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

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

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

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