Vulnerability and Criteria for Alcohol Use Disorder

Criteria for Alcohol Use Disorder

Alcohol is the most consumed drug in the United States today, with over 17.6 million—or 1-in-12 adults—currently suffering from alcohol abuse or dependence. As a result, Alcohol Use Disorder (AUD) is a common problem that affects people of every race and socioeconomic status, and managing treatment often involves factors that are unique to a particular community as well as the individual. 

Consumption of alcohol is extremely common, and a 2021 national survey on drug use and health across the United States indicates that more than 219 million people aged 12 and older report having at least one drink in their lifetime. However, some people can drink without serious consequences while others develop a potentially chronic problem quickly.

Understanding the criteria for Alcohol Use Disorder and what makes certain people or populations more vulnerable is critical to managing alcohol dependence, empowering individuals to take control of their lives, and fighting the cycle of addiction. 

AUD: A Disease or a Moral Failing?

In scientific terms, AUD is a medical diagnosis characterized by a person’s inability to stop drinking alcohol in spite of the detrimental impact it has on components of their life. Consumption often takes precedence over family, friends, and work despite an addict’s conscious mind wanting to make different choices. AUD exists across a spectrum from mild to severe, but fortunately, in most instances it’s responsive to modern evidence-based treatment modalities. 

AUD has been historically referred to as “alcoholism”, and the shift in language represents an attempt to destigmatize perceptions and inform about the nature and treatment of the disease. Because drinking alcohol is initially a choice, many people assume that overindulgence is simply a moral failing stemming from unaddressed personal issues or a lack of discipline. However, nothing could be further from the truth.

The underlying problem is actually one of brain chemistry and its interaction with addictive substances. When a person with AUD drinks, their brain quickly adapts itself to make seeking alcohol a critical imperative, capable of easily overriding their better judgment and conscious desires. If you’ve ever been extremely hungry and found your car wandering into a fast food drive thru when you know you would prefer to wait and eat the healthy food you have at home, you’ve experienced an extremely mild version of what happens with AUD.  Of course, there are mental health challenges associated with AUD that often need to be treated concurrently, such as depression, anxiety, or PTSD, and overcoming addiction often requires a multi-pronged approach. However, while there may have been opportunities to make some different choices, the science behind addiction is compelling, and delivers an actionable understanding of what AUD looks like and what puts people at risk.

How Do I Know If Someone Has AUD?

Much like other disease processes, AUD is accompanied by a variety of signs and symptoms that can range from mild to severe. Integrating the criteria for Alcohol Use Disorder into clinical practice will help identify those in need.

To determine if someone may be experiencing AUD, you can ask if they have:

  • Had times when they ended up drinking more, or longer, than they intended.
  • Wanted to cut down or stop drinking, or tried to and couldn’t.
  • Spent a lot of time drinking or dealing with the consequences.
  • Wanted a drink so badly they couldn’t think of anything else.
  • Found that drinking interfered with family or work relationships. 
  • Eliminated enjoyable activities because of drinking. 
  • Been injured or at risk for injury from drinking.
  • Continued to drink despite anxiety and mental health challenges surrounding drinking. 
  • Consumed far more drinks than everyone else on a regular basis. 
  • Experienced withdrawal symptoms such as trouble sleeping, shakiness, restlessness, nausea, sweating, a racing heart, dysphoria (feeling uneasy or unhappy), malaise (general sense of being unwell), feeling low, or a seizure? 

Vulnerable Populations

Like many other medical conditions, certain populations are more vulnerable than others. There are a variety of cultural, social, genetic, and individual traits that may indicate a greater susceptibility to AUD, and should be taken into account before consuming alcohol. With both modifiable and non-modifiable risk factors, knowing what populations are at greater risk improves the application of known criteria. 


Up to 60% of the vulnerability to AUD is thought to be inherited, so if a family member suffers from AUD a person is often vulnerable as well. Different genes create risk by affecting various biological processes and behavioral tendencies. Genetic studies of AUD summarized numerous genetic loci associated with AUD.


The intersection of genetic and environmental factors influences both drinking patterns and AUD risk. External stress is one of the most potent. People who have experienced trauma—especially in childhood—or an accumulation of significant stressors throughout life are often at greatly elevated risk. 

Mental Health

Genetic and environmental factors can also precipitate mental health conditions like anxiety and depression which can raise the risk of developing AUD. Conversely, AUD can also cause or exacerbate mental health issues as drinking patterns and consequences produce greater stress. 

Get To Know the Criteria for Alcohol Use Disorder

Knowing the criteria for Alcohol Use Disorder and who is most at risk is the first step in supporting the patient population and breaking the barriers of stigmatization. AUD is associated with serious medical complications, but can effectively be managed through evidence-based treatment modalities. 

Educational opportunities offered by Premiere such as Bottled Abyss - A Deep Dive into Alcohol Use Disorder Among Vulnerable Groups by Megan Arbour, PhD, RN, CNM, CNE, Associate Professor, Frontier Nursing University provide a detailed look into AUD criteria, risk factors, and treatment. Every course from Premiere’s award-winning online library of continuing education content is created by experts leading their field, and is ideal for keeping you current, compliant, and informed on a timeline that works for you. 


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