Last updated: Octobre, 2025
Although alcoholism is a commonly used term, even within the medical community, it is not a clinical diagnosis. The correct term is Alcohol Use Disorder (AUD).
Alcohol Use Disorder (AUD) is a recognized medical condition characterized by an inability to control or stop drinking when the brain and body adapt to regular alcohol consumption, despite negative social, occupational, or health consequences. This disorder encompasses a spectrum of drinking behaviors, from mild misuse to severe addiction. And it is a chronic but treatable condition.
The Spectrum of Alcohol Use — From Misuse to Dependence
Alcohol use disorder covers a range of alcohol use problems, not just addiction. So, while the layman’s image of an alcoholic is of someone who needs to constantly drink, someone with alcohol use disorder can exhibit the condition in a variety of ways, following a cycle that repeats over time.
This cycle involves three main stages that affect how the brain reacts to alcohol and to life without it.
1. Binge or Intoxication Stage
At first, drinking is associated with pleasant effects: relaxation, relief from stress, or a feeling of euphoria. Yet still maintaining control most of the time. As drinking becomes more frequent, the brain starts to connect alcohol with comfort and reward. Every time the person drinks, these associations grow stronger, and alcohol begins to feel essential for enjoyment or emotional relief.
2. Negative Emotion or Withdrawal Stage
When alcohol use stops or is reduced, the opposite feelings appear. Anxiety, irritability, and physical discomfort become common, and drinking again seems like the easiest way to feel “normal” or to escape those unpleasant sensations. At this stage, drinking is no longer about pleasure: it’s about avoiding pain.
3. Preoccupation or Anticipation Stage
Over time, thoughts about drinking take up more mental space. The person begins to look forward to the next drink or feels restless when it’s not available. Concentration, planning, and self-control decline, and daily life slowly starts to revolve around alcohol. At this point, dependence, tolerance and withdrawal appear, and drinking becomes a central part of life.
Understanding these stages helps explain why alcohol use disorder is not simply an addiction or a lack of willpower, but a condition that alters how the brain manages motivation, emotion, and decision-making. This also helps reduce stigma: not everyone with AUD fits the stereotype of an “alcoholic,” and many people who drink excessively can benefit from early support.
How Alcohol Use Disorder Is Diagnosed
A diagnosis of alcohol use disorder can only be made by a qualified medical professional. In order to make a diagnosis, they will consider a patient’s historic and current relationship with alcohol and make assessments against a set of diagnostic criteria, including factors considering the patient’s attitude towards alcohol, the effects of drinking on them and the impact it has on their wider life.
The 12 month criteria
The criteria are assessed based on the previous twelve months, so alcohol use disorder can be diagnosed even if the person has been sober for part of that time. Professionals look for recurring patterns such as:
- Drinking more or for longer than intended.
- Repeated attempts to cut down without success.
- Spending a lot of time obtaining, using, or recovering from alcohol.
- Strong craving or urge to drink.
- Alcohol use interfering with work, school, or home responsibilities.
- Continuing to drink despite conflicts or social problems.
- Giving up or reducing hobbies and social activities.
- Drinking in physically risky situations (for example, driving).
- Continuing to drink despite health or psychological issues caused by alcohol.
- Developing tolerance and needing more to feel the same effect.
- Experiencing withdrawal symptoms, or drinking to avoid them.
Causes and Risk Factors
Alcohol use disorder develops through the interaction of biological, psychological, and social factors.
- Biological: Genetics account for roughly half of the risk. Differences in how alcohol is metabolized and how the brain’s reward system responds can increase vulnerability.
- Psychological: Trauma, depression, anxiety, or chronic stress can lead people to use alcohol as a coping mechanism. Over time, the brain learns to associate alcohol with relief, reinforcing the cycle of dependence.
- Social and Environmental: Peer pressure, cultural norms around drinking, and stressful environments can make excessive alcohol use feel normal or acceptable.
Protective factors (strong support systems, therapy, and early education) can significantly reduce risk.
Health and Social Consequences
Physical Effects
Long-term heavy drinking affects nearly every organ system. It increases the risk of liver disease, heart problems, pancreatitis, certain cancers, and neurological damage. Even moderate but regular drinking can interfere with sleep, hormone balance, and immune function.
Psychological Impact
AUD often co-occurs with depression, anxiety, and sleep disorders. Emotional regulation becomes impaired, and guilt, irritability, or apathy can appear. These symptoms are both a cause and a consequence of prolonged alcohol use.
Social and Occupational Effects
Relationships, work performance, and finances often suffer. Absenteeism, conflict, or legal issues (e.g., driving under the influence) are common signs that alcohol has become disruptive. The earlier treatment begins, the more reversible these effects tend to be.
Treatment and Recovery
Recovery from alcohol use disorder involves three main stages: detoxification, rehabilitation, and long-term recovery.
Detoxification
The first step focuses on safely managing withdrawal under medical supervision.
Doctors may use medication to reduce symptoms such as anxiety, tremors, or insomnia while monitoring vital signs closely.
Rehabilitation
Therapy begins once the person is physically stable. A combination of individual counseling, group therapy, and behavioral approaches like Cognitive Behavioral Therapy (CBT) or Motivational Interviewing helps identify the underlying causes of drinking and develop healthier coping strategies.
Long-Term Recovery
After treatment, maintaining sobriety involves continued therapy, support groups, and lifestyle adjustments. Relapse prevention programs and family involvement play a crucial role in sustaining progress and rebuilding personal and professional stability.
Next Step: How We Can Help
If you or someone you care about may be struggling with alcohol use disorder, Hacienda Paradiso offers free, confidential consultations. Our team provides assessment, guidance, and evidence-based treatment to support long-term recovery.
Frequently Asked Questions
Not exactly. “Alcoholism” is an outdated term, while Alcohol Use Disorder covers a spectrum — from mild misuse to severe dependence.
Early signs include drinking more or longer than planned, craving alcohol, hiding or minimizing drinking habits, and experiencing mood changes or sleep problems when not drinking.
When alcohol starts to interfere with relationships, work, or health (or if stopping feels difficult) it may be time to seek professional evaluation for AUD.
Genetics play a role; people with a family history of alcoholism are more likely to develop AUD. However, environmental and psychological factors are equally important.
Withdrawal symptoms such as anxiety, sweating, nausea, or tremors may occur. That’s why detoxification should always be medically supervised.
Mild cases may respond to outpatient therapy or counseling, but moderate to severe AUD often requires structured inpatient or residential treatment to ensure safety and long-term success.
Recovery is different for everyone. Detox typically lasts one week, rehabilitation several weeks, and full recovery involves ongoing therapy and lifestyle support.
