With its presence splashed across TV screens, billboards and pop music lyrics, alcohol is everywhere. It's common, then, to assume that everyone consumes beer and liquor on a regular basis.
But when does "having a few" become a problem?
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People unable to manage their intake may have alcohol use disorder, a medical condition that doctors diagnose using 11 criteria.
The three levels of severity — mild, moderate and severe — are each defined by the number of symptoms cited.
"I think the easiest way to think about this illness is that someone with alcohol use disorder often exhibits behaviors indicating difficulty controlling their alcohol use, often has cravings or urges to drink, and has had his or her life impacted by drinking in a negative way," says Allison Lin, M.D., a psychiatrist at University of Michigan Addiction Treatment Services.
With signs that include a reduced ability to work and waning interest in social activities, alcohol use disorder doesn't just affect one individual. It can cause problems within that person's home, workplace and school.
And quitting isn't always easy: Nausea, sweating or shaking may occur from withdrawal and may require medical treatment. Withdrawal symptoms can be life-threatening if not medically managed.
"Like other chronic illnesses, we expect that people can have relapses after periods of doing well, and one of the goals of treatment is often to prevent or lessen the impacts of relapses," Lin says. "I also think of it as quite a complex illness influenced by both biological and psychosocial factors."
Sometimes people are afraid of talking about addiction, but I think it's important to try to talk openly about it in a caring way.Allison Lin, M.D.
Warning signs and treatment options
Because many people drink in social settings, it might be tough to tell if someone has an issue — and, if one is suspected, to approach the person about it.
"One challenge is that, especially early in the illness, many people with an alcohol use disorder have a hard time recognizing the problems that it's causing them," Lin says. "Oftentimes, family members and friends are the first to recognize the problems."
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Some common warning signs: personal problems or negative interactions with environment or peers.
Complicating recovery is that alcohol use disorder, while more common than the overuse of other drugs such as opioids, is less frequently addressed.
"I think opioid use disorders have received more recent national attention because the health care system has contributed to the problem, but also because there are effective interventions," Lin says.
But, she notes, there also are targeted, effective interventions for people who want to stop drinking.
Treatment can include medications or psychotherapy. Some medications, such as naltrexone, have shown to be effective in reducing alcohol use. Psychotherapy options, including cognitive behavioral therapy and motivational interviewing (a clinical approach rooted in making lifestyle changes), can work, too.
Abstinence from alcohol is strongly recommended after the detox period.
Conversation and compassion are key
Those in need aren't alone: Alcohol use disorder affects 16 million U.S. adults and 623,000 youths ages 12 to 17, according to the National Institutes of Health.
The first step to recovery is getting the conversation started — even if multiple attempts are needed.
SEE ALSO: How to Spot Signs of Opioid Addiction
"Sometimes people are afraid of talking about addiction, but I think it's important to try to talk openly about it in a caring way," Lin says. "Often when we work with folks struggling with alcohol and other substance use disorders in a treatment setting, it takes several tries and different approaches until the person agrees to treatment."
Openness to receiving treatment can fluctuate day to day, but providing consistent support is crucial.
Many people with alcohol use disorder can recover, Lin notes.
"I think the challenge is that when someone is struggling, it can feel really terrible, especially because the illness can also worsen other things like depression and anxiety," Lin says. "But over time, we know many people get better — often with the help of family, friends and also with treatment."
University of Michigan Addiction Treatment Services offers a comprehensive range of services and outpatient care to help treat mild to severe substance use disorders. To schedule an appointment, call 734-764-0231.
For U-M students, the Collegiate Recovery Program is a nontreatment program that offers support for those who may be struggling with a substance use disorder.