Alcohol use disorder (AUD) is defined as heavy or frequent consumption of alcohol that negatively interferes with functioning in school, work, social, and interpersonal activities. Someone with AUD may engage in binge drinking, which is defined as having 4-5 or more drinks on one occasion. Heavy drinking is characterized by consuming 8-15 drinks in one week.
- Research shows that 27.9 million people ages 12 and older were living with alcohol use disorder in 2024. Only 7.9 % of these people received treatment for alcohol use disorder.
- According to the National Survey on Drug Use and Health (NSDUH), in 2024, 62% of Americans over the age of 12 reported drinking alcohol in the past year.
- Approximately 57.0 million American adults stated they engaged in binge drinking in the past month, and 14 million in heavy alcohol use.
Understanding alcohol addiction
Alcohol is a legal beverage consumed in many forms, most commonly wine, beer, and spirits. In low doses, alcohol can lower anxiety and inhibitions, promoting a relaxed state. It acts as a depressant in larger quantities and can cause loss of motor function, slurred speech, and short-term memory loss.
According to the National Survey on Drug Use and Health (NSDUH), in 2019, over 60% of Americans admitted to having drunk alcohol in the past year, though most would not say they had an alcohol problem. It is possible to consume alcohol without being an alcoholic; however, if your life is negatively affected by alcohol, you may have an alcohol use disorder (AUD) or addiction.
What is an alcoholic?
There is a high possibility that you have come across the terms alcoholic and alcoholism at some point. These terms are widely used to describe someone who has an alcohol use problem, and for most people, it is considered the correct terminology for alcohol addiction. However, medical professionals and addiction specialists have been moving away from this term for years.
The reason for this is that these terms simplify alcohol use into very basic terms. In reality, alcohol use and misuse exist on a broad spectrum, and there is a vast difference between someone with no alcohol problems and someone with severe alcohol addiction. The term "alcoholism" could be applied to someone who drinks yet experiences no negative impact on their life as easily as it could to someone who is addicted. This does not help to identify alcohol use disorders (AUD) and can mean people with real problems believe they are fine.
Another reason "alcoholic" is not the preferred terminology is that it carries many societal connotations and baggage. These terms underplay alcohol abuse as being part of a wider mental health condition, one that can be treated and managed. Pejorative terms like alcoholic suggest a moral shortcoming that can lead people to not believe they have a mental illness.
For these reasons, most professionals now prefer the terms "alcohol misuse", "unhealthy alcohol use", or "alcohol use disorder" to describe the varying levels of alcohol abuse.
Alcohol addiction facts
The statistics below have been collected from the National Institute on Alcohol Abuse and Alcoholism (NIAAA).
General alcohol addiction statistics
- 27.9 million Americans ages 12 and older are living with alcohol use disorder.
- 7.9% of these individuals receive treatment through rehabilitation centers and outpatient clinics.
- 57.0 million Americans endorse binge drinking over one month.
- In 2022, the number of alcohol-related driving fatalities reached 13,524. This is the highest total since 2008.
- Teen alcohol use kills 3,629 people each year.
Alcohol addiction statistics for women
- According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), 10.7 million women aged 18 years or older had alcohol use disorder in the last year.
- 64.2 million American women who are 18 years or older report having drunk alcohol in the past month, and 25.2 million women in this group binge drink (defined as drinking on average four drinks on one occasion).
- 8.4% of pregnant women between the ages of 15 and 44 reported consuming alcohol in the past month.
- Data estimates that fetal alcohol spectrum disorders may affect as many as 1%-5% of first-grade students in America.
Alcohol addiction statistics for men
- 53.5% of adult men report having consumed alcohol in the past month, and 24.9% of men in this group have participated in binge drinking in the past month.
- About 12.9% of adult men were living with alcohol use disorder in the last year.
- While the gap between binge drinking likelihood in men and women is narrowing, men are still more likely than women to binge drink.
- Men are more likely than women to die by suicide while under the influence of alcohol.
Symptoms of alcohol addiction
Some of the central warning signs of alcohol use disorder (AUD) include displaying certain patterns of drinking, continuing to consume alcohol despite experiencing negative consequences (direct or indirect), and the presence of withdrawal symptoms.
If someone consumes an increasing volume of alcohol, this may also be indicative of a problem. Other drinking habits that may point toward AUD include consuming more alcohol than intended or finding it difficult to stop drinking. Those with alcohol use disorder may develop a tolerance to alcohol, meaning they require increasing amounts of the substance to produce the same effects.
Other psychological, physical, and functional symptoms of alcohol use disorder include:
- An impaired ability to attend and perform well in work or school settings.
- Giving up or missing time spent with friends, family, or participating in hobbies.
- Planning your schedule based on the pursuit of obtaining alcohol or recovery from alcohol.
- Mood changes, including irritability, low mood, anxiety, and mood swings between these states.
- Continuing to drink despite clear signs that alcohol is worsening a physical and/or mental health condition.
- Alcohol-related accidents, including falls, physical fights, or motor vehicle accidents that may lead to serious injury.
- Digestive problems, including chronic nausea, vomiting, diarrhea, and inflammation of the intestines.
- Liver damage.
Another indicator of AUD is experiencing intense cravings for alcohol and spending a large amount of time getting alcohol, drinking it, and recovering from alcohol. If someone displays withdrawal symptoms in the event they do not consume alcohol, this also indicates alcohol use disorder.
Causes of alcohol addiction
There is a range of biological, psychological, and social aspects that play a part in determining someone’s predisposition to developing alcohol use disorder. Some of the contributing factors that may lead to the development of AUD include:
- Genetics: Research shows that the heritability of alcohol use disorder is around 50%. This means that having one or more parents with this condition accounts for about half of someone’s risk of developing AUD.
- A family history of alcoholism: Research shows that having first-degree relatives (parents or siblings) with alcohol use disorder can contribute to the development of AUD. Although some individuals with AUD have several generations of family members with this condition.
- Exposure to trauma in childhood: Adverse childhood events (ACEs) cause long-lasting neurobiological changes that increase someone’s vulnerability to developing alcohol dependence, AUD, and other mental health concerns as adults.
- Drinking alcohol in adolescence: Youth who begin drinking earlier in life have a heightened risk of developing AUD or excessively consuming alcohol as an adult.
- Mental health concerns: There are strong associations between AUD and mental health concerns, particularly depression and anxiety. One study found that people with alcohol dependence are 4 times as likely to have major depressive disorder as those without alcohol dependence.
Young people and alcohol use
While alcohol use in youth is generally declining, a portion of young people demonstrate problematic drinking habits. A 2024 survey showed that 3% of 17- and 18-year-olds endorsed high-intensity drinking, which means consuming 10 or more drinks in a row, within the past two weeks.
These rates are higher in young adults regardless of their educational pursuits. The same survey found that 7.2% of youth between 19 and 23 years old who did not attend college reported high-intensity drinking within the past two weeks. The high-intensity drinking rate for full-time college students stood at 4.7%.
In terms of general consumption in adolescents, 7.4% of girls and 5.9% of boys between the ages of 12 and 17 have drunk in the past month. Regardless of age, drinking during youth can place someone at a substantial risk of injury, mental health concerns, and excessive alcohol consumption as an adult. These risks are especially compounded if youth do not seek treatment for alcohol problems.
Similar to adults, youth with alcohol dependence and AUD can benefit from residential and outpatient treatment options along with support groups.
Binge drinking
The term “binge drinking” refers to the consumption of five or more alcoholic drinks in a short time period (e.g., within 2 hours) on at least one occasion in a week. Binge drinking is most commonly associated with a regular pattern of alcohol use on specific days, such as Friday or Saturday nights.
It may not be considered an issue if the individual does not drink the rest of the week; however, even occasional binge drinking can lead to harm, and in many cases, prolonged periods of binge drinking can lead to alcohol dependence.
Read here to learn more about binge drinking and its impact on health.
High-functioning alcoholics
While the effects of alcohol abuse are prominent for most people, some may not realize they have a problem. So-called “high-functioning” alcoholics are able to consume damaging levels of alcohol without it impeding their personal or professional lives.
As the damaging nature of alcohol misuse does not affect high-functioning alcoholics in the same way, many do not realize they have an issue until it is too late, for example, if they start having withdrawal symptoms after short periods of not drinking. A New York Times article estimated that almost half of alcoholics may be high-functioning and that many high-profile professionals, such as doctors or professors, make up a significant portion of this figure.
Read here to learn more about functioning alcoholics.
Alcohol induced blackouts
Blackouts caused by alcohol are gaps in an individual's memory that occur during intoxication. These blackouts occur when a person has consumed enough alcohol to block the communication between short-term and long-term memory in the hippocampus. This creates a gap in the person's memory of the night before, as the short-term information is discarded before it can be stored in long-term memory.
There are two types of blackout caused by alcohol: fragmentary blackout and en bloc blackouts. Fragmentary blackouts are more common, where an individual will experience periods of memory separated by no memory at all. These are the more common forms of memory blackout when intoxicated by alcohol.
En bloc blackouts are extended periods of complete amnesia, where the person will have no memory at all for hours at a time. These are the most hazardous forms of blackout and are similar to taking high doses of GHB.
Research suggests that alcohol-related blackouts occur when blood alcohol concentration (BAC) reaches 0.16%, the same point where impulse control, coordination, judgment, and decision-making are also impaired. These blackouts are more likely to occur when alcohol enters the bloodstream quickly, and are more likely in those who take anti-anxiety and sleep medication.
Blackouts are different from passing out, where the intoxicated person loses consciousness, but they are no less dangerous. Blackouts have been linked to serious violent and sexual assaults (notably against women), and the crimes are rarely solved as there is no recollection of the event.
Alcohol withdrawal
Individuals with AUD will experience alcohol withdrawal if and when they choose to stop drinking after long periods of time. Withdrawal can also occur if someone with alcohol use disorder drinks less over time. Alcohol withdrawal can cause a range of physiological symptoms, including:
- Confusion.
- A spike in vital signs, including heart rate, blood pressure, body temperature, and breathing rate.
- An irregular heart rate.
- Pale, clammy skin.
- Shakiness of the hands and other parts of the body.
- Excessive sweating.
- Dilated pupils.
- Nausea.
- Fatigue
- Increased arousal.
- Vomiting.
- Headache.
- Mood changes, including low mood, irritability, and anxiety.
- Sleep disturbances, such as nightmares and difficulty sleeping.
In severe cases of alcohol withdrawal, individuals may experience a life-threatening episode called delirium tremens. This includes more severe confusion with a sudden onset, fever, hallucinations, seizures, and agitation. Individuals experiencing delirium tremens must receive medical attention.
Alcohol withdrawal time frame
Individuals who heavily or regularly use alcohol can see symptoms of withdrawal just 6 hours after they last consumed the substance. Between 6 and 12 hours after consuming alcohol, individuals can expect mild symptoms of withdrawal, such as some feelings of anxiety, slight difficulty sleeping, and a headache.
By the 24-hour mark, individuals tend to display an increase in these symptoms. This is also around the time when someone may experience hallucinations if their withdrawal is severe.
Symptoms will worsen before resolving between 24 and 72 hours after alcohol consumption. This is also when someone may experience delirium tremens, so it is important to monitor symptoms closely to ensure medical intervention is not needed.
Without proper treatment, individuals can experience lasting withdrawal symptoms such as mood changes and insomnia weeks after their last drink.
Alcohol detoxification
The first step to recovery from alcohol use disorder is to remove the substance from the body. Cessation from alcohol to intentionally eliminate its presence in the system is known as alcohol detoxification. Some individuals may stop consuming alcohol on their own or gradually cut down on their drinking habits at home. While this may be enough for those with mild alcohol use issues, those with alcohol addiction will often require help to fully detox.
As alcohol withdrawal and detox can be dangerous for those with severe use disorders, it is recommended to seek professional assistance from a substance use disorder program or other treatment provider. Residential or inpatient treatment programs offer round-the-clock medical supervision for the detoxification process. There are also similar options available on an outpatient basis for those unable to commit to inpatient care.
Since outpatient detoxification programs provide less oversight, they are not recommended for individuals recovering from severe AUD or heavy alcohol dependence.
Medications used during alcohol detoxification
Medication-assisted treatment (MAT) is often recommended to assist with alcohol withdrawal. The type of medication your provider recommends will depend on how severe your condition is, what other medical conditions you have (if any), and other medications you take.
Low-risk individuals undergoing alcohol detoxification after mild alcohol dependence may benefit from gabapentin or carbamazepine to manage their symptoms on a short-term basis. Individuals with moderate alcohol dependence may be prescribed barbiturates or benzodiazepines to lower their risk of complications such as seizures. These medications may potentially be supplemented with beta-blockers if someone’s vital signs are not stable.
In the event of severe alcohol withdrawal symptoms, individuals often benefit from long-acting medications given intravenously. These include benzodiazepines (for alcohol withdrawal symptoms) and other medications for other health concerns that may be impacting their care.
Alcohol addiction treatment
Accessing help and thinking about recovering from alcohol addiction is a daunting prospect; however, it need not be faced alone. In fact, many individuals with AUD may not be successful immediately after receiving treatment.
There are many ways to get the help you need, through professional organizations and support groups, as well as alcohol addiction treatment and rehabilitation centers. The latter provides the best chance of a full recovery, owing to the professional attention addiction treatment centers can provide.
There are various advantages to each treatment setting, as they cater to individuals with different needs.
Residential alcohol rehab
This treatment setting offers 24/7 alcohol detoxification, medication-assisted treatment, and medical supervision to individuals who stay overnight for a set period of time. Individuals may participate in alcohol rehab for 30, 60, or 90 days, depending on the program’s structure and the individual’s needs. Individuals in residential alcohol rehab can expect to participate in group and individual therapy during their time in the program.
Outpatient programs
There are several varieties of outpatient programs for alcohol detoxification. Typical outpatient programs may involve 3-5 hours of care each week, including meeting with a therapist, undergoing medical exams and check-ins, and receiving medication to assist with withdrawal symptoms.
There are also more comprehensive outpatient services for those who need more concentrated care. Intensive outpatient programs, also called IOPs, offer between 9 and 20 hours of services provided several days per week. These may last for 8 to 12 weeks, since they are less restrictive, allowing individuals to remain in their homes and possibly even continue working while receiving treatment.
Partial hospitalization programs (PHPs) offer full-day services, provided for between 20 to 30 hours per week. Since these programs are a bigger time commitment, PHPs may last between 2 and 6 weeks. Discharge from any outpatient program is dependent on someone meeting their goals and making a plan for the next step in their recovery.
Counseling and therapy
Talk therapies, also known as counseling, are an integral part of the AUD recovery process. This step involves receiving treatment for any co-occurring mental health concerns (such as major depressive disorder, anxiety disorders, and post-traumatic stress disorder).
Counseling typically takes place two to four times each month and sessions focus on addressing personally meaningful goals. Since these conditions can complicate the treatment process and lead someone to relapse, it is important to receive treatment for mental health concerns alongside any treatment for AUD.
Counseling for individuals with alcohol use disorder may involve discussing feelings and identifying triggers associated with alcohol use and replacing alcohol consumption with more supportive habits that enable a healthier lifestyle. Therapists may also assist individuals in modifying their environment and social support systems to foster success in the treatment process.
Support groups
Peer support is another important part of AUD treatment. Support groups meet in informal settings to establish and maintain assistance from individuals who are also recovering from AUD.
While some of the more well-known support groups for alcohol addiction are anonymous, not all take this format. Support groups may be in-person or online, allowing for greater accessibility to a range of individuals.
Managing alcohol addiction long-term
There are several steps involved in managing alcohol addiction long-term, which can make the process seem overwhelming. However, education is an essential first step, as this helps individuals build a plan for their future.
In addition, people with this condition see the best results by developing a strong social network and connecting with an interprofessional care team (consisting of doctors, therapists, and pharmacists). This allows them to receive sufficient support across all areas of their life and can lead to greater success rates.
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