Maybe you’ve been noticing the pattern for months, or maybe something shifted this week that made you finally search for answers. You’re drinking more than you planned, more often than feels right, and the worry in the back of your mind is getting louder. The good news is that looking for information means you’re already taking the first step toward clarity, and you’re not alone in this.
What many people call “alcoholism” is clinically known as Alcohol Use Disorder, or AUD, a medical condition recognized by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) that affects millions of Americans. According to the 2024 National Survey on Drug Use and Health, approximately 27.9 million people ages 12 and older had AUD in the past year.
Alcohol changes your brain and body over time, creating patterns that become increasingly difficult to break without support. Whether you’re concerned about your own relationship with alcohol or worried about someone you love, understanding what alcohol use disorder actually looks like and how alcohol addiction treatment works can help you make informed decisions about next steps.
Quick Takeaways
- Alcohol use disorder is diagnosed using 11 criteria; meeting 2+ means AUD is present, and it’s worth getting a professional assessment to talk through next steps.
- Alcohol withdrawal can be life-threatening and requires medical supervision if you’ve been drinking heavily for extended periods.
- Treatment levels range from medical detox through residential care to flexible outpatient programs, determined by your withdrawal risk and life stability.
- Evidence-based therapies like CBT and DBT address the thoughts, emotions, and behaviors driving your drinking patterns.
- FDA-approved medications can reduce cravings and block alcohol’s rewarding effects when combined with behavioral treatment.
- Your severity level (mild, moderate, or severe AUD) indicates where treatment starts, not your potential for recovery.
- Many people notice physical improvements within weeks of stopping or reducing drinking, and longer-term recovery continues over months.
Recognizing the Signs of Alcohol Use Disorder
The signs of alcoholism don’t always look like what you see in movies or imagine when you think about addiction. Sometimes they’re subtle, showing up as small changes in habits, relationships, or how you feel physically. Early recognition matters because alcohol use disorder exists on a spectrum, and getting help at any point along that spectrum improves your chances of recovery without experiencing more severe consequences.
Common Symptoms of Alcoholism
There are a number of common signs of alcohol use disorder to be on the lookout for. They include:
| Category | Signs of Alcoholism |
| Physical Signs | Increased tolerance where you need more alcohol to feel effects, experiencing withdrawal symptoms when not drinking, craving alcohol throughout the day |
| Behavioral Changes | Time spent drinking increases steadily, drinking habits become rigid or secretive, unable to stop drinking once you start, consuming alcohol in larger amounts than you intended, drinking too much despite promises to yourself to cut back |
| Social/Occupational Impact | Relationship problems with family or friends intensify, family life gets disrupted by drinking behavior, trouble showing up consistently at work or school, avoiding activities that don’t involve alcohol, and drinking means missing important commitments |
| Psychological Indicators | Drinking to cope with stress or uncomfortable emotions, preoccupation with when you can drink next, anxiety about running out of alcohol, using alcohol to avoid withdrawal symptoms, denial, or minimizing how much alcohol you consume |
You might recognize some of these patterns in yourself or someone close to you, and seeing them laid out can feel uncomfortable. That discomfort itself is valuable information. The reality is that someone can appear highly functional on the surface while struggling significantly beneath it, which is why the term “functional alcoholic” can be misleading in suggesting the problem isn’t serious.
When Drinking Becomes a Medical Condition
There’s a meaningful difference between occasionally having too much to drink at a celebration and developing alcohol use disorder. Physical dependence develops when your body’s ability to function has adapted to regular alcohol consumption, essentially recalibrating its baseline to expect alcohol’s presence. When someone with physical dependence stops drinking suddenly, their nervous system struggles to regain balance, triggering alcohol withdrawal symptoms that range from uncomfortable to medically dangerous.
Psychological dependence operates differently but intertwines with physical changes. This is when drinking means coping with life itself, when alcohol becomes your primary tool for managing stress, socializing, celebrating, or getting through difficult emotions. The mental craving for alcohol can feel as powerful as physical withdrawal, driving you back to drinking even when you genuinely want to stop.
How Alcohol Use Disorder Is Diagnosed
Medical professionals use specific, standardized criteria rather than subjective judgment when diagnosing alcohol use disorder. This diagnostic process helps determine not only whether you meet criteria for AUD, but also which severity level best describes your situation and which treatment approaches best match your needs.
DSM-5 Criteria Explained
The DSM-5 identifies 11 criteria that clinicians use to diagnose alcohol use disorder. Here they are translated into everyday language:
- Drinking more or longer than intended: You plan to have one or two drinks, but end up consuming alcohol well beyond that, often losing track of how much you’ve had to drink.
- Unsuccessful attempts to cut down: You’ve tried to stop drinking or reduce your alcohol consumption multiple times, but haven’t been able to maintain those changes.
- Time spent on alcohol: A significant portion of your day revolves around obtaining alcohol, drinking, or recovering from drinking behavior.
- Craving alcohol: You experience strong urges or desires to drink, sometimes making it hard to think about anything else.
- Failing to fulfill obligations: Your alcohol use has caused you to miss work, neglect family responsibilities, or fall short on important commitments.
- Continued use despite relationship problems: You keep drinking even though it’s damaging your personal relationships and causing conflicts with loved ones.
- Giving up activities: You’ve stopped participating in hobbies, social events, or activities you once enjoyed in favor of drinking.
- Drinking in dangerous situations: You consume alcohol in situations where it’s physically hazardous, such as before driving or in other risky circumstances.
- Continued use despite health problems: You keep drinking even though you know it’s causing or worsening physical or mental health conditions.
- Tolerance: You need to drink much more alcohol than you used to in order to feel the same effects, or drinking the same amount produces less effect.
- Experiencing withdrawal symptoms: When you stop drinking or reduce intake, you develop uncomfortable or dangerous physical symptoms that only subside when you drink again.
You don’t need to meet all 11 criteria to have alcohol use disorder. Meeting just two indicates a diagnosable medical condition that warrants professional help.
Severity Levels: Mild, Moderate, and Severe AUD
The number of criteria you meet determines the severity classification of your alcohol use disorder:
- Mild AUD: Meeting 2-3 criteria indicates mild alcohol use disorder, where patterns are emerging but may be easier to address with early intervention and outpatient support
- Moderate AUD: Meeting 4-5 criteria indicates moderate alcohol use disorder, typically requiring structured treatment such as intensive outpatient programs or partial hospitalization to address established patterns
- Severe AUD: Meeting 6 or more criteria indicates severe AUD, often requiring comprehensive care that may include medical detox, residential treatment, or intensive daily programming with medical oversight
What your severity level really tells clinicians is where to start your treatment journey, not where it will end. People with severe AUD can and do achieve lasting sobriety with proper support, just as those with mild AUD benefit from taking their symptoms seriously. Every level responds to evidence-based approaches, and the goal is always the same: helping you build a life where alcohol no longer controls your choices.
The Role of Medical and Mental Health Assessment
A comprehensive evaluation for alcohol use disorder extends beyond the DSM-5 criteria to include thorough physical and mental health screening. Clinicians assess for co-occurring conditions such as depression, anxiety, trauma, and other mental health disorders that often accompany alcohol addiction. This dual focus ensures treatment addresses both substance use and underlying psychological factors driving drinking behavior.
The medical assessment examines how excessive alcohol use has impacted your physical health, checking for liver disease, high blood pressure, digestive problems, and other alcohol-related medical conditions. Learning about these health risks helps providers create a safe treatment plan and determine whether medical detox is necessary before beginning therapeutic work. This comprehensive approach to assessment directly informs treatment recommendations, ensuring you receive care matched to your specific clinical needs.
Alcohol Withdrawal and When to Seek Urgent Care
Alcohol withdrawal can range from uncomfortable to life-threatening, depending on the severity of your alcohol dependence and drinking history. Knowing about withdrawal symptoms and recognizing when to seek emergency medical care can literally save your life.
Alcohol Withdrawal Symptoms
Alcohol withdrawal symptoms typically begin within a few hours to a day after your last drink and progress through predictable stages:
| Severity Level | Timeline | Common Symptoms |
| Mild Withdrawal | 6-24 hours after last drink | Anxiety, trouble sleeping, sweating, nausea, tremors, headache, irritability, increased heart rate |
| Moderate Withdrawal | 24-72 hours after last drink | All mild symptoms plus confusion, rapid heart rate, elevated blood pressure, profuse sweating, fever, and disorientation |
| Severe Withdrawal | 48-72 hours after last drink (can occur later) | Hallucinations (visual, auditory, or tactile), seizures, severe confusion, delirium tremens (DTs), life-threatening cardiovascular stress, extreme agitation |
What drives this progression is how your central nervous system attempts to recalibrate without alcohol’s depressant effects. Your body has essentially learned to function with alcohol as a baseline, and suddenly removing it creates a dangerous state of hyperexcitability.
Alcohol Withdrawal Can Be Dangerous: When to Seek Emergency Help
Certain alcohol withdrawal symptoms require immediate medical attention, as they can become life-threatening without proper intervention:
- Seizures or convulsions: Any seizure activity during withdrawal is a medical emergency requiring immediate hospital care.
- Severe confusion or delirium: Disorientation, inability to recognize people or place, or hallucinations indicate dangerous withdrawal progression.
- Chest pain or irregular heartbeat: Cardiovascular complications from withdrawal can lead to a heart attack or stroke.
- Severe vomiting or inability to keep down fluids: Dehydration during withdrawal becomes dangerous quickly.
- Suicidal thoughts or severe depression: Mental health crises during withdrawal require crisis intervention.
- History of severe withdrawal: If you’ve experienced seizures, DTs, or hospitalization during previous attempts to stop drinking, you’re at high risk again.
Medical detox isn’t about comfort alone, though managing symptoms matters deeply for your well-being. It’s about preventing medical emergencies that can occur when withdrawal progresses unchecked, providing 24/7 monitoring and immediate intervention when complications arise.
Treatment Options and Recovery Support
Effective treatment for alcohol use disorder combines multiple approaches tailored to your specific needs, severity level, and life circumstances. The options available today offer more flexibility and evidence-based support than ever before.
Detox vs Residential vs Outpatient: How Clinicians Decide
Clinicians use specific clinical criteria to determine which level of care provides the appropriate balance of safety, structure, and support for your situation:
| Level of Care | Clinical Indicators | What It Provides |
| Medical Detox | history of seizures or DTs,co-occurring medical conditions high blood alcohol levels at assessmentprevious dangerous withdrawal | 24/7 medical monitoringmedications to manage withdrawal symptoms safelynursing carephysician oversight |
| Residential/Inpatient Treatment | need for structure beyond detox unstable or unsafe housing situationlimited support systemprevious outpatient treatment unsuccessfulco-occurring mental health disorders requiring intensive caresevere AUD needing daily therapeutic intervention | 24/7 structured environmentdaily individual and group therapymedical oversightremoval from triggering environmentsintensive skill-building |
| Partial Hospitalization (PHP) | need for daily structure, but have stable housingmoderate-to-severe AUDadequate support systemco-occurring disorders requiring intensive but not 24/7 care | programming 5-6 days per week for 6+ hours dailycomprehensive therapymedical monitoringreturn home eveningsmaintains some daily life structure |
| Intensive Outpatient (IOP) | mild-to-moderate AUDcompleted detox or minimal withdrawal riskstable and supportive home environmentable to maintain work or family commitmentsstrong motivation for recovery | treatment 3-5 days per week for 3 hours per sessiongroup and individual therapy relapse preventionallows maintenance of responsibilities |
| Outpatient (OP) | mild AUDmaintenance phase after completing a higher level of care ongoing accountability needsstable recovery with minimal relapse risk | 1-2 sessions per weekcontinued skill reinforcementlong-term supportflexibility for work and life |
Treatment isn’t static. Your team reassesses your progress regularly and adjusts your level of care as you build stability, often stepping down through progressively less intensive programs as your recovery strengthens.
Evidence-Based Behavioral Treatment for Alcohol Use Disorder
Behavioral treatment forms the foundation of alcohol use disorder recovery, teaching you skills to change your relationship with alcohol and address underlying patterns driving your drinking behavior:
- Cognitive Behavioral Therapy (CBT):
- Identifies the thoughts and beliefs that trigger drinking.
- Teaches you to challenge and change those patterns.
- Develops practical coping skills for managing cravings and high-risk situations without consuming alcohol.
- Dialectical Behavior Therapy (DBT):
- Focuses on emotion regulation and distress tolerance, helping you handle difficult feelings and stressful situations that previously led to heavy drinking.
- Particularly valuable for people with co-occurring mental health disorders.
- Motivational Enhancement Therapy:
- Builds your internal motivation to change your drinking behavior by exploring your personal values, goals, and reasons for pursuing recovery, and by strengthening your commitment when ambivalence arises.
- Relapse Prevention Planning:
- Teaches you to recognize warning signs and high-risk situations.
- Create detailed action plans for managing cravings and triggers.
- Develop strategies for handling setbacks without returning to active alcohol addiction.
- Family Therapy:
- Addresses how alcohol use disorder has affected personal relationships.
- Educates loved ones about recovery.
- Rebuilds trust and communication patterns damaged by drinking behavior.
What makes these approaches effective isn’t just learning about alcohol use disorder intellectually. It’s practicing new skills repeatedly until they become your automatic response to stress, cravings, and difficult emotions rather than reaching for a drink.
Medication Options for Alcohol Use Disorder
Several FDA-approved medications support recovery from alcohol use disorder by reducing cravings, blocking alcohol’s rewarding effects, or creating unpleasant reactions to drinking. These medications work best when combined with behavioral treatment, not as standalone solutions.
- Naltrexone: Blocks opioid receptors in the brain that contribute to alcohol’s rewarding effects, reducing cravings and the pleasure response from drinking, making it easier to avoid relapse during early recovery.
- Acamprosate (Campral): Helps restore brain chemistry balance disrupted by long-term heavy drinking, reducing the physical and emotional discomfort that often drives relapse, particularly effective for people committed to complete abstinence.
- Disulfiram (Antabuse): Creates unpleasant physical reactions (nausea, flushing, rapid heartbeat) when you consume alcohol, acting as a deterrent for people who benefit from an additional barrier against impulsive drinking.
The right medication depends on multiple factors, including your drinking patterns, treatment goals, other medications you take, and any medical conditions you’re managing. Your healthcare provider experienced in addiction medicine will consider whether you’re pursuing complete abstinence or harm reduction, your history with alcohol use disorder, and which approach aligns with your broader treatment plan. Medications aren’t magic bullets, but for many people, they significantly reduce the physiological pull toward alcohol while therapy addresses the psychological and behavioral components of recovery.
The Role of Support Groups and Community
Mutual support groups provide crucial peer connection, accountability, and shared experience that complement professional treatment for alcohol use disorder. These self-help groups create community with others who understand the challenges of recovery firsthand, reducing the isolation that often accompanies alcohol addiction.
Multiple support group approaches exist, from 12-step programs to SMART Recovery and other secular options, allowing you to find a community that aligns with your values and recovery philosophy. Family support and education programs strengthen recovery by helping loved ones understand alcohol use disorder, set healthy boundaries, and provide effective encouragement. While support groups serve as powerful adjuncts to professional treatment, they complement rather than replace evidence-based behavioral treatment and medical care for alcohol dependence.
Finding the Right Treatment Path for Alcohol Use Disorder
Choosing a treatment program for alcohol use disorder requires asking the right questions to ensure you receive evidence-based, comprehensive care matched to your needs. This decision matters deeply, and you deserve transparency from any program you consider.
Questions to Ask Any Rehab Program
Use these questions to evaluate whether a treatment program offers the clinical quality, approach, and support you need for lasting recovery:
- What levels of care do you offer, and how do you determine which level is appropriate for my situation?
- What evidence-based therapies do you use, and how are they integrated into daily programming?
- Do you treat co-occurring mental health disorders alongside alcohol use disorder?
- Is medication management available for both withdrawal symptoms and long-term craving reduction?
- What does a typical day or week look like at each level of care you offer?
- How do you involve family in the treatment process, and what family support resources do you provide?
- What continuing care, alumni programming, or aftercare support do you offer after program completion?
- Do you accept my insurance, and what specific services are covered versus out-of-pocket costs?
- What are your staff credentials, licensure levels, and specific experience treating alcohol addiction?
- How do you measure treatment outcomes, and what are your completion and long-term sobriety rates?
Programs with nothing to hide welcome these questions and provide detailed, honest answers. If a program seems evasive or pressures you to commit before addressing your concerns, that’s valuable information about how they operate.
The Benefits of Recovery from Alcohol Use Disorder
Recovery from alcohol use disorder creates profound improvements across every area of your life, beginning with dramatic physical health benefits. Within weeks of stopping drinking, your liver begins healing, your blood pressure often normalizes, and your body’s ability to fight disease strengthens as your immune system recovers.
Beyond physical healing, recovery restores mental health stability, improves sleep quality, sharpens cognitive function, and allows emotional regulation to return to normal patterns. Your personal relationships and family life rebuild as trust returns and the chaos of active alcohol addiction fades, opening possibilities for genuine connection and intimacy. Professional opportunities expand as reliability improves, and you rediscover interests and activities that drinking behavior had pushed aside, creating a fuller, more satisfying life built on genuine stability rather than temporary relief from a bottle.
Taking the First Step Toward Recovery
Seeking help for alcohol use disorder demonstrates strength and self-awareness, not weakness or failure. Recognizing that you have a medical condition requiring professional treatment is the beginning of change, not an admission of defeat. Thousands of people achieve lasting recovery from alcohol addiction every year by reaching out for support.
You don’t have to stop drinking alone. Professional help provides the safety, structure, and skills that make recovery achievable and sustainable. Treatment works, and recovery creates opportunities for a life beyond anything alcohol dependence allowed. Many paths lead to lasting sobriety, and finding yours starts with taking that first step today.
Frequently Asked Questions About Alcoholism
What is considered alcoholism?
Alcoholism, clinically called alcohol use disorder, is diagnosed when someone meets at least two of 11 DSM-5 criteria including drinking more than intended, unsuccessful attempts to cut down, experiencing withdrawal symptoms, and continued use despite negative consequences. Severity ranges from mild to severe based on the criteria met.
What is a functional alcoholic?
A functional alcoholic maintains work, relationships, and responsibilities while meeting criteria for alcohol use disorder. This term can be misleading because “functioning” doesn’t mean the drinking isn’t causing harm. Many people with severe AUD appear highly functional until sudden medical or personal crises reveal the underlying problem.
Is alcoholism curable?
Alcohol use disorder is a chronic condition that can be successfully managed but not cured in the traditional sense. With evidence-based treatment including behavioral therapy, medication management, and ongoing support, people achieve lasting recovery and build fulfilling lives in sobriety. Long-term remission is absolutely achievable.
Begin Your Recovery Journey in Colorado
Mile High Recovery Center offers a large continuum of care for alcohol use disorder, from inpatient stabilization through long-term outpatient support. Our evidence-based treatment approach combines behavioral therapies, medication management when appropriate, and community-centered recovery in a compassionate, LGBTQ+ affirming environment.
Our programs include access to Mile High Sober Living for those needing structured housing support during recovery. If you or a loved one is struggling with alcohol use disorder, contact Mile High Recovery Center today to speak with our admissions team about which treatment option is right for you.
