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UK-NOTPR-1010 | April 2022



Alcohol Use Disorder

Understanding Alcohol Use Disorder

Alcohol use disorder is associated with excessive and uncontrollable drinking that significantly affects a person’s ability to go about their normal activities at work and home, and which can have a severe impact on their overall health.1

Alcohol use disorder overview

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 become ‘sensitised’ and no longer feel the pleasurable effects of drinking, and yet they find themselves craving alcohol.3 Individuals may also drink to avoid the effects associated with alcohol withdrawal (‘negative reinforcement’), rather than to feel pleasure (‘positive reinforcement’).3

Facts About Alcohol Use Disorder

Alcohol use disorder is associated with excessive and uncontrollable drinking that significantly affects a person’s ability to go about their normal activities at work and home, and which can have a severe impact on their overall health.1

Alcohol is now the leading risk factor for ill-health, early mortality and disability among those aged 15 to 49 in England.4


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 often want to reduce their drinking, but is unable to because of cravings and withdrawal symptoms.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, when driving or operating machinery.1


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

107 million

people worldwide suffer from alcohol use disorder.5

26 years

is the average age of onset.6

Epidemiology and burden

Worldwide, 107 million people suffer from alcohol use disorder.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 Men are more likely to have alcohol use disorder than women.1,6


Harmful alcohol use is a causal factor in more than 200 health conditions, ranging from liver diseases, cancer, and cardiovascular disease to HIV/AIDS.7 In a multinational survey of 2,979 alcohol-dependent patients, 77% suffered from at least one comorbid condition.8 There is also a causal relationship between harmful use of alcohol and a range of behavioural and mental disorders.7


In 2016, alcohol use ranked as the seventh biggest risk factor worldwide, for early death and disability, accounting for 2.2% of all deaths in women and 6.8% of all deaths in men.9 Among people aged 15–49 years, alcohol use was the leading risk factor for premature death, responsible for 3.8% of deaths in women and 12.2% of deaths in men.9 Many of these deaths, particularly in younger age groups, are from injuries relating to road traffic accidents and violence, alcohol-related injuries and also from suicides.7


A global survey by the World Health Organisation (WHO) found that people with alcohol use disorder miss an average of two extra days of work or activities per year.10 The disorder can also affect a person’s mental health, emotions, and relationships with their family and colleagues.6

Facts About Alcohol Use Disorder

Alcohol use is the seventh leading risk factor for early death and disability worldwide.10

Worldwide, 3 million deaths every year result from harmful use of alcohol, representing 5.3% of all deaths.9

Diagnosis and care

Alcohol use disorder can be diagnosed after discussion with a doctor about a person’s habits and behaviours with alcohol, as well as looking at any physical symptoms that may be present.11


An important part of the treatment of alcohol use disorder is setting a treatment goal, which can include abstinence or moderation. Whereas abstinence provides the greatest health benefit,12 many people are reluctant or unable to stop drinking altogether,1 and the option of reducing alcohol consumption may be a more realistic goal to reduce the harms associated with alcohol use.12


Alcohol use disorder has been reported to have the widest treatment gap (i.e., proportion of untreated patients) of all mental health disorders.13 A US study of 34,653 participants, showed that many people avoid treatment because they feel there is a stigma surrounding the disorder.14 Support groups are an important part of treatment for alcohol use disorder and have shown to be linked to higher rates of abstinence in those who access them.15 Of those who do receive treatment, many make a recovery in the long-term.16

  1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Association; 2013.
  2. Volkow ND et al. Neurpharmacology. 2004;47(Suppl 1):3-13.
  3. Gilpin NW, Koob GF. Alcohol Res Health. 2008;31(3):185-195.
  4. The public health burden of alcohol and cost-effectiveness of alcohol control policies: an evidence review. Public Health England. 2016. Available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/733108/alcohol_public_health_burden_evidence_review_update_2018.pdf [Accessed March 2022]
  5. GBD 2017 Disease and Injury Incidence and Prevalence Collaborators. Lancet. 2018;392(10159):1789–1858
  6. Grant BF et al. JAMA Psychiatry. 2015;72(8):757–766.
  7. WHO Key Facts: Alcohol. Available at: https://www.who.int/news-room/fact-sheets/detail/alcohol [Accessed March 2022]
  8. Odlaug BL et al. Alcohol and Alcoholism. 2016;51(2):201-209.
  9. GBD 2016 Alcohol Collaborators. Lancet. 2018;392(10152):1015-1035.
  10. Alonso J et al. Mol Psychiatry. 2011;16(12):1234-1246.
  11. Alcohol Use Disorder – Diagnosis & treatment guide: Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/alcohol-use-disorder/diagnosis-treatment/drc-20369250 [Accessed March 2022]
  12. NHS Guide: Alcohol Misuse - Treatment. https://www.nhs.uk/conditions/alcohol-misuse/treatment/ [Accessed March 2022]
  13. Kohn R et al. Bull World Health Oran. 2004;82(11):858-866.
  14. Keyes KM et al. AM J Epidemiol. 2010;172(12):1364-1372.
  15. Tracy K, Wallace SP. Subst Abuse Rehabil. 2016;7:143-154.
  16. Dawson DA et al. Addiction. 2005;100(3):281-292.

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