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Alcohol Use Disorders

MedGen UID:
1377308
Concept ID:
C0001956
Mental or Behavioral Dysfunction
Synonyms: Alcohol Use Disorder; Use Disorders, Alcohol

Definition

What is alcohol use disorder (AUD)? For most adults, moderate alcohol use is probably not harmful. However, about 18 million adult Americans have an alcohol use disorder (AUD). This means that their drinking causes distress and harm. AUD can range from mild to severe, depending on the symptoms. Severe AUD is sometimes called alcoholism or alcohol dependence.CHAR(13) AUD is a disease that causes:CHAR(13) -Craving - a strong need to drink. CHAR(13) -Loss of control - not being able to stop drinking once you''ve started. CHAR(13) -Negative emotional state - feeling anxious and irritable when you are not drinking. CHAR(13) What is binge drinking? Binge drinking is drinking so much at once that your blood alcohol concentration (BAC) level is 0.08% or more. For a man, this usually happens after having 5 or more drinks within a few hours. For a woman, it is after about 4 or more drinks within a few hours. Not everyone who binge drinks has an AUD, but they are at higher risk for getting one.CHAR(13) What are the dangers of too much alcohol? Too much alcohol is dangerous. Heavy drinking can increase the risk of certain cancers. It may lead to liver diseases, such as fatty liver disease and cirrhosis. It can also cause damage to the brain and other organs. Drinking during pregnancy can harm your baby. Alcohol also increases the risk of death from car crashes, injuries, homicide, and suicide.CHAR(13) How do I know if I have an alcohol use disorder (AUD)? You may have an AUD if you can answer yes to two or more of these questions:CHAR(13) In the past year, have you:CHAR(13) -Ended up drinking more or for a longer time than you had planned to?. CHAR(13) -Wanted to cut down or stop drinking, or tried to, but couldn''t?. CHAR(13) -Spent a lot of your time drinking or recovering from drinking?. CHAR(13) -Felt a strong need to drink?. CHAR(13) -Found that drinking - or being sick from drinking - often interfered with your family life, job, or school?. CHAR(13) -Kept drinking even though it was causing trouble with your family or friends?. CHAR(13) -Given up or cut back on activities that you enjoyed just so you could drink?. CHAR(13) -Gotten into dangerous situations while drinking or after drinking? Some examples are driving drunk and having unsafe sex. CHAR(13) -Kept drinking even though it was making you feel depressed or anxious? Or when it was adding to another health problem?. CHAR(13) -Had to drink more and more to feel the effects of the alcohol?. CHAR(13) -Had withdrawal symptoms when the alcohol was wearing off? They include trouble sleeping, shakiness, irritability, anxiety, depression, restlessness, nausea, and sweating. In severe cases, you could have a fever, seizures, or hallucinations. CHAR(13) If you have any of these symptoms, your drinking may already be a cause for concern. The more symptoms you have, the more serious the problem is.CHAR(13) What should I do if I think that I might have an alcohol use disorder (AUD)? If you think you might have an AUD, see your health care provider for an evaluation. Your provider can help make a treatment plan, prescribe medicines, and if needed, give you treatment referrals.CHAR(13) NIH: National Institute on Alcohol Abuse and AlcoholismCHAR(13) [from MedlinePlus]

Professional guidelines

PubMed

Mirijello A, Sestito L, Antonelli M, Gasbarrini A, Addolorato G
Eur J Intern Med 2023 Feb;108:1-8. Epub 2022 Aug 16 doi: 10.1016/j.ejim.2022.08.013. PMID: 35985955
Jesse S, Bråthen G, Ferrara M, Keindl M, Ben-Menachem E, Tanasescu R, Brodtkorb E, Hillbom M, Leone MA, Ludolph AC
Acta Neurol Scand 2017 Jan;135(1):4-16. Epub 2016 Sep 1 doi: 10.1111/ane.12671. PMID: 27586815Free PMC Article
Latt N, Dore G
Intern Med J 2014 Sep;44(9):911-5. doi: 10.1111/imj.12522. PMID: 25201422

Recent clinical studies

Etiology

Ceci FM, Ferraguti G, Petrella C, Greco A, Tirassa P, Iannitelli A, Ralli M, Vitali M, Ceccanti M, Chaldakov GN, Versacci P, Fiore M
Curr Med Chem 2021;28(15):2943-2959. doi: 10.2174/0929867327999200818111654. PMID: 32811396
Higgins-Biddle JC, Babor TF
Am J Drug Alcohol Abuse 2018;44(6):578-586. Epub 2018 May 3 doi: 10.1080/00952990.2018.1456545. PMID: 29723083Free PMC Article
Ipser JC, Wilson D, Akindipe TO, Sager C, Stein DJ
Cochrane Database Syst Rev 2015 Jan 20;1(1):CD007505. doi: 10.1002/14651858.CD007505.pub2. PMID: 25601826Free PMC Article
Schuckit MA
Lancet 2009 Feb 7;373(9662):492-501. Epub 2009 Jan 23 doi: 10.1016/S0140-6736(09)60009-X. PMID: 19168210
Saunders JB, Aasland OG, Babor TF, de la Fuente JR, Grant M
Addiction 1993 Jun;88(6):791-804. doi: 10.1111/j.1360-0443.1993.tb02093.x. PMID: 8329970

Diagnosis

Mirijello A, Sestito L, Antonelli M, Gasbarrini A, Addolorato G
Eur J Intern Med 2023 Feb;108:1-8. Epub 2022 Aug 16 doi: 10.1016/j.ejim.2022.08.013. PMID: 35985955
Carvalho AF, Heilig M, Perez A, Probst C, Rehm J
Lancet 2019 Aug 31;394(10200):781-792. doi: 10.1016/S0140-6736(19)31775-1. PMID: 31478502
Higgins-Biddle JC, Babor TF
Am J Drug Alcohol Abuse 2018;44(6):578-586. Epub 2018 May 3 doi: 10.1080/00952990.2018.1456545. PMID: 29723083Free PMC Article
Schuckit MA
Lancet 2009 Feb 7;373(9662):492-501. Epub 2009 Jan 23 doi: 10.1016/S0140-6736(09)60009-X. PMID: 19168210
Saunders JB, Aasland OG, Babor TF, de la Fuente JR, Grant M
Addiction 1993 Jun;88(6):791-804. doi: 10.1111/j.1360-0443.1993.tb02093.x. PMID: 8329970

Therapy

Bahji A, Bach P, Danilewitz M, Crockford D, Devoe DJ, El-Guebaly N, Saitz R
J Addict Med 2022 Nov-Dec 01;16(6):630-638. doi: 10.1097/ADM.0000000000000992. PMID: 35653782Free PMC Article
Kelly JF, Humphreys K, Ferri M
Cochrane Database Syst Rev 2020 Mar 11;3(3):CD012880. doi: 10.1002/14651858.CD012880.pub2. PMID: 32159228Free PMC Article
Jonas DE, Amick HR, Feltner C, Bobashev G, Thomas K, Wines R, Kim MM, Shanahan E, Gass CE, Rowe CJ, Garbutt JC
JAMA 2014 May 14;311(18):1889-900. doi: 10.1001/jama.2014.3628. PMID: 24825644
Boden JM, Fergusson DM
Addiction 2011 May;106(5):906-14. Epub 2011 Mar 7 doi: 10.1111/j.1360-0443.2010.03351.x. PMID: 21382111
Schuckit MA
Lancet 2009 Feb 7;373(9662):492-501. Epub 2009 Jan 23 doi: 10.1016/S0140-6736(09)60009-X. PMID: 19168210

Prognosis

Sarfraz A, Sarfraz Z, Sarfraz M, Thevuthasan S, Khan T, Inam I, Pandav K, Fatima F, Patel G, Baralt D, Ferrer GF, Cabrera E, Michel G, Sanchez-Gonzalez MA
Psychiatr Danub 2022 Fall;34(3):535-543. doi: 10.24869/psyd.2022.535. PMID: 36257004
Asrani SK, Devarbhavi H, Eaton J, Kamath PS
J Hepatol 2019 Jan;70(1):151-171. Epub 2018 Sep 26 doi: 10.1016/j.jhep.2018.09.014. PMID: 30266282
US Burden of Disease Collaborators, Mokdad AH, Ballestros K, Echko M, Glenn S, Olsen HE, Mullany E, Lee A, Khan AR, Ahmadi A, Ferrari AJ, Kasaeian A, Werdecker A, Carter A, Zipkin B, Sartorius B, Serdar B, Sykes BL, Troeger C, Fitzmaurice C, Rehm CD, Santomauro D, Kim D, Colombara D, Schwebel DC, Tsoi D, Kolte D, Nsoesie E, Nichols E, Oren E, Charlson FJ, Patton GC, Roth GA, Hosgood HD, Whiteford HA, Kyu H, Erskine HE, Huang H, Martopullo I, Singh JA, Nachega JB, Sanabria JR, Abbas K, Ong K, Tabb K, Krohn KJ, Cornaby L, Degenhardt L, Moses M, Farvid M, Griswold M, Criqui M, Bell M, Nguyen M, Wallin M, Mirarefin M, Qorbani M, Younis M, Fullman N, Liu P, Briant P, Gona P, Havmoller R, Leung R, Kimokoti R, Bazargan-Hejazi S, Hay SI, Yadgir S, Biryukov S, Vollset SE, Alam T, Frank T, Farid T, Miller T, Vos T, Bärnighausen T, Gebrehiwot TT, Yano Y, Al-Aly Z, Mehari A, Handal A, Kandel A, Anderson B, Biroscak B, Mozaffarian D, Dorsey ER, Ding EL, Park EK, Wagner G, Hu G, Chen H, Sunshine JE, Khubchandani J, Leasher J, Leung J, Salomon J, Unutzer J, Cahill L, Cooper L, Horino M, Brauer M, Breitborde N, Hotez P, Topor-Madry R, Soneji S, Stranges S, James S, Amrock S, Jayaraman S, Patel T, Akinyemiju T, Skirbekk V, Kinfu Y, Bhutta Z, Jonas JB, Murray CJL
JAMA 2018 Apr 10;319(14):1444-1472. doi: 10.1001/jama.2018.0158. PMID: 29634829Free PMC Article
Rehm J, Mathers C, Popova S, Thavorncharoensap M, Teerawattananon Y, Patra J
Lancet 2009 Jun 27;373(9682):2223-33. doi: 10.1016/S0140-6736(09)60746-7. PMID: 19560604
Wilcox HC, Conner KR, Caine ED
Drug Alcohol Depend 2004 Dec 7;76 Suppl:S11-9. doi: 10.1016/j.drugalcdep.2004.08.003. PMID: 15555812

Clinical prediction guides

Herrero-Montes M, Alonso-Blanco C, Paz-Zulueta M, Pellico-López A, Ruiz-Azcona L, Sarabia-Cobo C, Boixadera-Planas E, Parás-Bravo P
PeerJ 2022;10:e13368. Epub 2022 May 4 doi: 10.7717/peerj.13368. PMID: 35547188Free PMC Article
Sanchez-Roige S, Palmer AA, Fontanillas P, Elson SL; 23andMe Research Team, the Substance Use Disorder Working Group of the Psychiatric Genomics Consortium, Adams MJ, Howard DM, Edenberg HJ, Davies G, Crist RC, Deary IJ, McIntosh AM, Clarke TK
Am J Psychiatry 2019 Feb 1;176(2):107-118. Epub 2018 Oct 19 doi: 10.1176/appi.ajp.2018.18040369. PMID: 30336701Free PMC Article
Ipser JC, Wilson D, Akindipe TO, Sager C, Stein DJ
Cochrane Database Syst Rev 2015 Jan 20;1(1):CD007505. doi: 10.1002/14651858.CD007505.pub2. PMID: 25601826Free PMC Article
Bush K, Kivlahan DR, McDonell MB, Fihn SD, Bradley KA
Arch Intern Med 1998 Sep 14;158(16):1789-95. doi: 10.1001/archinte.158.16.1789. PMID: 9738608
Saunders JB, Aasland OG, Babor TF, de la Fuente JR, Grant M
Addiction 1993 Jun;88(6):791-804. doi: 10.1111/j.1360-0443.1993.tb02093.x. PMID: 8329970

Recent systematic reviews

Bahji A, Bach P, Danilewitz M, Crockford D, Devoe DJ, El-Guebaly N, Saitz R
J Addict Med 2022 Nov-Dec 01;16(6):630-638. doi: 10.1097/ADM.0000000000000992. PMID: 35653782Free PMC Article
Andersen KAA, Carhart-Harris R, Nutt DJ, Erritzoe D
Acta Psychiatr Scand 2021 Feb;143(2):101-118. Epub 2020 Dec 1 doi: 10.1111/acps.13249. PMID: 33125716
Kelly JF, Humphreys K, Ferri M
Cochrane Database Syst Rev 2020 Mar 11;3(3):CD012880. doi: 10.1002/14651858.CD012880.pub2. PMID: 32159228Free PMC Article
Wlodarczyk O, Schwarze M, Rumpf HJ, Metzner F, Pawils S
PLoS One 2017;12(6):e0179140. Epub 2017 Jun 13 doi: 10.1371/journal.pone.0179140. PMID: 28609440Free PMC Article
Jonas DE, Amick HR, Feltner C, Bobashev G, Thomas K, Wines R, Kim MM, Shanahan E, Gass CE, Rowe CJ, Garbutt JC
JAMA 2014 May 14;311(18):1889-900. doi: 10.1001/jama.2014.3628. PMID: 24825644

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