Alcohol Use Disorder (AUD): When Drinking Becomes A Headache

Alcohol use is a serious health problem worldwide, leading to many physical, mental, and behavioral health problems. Besides physical health, it also leads to a significant number of mortality every year. As per the WHO, worldwide, harmful use of alcohol results in 3 million deaths every year which is about 5.3 % of all the deaths. Alcohol abuse or alcoholism is often referred to as AUD by the general population. As per the NIAAA, Alcohol Use Disorder (AUD) is “a chronic relapsing brain disorder characterized by an impaired ability to stop or control use despite adverse social, occupational, or health hazards.” AUD affects a person’s overall behavior and thinking process. 

According to Delveinsight, the total prevalent population of Alcohol Use Disorder (AUD) in the 7MM (the United States, the UK, Spain, Germany, Italy, France, and Japan) was found to be 25,774,817 in 2017. According to the 2019 National Survey on Drug Use and Health (NSDUH), in the United States, 14.1 million adults ages 18 and older (i.e. 5.6 percent of this age group) had AUD which includes 8.9 million men (7.3 percent of men in this age group) and 5.2 million women (4.0 percent of women in this age group). Similarly, in the age group of 12 to 17 years, an estimated 414,000 adolescents had AUD.

Among the EU5 countries, Germany had the highest prevalent population of Alcohol Use Disorder (AUD) with 2,105,809 cases, followed by France, which had the prevalence of 1,749,920 cases in 2017. On the other hand, Spain had the lowest prevalent population of 274,084 cases.

What are the risk factors for Alcohol Use Disorder (AUD)?

The exact causes of AUD are unknown; however, some external and internal factors are supposed to increase the risk of AUD. Environmental and social factors such as economic status, religion, culture in society, and family status are the common factors that influence initial alcohol use. Similarly, at the individual level, factors including age, education, personality, genetics, preference (personal choice), gender, psychological behavior also contribute to alcohol consumption. 

What are the signs and symptoms of Alcohol Use Disorder (AUD)? And How is it diagnosed?

Depending upon the number of symptoms the person experiences, the AUD can be divided into three categories, namely mild AUD, moderate AUD, and severe AUD. AUD is identified on the basis of the American Psychological Association’s criteria, commonly called as Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The severity criteria for AUD is assessed upon factors such as –

• Experiencing strong and uncontrollable cravings to drink.
• Getting sick from drinking and it is causing trouble in occupation, at home, and at school or at other places.
• Ended up drinking more or longer than intended.
• Devoted a lot of time to drink and to get over its aftereffects.
• Tried more than once to cut down or stopped drinking but couldn’t.
• Continuous drinking, even it is affecting relationships with friends and family.
• Lack of interest in activities that once were important and interested the person.
• Experiencing withdrawal symptoms such as anxiety, depression, restlessness, nausea, sweating, sleeping, shakiness, or irritability when staying away from alcohol.
• Getting into situations while or after drinking that have increased the chances of getting hurt.
• Continuous drinking even though it makes him depressed or anxious.
• Had to drink more than the usual number to get that desired effect in the body.

What are the major health complications that arise due to Alcohol Use Disorder?

Alcohol consumption leads to many chronic and acute health complications. As per the WHO, alcohol’s harmful use leads to more than 200 disease and injury conditions. Around 5.1 % of the global burden of disease and injury is attributable to alcohol, as measured in disability-adjusted life years (DALYs). Some of the leading health complications that arise due to heavy drinking include liver disease, Immune system dysfunction, pancreatitis, ulcer, gastrointestinal disease, cardiovascular disease, damage to the brain, and many others. The change in physical characteristics such as judgment, memory, weakness, mood, numbness, and dehydration are also quite evident. 

What is the treatment option for Alcohol Use Disorder (AUD)?

Even for the person with mild symptoms, the AUD can be dangerous; thus, treatment plays an important role. The first thing for proper treatment involves recognizing the need for help to overcome the issue. Different people may respond differently to a treatment. Initially, it is quite difficult for the person to stop alcohol abruptly. However, without a doubt, early intervention can help to produce favorable outcomes. The treatment pattern follows a systematic program, starting with detox or other options depending upon the person. Long-term alcohol consumption leads the body to chemical dependency; the sudden discontinuation leads to many physical discomforts; it may even lead to death. 

Different treatment options are available for AUD, including medications, mutual-support groups, behavioral therapies, and many others. The US FDA has approved medication-assisted treatment for AUD, including acamprosate calcium, disulfiram, oral naltrexone, and extended-release injectable naltrexone. Off-label antidepressants are also prescribed in AUD.

However, it is common for the patients receiving treatment for Alcohol Use Disorder (AUD) to undergo or experience “withdrawal symptoms” when he doesn’t take alcohol for days or weeks. The Withdrawal symptoms impact the brain and cause intense anxiety, hallucinations, depression, and restlessness. The physical symptoms such as occasional seizures, nausea, problems in sleeping, vomiting, rapid heartbeat, agitation, sweating are also quite common. 

For this, Behavioral treatments that consist of group counseling sessions, motivational enhancement therapy, cognitive–behavioral therapy, and marital & family counseling may help.  Apart from the above-marketed therapies, some of the key companies such as Adial Pharmaceuticals, Opiant Pharmaceuticals, Neurelis, Tonix Pharmaceuticals, and Mapreg are diligently working towards developing new therapies for Alcohol Use Disorder (AUD). 

Many emerging therapies are in different developmental and early phases of a clinical trial for AUD. In the coming years, the launch of emerging therapies and the rise in the number of healthcare spending across the world is expected to improve the quality of life for people with AUD and their families. Regular monitoring of patients’ alcohol consumption by family members and caregivers, raising awareness about alcohol use, providing professional help to mild AUDs patients, avoiding delay in treatment to patients with severe AUD can significantly improve the health of society.  Similarly, taking steps at a personal level such as a change in the lifestyle and habits, expressing concerns with family members and friends, seeking professional help at early stages, recognizing and avoiding the pressure to drink can reduce alcohol use.