The American Psychiatric Association says: 'Alcohol use disorder (AUD) involves frequent or heavy alcohol drinking that becomes difficult to control and leads to problems such as in relationships, work, school, family, or other areas.'
More specifically, the APA publishes the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which defines Alcohol Use Disorders as 'anyone meeting any 2 of the 11 criteria below] during the same 12-month period.
The severity is defined as:
Mild: The presence of 2 to 3 symptoms
Moderate: The presence of 4 to 5 symptoms
Severe: The presence of 6 or more symptoms
Had times when you ended up drinking more, or longer, than you intended?
More than once wanted to cut down or stop drinking, or tried to, but couldn’t?
Spent a lot of time drinking? Or being sick or getting over other aftereffects?
Wanted a drink so badly you couldn’t think of anything else?
Found that drinking—or being sick from drinking—often interfered with taking care of your home or family? Or caused job troubles? Or school problems?
Continued to drink even though it was causing trouble with your family or friends?
Given up or cut back on activities that were important or interesting to you, or gave you pleasure, in order to drink?
More than once gotten into situations while or after drinking that increased your chances of getting hurt (such as driving, swimming, using machinery, walking in a dangerous area, or having unsafe sex)?
Continued to drink even though it was making you feel depressed or anxious or adding to another health problem? Or after having had a memory blackout?
Had to drink much more than you once did to get the effect you want? Or found that your usual number of drinks had much less effect than before?
Found that when the effects of alcohol were wearing off, you had withdrawal symptoms, such as trouble sleeping, shakiness, restlessness, nausea, sweating, a racing heart, or a seizure? Or sensed things that were not there?
ChatGPT indicates that the Diagnostic and Statistical Manual of Mental Disorders (DSM) is widely used by mental health professionals worldwide, not just in the United States. It also notes that 'the World Health Organization (WHO) publishes the International Classification of Diseases (ICD), which includes a section on mental and behavioral disorders. In some regions, the ICD may be used as the primary diagnostic reference instead of or alongside the DSM'. I had a look at the ICD and it appears to use the terms 'abuse' and 'dependence' as used in older versions of the DSM. I found the ICD difficult to use: hundreds of results when I use the search term "alcohol" and I could't readily find definitions.
Would anyone like to comment on definitions and the extent to which there is international consensus?
Also, WHO estimates that there are 280 million people globally with Alcohol Use Disorders. It would be interesting to know how this estimate was reached.
Best wishes, Neil
HIFA profile: Neil Pakenham-Walsh is coordinator of HIFA (Healthcare Information For All), a global health community that brings all stakeholders together around the shared goal of universal access to reliable healthcare information. HIFA has 20,000 members in 180 countries, interacting in four languages and representing all parts of the global evidence ecosystem. HIFA is administered by Global Healthcare Information Network, a UK-based nonprofit in official relations with the World Health Organization. Email: neil@hifa.org
