Alcohol Use Disorder
Drinking too much – on a single occasion or over time – can take a serious toll on your health. Alcohol can potentially impact your brain, liver, heart, pancreas and immune system, as well as increase the likelihood of certain cancers. Stopping the use of alcohol abruptly or “stopping cold turkey” can be deadly. Alcohol cessation should be medically monitored. There are prescription medications available for the treatment of an AUD. If you are interested in discussing these medications please talk with your provider.
The definitions for the different levels of drinking include the following:
- Moderate Drinking: According to the Dietary Guidelines for Americans, moderate drinking is up to 1 drink per day for women and up to 2 drinks per day for men.
- Binge Drinking: Substance Abuse and Mental Health Services (SAMHSA) defines binge drinking as drinking 5 or more alcoholic drinks on the same occasion on at least 1 day in the past 30 days.
- Heavy Drinking: SAMHSA defines heavy drinking as drinking 5 or more drinks on the same occasion on each of 5 or more days in the past 30 days.
Excessive drinking can put someone at risk of developing an alcohol use disorder in addition to other health and safety problems. Genetics have also been shown to be a risk factor for the development of an Alcohol Use Disorder (AUD). Problem drinking that becomes severe is given the medical diagnosis of “alcohol use disorder” or AUD. AUD is a chronic relapsing brain disease characterized by compulsive alcohol use, loss of control over alcohol intake, and a negative emotional state when not using. To be diagnosed with AUD, individuals must meet certain criteria outlined in the current edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Anyone meeting any 2 of the 11 criteria during the same 12-month period receives a diagnosis of AUD. The severity of AUD—mild, moderate, or severe—is based on the number of criteria met.
Opioid Use Disorder
Opioids are a class of drugs that include the illegal drug heroin, synthetic opioids such as fentanyl, and pain relievers available legally by prescription, such as oxycodone (OxyContin®), hydrocodone (Vicodin®), codeine, morphine and many others. Drug overdoses have steadily increased and are now the number one cause of death for Americans under 50.
Symptoms of opioid use disorders include:
- Strong desire for opioids
- Inability to control or reduce use
- Continued use despite interference with major obligations or social functioning
- Use of larger amounts over time
- Development of tolerance
- Spending a great deal of time to obtain and use opioids.
Withdrawal symptoms that occur after stopping or reducing use include:
- Negative mood
- Nausea or vomiting
- Muscle aches
- Diarrhea, fever, and insomnia
To be diagnosed with Opioid Use Disorder (OUD), individuals must meet certain criteria outlined in the DSM-5. Under DSM-5, anyone meeting any 2 of the 11 criteria during the same 12-month period receives a diagnosis of OUD. The severity of OUD—mild, moderate, or severe—again is based on the number of criteria met.
Opioids reduce the perception of pain but can also produce drowsiness, mental confusion, euphoria, nausea and constipation. Depending upon the amount of drug taken, opioids can depress respiration. Both opioid drugs such as illegal heroin and legally available pain relievers such as oxycodone and hydrocodone can cause serious health effects in those who misuse them. Some people experience a euphoric response to opioid medications, and it is common that people misusing opioids try to intensify their experience by snorting or injecting them. These methods increase their risk for serious medical complications, including overdose. Other users have switched from prescription opiates to heroin as a result of availability and lower price. Because of variable purity and other chemicals and drugs mixed with heroin on the black market, this also increases risk of overdose. People who inject heroin are at a higher risk of HIV and Hepatitis C in addition to sudden death from misuse of injectables.