Alcohol use disorder (AUD) is the most common form of substance use disorder, affecting 29% of US adults.1,3 Unhealthy alcohol use can contribute to the development or worsening of several different medical conditions like high blood pressure, pancreatitis, and cancer.1 Unhealthy alcohol use covers a range of use from risky alcohol drinking to AUD. Defining a person’s alcohol use is determined by many factors, such as quantity of drinks, patterns of use, and behaviors.
Alcohol misuse includes binge drinking, which is consuming 4-5 drinks within the span of two hours, and heavy alcohol use, which is consuming 4-5 drinks a day. Alcohol misuse in any form can increase the risk of someone developing AUD, a medical condition characterized by an impaired ability to control one’s alcohol use.
According to a 2024 study, almost 30 million people 12 and older were diagnosed with AUD in America in 2023.2 This statistic is not only alarming, but showcases the severity of this condition and the reach it has across age groups. Unhealthy alcohol use in any form is the third most common cause of preventable death in the US, leading to an estimated 1 in every 10 deaths of working-aged adults.1
RISKS BY AGE GROUP
Alcohol patterns and effects differ between age groups. Typically, younger age groups will take part in heavier binge drinking, while older age groups may begin to mature out of heavy use.
According to a 2022 study, nearly 7% of adolescents aged 12-17 reported drinking within the last month, and half of this percentage reported binge drinking. During this time, the brain is continuing to develop, and disruptions to this growth can be critical and increase the likelihood of AUD and developing anxiety and depression later in life.4
In the same study, researchers found that emerging young adults between 18 years old and their late 20s showed a heightened risk of developing AUD. This same group reported 50% drinking within the last month, and 60% said they were binge drinking. Young adults are the age group with the highest reported cases of AUD, with about 1 in 6 receiving the diagnosis it yearly.4
The late 20s to mid-life adulthood age is where many people reduce their consumption, a process called “maturing out,” usually due to major life changes including marriage, parenthood, and long-term employment. However, some people in this group may continue patterns from when they are younger or start heavy drinking. During this time of life is when people begin to seek treatment for AUD, often between their 30s-50s.4
AUD is less common in older adults (65+), but in recent years, researchers have seen an increase in diagnoses. About 1 in 10 older adults engage in heavy drinking, and 1 in 25 have had or have AUD. It is important to remember that age-specific physiological changes can intensify alcohol’s effects and increase the risk of health problems. This age group is the most likely to be on other medications that may interact with alcohol differently.4
It is important to remember that AUD is a disease and, while there are patterns researchers notice throughout one’s life, the condition may affect each person in a different way.
CHALLENGE STIGMA
AUD is among the most highly stigmatized medical conditions in the Western hemisphere,5 and many individuals with AUD are viewed as being “more responsible” for their condition. Many people living with AUD will experience more social rejection and negative emotions compared to some other substance use disorders.6 This social judgment and discrimination can lead to feelings of shame, fear, and isolation. For many individuals living with AUD, stigmatization discourages them from seeking treatment and support, keeping them in a cycle of addiction.
Additionally, many people will face internalized stigma, which can undermine self-esteem and self-efficacy, making it harder to recognize their need for treatment. Clinicians may also become influenced by societal biases, which can affect the quality of care a person living with AUD could receive or be offered.7
There are many approaches we can adopt as a society to further support friends, family, and patients living with AUD. Using person-centered language emphasizes the individuality and worth of people by focusing on the individual versus a generalization of one group. Instead of using language like alcoholic, abuse, or relapse, try using phrases like person with AUD, use/misuse, and recurrence/return to use.7
Many patients may face stigma because they are not ready to stop using entirely. By redefining recovery away from “completely stopping use,” we encourage people to make small reductions to their alcohol use, which can still improve the odds of not experiencing risks.7
Normalizing the conversation around AUD will help make people more comfortable with disclosing information about their alcohol use. People may be more likely to seek help from a primary care provider for a medical condition related to their alcohol use rather than fully addressing an AUD. Acknowledging AUD as a chronic disease like Type 1 Diabetes or hypertension can increase comfort in discussing treatment options.8
TREATMENT + RECOVERY
Recovery looks different for each person. Some people can experience recovery by completely cutting out alcohol from their life, while others experience recovery characterized by improvement in function and risk reduction without indefinite abstinence.
There are many treatment options to support patients with AUD during their recovery journey. Some of those include counseling, Cognitive Behavioral Therapy, 12 Step Facilitation, and treatment with medication (Acamprosate, Naltrexone, or Disulfiram).
People with AUD in recovery are at risk of experiencing withdrawal symptoms which can range from nausea and vomiting to hypertension and seizures. There are several guides available to help clinicians and patients manage withdrawal symptoms,9 and OPEN offers Clinician-to-Clinician Consult Services where clinicians can meet with clinicians and get support with managing AUD and other substance use disorders.
CONCLUSION
Alcohol Use Disorder is a chronic disease that affects millions of people across the world, and it is treatable. Before engaging in alcohol use, it is important to know and understand the potential risks involved.
Together, we can decrease the stigma against AUD and help people living with AUD.
To learn more about Alcohol Use Disorder, explore our full educational guide here.
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