Suzanne Watson MD, MDiv, MEd

Del Mar Psychiatry


In-Person Appointments & Telemedicine Available, 317 14th Street, Suite D
 Del Mar, CA 92014

Alcohol Use Disorder


The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) changed from differentiating Alcohol Abuse and Alcohol Dependence to a single category of Alcohol Use Disorder. DSM-5 criteria are as follows:

A maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by 2 or more of the following, occurring at any time in the same 12-month period:

  • Alcohol is often taken in larger amounts or over a longer period than was intended.

  • There is a persistent desire or unsuccessful efforts to cut down or control alcohol use.

  • A great deal of time is spent in activities necessary to obtain alcohol, use alcohol, or recover from its effects.

  • Craving, or a strong desire or urge to use alcohol.

  • Recurrent alcohol use resulting in a failure to fulfill major role obligations at work, school, or home.

  • Continued alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol.

  • Important social, occupational, or recreational activities are given up or reduced because of alcohol use.

  • Recurrent alcohol use in situations in which it is physically hazardous.

  • Alcohol use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by alcohol.

  • Tolerance, as defined by either of the following:

    1. A need for markedly increased amounts of alcohol to achieve intoxication or desired effect.
    2. A markedly diminished effect with continued use of the same amount of alcohol.
  • Withdrawal, as manifested by either of the following:

    1. The characteristic withdrawal syndrome for alcohol
    2. Alcohol (or a closely related substance, such as a benzodiazepine) is taken to relieve or avoid withdrawal symptoms.

Specify if the Alcohol Use Disorder is:

  • Mild – Presence of 2–3 symptoms
  • Moderate – Presence of 4–5 symptoms
  • Severe – Presence of 6 or more symptoms

Causes of Alcohol Use Disorder

Alcohol use disorder can develop over time as a result of several different factors. Some patients may be genetically predisposed to developing these conditions, including those with a family history of alcohol problems. Many people may develop alcoholism as a result of high stress and anxiety levels, low self-esteem, or depression. Additional risk factors for developing alcoholism may include:

  • Steady and increased drinking over time
  • People who begin drinking at an early age
  • Social and cultural factors
  • Certain mental health disorders such as bipolar disorder
  • Mixing alcohol and medication

Complications of Alcohol Use Disorder

In addition to the personal and social ramifications, alcohol can affect a person's judgment causing poor choices to be made. People suffering from alcohol use disorder may be involved in motor vehicle accidents, domestic disputes, and have an increased likelihood of committing violent crimes. Alcoholism may also cause a variety of health-related problems including:

  • Liver disease
  • Heart problems
  • Digestive problems
  • Sexual dysfunction
  • Weakened immune system
  • Diabetes complications
  • Increased cancer risk
  • Neurological problems
  • Birth defects if alcohol is used during pregnancy

Treatment of Alcohol Use Disorder

Treatment varies, but the common goals are to help the individual stop abusing alcohol, maintain an alcohol-free lifestyle, and sustain a productive family and professional life. The first step in successful treatment often begins when the individual admits that they have a problem and need help. Treatments may differ based on the individual, and on different factors such as dependence on alcohol, physical health and medical history, age and lifestyle. Common treatment options for alcoholism may include:

  • Counseling and  therapy
  • Detoxification
  • Intervention
  • Medication
  • Spiritual practice

These treatments may be administered at an inpatient or outpatient facility, and may be short or long-term. In addition, alcohol use disorder  commonly occurs along with other mental health disorders, so treatment for these underlying conditions may be a part of the treatment process.  It is important for people going through treatment to have a strong support system through friends and family  and through groups like Alcoholics Anonymous. Recovery from alcoholism is a life-long commitment that requires strength and determination.

For more information including finding treatment in your area, click HERE to visit the Substance Abuse and Mental Health Services Administration web site.

To find a list of all AA meetings in San Diego, click HERE, and for the main Alcoholics Anonymous web site click HERE. 


Additional Resources

Del Mar Psychiatry