develop a community, which is supportive of recovery.
A major barrier to recovery can be access to care. Sage Prairie has partnered with navigators to assist individuals to fund treatment and access other financial services available through Federal, State and local programs and scholarships.
Patients are given a healthy meal each treatment day. Patients living in housing are offered a free local gym membership to improve their physical health.
Fermented grain, fruit juice and honey have been used to make alcohol (ethyl alcohol or ethanol) for thousands of years. Fermented beverages existed in early Egyptian civilization, and there is evidence of an early alcoholic drink in China around 7000 B.C. In India, an alcoholic beverage called sura, distilled from rice, was in use between 3000 and 2000 B.C.
The Babylonians worshiped a wine goddess as early as 2700 B.C. In Greece, one of the first alcoholic beverages to gain popularity was mead, a fermented drink made from honey and water. Greek literature is full of warnings against excessive drinking.
Several Native American civilizations developed alcoholic beverages in pre-Columbian1 times. A variety of fermented beverages from the Andes region of South America were created from corn, grapes or apples, called “chicha.”
In the sixteenth century, alcohol (called “spirits”) was used largely for medicinal purposes. At the beginning of the eighteenth century, the British parliament passed a law encouraging the use of grain for distilling spirits. Cheap spirits flooded the market and reached a peak in the mid-eighteenth century. In Britain, gin consumption reached 18 million gallons and alcoholism became widespread.
The nineteenth century brought a change in attitudes and the temperance movement began promoting the moderate use of alcohol—which ultimately became a push for total prohibition. In 1920 the US passed a law prohibiting the manufacture, sale, import and export of intoxicating liquors. The illegal alcohol trade boomed and by 1933, the prohibition of alcohol was cancelled.
Today, an estimated 15 million Americans suffer from alcoholism and 40% of all car accident deaths in the US involve alcohol.