How to Recognize an Alcohol Dependence (Alcohol Use Disorder)

Medically reviewed by Timothy J. Legg, PhD, PsyD, CRNP, ACRN, CPH on December 6, 2017Written by Healthline Editorial Team on June 2, 2015

Recognizing the signs of alcohol use disorder

It can be easy to tell when a person has been drinking. Signs include slurred speech, uncoordinated movements, lowered inhibitions, and the smell of alcohol on the breath. However, identifying an addiction may not be so black and white.

People with alcohol use disorder (AUD) may be able to hide many of the more obvious symptoms of addiction for a long period of time. People with the addiction and the people around them may choose to ignore the addiction. They may also find themselves in a state of denial about the realities of their alcohol use.

Warning signs of alcohol use disorder

Pay attention to the warning signs if you suspect that a loved one is addicted to alcohol. Certain behaviors may indicate that a person’s pattern of drinking is the result of addiction.

Signs of AUD include:

  • being unable to control how much you drink
  • being unable to control when you drink
  • feeling compelled or having uncontrollable cravings to drink
  • having a “tolerance” to alcohol so that you need to consume increasingly larger amounts of alcohol in order to experience the same effects
  • having to drink in order to feel “normal” or “good”
  • storing alcohol in hidden places, such as at work, in your car, or in unusual places in your house
  • drinking alone or in secret
  • irritability if you can’t drink when you want to
  • continuing to drink despite negative consequences in your personal or professional life
  • preferring to drink over engaging in other activities and hobbies, including spending time with friends and family
  • experiencing blackouts, or periods of time when you can’t remember what you did, where you were, or who you were with

Physical symptoms may occur when the person is unable to drink. This is known as withdrawal. These symptoms are signs of a physical addiction. The body feels it’s unable to act and function as it should without the alcohol. Withdrawal symptoms may include:

  • nausea
  • sweating
  • shaking
  • hallucinations
  • convulsions
  • vomiting

What is alcohol abuse?

Although the term is no longer used in the new edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), alcohol abuse continues to be used in many articles and in discussions about AUD.

Alcohol abuse is different from AUD, which has been considered to be the more “severe” of the two conditions. People who abuse alcohol but aren’t physically addicted may experience the same signs and symptoms as people who have AUD. But people who abuse alcohol often don’t have the same cravings or need to drink that a person with AUD does. Instead, a person who abuses alcohol isn’t able to control their drinking when they do drink.

Alcohol abuse can come with many health complications and can lead to AUD if it’s not treated.

How is alcohol use disorder diagnosed?

There’s no simple diagnostic test to confirm AUD. Rather, addiction is a diagnosis of exclusion. When all behaviors and health problems are taken into consideration, a doctor may determine that the drinking is in fact an addiction.

To reach a more informed conclusion, some doctors use questionnaires to evaluate a dependence on alcohol as well as behavior when it’s consumed.

Family members, colleagues, and friends may also be asked to answer similar questions. They may be able to help the doctor understand the root of the problem as well as any behaviors that trigger drinking. Knowing this will help the doctor determine the best course of treatment for the person’s specific situation.

CMS Id: 22299