What Is Alcohol Use Disorder?

Alcohol use disorder (AUD) is a medical diagnosis describing a pattern of drinking that continues despite causing problems. It replaced the older split between "alcohol abuse" and "alcohol dependence" in 2013, and that change matters: it recognised that drinking problems exist on a spectrum rather than as a category you are either in or out of.

How it is actually diagnosed

Clinicians assess eleven criteria over a twelve-month period. They include drinking more or longer than intended, wanting to cut down but not managing it, spending a lot of time drinking or recovering, craving, drinking interfering with work or home, continuing despite relationship problems, giving up other activities, drinking in risky situations, continuing despite physical or psychological harm, needing more for the same effect, and withdrawal symptoms.

Meeting two or three indicates mild AUD, four or five moderate, six or more severe. Two is a low bar by design — it catches problems early, when they are far easier to address.

Why the spectrum framing changes things

Most people picture severe, late-stage dependence when they hear "alcoholic". The clinical reality is that the large majority of people who meet AUD criteria are employed, housed, and functioning — often visibly well. They notice the problem privately long before anyone else would.

The practical cost of the stereotype is that people compare themselves to it, conclude they are nothing like it, and wait. Mild and moderate AUD respond well to outpatient treatment, and waiting until the picture matches the stereotype means waiting until treatment is harder.

What treatment looks like

For mild to moderate AUD, outpatient care is standard: an evaluation, medication where it helps, and follow-up. Naltrexone — FDA-approved for AUD since 1994 — reduces the reward response that drives craving. Severe AUD with withdrawal risk may require a higher level of care first, which a provider will tell you directly.