What an Alcohol Use Disorder Diagnosis Means

What an Alcohol Use Disorder Diagnosis Means Addiction Alcohol Use Print What an Alcohol Use Disorder Diagnosis Means By Buddy T facebook twitter Buddy T is an anonymous writer and founding member of the Online Al-Anon Outreach Committee with decades of experience writing about alcoholism. Learn about our editorial policy Buddy T Medically reviewed by Medically reviewed by Steven Gans, MD on August 05, 2016 Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Steven Gans, MD Updated on September 27, 2019 Jack Andersen / Getty Images More in Addiction Alcohol Use Binge Drinking Withdrawal and Relapse Children of Alcoholics Drunk Driving Addictive Behaviors Drug Use Nicotine Use Coping and Recovery There really is no official diagnosis of alcoholism. The condition that has long been termed alcoholism is technically called severe alcohol use disorder, according to the May 2013 publication of the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSMâ€"5) by the American Psychiatric Association.  With the DSM-5, if a person exhibits two or more symptoms from a list of 11 criteria, they are diagnosed as having an alcohol use disorder, with classifications of mild, moderate, and severe.?? The  DSM-IV (published in 1994) likewise had no alcoholism diagnosis but instead described two distinct disordersâ€"alcohol abuse and alcohol dependenceâ€"with specific criteria for each diagnosis.  The  DSM-5 combines those two disorders into one alcohol use disorder with sub-classifications of severity.?? Alcohol Use Disorder Severity When a person is diagnosed with alcohol use disorder, the severity of the condition is determined by the number of symptoms they have.Mild: 2-3 symptoms presentModerate: 4-5 symptoms presentSevere: 6 or more symptoms present Although there is a lot of overlap between the criteria (list of symptoms) used by the DSM-IV and the DSM-5, there are two significant changes. The DSM-5 eliminates having legal problems as a result of drinking as a criterion for diagnosis but adds craving for alcohol as a criterion. Symptoms Listed in DSM-5 The DSM-5 lists 11 symptoms that can be used to determine if someone has an alcohol use disorder.?? Alcohol is often taken in larger amounts or over a longer period than was intended.There is a persistent desire or unsuccessful efforts to cut down or control alcohol use.A great deal of time is spent in activities necessary to obtain alcohol, use alcohol, or recover from its effects.Craving, or a strong desire or urge to use alcohol.Recurrent alcohol use resulting in a failure to fulfill major role obligations at work, school, or home.Continued alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol.Important social, occupational, or recreational activities are given up or reduced because of alcohol use.Recurrent alcohol use in situations in which it is physically hazardous.Alcohol use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by alcohol.Tolerance, as defined by either of the following: a) A need for markedly increased amounts of alcohol to achieve intoxication or desired effect, or b) A markedly diminished effect with continued use of the same amount of alcohol.Withdrawal, as manifested by either of the following: a) The characteristic withdrawal syndrome for alcohol b) Alcohol (or a closely related substance, such as a benzodiazepine) is taken to relieve or avoid withdrawal symptoms. The Different Types of Alcohol Use Disorders DSM-5 Draws Some Criticism The criteria of diagnosing alcohol use disorder came under some criticism because, under the DSM-5, any college student who occasionally engaged in binge drinking and admitting to craving a cold beer once in a while could be diagnosed with the disorder and labeled an alcoholic. Likewise, if tolerance and withdrawal symptoms are the only two necessary  factors required for someone to be diagnosed, then anyone drinking a couple of glasses of wine with dinner each evening will have measurable and noticeable tolerance and withdrawal. It won’t be present to the extent of causing significant dysfunction, but it will be quite evident on exam, according to Dr. Stuart Gitlow, addiction psychiatrist and past president of the American Society of Addiction Medicine. That person now has a mild alcohol use disorder.?? Why the DSM-5 Alcohol Use Disorder Diagnosis is Controversial