Alcohol misuse

What it is

Alcohol use disorder is read off the pattern of drinking, and a focused history is what sets that pattern out. It starts with the amount and type or types of alcohol taken, and with the onset, progress and duration of alcohol drinking. It then asks for the marks that make the drinking a disorder: drinking larger quantities than intended; attempts to decrease or stop drinking; a significant amount of time spent to drink alcohol or to recover from its effects; craving for alcohol; using alcohol in hazardous situations such as driving; and tolerance, which is the need to increase the amount consumed of alcohol to maintain the same effect. Withdrawal symptoms sit on the same list and are asked about in their own right. The same list is written elsewhere as a use disorder common to all substances: 2 or more of 11 symptoms in 12 months, grouped as 1) impaired control, symptoms 1 to 4; 2) social impairment, 5 to 7; 3) risky use, 8 to 9; 4) pharmacologic, 10 to 11, that is tolerance and withdrawal. Severity is mild at 2 to 3 symptoms, moderate at 4 to 5, and severe at 6 or more.