The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, also known as the DSM-5, includes a disorder termed alcohol use disorder and provides diagnostic criteria for it.1,2 The DSM-IV contained two separate disorders termed alcohol dependence and alcohol abuse, but the DSM-5 combined them.2 In the DSM-5, a person’s alcohol use disorder can be mild, moderate, or severe, with severity depending on how many symptoms are present.1,2
It was estimated that nationally in 2018 over 14,800,000 individuals 12 years old or older had an alcohol use disorder in the last year.3 Based on 2016-2017 surveys, it was estimated that in Texas on average each year over a million individuals 12 years old or older had an alcohol use disorder in the last year.4
Alcohol Use Statistics
- Over 139,800,000 individuals 12 years old or older used alcohol in the last month, including over 7,100,000 individuals in the 12 through 20 age group.
- Over 67,000,000 individuals 12 years old or older had “binge alcohol use” (for male individuals, this was drinking at least 5 drinks during one occasion during, at minimum, 1 out of the last 30 days, and the only difference for female individuals was that it was at least 4 drinks rather than at least 5) in the last month, including over 4,300,000 individuals in the 12 through 20 age group.
- Over 16,500,000 individuals 12 years old or older had “heavy alcohol use” (this was binge alcohol use on at minimum 5 days out of the last 30) in the last month, including over 800,000 individuals in the 12 through 20 age group.
Based on 2016-2017 surveys, it was estimated that in Texas on average each year:4
- Over 10,600,000 persons in the 12 and up age group used alcohol in the last month, including over 600,000 persons 12 to 20 years old.
- Over 5,300,000 persons in the 12 and up age group had “binge alcohol use” in the last month, including over 300,000 persons 12 to 20 years old.
A survey of Texas college students in 2017 found that, of the persons whose responses were used in the study:5
- Use of alcohol during the last month was reported by over 57%.
- Use of alcohol during the last year was reported by over 72%.
- Use of alcohol in their lives was reported by over 78%.
- Having at least 5 drinks during one sitting at minimum one time during the 30 days before the survey was reported by around 37% of men, and drinking this amount at minimum 6 times during the last 30 days was reported by around 7% of men.
- Having at least 4 drinks during one sitting during the last 30 days was reported by 34% of women, and drinking this amount at minimum 6 times during the last 30 days was reported by around 4% of women.
Based on 2016-2017 surveys, it was estimated that on average each year over a million persons in the 12 and up age group in Texas needed alcohol use treatment in the last year yet did not get it.4
There were 16,165 admissions of Texas residents to treatment that took place in 2018 where alcohol was the primary substance, and among these:6
- Nearly two-thirds were admissions of male individuals.
- Over half were admissions of individuals in the 26 through 44 age group.
- Over half were admissions of non-Hispanic white individuals, followed by Hispanic/Latino individuals at over 29%.
Alcohol Use Disorder Treatment
If an individual abruptly quits drinking after drinking a lot for a while, the individual could go into withdrawal.7 Alcohol withdrawal may be deadly.8 Medicines can be prescribed to increase the safety of this process as well as decrease how distressing it is.7
For individuals who detox, relapse is much more probable if they do not get further treatment.7 To treat alcohol use disorder, a person might receive medicine and/or behavioral treatments (which also could be called “talk therapy” or counseling).7,9
Acamprosate, naltrexone, or disulfiram might assist an individual who has alcohol use disorder to decrease or quit alcohol consumption and not resume use.7
Behavioral therapies that might effectively address an individual’s alcohol abuse include:10
- Contingency management (CM) interventions: This might encourage an individual to not use alcohol and improve treatment retention. Positive behaviors are encouraged through rewards. An individual might receive vouchers or entries to win prizes.
- Cognitive-behavioral therapy (CBT): This may teach a person to identify as well as rectify behaviors that are problematic. It may assist a person to develop plans for staying away from high-risk situations and coping with cravings.
- Motivational enhancement therapy (MET): This may assist a person to be better engaged in treatment as well as to decrease problem drinking. Assessment takes place first, then the next session includes: giving feedback (through which the therapist spurs conversation regarding the person’s use of substances as well as evokes self-motivational statements); to create a change plan as well as bolster motivation, utilizing motivational interviewing principles; and proposing coping strategies for circumstances that are high-risk as well as talking about them with the person. Monitoring change, reviewing quitting strategies the person is utilizing, and continuing promoting dedication to change or staying substance-free take place in following sessions.
- Community reinforcement approach plus vouchers: A person with alcohol as well as cocaine addictions might take part in this outpatient therapy, which lasts for 24 weeks. It includes individual counseling at least once per week, disulfiram for persons who abuse alcohol, urine testing, and vouchers if urine tests negative for cocaine. One objective is to stay abstinent for sufficient time for new skills to be learned by persons to assist perpetuation of it.
- 12-step facilitation therapy: This is meant to raise a substance-abusing person’s probability of becoming affiliated with 12-step groups as well as actively involved in them, thus encouraging abstinence. Key concepts include acceptance as well as surrender.
Addiction in general is able to be treated and successfully managed.10
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author.
- National Institute on Alcohol Abuse and Alcoholism. (2016). Alcohol use disorder: A comparison between DSM–IV and DSM–5.
- Substance Abuse and Mental Health Services Administration. (2019). Results from the 2018 National Survey on Drug Use and Health: Detailed tables.
- (2019). 2016-2017 NSDUH state-specific tables.
- Marchbanks, M. P., Krinhop, K., Williams, A., Johnson, C. T., Kim, Y., Davis, N. T. & Brattin, Z. E. (2017). 2017 Texas survey of substance use among college students.
- Maxwell, J. C. State of Texas: Drug use patterns and trends, 2019.
- National Institute on Alcohol Abuse and Alcoholism. Frequently asked questions: Searching for alcohol treatment.
- Center for Substance Abuse Treatment. (2015). Detoxification and substance abuse treatment: A treatment improvement protocol TIP 45.
- National Institute on Alcohol Abuse and Alcoholism. What types of alcohol treatment are available?.
- National Institute on Drug Abuse. (2018). Principles of drug addiction treatment: A research-based guide (third edition).