Alcohol use disorder (AUD) is a pattern of problematic drinking that runs on a spectrum of mild, moderate, to severe levels of alcohol dependence. Although AUD affects millions of people around the world, it is still widely misunderstood.

Moderate and severe AUD is commonly referred to as alcoholism, and people who have issues with AUD are often called alcoholics in popular culture, but these are terms that we choose not to use for a few reasons. For one, getting hung up on questions like “Am I an alcoholic?” can keep us stuck and prevent us from doing anything about our drinking—if we’re waiting to hit “rock bottom” we might delay getting treatment until the consequences become severe. Another reason is that everybody experiences AUD differently, and we all have the right to seek help regardless of where we fall on the AUD spectrum. Lastly, not everyone is interested in identifying as an alcoholic, as many of us don’t view addiction as an identity, but rather as an experience. Although the label “alcoholic” can be helpful for some, we should all get to individually decide what we call ourselves.

If you think that you may be on the AUD spectrum, it doesn’t mean you are a bad person or that you are morally weak—it means it’s time to learn some new coping mechanisms. In this article, we’ll take you through what the AUD spectrum looks like, common co-occurring conditions, treatment for AUD, and better words we can use when we talk about AUD. 

The Spectrum of AUD

Here at Tempest, we think that everyone should look at their relationship with alcohol. We can all benefit from truly getting curious about how alcohol shows up in our lives and w However, there are times that it’s helpful to rely on clinical guidelines to understand if our drinking is problematic.

The Diagnostic and Statistical Manual of Mental Disorders (DSM–5) has a list of 11 diagnostic criteria that can help determine if and where a person falls on the spectrum of alcohol use disorder. While these are not the only criteria that determine if a person has a drinking problem, these are the main criteria used by healthcare providers. The criteria are:

1. Drinking larger quantities or for longer periods of time than originally intended.
2. Wanted or tried to cut down on drinking but was not able to.
3. Alcohol takes up a lot of time, as does recovering from drinking (hangovers).
4. Having alcohol cravings.
5. Drinking or hangovers caused issues with work, family, and other responsibilities. 
6. Continued to drink despite the issues it caused.
7. Stopped or lessened other activities in order to drink. 
8. Drinking has put you in dangerous situations (driving under the influence, unprotected sex, etc).
9. Drinking even though it was making depression and anxiety worse.
10. Tolerance has increased, meaning you need to drink more to get the same effect.
11. Experiencing symptoms of withdrawal.

The AUD spectrum is divided into three categories—mild, moderate, severe—and where someone falls on the spectrum depends on the number of criteria and frequency at which these criteria are experienced.

• Mild AUD means having 2 to 3 of these symptoms in the past year. 
• Moderate AUD means having 4 to 5 of these symptoms in the past year.
• Severe AUD means having 6 or more of these symptoms in the past year.

A Note About Alcohol Withdrawal

Over time, severe AUD can cause serious health complications, including withdrawal.  Alcohol withdrawal can be a medical emergency and is often characterized by insomnia, rapid heartbeat, changes in blood pressure, sweating, tremors and/or hallucinations. If you are concerned you may be experiencing withdrawal, contact a healthcare provider immediately. 

Co-Occurring Conditions

Co-occurring mental health issues with AUD are common—about half of the people who experience mental illness will also experience a substance use disorder at some point in their lives, and vice versa. Excessive alcohol use can also intensify mental health symptoms, and it can interfere with psychiatric medications or cause them to be ineffective. Some of the most prevalent co-occurring conditions include depression, PTSD, and anxiety. Many people drink to cope with these issues, but alcohol can actually exacerbate the symptoms. However, when a person removes alcohol from their life and goes into recovery—working with a therapist and learning new coping mechanisms—it can greatly improve their mental health treatment outcomes.

Treatment

Here at Tempest, we believe in a holistic approach to recovery. This means treating the whole person, not just the alcohol use. By focusing on the root causes of addiction, we are able to make room for sustainable sobriety. 

Here are a few examples of how this works:

• Addressing issues like depression, anxiety, and trauma with a mental health professional instead of self-medicating with alcohol.
• Learning new, healthier coping mechanisms.
• Understanding and addressing social and environmental barriers that drive us to drink.
• Treating our physical selves and reestablishing the mind-body connection.
• Developing new rituals of self-care for better sleep, nutrition, and exercise. 
• Connecting with others on the same path.
• Reframing our thoughts around alcohol: normalizing alcohol-free lifestyles, destigmatizing addiction issues, and understanding recovery looks different for everyone.

Tempest membership uses a unique combination of tools, teachings, and practices including Integral Recovery, Mindfulness-Based Stress Reduction, Cognitive and Dialectical Behavioral Therapies, and peer intervention. Our content is based on our own personal experiences—our Peer Coaches, Subject Matter Experts, and our members all helped inform how we designed our program. We use the most recent scientific findings in addiction recovery, structured in an intuitive, easy-to-use format. We provide members with an in-depth understanding on how addiction and alcohol affect the brain, and how we can find better ways to cope instead of drinking.

How We Talk About AUD 

Person-first language puts the individual before their use, condition, or disease. The things that people struggle with are a part of who they are as a whole, not the sole identifying factor. Many of the folks on the Tempest staff are sober and choose to identify as people who are in recovery from AUD, rather than alcoholics or addicts. 

You’ll also notice that the “U” in AUD stands for use, instead of abuse. Alcohol use disorder is a medical issue that affects our mental and physical health, it isn’t a moral failing or a sign of weak character, and the language we use should reflect that. Calling a person an alcohol abuser, substance abuser or addict defines the whole person, whereas a person with alcohol or substance use disorder describes the issue they are dealing with. See the difference? The nuances in the language we use can help reduce stigma towards people who have addiction issues. 

More Resources

You can check out these resources to learn more about AUD, co-occurring conditions, and treatment options:

• You Don’t Have to Hit Rock Bottom to Quit Drinking: You have the right to address AUD whenever you’re ready—no rock bottom required.
• How Drinking Makes Your Depression Worse: How AUD impacts depression, and waht you can do about it.
• Why Drinking Makes Your Anxiety Worse: How AUD impacts anxiety, and what you can do about it.
• How to Build a Sobriety Toolbox: Ways to incorporate healthier coping mechanisms into your life.
• An Inclusive Guide and Glossary for Talking About Addiction and Recovery: Want to talk about addiction and recovery with others? Learn the inclusive terminology with our guide.

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If you feel like alcohol is preventing you from living the life you’ve always wanted, that’s all the reason you need to give something new a try.  Whenever you’re interested in changing your relationship with alcohol, we’ll be here to help.