Understanding The DSM-5 Criteria For Alcohol Use Disorder (AUD)

Given the widespread prevalence of problem drinking, heavy drinking, and binge drinking among young adults and the general public, healthcare providers must rely on a standardized manual for defining alcohol use disorder (AUD). 

AUD is a term that encompasses both alcohol abuse and alcohol dependence. It has also colloquially been known as alcoholism.

Today, the manual most commonly used to diagnose alcohol use disorder is the DSM-5.

The Diagnostic & Statistical Manual of Mental Disorders, Fifth Edition

The first step to dealing with any problem in a structured way is to define the problem as clearly as possible.

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) defines the problem by creating a taxonomy, or classification system, for mental health disorders. Conditions range from anxiety disorders and schizophrenia to substance use disorders and many more.

With the DSM-5, psychiatry and addiction medicine professionals across the United States can use the same terms, assign the proper ICD-10 medical codes, and administer the best recommended treatments for each case.

DSM-5 Alcohol Use Disorder Criteria

According to the DSM-5, alcohol use disorder is “a problematic pattern of alcohol use leading to clinically significant impairment or distress, as manifested by at least two of the following [criteria], occurring within a 12-month period.”

In other words, if you experienced any two of the symptoms from the following criteria/questionnaire in the past year, you can be diagnosed as having an AUD:

1. Alcohol is often taken in larger amounts or over a longer period than was intended. [Do you drink more than you mean to?]
2. There is a persistent desire or unsuccessful efforts to cut down or control alcohol use. [Do you want to stop, but can’t?]
3. A great deal of time is spent in activities necessary to obtain alcohol, use alcohol, or recover from its effects. [Is drinking taking over your life?]
4. Craving, or a strong desire or urge to use alcohol. [If you can’t drink, are you thinking about drinking?]
5. Recurrent alcohol use resulting in a failure to fulfill major role obligations at work, school, or home. [Is your drinking getting in the way of day-to-day activities?]
6. Continued alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol. [Is drinking getting in the way of your relationships?]
7. Important social, occupational, or recreational activities are given up or reduced because of alcohol use. [Are you sitting things out because of alcohol?]
8. Recurrent alcohol use in situations in which it is physically hazardous. [Are you drinking in risky settings, or doing risky things while drinking?]
9. Alcohol use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by alcohol. [Do you know drinking isn’t good for you, but you do it anyway?]
10. Tolerance, or needing increased amounts of alcohol to achieve intoxication, or having a diminished effect with continued use of the same amount of alcohol. [Do you need to drink more than you used to?]
11. Withdrawal, or the characteristic withdrawal syndrome for alcohol as well as drinking alcohol (or taking a benzodiazepine) to relieve or avoid alcohol withdrawal symptoms. [Do you feel withdrawal symptoms when you stop drinking?]

Mild, Moderate, & Severe AUDs

The DSM-5 further classifies AUDs by severity, determined by how many of the eleven diagnostic criteria are met. 

• mild AUDs – defined as the presence of 2-3 criteria
• moderate AUDs – defined as the presence of 4-5 criteria
• severe AUDs – defined as the presence of 6 or more criteria

These levels of severity are often used by clinicians when determining risk, eligibility for certain treatment programs, recommended treatment options, and even cost.

DSM History & Background

The American Psychiatric Association and the New York Academy of Medicine published the original “Diagnostic and Statistical Manual: Mental Disorders” in 1952 to establish a unified terminology for mental health diagnoses.

The DSM-II, an updated second edition, was published in 1962 and was followed by the DSM-III in 1980 and the DSM-IV in 1994.  Each was intended to improve clinicians’ and public health professionals’ ability to understand and properly manage an ever-increasing range of mental-health conditions.

The 5th edition, published in May 2013, is the first “living document” version of the DSM, meaning that it has received and will receive updates and revisions as needed. In March 2022, a revised version known as the DSM-5-TR was released.

Professional Substance Abuse Treatment

Chronic or compulsive alcohol consumption and drug use puts you and your loved ones at increased risk for health problems, legal problems, financial jeopardy, and more. Fortunately, treatment is available. 

Ark Behavioral Health hosts a variety of inpatient and outpatient treatment programs for substance use disorders, as well as other related conditions and comorbidities. To learn if Ark Behavioral Health is the right option for you, please contact a representative today.