The latest National Survey on Drug Use and Health (NSDUH) shows that over 14 million Americans over the age of 12 have an alcohol use disorder (AUD). No two AUDs are the same, however. Various risk factors, frequency of misuse, symptoms, and consequences help define a drinking problem, which can be mild, moderate, or severe.1
Where someone falls on the spectrum of alcohol misuse or addiction helps create the diagnosis and treatment plan for overcoming a drinking problem.
What Are the Stages of a Drinking Problem?
Alcohol use disorders or severe drinking problems do not happen overnight. For some, they occur over many years of increasingly negative drinking patterns. Below are typical stages through which someone may progress.
In the experimental stage, people consume alcohol on an occasional basis, usually at parties or when celebrating with friends or family. Some people enjoy a drink of alcohol with a meal, like a glass of wine or cocktail. They can limit their alcohol consumption to one or two drinks.
Experimental drinking may lead to bingeing on alcohol. While misusing alcohol occurs in this stage, it does not initially equate to a drinking problem. Diagnostically, binge drinking for men means consuming five or more alcoholic drinks in two hours or less, and for women, four drinks in less than two hours.2
Binge drinking is highest among young adults, but people of all ages engage in it and experience negative consequences. Among teenagers, 44% admit to drinking eight or more alcoholic drinks in a row. One in four adults reports bingeing on eight or more drinks. Men tend to binge drink more often than women.2
Someone who frequently drinks likely makes an emotional connection with alcohol—for example, going to happy hour after work to relieve stress from the workday. They consume a few drinks before going to a party to ease anxiety. They find that drinking alcohol helps them escape their grief, loneliness, and other negative emotions.
Frequent drinking leads to developing a higher tolerance for alcohol. Tolerance refers to the amount of alcohol it takes for someone to achieve a desired effect. It may take someone two beers to feel a buzz when they first start drinking, but over time, they may need five or six to feel a buzz. Frequent drinking is a sign that someone is developing a drinking problem.
Problem drinking is not the same as having a drinking problem, although there is a direct link between the two. Problem drinking describes a person whose drinking behaviors create negative consequences that interfere with personal, professional, academic, and social responsibilities.
At this stage, drinking alcohol occurs weekly and possibly daily and leads to one or more of the following:3
- Driving under the influence (DUI), arrests, accidents, deaths, etc.
- Physical health problems including liver disease, blood pressure fluctuations, alcohol poisoning, injuries, hangovers, etc.
- Psychological symptoms including anxiety, depression, suicidal ideations, mood swings, etc.
- Fetal alcohol syndrome in newborns
- Broken relationships with friends and family
- Financial struggles
- Loss of job, home, car, etc.
Despite experiencing problems like these, a person will continue to drink. People at this stage clearly have a drinking problem but may not be ready to admit it or stop.
Becoming dependent on alcohol means efforts to quit drinking are unsuccessful because they are psychologically and physically dependent. When trying to stop, they experience withdrawal symptoms that can be overwhelming and painful, including the following:4
- Flu-like symptoms such as chills, fever, sweats, etc.
- Muscle spasms
- Digestive problems
- Tremors or shaking
- Extreme mood swings
- Sleep disorders
- Obsessive thoughts about drinking
Dependent drinking often leads to addiction.
Someone at this stage has a drinking problem that is controlling their life. They do not enjoy drinking alcohol but must continue to avoid seizures, delirium tremens, and other dangerous effects of quitting cold turkey.
The Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association, says the following 11 criteria help diagnose AUD:5
- Drinking more than intended or for longer periods of time than intended
- Trying to control alcohol misuse without success
- Spending a lot of time on getting, misusing, and recovering from drinking
- Craving alcohol
- Continuing to misuse alcohol even though it interferes with personal, professional, academic, and social duties
- Avoiding activities that were once enjoyed
- Drinking alcohol despite broken relationships with family, friends, coworkers, etc.
- Misusing alcohol in dangerous places
- Continuing to misuse alcohol even though it will knowingly increase physical or mental problems
- Building a tolerance
- Experiencing withdrawal symptoms when trying to quit drinking alcohol
To determine the severity of a person’s AUD, professionals use the following guidelines:5
- 2-3 symptoms are mild
- 4-5 symptoms are moderate
- 6+ symptoms are severe
Drinking Problem Assessment
Other than the symptoms set by the DSM5, a person may show more behaviors signaling they have a drinking problem. Answering yes to any of the self-assessment questions below suggests that someone may have a drinking problem and should seek an evaluation from a substance abuse treatment professional at a drug rehab.6
- Are they neglecting personal hygiene?
- Do they lie or manipulate others?
- Do they steal or engage in criminal activities?
- Do they get defensive when asked about their alcohol misuse?
- Are their coordination and speech impaired much of the time?
- Do they participate in risky behaviors to acquire or consume alcohol?
- Have they changed friend groups to include more people who misuse alcohol?
Some people with a drinking problem may also struggle with drug addiction. Co-occurring disorders are common, like alcohol and opioid addiction. It is crucial to seek treatment for alcohol and opiate detox and recovery simultaneously.
Treatment for a Drinking Problem
If someone has a drinking problem or wants to prevent it, they can contact a local addiction treatment recovery center, like Virtue Recovery Center (VRC).
VRC offers assessments to determine if someone has a drinking problem and, if so, creates a treatment plan unique to their needs. Treatment plans integrate multiple therapies and may include the following:7
- Medication to ease alcohol detox withdrawal symptoms
- Medication-assisted treatments to help maintain sobriety
- Individual and group behavioral therapies
- Individual and group alternative therapies
- Family therapies
- Aftercare planning
Drug & Alcohol Addiction Rehab Center Locations
- Chandler, Arizona: 111 S Hearthstone Way, Chandler, AZ 85226, United States
- Sun City West, Arizona: 13951 W Meeker Blvd, Sun City West, AZ 85375, United States
- Las Vegas, Nevada: 8225 W Robindale Rd, Las Vegas, NV 89113
- Astoria, Oregon: 263 W Exchange St, Astoria, OR 97103, United States
- Houston, Texas: 9714 S Gessner Rd, Houston, TX 77071, United States
- Killeen, Texas: 5200 S W S Young Dr, Killeen, TX 76542, United States
Services are available through inpatient and outpatient alcohol rehab programs. Call them today to learn more about how they can help someone with a drinking problem.
- National Institute on Alcohol Abuse and Alcoholism. 2021. Understanding Alcohol Use Disorder.
- Center for Disease Control and Prevention. 2022. Binge Drinking.
- Aronson, M.D., M.D. 2022. UptoDate: Patient Education: Alcohol Use- When is Drinking a Problem? Beyond the Basics.
- Newman RK, Stobart Gallagher MA, Gomez AE. 2022. Alcohol Withdrawal.
- National Institute on Alcohol Abuse and Alcoholism. 2021. Alcohol Use Disorder: A Comparison Between DSM-IV and DSM-V.
- Narconon International. 2023. The 5 Most Common Behavior Traits of an Addict.
- National Library of Medicine. 2017. MedlinePlus: Alcohol Use Disorder (AUD) Treatment.
- About the Author
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Nicki Lugo is currently employed as Clinical Director at Virtue Recovery Center in Las Vegas. Nicki is a licensed clinical professional counselor (CPC) in the state of Nevada and a licensed associate counselor (LAC) in the state of Arizona. She is also a licensed clinical alcohol and drug counselor (LCADC) in Nevada. Additionally, Nicki has specialized training in treating trauma and is a certified clinical trauma specialist (CCTS).
Nicki has earned a Master of Science degree in Psychology with an emphasis in Behavioral Health from the University of Phoenix and a Master of Science in Professional Counseling from Grand Canyon University. Currently, Nicki is pursuing a Doctor of Philosophy (PhD) in Counseling Education and Supervision at Grand Canyon University. Nicki’s research interests include the use of Positive Psychology interventions with dual diagnosis clients. Nicki hopes to contribute to the body of knowledge in treating substance use disorders.
Nicki’s long-term career goals include advancing in leadership roles within Virtue Recovery Center which is a quickly growing substance use disorder treatment facility. She hopes that one day her research and advocacy will help to save the lives of those who have been affected by substance use. She likes to say that advocacy is her passion and leadership is her superpower.