Understanding Alcohol Use Disorder -- the Basics

Medically Reviewed by Jennifer Casarella, MD on December 19, 2022
3 min read

Alcohol use disorder (previously called alcoholism or alcohol abuse) can cause major health issues, alienate you from your family, and interfere with your work. Fortunately, early treatment can help you and your loved ones avoid the more unfortunate consequences of the condition.

Consumed in excess, alcohol is poisonous and is considered a drug. It is estimated that between 18 million -- or one in 12 adults -- in the U.S. misuse alcohol or have an alcohol addiction.

Nearly 100,000 Americans die each year as a result of alcohol misuse, and alcohol is a factor in more than half of the country's homicides, suicides, and traffic accidents. Alcohol misuse also plays a role in many social and domestic problems, from job absenteeism and crimes against property to spousal and child abuse.  Learn more about how alcohol addiction destroys families.

The immediate physical effects of drinking alcohol range from mild mood changes to complete loss of coordination, vision, balance, and speech -- any of which can be signals of acute alcohol intoxication, or drunkenness. These effects usually wear off in a matter of hours after a person stops drinking. Many law-enforcement agencies regard a .08 percentage of alcohol in the bloodstream as evidence of intoxication. Larger amounts of blood alcohol can impair brain function and eventually cause unconsciousness. An extreme overdose, alcohol poisoning, can be fatal.

Alcohol use disorder is a potentially fatal disease, characterized by cravings, tolerance (needing more), physical dependence, and loss of control over consuming alcohol. Alcohol intoxication may or may not be obvious to observers. Even in highly functional alcoholics, chronic alcoholism can lead to physical problems. Most common is damage to your liver, which over time can lead to cirrhosis (scarred liver).

Other risks include depression, chronic gastritis that leads to stomach bleeds, pancreatitis, high blood pressure, heart failure, numbness and tingling in your feet and changes in your brain. Alcohol addiction can also increase your risk for infections including pneumonia and tuberculosis.

Alcohol use disorder can also lead to impotence in men, damage to the fetus in pregnant women, and an elevated risk of cancer of the larynx, esophagus, liver, breast, stomach, pancreas, and upper gastrointestinal tract. Because heavy drinkers seldom have adequate diets, they may have nutritional deficiencies. Heavy drinkers typically have impaired liver function, and up to one in five develops cirrhosis.

Alcohol use disorder makes abstinence -- an important goal of treatment -- extremely difficult. The condition is also complicated by denial: People with alcohol use disorder might be reluctant to admit their excess drinking either because of denial or guilt. Another barrier to receiving care is that physicians screen only about 15% of their primary care patients for alcohol use disorders.

Historically, alcoholic behavior was blamed on a character flaw or weakness of will; experts now consider alcohol addiction, and addiction more generally, a disease.

In young people binge drinking is more acceptable, and teenagers tend to drink with friends. Older people are more likely to drink alone, and take medications or have co-morbidities that make drinking more risky. Both situations can make it hard to identify a problem drinker.

The cause of alcohol addiction seems to be a blend of genetic, physical, psychological, environmental, and social factors. A given person's risk of developing alcohol use disorder is three to four times greater if a parent is alcoholic. While children of people with the disorder have an increased risk of struggling with alcohol, many children of people who have alcohol use disorder or dependence issues do not develop a problem.

If you or a loved one are struggling with a substance abuse disorder, WebMD Connect to Care advisors are standing by to help.