The DEFINITION of ALCOHOL USE DISORDER (AUD)

What was once called alcoholism, alcohol abuse, or alcohol addiction is now classified as either Alcohol Use Disorder (AUD), focusing only on alcohol use, or Substance Use Disorder (SUD), focusing on drug and alcohol use. The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) lists the diagnostic features of all recognized mental disorders, including AUD and SUD.

AUD is a chronic relapsing brain disease characterized by compulsive alcohol use, loss of control over alcohol intake, an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences, and a negative emotional state when not using. An estimated 15 million people in the United States have AUD. 

Ref: NIAA-NIH Understanding Alcohol Use Disorder

ALCOHOL USE IN THE UNITED STATES

  • People Ages 12 and Older: According to the 2019 NSDUH, 14.5 million (nearly 15 million) people ages 12 and older (5.3 percent of this age group) had AUD. This number includes 9.0 million men (6.8 percent of men in this age group) and 5.5 million women (3.9 percent of women in this age group)
  • Youth Ages 12 to 17: According to the 2019 NSDUH, an estimated 414,000 adolescents ages 12 to 17 (1.7 percent of this age group) had AUD. This number includes 163,000 males (1.3 percent of males in this age group) and 251,000 females (2.1 percent of females in this age group).

TREATMENT OF AUD IN THE UNITED STATES

  • According to the 2019 NSDUH, about 7.2 percent of people ages 12 and older who had AUD in the past year received any treatment in the past year. This includes about 6.9 percent of males and 7.8 percent of females with past-year AUD in this age group.9 According to the 2019 NSDUH, about 6.4 percent of adolescents ages 12 to 17 who had AUD in the past year received any treatment in the past year. This includes about 6.4 percent of males and 6.4 percent of females with past-year AUD in this age group.
  • According to the 2019 NSDUH, about 7.3 percent of adults ages 18 and older who had AUD in the past year received any treatment in the past year. This includes about 6.9 percent of males and 7.9 percent of females with past-year AUD in this age group.9
  • Less than 4 percent of people with AUD were prescribed a medication approved by the U.S. Food and Drug Administration (FDA) to treat their disorder.10
  • People with AUD were more likely to seek care from a primary care physician for an alcohol-related medical problem, rather than specifically for drinking too much alcohol.

Ref: NIAAA-NIH Alcohol Facts and Statistics

Information last updated 9/2021.

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List of Online Support to Help You Stay Sober

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With the closing of all Face-to-Face meetings and Stay-at-Home orders it has been particularly difficult to stay connected to the recovery network. Many of us miss the personal connections, the many hugs and seeing our fellow travelers. But luckily today’s technology has allowed us to connect online. There is a plethora of meetings, groups and apps to help you stay sober during this difficult time.

Here is an awesome list from the NY Times article: Online Help to Stay Sober During a Pandemic

For Those Looking for Recovery Support

AA-Alcoholics Anonymous The worldwide 12-step abstinence program has extensive online resources.

CA-Cocaine Anonymous Online International group offering online support through email and voice-only conference calls.

NA-Narcotics Anonymous Meetings worldwide for people struggling with drugs. Directory of online meetings, using Zoom, Skype and other platforms.

In the Rooms Clearinghouse of 30 online meetings offering supports with a variety of approaches to different substance use disorders.

LifeRing Organization focusing on practical, secular support, with online meetings.

Moderation Management For people seeking to moderate their drinking and not necessarily abstain, this growing group has an international network of online meetings.

Recovery Dharma This organization uses Buddhist practices and principles to support individuals in recovery. Directory of daily online meditations and meetings.

Substance Abuse and Mental Health Services Administration Federal hotline offering referrals to local treatment and support services.

SMART Recovery Abstinence-based international organization that uses a cognitive behavioral therapy tool kit. Has a directory of online meetings.

Women for Sobriety Dedicated to helping women recover from substance use disorders, with online gatherings.

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Free Support Apps

There are many free apps available. Here are just a few:

Connections Evidence-based, multipurpose app to help track sobriety and connect with supportive peers and Addiction Policy Forum counselors.

I Am Sober Popular, well-regarded app for planning and maintaining recovery.

Sober Grid Large online sober-support community and peer counseling.

For Those Who Support People in Recovery

Nar-Anon Global support network for those affected by someone else’s addiction. Live chat and forum available.

Al-Anon Using a 12-step focus, this organization offers online and phone meetings for those whose friends and relatives struggle with alcohol use disorder, among other substances.


Families Anonymous
 Offers online 12-step meetings for family and friends with a loved one struggling with drugs, alcohol and related behavioral problems.

SMART Recovery Friends and Family This secular, cognitive behavioral-based program offers online meetings for families and friends of someone recovering from substance abuse.

Written For NY Times: Jan Hoffman writes about behavioral health and health law. Her wide-ranging subjects include opioids, vaping, tribes and adolescents. @JanHoffmanNYT

A version of this article appears in print on , Section A, Page 3 of the New York edition with the headline: Here to Help; Online Resources for Help With Sobriety.




How To Support Someone After a Relapse

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The path toward recovery from any addiction is often not a straight line.

Unfortunately, addiction relapse is quite common. According to studies, nearly half of all people who try to get sober, return to heavy drinking or drug use, and even more experience a mild slip. There are several reasons for this high number. Short term treatment – 30 days isn’t enough. Studies show that the first 90 days in recovery hold the highest risk for relapse, while longer-term treatment shows the highest success rates.

A relapse is a productive tool that highlights the elements that must be added to the recovery plan to realize a more robust means of avoiding triggers, changing or removing connections with non-supportive people or developing a more firmly rooted sense of hope. -James F. Tenney, MS, Psy.D

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With that in mind, it is also very difficult to come back from a relapse. It’s hard to get past the shame and the feeling of failure. I have experienced many negative comments after my relapse. Some people just stopped talking to me as if I had the plague. I even sat at a meeting and after sharing another person shared, and said something like, if she keeps relapsing then she is not a good example of recovery to the newcomers.

To help people come back and stay we need to watch what we say to them in this very fragile time.

Things NOT to Say to Someone After a Relapse:

  • Oh, no! That’s horrible!
  • Does it get any better out there?!
  • Thanks for sharing your story so I can stay sober.
  • Relapse is not part of recovery.
  • I thought you were stronger than that.
  • Did you call someone before you drank?
  • You just need more willpower.
  • You have to start at day one.
  • You just have to try harder.
  • You can do anything you really want to do.
  • Again?

So when you are trying to help someone after a relapse, remember that your friend will be fighting the urge to use again, and this is a great burden to carry. Be sensitive to their situation and lend support instead of criticism. What you can say is that you still love them, you don’t think any less of them and you will be there to give support as they continue on the journey to recovery.

Things to Say to Someone After a Relapse:

  • I am so glad that you are back.
  • How can I help you?
  • I am happy to see you giving recovery another try.
  • Do not give up!
  • We are in this together.
  • We love you!
  • Don’t beat yourself up, it won’t help you.
  • Can I take you to a meeting?
  • Please call me.

The number-one thing to remember about helping someone after they relapse is to help them focus on  rediscovering their sense of self-worth!

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For many, just making the decision to seek treatment for drug addiction shows the strength of character and willingness. Staying sober for the first day, the first week, or the first month is huge. If your friend has done any of the above, he or she has something to be proud of—and reason to believe “I’ve beaten obstacles before and I can beat them again!”

Encourage your friend to remember those past victories and how good it felt to achieve them. If you were part of the process, reminisce together and let your friend know how proud you are of them. Paying attention to what was done right encourages more victories.

As far as possible, keep the relapse itself out of the conversation—except in the context of “How can we ensure it doesn’t happen again?” There’s a subtle but powerful difference between “What went wrong?” and “How can we keep the same thing from going wrong in the future?”—the first implies “I was [and probably will always be] a victim,” the second says, “I hold the real power.”

Whatever help they ask for (or don’t ask for), let them lead the conversation. Some people regain their footing quickly after a relapse. Others need weeks of encouragement—even professional treatment—to keep from returning to the full addiction lifestyle. But all need to be respected and treated as individuals. Build on what you know of your friend’s temperament, weaknesses, and strengths and offer unconditional support for where they are in their recovery.