Alcohol Use Disorder: Signs, Health Risks, and Treatment Options
Plain, fact-first answers about how care works here. Want to talk to a person? Call (888) 464-2144.
- The Archangel Centers is a licensed outpatient addiction treatment provider.
- The Archangel Centers operates clinics in Tinton Falls, NJ and Charlotte, NC.
- Alcohol use disorder is part of the outpatient continuum at The Archangel Centers.
- Medication-assisted treatment (MAT) includes Suboxone, Vivitrol, and Sublocade.
- The Archangel Centers works with most major commercial insurance plans with free benefits verification.
Alcohol use disorder (AUD) is a medical condition characterized by an impaired ability to stop or control alcohol use despite negative consequences. It exists on a spectrum from mild to severe, and it affects tens of millions of adults in the United States. This guide explains what AUD is in clinical terms, how to recognize it in yourself or someone you care about, what the health risks look like over time, and what evidence-based treatment looks like across the continuum of care.
This page is informational. If you are looking for treatment, see the levels of care explained section, or call (888) 464-2144 to speak with admissions at The Archangel Centers.
What alcohol use disorder is
In the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the American Psychiatric Association replaced the older "alcohol abuse" and "alcohol dependence" categories with a single diagnosis: alcohol use disorder. A clinician makes the diagnosis based on whether the person meets at least two of eleven criteria within a twelve-month period.
The criteria fall into four broad themes:
1. Impaired control: drinking more or longer than intended, persistent desire or unsuccessful efforts to cut down, time spent obtaining and using alcohol, craving 2. Social impairment: failure to fulfill major obligations, continued use despite social or interpersonal problems, important activities given up or reduced 3. Risky use: drinking in physically hazardous situations, continued use despite physical or psychological problems 4. Pharmacological: tolerance (needing more to get the same effect), and withdrawal (symptoms when reducing or stopping)
Severity is graded by the number of criteria met: 2 to 3 is mild, 4 to 5 is moderate, and 6 or more is severe.
Signs and symptoms
The clinical criteria above describe a diagnosis. In everyday life, what does AUD look like? Common signs include:
A single sign, in isolation, does not make a diagnosis. A clinician puts the pattern together. Free, confidential screening tools, including the AUDIT (Alcohol Use Disorders Identification Test) and the CAGE questionnaire, are available through SAMHSA and most primary care providers.
- Drinking earlier in the day than intended, or finishing more than planned almost every time
- Repeated promises (to self or others) to cut back, followed by repeated returns to the same pattern
- Hiding drinking, or feeling defensive when someone asks about it
- A growing tolerance: more drinks needed to feel the effect, or alcohol no longer producing the relief it used to
- Morning shakes, sweating, anxiety, or nausea that resolves once the person drinks again
- Memory gaps, especially around evenings of heavy use
- Withdrawing from relationships, hobbies, or work commitments that once mattered
- Increasing irritability, depression, or anxiety, especially during periods of not drinking
- Legal issues, including driving under the influence, public intoxication, or domestic incidents
What are the health risks of chronic alcohol use?
Alcohol affects nearly every organ system. The risks accumulate over years, often silently, and many are reversible if drinking stops or is significantly reduced.
Liver
Fatty liver, alcoholic hepatitis, fibrosis, and cirrhosis are a progression that can begin within years of sustained heavy drinking. Cirrhosis is irreversible, but earlier stages often improve with sustained abstinence.
Cardiovascular
Sustained heavy drinking raises blood pressure, increases the risk of atrial fibrillation, weakens heart muscle (alcoholic cardiomyopathy), and elevates stroke risk.
Cancer
The National Cancer Institute identifies alcohol as a known human carcinogen. Risk is elevated for cancers of the mouth, throat, esophagus, larynx, liver, colon, rectum, and (in women) breast.
Brain and nervous system
Alcohol disrupts sleep architecture, depresses mood over time, contributes to memory and cognitive problems, and in severe long-term use can cause Wernicke-Korsakoff syndrome.
Mental health
The relationship between alcohol and mood is bidirectional. Heavy drinking worsens depression and anxiety, and depression and anxiety often drive heavier drinking. See depression and addiction and anxiety and addiction for how dual-diagnosis care addresses both at once.
Alcohol withdrawal: when medical detox matters
Alcohol is one of the few substances whose withdrawal can be life-threatening. People who have been drinking heavily daily for an extended period should not stop suddenly without medical supervision. The withdrawal syndrome ranges from mild to severe:
Medically supervised detox uses benzodiazepine taper protocols, vitamin replacement (especially thiamine to prevent Wernicke-Korsakoff), and 24-hour monitoring. The Archangel Centers does not provide medical detox on-site; we coordinate placement with accredited partner facilities, then receive the client into outpatient care for step-down. See medical detox in Tinton Falls for how that works in practice.
- Mild (6 to 24 hours after last drink): tremor, anxiety, sweating, nausea, headache, insomnia
- Moderate (12 to 48 hours): elevated heart rate and blood pressure, agitation, possible hallucinations
- Severe (24 to 72 hours): withdrawal seizures
- Delirium tremens (48 to 96 hours): severe agitation, confusion, fever, autonomic instability, and a meaningful mortality risk if untreated
Treatment levels of care
Evidence-based treatment for alcohol use disorder is matched to severity. The American Society of Addiction Medicine (ASAM) describes a continuum of care that scales from outpatient counseling to medically managed inpatient treatment. The most common levels:
Most clients move through the continuum: detox if needed, then partial care, then IOP, then outpatient, then alumni and aftercare. The continuum is not a ladder to climb once; many people cycle through it as life changes. For a deeper look at how the levels of care relate, see the addiction treatment continuum.
| Level | What it looks like | Who it's for |
|---|---|---|
| Outpatient (OP) | Individual therapy, periodic groups | Mild AUD, or step-down from a higher level |
| Intensive Outpatient (IOP) | 3 or 5 days per week, 3 clinical hours each | Moderate AUD, or step-down from PHP |
| Partial Care / PHP | Full clinical day, 5 or 6 days per week | Severe AUD, dual-diagnosis presentations, or step-down from detox or inpatient |
| Medical Detox | 24-hour medical monitoring | Active withdrawal management |
| Inpatient / Residential | Live-in clinical setting | Severe AUD with limited home stability or high relapse risk |
Medication-assisted treatment for alcohol use disorder
Three medications are FDA-approved for the treatment of alcohol use disorder:
Medication is not a moral question. It is a clinical decision. Research consistently shows that medication-assisted treatment, combined with counseling, produces better outcomes than counseling alone for moderate and severe AUD.
- Naltrexone (oral and injectable, brand name Vivitrol for the long-acting form): reduces alcohol cravings and the rewarding effect of drinking
- Acamprosate: helps people who have already stopped drinking maintain abstinence by reducing post-acute withdrawal symptoms
- Disulfiram: produces an unpleasant reaction if alcohol is consumed; useful for highly motivated patients with social support
Therapy approaches with the strongest evidence
A number of therapy modalities have well-documented effectiveness for alcohol use disorder. Most treatment programs combine several.
- Cognitive behavioral therapy (CBT) teaches clients to identify the thoughts and situations that lead to drinking, and to build coping skills that interrupt the pattern. See CBT for addiction.
- Motivational interviewing (MI) is a collaborative conversational style that helps clients resolve ambivalence about change.
- Dialectical behavior therapy (DBT) is especially useful when emotion regulation and impulse control are central to the drinking pattern.
- Family therapy addresses the interpersonal context of drinking. Alcohol use disorder is a family disease; recovery is a family process.
- trauma-informed therapy is available for trauma processing when drinking is linked to unresolved traumatic experience.
What co-occurring conditions does Archangel treat?
Most adults entering treatment for alcohol use disorder also meet criteria for at least one co-occurring mental health condition. Depression, generalized anxiety, post-traumatic stress, and bipolar disorder are the most common. The clinical evidence is clear: treating both at the same time, by the same team, produces better outcomes than treating them sequentially.
What recovery from alcohol use disorder looks like
There is no single picture of recovery. Some people stop drinking entirely and stay abstinent. Others reduce significantly. Most who recover do so over years, with setbacks along the way, and with support from a combination of professional treatment, peer community (Alcoholics Anonymous, SMART Recovery, Recovery Dharma, or others), family involvement, and ongoing self-care. Recovery is not the absence of work. It is the presence of a sustainable structure that makes the work possible.
What predicts a sustainable recovery:
- Treatment matched to severity, not the cheapest available
- Co-occurring conditions treated alongside the substance use, not after
- A continuous relationship with a clinical team, not a one-time program
- Family involvement, where the family is willing and the client consents
- Time. Brain healing takes months. Habit change takes longer.
Frequently Asked Questions
How many drinks per week is too many?
Can I just stop drinking on my own?
Is alcohol use disorder a disease?
Will my insurance cover treatment?
Can someone be in recovery without going to AA?
How long is a typical alcohol treatment episode at The Archangel Centers?
Can I keep working while in treatment for alcohol use disorder?
Do I have to be sober before I call?
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