According to the National Institute on Alcohol Abuse and Alcoholism, in 2019, 14.1 million adults ages 18 and older had Alcohol Use Disorder (AUD). This includes 8.9 million men and 5.2 million women. What is alcohol use disorder? Alcohol use or alcohol dependence is now a single disorder called AUD with three classifications-mild, moderate, and severe subclasses. AUD is a chronic relapsing brain disease, with the impaired ability to stop or control alcohol use. Alcohol can have adverse effects on all aspects of their life-personal, professional and health status.
Moderate alcohol use is having 1 drink per day for women and 2 drinks per day for men. Severe/excessive alcohol was previously now as alcohol dependency or alcoholism. This now refers to binge drinking, heavy drinking (15 or more drinks per week for men or 8 or more drinks per week for women), drinking by pregnant women or drinking under the age of 21.
Severe alcohol use is a pattern that involves being unable to control drinking or the inability to limit drinking. Many people continue to use alcohol even when it causes problems at home or work. Eventually it requires more drinks or alcohol to get the same effect. They will have withdrawal symptoms when decreasing or trying to stop drinking. With severe alcohol use, getting their next drink is all they can think about.
Complications related to severe alcohol use is divided into short term and long-term health risks. Short term effects involves impaired judgement and coordination with decreased or slow reaction time. This can lead to increase risk for injury-motor vehicle accidents, falls, drownings, and burns. There is an increased risk for violence, including homicide, suicide and assault. Alcohol poisoning is a risk for overuse of alcohol. Overuse can also lead to risky sexual behaviors with increased risk for sexual transmitted diseases. Miscarriage and stillbirth rates increase with an increased risk for fetal alcohol syndrome disorders.
Long-term health conditions from severe alcohol use are high blood pressure, heart disease, liver disease, stroke, and digestion problems. Risk for cancer of the breast, mouth, esophagus, liver and colon increase with severe alcohol use. The immune system decreases, learning and memory problems increase, mental health problems-depression and anxiety worsen with increased alcohol usage. Socially alcohol use can lead to family problems, lost productivity and unemployment.
There are several screening tools to screen for alcohol use. This provides objective data related to alcohol use and complications from alcohol. Tools that you can use for screening:
1. CAGE
2. RAPS
3. AUDIT
4. TWEAK
I use the CAGE most often in office for patient screening.
-Have you ever felt you should CUT down on your drinking?
-Have people ANNOYED you by criticizing your drinking?
– Have you ever felt bad or GUILTY about your drinking?
– Have you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover (i.e., as an EYE-OPENER)?
The AUDIT (Alcohol Use Disorders Identification Test) is a 10-item screening tool/questionnaire. There are 3 questions on the amount and frequency of drinking. Three questions related to alcohol dependency and 4 questions dealing with problems caused by alcohol.
here are resources to assist you with your alcohol use disorder. Please reach out to your primary care provider (PCP) for screening and assistance. We will complete a screening related to your drinking habits, perform a physical exam, lab tests and imaging if needed. Sometimes a psychological assessment will be performed if needed, along with screening for depression or anxiety. Development of an individual treatment plan depends on your individual needs, this can include a brief intervention in office, referrals to individual or group counseling, outpatient programs or residential inpatient stays if needed.
There are support groups available:
1. Alcoholics Anonymous-groups in Martinsville, VA
2. Women for Sobriety
3. Al-Anon
4. Alateen
5. Hope and Healing from Addiction-The Community Fellowship
6. Piedmont Community Services-Martinsville, VA
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