Alcohol Use Disorder

Alcohol use disorder is a pattern of alcohol use that leads to significant impairment or distress, including an inability to control drinking despite harmful consequences to health, relationships, or daily functioning.

• Strong cravings for alcohol and difficulty cutting down or stopping despite wanting to
• Continuing to drink despite it causing problems at work, home, or in relationships
• Needing increasing amounts of alcohol to feel the same effect (tolerance)
• Withdrawal symptoms — such as shaking, sweating, anxiety, or, in severe cases, seizures or hallucinations — when not drinking
• Spending significant time obtaining, using, or recovering from alcohol

• Develops through a combination of genetic predisposition, psychological factors such as stress or coexisting mental health conditions, and social or environmental influences, including availability of alcohol and social norms around drinking.

• Diagnosed through a careful history of drinking patterns, using a structured screening tool where available, together with assessment of the impact on health, work, and relationships.
• Assessment for physical complications (such as liver disease) and coexisting mental health conditions is an important part of evaluation.
• Severity of dependence, including the presence and pattern of withdrawal symptoms, guides the safest approach to reducing or stopping alcohol use.

Brief advice and motivational counselling at primary care level can be effective for people with harmful drinking patterns who are not yet severely dependent.

For people with more significant dependence, planned withdrawal (detoxification) may be needed, sometimes using a benzodiazepine on a reducing schedule under medical supervision to manage withdrawal symptoms safely, particularly given the risk of severe withdrawal including seizures.

Thiamine (vitamin B1) supplementation is given to people with alcohol dependence to help prevent serious neurological complications associated with heavy drinking.

Ongoing psychosocial support, counselling, and connection to community support groups are important for maintaining recovery after the acute phase.

People with signs of severe withdrawal, such as confusion, hallucinations, or seizures, require urgent hospital-level care.

• Seek early support and honest conversation with a health worker if drinking is becoming difficult to control.
• Build a support network, including family, friends, or community support groups, to help sustain reduced drinking or abstinence.
• Address coexisting stress, anxiety, or depression, which can otherwise drive continued drinking.
• Avoid sudden, unsupervised stopping of heavy, long-term drinking, as withdrawal can be medically dangerous — seek medical advice first.