Is Alcoholism A Mental Disorder?

Alcohol use disorder (AUD), which people used to call alcoholism, is a medical condition in which a person can’t control or quit their use of alcohol.

AUD fits under the diagnostic category of substance use disorders and is classified as a mental health disorder.

Why Is Alcohol Use Disorder A Mental Health Disorder?

AUD is considered a mental health disorder because it affects a person’s ability to function cognitively, emotionally, and behaviorally.

AUD can also damage the brain over time, making it harder to change patterns of alcohol misuse.

According to the 2023 National Survey on Drug Use and Health, approximately 28.9 million Americans aged 12 and older met diagnostic criteria for alcohol use disorder in the past year, yet fewer than 10% received treatment.

Is Alcohol Use Disorder Also A Disease?

Starting early in the last century and continuing through recent years, the American Psychiatric Association (APA) and the American Medical Association (AMA) have made changes to the classification of AUD and how it is referred to.

In medical nomenclature, AUD was first referred to as a disease as early as 1933. The AMA officially designated it as such in 1956.

In 1994, the APA switched from “alcoholism” to “alcohol dependence” (or abuse) as a way of referring to the condition. And in 2013, they replaced “alcohol dependence” with “alcohol use disorder.”

There is some disagreement over whether AUD should still be considered a chronic disease. Some rehab centers, for example, refer to alcohol addiction and addiction in general as a disease.

But the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, as well as the NIAAA and many other organizations, agree that AUD is a mental health disorder.

What Are The Symptoms Of Alcohol Use Disorder?

Like other substance use disorders, AUD has symptoms that are generally characterized by an inability to control use of the substance.

Symptoms of AUD can include:

• trying to cut down on alcohol but not being able to
• drinking more than intended
• drinking that interferes with work, school, or home responsibilities
• continuing to drink even though it leads to feelings of depression
• getting into potentially harmful situations because of drinking

These are among the most common symptoms. The full DSM-5 diagnostic criteria include 11 indicators, and the number of criteria met determines whether AUD is classified as mild, moderate, or severe.

Dual Diagnosis

Another feature of AUD is that it often co-occurs with other mental health disorders, creating a negative feedback loop regarding the person’s mental health.

In other words, the co-occurring mental health disorders interact in such a way that it is difficult to tell the two disorders of the dual diagnosis apart.

In this case, the person may use alcohol consumption as a way to self-medicate.

Co-occurring disorders or comorbidity with AUD can include:

• bipolar disorder
• anxiety disorders
• personality disorders
• schizophrenia
• post-traumatic stress disorder (PTSD)

Who Is At Risk For Alcohol Use Disorder?

Risk factors for alcohol use disorder also point to the fact that AUD is a mental health condition. In general, people are at risk for AUD the greater the rate of how much, how often, and how quickly they consume alcohol.

Other risk factors include:

• drinking at an early age
• the presence of other mental health issues
• history of trauma
• history of childhood trauma
• genetics
• family history

Alcohol Use Disorder Treatment

If you or a loved one have symptoms of AUD or have been diagnosed with AUD, there is hope for recovery, but it requires treatment.

Quality treatment programs for AUD can address many aspects of the condition as well as other mental health problems that may be affecting a person’s ability to take steps in addressing AUD.

Alcohol treatment often occurs at the inpatient level of care, but you can also find outpatient services for the condition.

Alcohol Detox

Unlike withdrawal from most other substances, alcohol withdrawal can be life-threatening. Seizures, delirium tremens, and cardiac complications can occur within hours to days of the last drink, even in people who don’t consider their drinking severe.

Anyone with significant alcohol dependence should seek medical supervision before stopping, rather than attempting to quit cold turkey.

Alcohol withdrawal symptoms may include:

• anxiety
• shakiness
• headache
• insomnia
• nausea
• sweating
• vomiting
• hallucinations
• delirium tremens (DTs)
• psychosis
• high blood pressure
• fast heart rate

Medical detox helps people go through withdrawal safely so they can begin treatment.

Psychiatry

Because alcohol affects the brain and often co-occurs with other mental health disorders, people seeking treatment may require psychiatric services.

Psychiatric treatment may include medications to address the co-occurring conditions or symptoms occurring as a result of long-term drinking.

These symptoms may include:

• worry
• sleep disturbances
• dysphoria (a state of unease)
• irritability
• sadness

Medication-Assisted Treatment

Other treatment options for AUD may include medication-assisted treatment (MAT).

MAT involves the use of medications to help people control alcohol cravings so they can focus on addressing the behavioral health challenges that AUD presents.

Medications used to treat AUD may include:

• naltrexone
• disulfiram
• acamprosate

Naltrexone is available as a daily oral tablet or as a monthly extended-release injection (Vivitrol), which can improve adherence by eliminating the need for daily dosing.

Behavioral Therapy

Behavioral therapy is another major component of addiction treatment in general, and AUD is no exception.

Evidence-based treatment programs offer therapy at the individual and group levels.

Therapeutic modalities may include:

• family therapy
• motivational enhancement therapy (MET)
• motivational interviewing (MI)
• cognitive behavioral therapy (CBT)

Support Groups

Finally, people who go through the treatment process for alcohol addiction will need support at a variety of levels.

Treatment centers often incorporate peer recovery support groups into their programs. These groups can be informal.

Support groups can also include Alcoholics Anonymous (AA), SMART Recovery, and others.

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Written by the Addiction Resource Editorial Staff