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Categories Insights Tags Alcohol Use Disorder (AUD), Behavioral Health, CEO Insights, Mental Health, National Institute on Alcohol Abuse and Alcoholism (NIAAA), National Institute on Drug Abuse (NIDA), National Institutes of Health (NIH), Thought Leadership

Alcohol Use Disorder: Hope for Recovery

Alcohol Use Disorder: Hope for Recovery

Written by: Anton Bizzell, MD

Alcohol use disorder (AUD) is often referred to as the hidden substance use disorder (SUD). With alcohol use legal and socially acceptable in many settings, the symptoms of AUD may initially go unnoticed. Yet individuals with AUD may experience significant difficulties in their relationships, work, and health.

In a newly released analysis, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) at the National Institutes of Health (NIH) found that over 70 percent of the adult population drank alcohol in 2017. Alcohol-related deaths more than doubled from 1999 to 2017. Overdoses of alcohol alone or in combination with other drugs accounted for 18 percent of the deaths in 2017; 31 percent of the deaths resulted from alcohol-related liver disease. Researchers note that the since this study examined only death certificate data, the actual number of lives lost may be significantly higher.

The death rates increased higher for women than for men, and gender differences persist in risks for alcohol-related cardiovascular disease, liver disease, and cancer. In addition, while prevalence of alcohol use and binge drinking remained stable for men, the prevalence of alcohol use increased by over 10 percent for women and binge drinking increased by over 23 percent among women.

The NIAAA screening tool for AUD includes questions a provider can use to diagnose whether an individual may have an AUD. Individuals who are struggling with their drinking, or families and friends concerned about their loved ones, can start by considering the following questions.

In the past year, have you:

  •  Tried to cut down or stop drinking more than once, but couldn’t?
  •  Found that drinking or being sick from drinking got in the way of you taking care of your home or your family, or caused problems at work or school?
  •  More than once gotten into situations while drinking that could be dangerous, such as driving, having unsafe sex, using machinery, walking in an unsafe neighborhood; or had a memory blackout?
  •  Kept drinking even though it was making you depressed or anxious, or adding to other health problems?
  •  Found that when the effects of alcohol were wearing off, you had withdrawal symptoms, such as trouble sleeping, shakiness, irritability, anxiety, depression, restlessness, nausea, or sweating?

In addition to peer-led support models such as Alcoholics Anonymous, there are many options for professionally-led treatment. Treatment for AUD often involves a combination of talk therapy and medication. Therapy can be for individuals, groups, or families, under the direction of a licensed counselor trained in substance use disorders. Medication to help individuals stop drinking and avoid relapse can be administered under the care of a licensed primary care provider or a board-certified addiction medicine physician. In addition, different levels of care and care settings are available to meet the needs of each situation, including outpatient, partial hospitalization, residential, or intensive inpatient.

Although the consequences of AUD can be devastating, hope for recovery is possible with evidence-based, timely intervention.

Reference: White, A. M., Castle, I. J. P., Hingson, R. W., & Powell, P. A. (2020). Using Death Certificates to Explore Changes in Alcohol‐Related Mortality in the United States, 1999 to 2017. Alcoholism: Clinical and Experimental Research.

The Bizzell Group (Bizzell) was founded by CEO Anton Bizzell, M.D., a substance use disorders expert and former Medical Officer at NIAAA. Our recent work includes systematic, integrated approaches designed to effect lasting change in the field of substance use disorders through projects with the National Institute on Drug Abuse (NIDA), the National Cancer Institute (NCI), the Food and Drug Administration (FDA), the Substance Abuse and Mental Health Services Administration (SAMHSA), and the United States Chamber of Commerce Foundation (USCCF). Learn more about how Bizzell advances data-driven, research-informed, innovative solutions to solve complex, real-world challenges. www.BizzellUS.com

Categories Insights Tags Alcohol, Health, National Institute on Drug Abuse (NIDA), National Institutes of Health (NIH), Thought Leadership

National Alcohol Screening Day

National Alcohol Screening Day (NASD) is an initiative first launched in 1999 by the National Institutes of Health (NIH).  NASD is held annually on the first Thursday of the first full week of April. The purpose of this event is to increase public awareness that alcohol abuse and alcoholism are recognized disorders which can be treated. During this day, members of the public are encouraged to visit screening centers and asked to complete written self-assessments about their alcohol use.

According to The Community Guide, there are 2,000 alcohol poisoning deaths in the U.S. each year and alcohol abuse is higher in college students, who do tend to frequently drink in large volumes.  Excessive, fast consumption of alcohol is known as ‘binge drinking’, and this kind of alcohol abuse can lead to many recognized health problems such as anxiety, depression or sexual problems.  The long-term effects of alcohol abuse include an increased risk of developing certain cancers, liver cirrhosis, high blood pressure and heart problems.
National Alcohol Screening Day awareness continues to grow nationally, and the U.S. government is supporting programs and policies to reduce binge drinking and expand access through the Affordable Care Act to new health insurance plans to cover alcohol screening and brief counseling. The National Institute on Drug Abuse (NIDA) has launched two online screening tools that providers can use to assess for substance use disorder (SUD) risk among adolescents 12-17 years old.

Two Screening Options: Providers can select the tool that makes sense for their clinical practice.

CAGE Questionnaire  

The CAGE can identify alcohol problems over the lifetime. Two positive responses are considered a positive test and indicate further assessment is warranted.

The questionnaire takes less than one minute to administer and is often used in the primary care of other general settings as a quick screening tool rather than as an in-depth interview for those who have alcoholism.  The CAGE questionnaire does not have a specific intended population and is meant to find those who drink excessively and need treatment. The CAGE questionnaire is reliable and valid for assessment of alcohol abuse; however, it is not valid for diagnosis of other substance use disorders, although somewhat modified versions of the CAGE questionnaire have been frequently implemented for such a purpose.

AUDIT-C Overview 

The Alcohol Use Disorders Identification Test (AUDIT) can detect alcohol problems experienced in the last year. A score of 8+ on the AUDIT generally indicates harmful or hazardous drinking. Questions 1–8 = 0, 1, 2, 3, or 4 points. Questions 9 and 10 are scored 0, 2, or 4 only. The Audit-C is a 3-item alcohol screen that can help identify persons who are hazardous drinkers or have active alcohol use disorders (including alcohol abuse or dependence). The AUDIT-C is a modified version of the question AUDIT instrument.

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