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Medical Criteria for Alcoholism

Learn about the medical criteria for alcoholism in this Howcast video featuring addictions specialist Paul J. Rinaldi, Ph.D.


In the addiction field we're often asked what the medical criteria is for alcohol problems. Most people want to know if there's medical criteria for alcoholism. We don't use the term alcoholism any longer, we use the term alcohol use disorder. In terms of medical criteria, there's psychological and medical consequences of alcohol problems.

The medical criteria isn't the only criteria that defines an alcohol use disorder. But there are medical issues that go along with the diagnosis of an alcohol use disorder. And some of those are around the issues of tolerance and withdrawal. Tolerance is defined as the body needing more and more alcohol to get the desired effect. When people have real problems with alcohol, the desired effect is generally being inebriated. Whereas someone who doesn't have problems, the desired effect may just be a little bit of relaxation. You have a glass of wine or a cocktail. You're relaxed. You feel a little bit better, not that you felt bad to begin with. But it often is in a context, a social context, not sitting alone at home and drinking.

When people have alcohol use disorder, the desired effect is most often inebriation. And tolerance what that means is that to get that desired effect, whereas you may start off needing two cocktails, over time you may need five cocktails or six cocktails. And that's a medical consequence because it's actually the body needing more and more alcohol, building up a tolerance. Your liver builds a tolerance, and your kidneys build a tolerance.

And then the other medical effect is around when you don't drink which is medical withdrawal. And alcohol withdrawal can affect medically in different ways. The most serious consequence can be seizures, and seizures can be life threatening for people. So it's extremely dangerous besides the fact when people have seizures they're unpredictable. People can have seizures while driving even though they're not drunk. It may be they drank the day before, and then they, the next day, because their body is telling them they need alcohol, they may then have a seizure which, again, can be in the context of doing something dangerous, driving, walking on the street, and falling and hitting your head, and then creating another medical problem.

Another severe medical consequence of prolonged alcohol can be an effect on the brain where sometimes people refer to it as a wet brain. People can have what's called DTs or Delerium Tremens. That can be very serious where people actually have symptoms of psychosis. They hallucinate. They see bugs drawling on themselves. That's a very severe form of alcohol problems, the most severe form. And sometimes people, their brains, don't recover from that. The good news is that medically most people, unless they've done very severe damage to their brain, their liver, or their kidneys, their bodies will recover when alcohol is stopped and with proper treatment.

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