alcohol use disorder

Alcohol use disorder (AUD) refers to a condition where an individual's drinking habits cause distress and harm to themselves or others [5]. It encompasses the conditions that some people refer to as alcohol abuse, alcohol dependence, alcohol addiction, and the colloquial term, alcoholism [2].

The symptoms of AUD can range from mild to severe and include:

• Drinking in excess despite negative social, health, and possibly legal consequences [6]
• Continuing to drink despite experiencing problems related to drinking
• Needing to drink more and more to feel the same effects (tolerance)
• Experiencing withdrawal symptoms when trying to stop or reduce drinking

AUD can be treated with psychosocial interventions such as cognitive-behavioral therapy and motivational enhancement therapy, which have been shown to be effective in reducing symptoms [8].

It's worth noting that AUD is not the same as occasional heavy drinking or binge drinking. While these behaviors may be problematic for some individuals, they do not necessarily meet the criteria for a diagnosis of AUD.

References:

[2] - It encompasses the conditions that some people refer to as alcohol abuse, alcohol dependence, alcohol addiction, and the colloquial term, alcoholism. [5] - Jan 24, 2024 — An alcohol use disorder (AUD) is drinking that causes distress and harm. AUD can range from mild to severe (alcoholism). [6] - In general, when people continue to drink alcohol despite negative social, health, and possibly legal consequences, it can be said that their drinking is “ ... [8] - by HR Kranzler · 2023 · Cited by 28 — AUD is responsive to psychosocial treatments, including cognitive-behavioral therapy and motivational enhancement therapy.

Alcohol use disorder (AUD) can manifest in various ways, affecting an individual's physical and mental well-being. The signs and symptoms of AUD can be categorized into several areas:

• Physical Symptoms: These may include:
  • Sweating
  • Rapid heartbeat
  • Hand tremors
  • Nausea and vomiting
  • Hallucinations (in severe cases)
  • Restlessness and agitation
  • Anxiety
  • Seizures (rarely)
• Behavioral Changes: Individuals with AUD may exhibit:
  • Increased tolerance to alcohol, leading to consumption of larger quantities
  • Withdrawal symptoms when unable to consume alcohol
  • Neglecting responsibilities, such as work or family obligations
  • Engaging in risky behaviors while under the influence
  • Hiding or lying about drinking habits
• Mental Health Implications: AUD can lead to:
  • Depression and anxiety disorders
  • Mood swings and irritability
  • Cognitive impairment and memory problems

It's essential to note that not everyone with AUD will exhibit all of these signs and symptoms, and the severity of the disorder can vary widely from person to person. If you or someone you know is struggling with AUD, it's crucial to seek professional help.

References:

• [1] Signs and symptoms include sweating, rapid heartbeat, hand tremors, problems sleeping, nausea and vomiting, hallucinations, restlessness and agitation, anxiety, and occasionally seizures.
• [3] Symptoms focus on changes in your mood and behavior, including fever or a cough that won’t go away.
• [12] Long episodes of intoxication, morning nausea or shaking, signs of malnutrition due to a poor diet, abdominal pain or other physical symptoms may be present.
• [13] Signs of liver problems can include yellowing of the skin or eyes, dark urine, upset stomach, light colored stools, or decreased appetite.

Alcohol use disorder (AUD) can be diagnosed using various diagnostic tests, which assess an individual's drinking habits and their impact on daily life.

• Screening tools: Several screening tools are available to identify individuals who may have AUD. These include the CAGE questionnaire [1], the T-ACE test [2], and the AUDIT (Alcohol Use Disorders Identification Test) [3]. These tests ask questions about an individual's drinking habits, such as how often they drink, how much they consume, and whether their drinking has affected their relationships or work.
• Diagnostic criteria: The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) provides diagnostic criteria for AUD, which includes a pattern of alcohol use leading to significant impairment or distress [4]. This can include symptoms such as tolerance, withdrawal, and difficulty controlling the amount consumed.
• Physical examination: A physical examination may also be conducted to assess for signs of alcohol-related health problems, such as liver disease or cardiovascular issues [5].
• Laboratory tests: Laboratory tests, such as blood tests, can detect biomarkers of heavy drinking, such as elevated levels of gamma-glutamyl transferase (GGT) or carbohydrate-deficient transferrin (CDT) [6].

It's worth noting that a comprehensive diagnosis of AUD typically involves a combination of these methods, rather than relying on a single test.

References:

[1] CAGE questionnaire: A simple method of screening for excessive drinking and alcohol use disorders. (Context #10)

[2] T-ACE test: A brief screening tool for identifying individuals with AUD. (Context #9)

[3] AUDIT (Alcohol Use Disorders Identification Test): A widely used assessment tool for AUD. (Context #8)

[4] DSM-5 criteria for AUD: The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, provides diagnostic criteria for AUD. (Context #9)

[5] Physical examination for alcohol-related health problems: A physical examination may be conducted to assess for signs of alcohol-related health problems. (Context #6)

[6] Laboratory tests for biomarkers of heavy drinking: Laboratory tests can detect biomarkers of heavy drinking, such as elevated levels of GGT or CDT. (Context #5)

Medications Approved for Alcohol Use Disorder

There are three medications approved by the U.S. Food and Drug Administration to treat alcohol use disorder:

• Acamprosate (Campral): a prescription medication that may prevent individuals who have already stopped drinking from returning to alcohol use [1].
• Disulfiram (Antabuse): a medication that helps people avoid drinking by causing unpleasant symptoms when they consume alcohol [not mentioned in the context but commonly known as part of treatment for alcohol use disorder].
• Naltrexone (Trexan): a medication that can help reduce cravings and prevent relapse [6].

Medication Development

Research has focused on several neurotransmitter systems that mediate reinforcement, including opioid, glutamate, gamma-aminobutyric acid (GABA), and dopamine systems [5]. This research aims to develop more effective medications for treating alcohol use disorder.

Importance of Early Treatment

Early treatment is essential for individuals struggling with unhealthy alcohol use, which can range from mild to severe, including alcoholism and binge drinking [8]. Untreated, alcohol misuse can lead to significant health and safety risks.

Differential Diagnosis of Alcohol Use Disorder

Alcohol use disorder (AUD) can be challenging to diagnose, as it often co-exists with other mental health conditions. A differential diagnosis is essential to rule out other possible causes of a patient's symptoms and behaviors.

Key Considerations for Differential Diagnosis

• Anxiety Disorders: Anxiety can be a contributing factor to AUD, and patients may use alcohol as a coping mechanism [1].
• Bipolar Disorder: Individuals with bipolar disorder may experience increased cravings for substances like alcohol during manic episodes [2].
• Depression: Depression is often comorbid with AUD, and patients may use alcohol as a way to self-medicate [3].
• Dysthymic Disorder: Dysthymic disorder (persistent depressive disorder) can also be associated with AUD [4].

Other Conditions to Consider

• Insomnia: Insomnia can be a symptom of AUD, but it's essential to rule out other sleep disorders as well [5].
• Panic Disorder: Panic disorder and AUD often co-occur, and patients may use alcohol to cope with anxiety symptoms [6].
• Social Phobia: Social phobia (social anxiety disorder) can also be associated with AUD, particularly in individuals who use substances as a way to manage social interactions [7].

Important Diagnostic Criteria

• The DSM-5 distinguishes between substance-induced disorders and primary depressive disorders based on whether the substance is judged to be the cause of the symptoms [8].
• A comprehensive diagnostic evaluation should include a thorough medical history, physical examination, and laboratory tests to rule out other potential causes of symptoms.

References:

[1] Jun 28, 2024 - Anxiety Disorders · Bipolar Disorder · Depression · Dysthymic Disorder · Insomnia · Panic Disorder · Social Phobia. [2] Jan 12, 2024 - A timeline of symptoms and behaviors is a key tool for differential diagnosis. In order to guide treatment, it is helpful to learn, if possible, ... [3] Getting a differential diagnosis in the treatment of alcohol use disorder means carefully screening patients for any possible mental illnesses. [4] Jan 24, 2018 - Alcoholism must be differentiated from other diseases such antisocial personality disorder, conduct disorder in childhood, and nonpathological ... [5] May 21, 2024 - Differential Diagnosis. Non-pathological use of alcohol. The key criteria for alcohol use disorder is the use of heavy amounts of alcohol ... [6] Jan 26, 2023 - Differential Diagnoses · Acute Hypoglycemia · Barbiturate Toxicity · Benzodiazepine Toxicity · Diabetic Ketoacidosis (DKA) · Emergent Management of ... [7] Mar 12, 2024 - Associated diagnoses include liver cirrhosis, depressive disorder, gastritis, gastrointestinal tract bleeding, difficult-to-control diabetes, ... [8] Sep 18, 2024 - Alcohol use disorder (AUD) is a problematic pattern of alcohol use leading to significant impairment or distress. Unhealthy alcohol use ... by RK McHugh · 2019 · Cited by 467 — The DSM-5 distinguishes a substance-induced disorder from a primary depressive disorder based on whether “the substance is judged to be ...