People with alcohol use disorder consume alcohol in large amounts, which affects how they behave and can cause serious health issues.¹ People with the disorder are often aware of the harm it is causing, but still find it difficult to reduce their drinking.¹

Long-term exposure to alcohol is thought to cause changes in the brain circuits involved in reward, motivation, memory, and self-control, which increase a person’s drive to consume alcohol.² A person with alcohol use disorder can no longer feel the pleasurable effects of drinking, and yet they find themselves craving alcohol.³ Individuals therefore drink to avoid the effects associated with alcohol withdrawal (‘negative reinforcement’), rather than to feel pleasure (‘positive reinforcement’).³

Core signs of alcohol use disorder are that a person is drinking large amounts of alcohol, for longer periods than intended, and that this is having a significant impact on their ability to go about normal daily activities.¹ A person with alcohol use disorder will normally want to reduce their drinking, but is unable to because of cravings and withdrawal symptoms, such as feeling sick or anxious.¹

A person’s drinking can lead to them neglecting their responsibilities at home, such as child care or doing the chores, and missing days at work.¹ They may continue to drink alcohol even when it puts themselves or others in danger, for example, by driving or operating machinery under the influence of alcohol.¹

Physical symptoms of alcohol use disorder may include shaking, difficultly walking, and difficulty sleeping.¹ Severe alcohol use disorder is associated with higher rates of suicidal thoughts and attempts.¹

Worldwide, 107 million people suffer from alcohol use disorder.⁴ Alcohol consumption varies according to religious and cultural attitudes, and tends to be higher in high-income countries.⁵ Alcohol use disorder normally develops in people’s 20s and 30s, although affected individuals typically start to drink too much in their mid-teens.^1,6 Men are twice as likely to have alcohol use disorder as women.⁶

Alcohol consumption is a causal factor in more than 200 disease and injury conditions, including mental and behavioral disorders, liver cirrhosis, cancer, and cardiovascular disease.⁷ In a multinational survey, 77% of people with alcohol use disorder suffered from at least one comorbid condition.⁸

Alcohol use is the seventh biggest risk factor for early death and disability worldwide, accounting for 2.2% of all deaths in women and 6.8% of all deaths in men.⁵ Among people aged 15–49 years, alcohol use is the leading risk factor for premature death, responsible for 3.8% of deaths in women and 12.2% of deaths in men.⁵ Many of these deaths are from injuries relating to road traffic accidents and violence.⁷

A global survey by the World Health Organization (WHO) found that people with alcohol use disorder miss an average of two extra days of work or activities per year.⁹ The disorder affects a person’s mental health, emotions, and relationships with their partner, family, and colleagues.⁶

People who are concerned that they – or their loved ones – are experiencing symptoms of alcohol use disorder should see their doctor for help and advice. Alcohol use disorder can be diagnosed after discussion with a doctor about a person’s habits and behaviors with alcohol, as well as looking at any physical symptoms that may be present.¹

An important part of the treatment of alcohol use disorder is setting a treatment goal, which can include abstinence or reduction. Whereas abstinence provides the greatest health benefits, many people are reluctant or unable to stop drinking altogether, and the option of reducing alcohol consumption may be an alternative way to reduce the harms associated with alcohol use.¹⁰

Alcohol use disorder has the widest treatment gap (i.e., proportion of untreated patients) of all mental disorders; only one in five of those with alcohol use disorder will seek treatment.^6,11 Many people avoid treatment because they feel there is a stigma surrounding the disorder.¹² Support groups are an important part of treatment for alcohol use disorder, both for the individual and their loved ones. Of those who do receive treatment, many make a recovery in the long-term.¹³