We don’t use the word “alcoholic” at Monument because your drinking does not define you. And what many people don’t know is that alcohol use disorder is a medical condition that can be diagnosed by a doctor and treated with evidence-based tools. We know how scary the “do I have a drinking problem?” Google search can be, and are here to help you navigate this question without the infinite scrolling and misinformation.
What is alcohol use disorder? Let’s start with a helpful analogy
Here’s an analogy from Monument advisor Dr. Mark Willenbring, who has treated thousands of patients with alcohol use disorder: Think of a water slide. What would happen if you set a marker about 15 feet down from the top? You’ve told yourself, I won’t go past that line. On your first go, you pass the mark. Okay, now the second time, you again pass the mark. See a pattern here? How often can you stop before the 15-foot line? What if that line marks three drinks?
Continuously passing that line of the drink limit you set for yourself is a sign of alcohol use disorder, or AUD. In addition to excessive drinking, another key sign of AUD is anticipation. Are you exhilarated before going down the water slide? Do you consistently look forward to it? Is the anticipation often even better than the ride itself?
Alcohol use disorder (AUD) is characterized by drinking more than you want and for longer than you want, despite wanting to cut down.
It’s also characterized by having strong urges related to drinking alcohol during certain times of the day.
Alcohol use disorder is also more common than you think. Closer to 40 million people drink too much per the CDC, including binge drinking and other alcohol misuse. The bottom line is: You are not alone. AUD is a medical condition, like any other health condition. Recognizing AUD as a medical issue and treating it that way is necessary to get the support you deserve, without any of the shame or stigma.
Making progress together: For family, friends, and those in recovery
‘Wait, how is this a medical condition?’ Let’s break it down.
Alcohol use disorder limits your ability to control or quit alcohol consumption, despite the consequences experienced from excessive drinking and alcohol dependence.
Statistically speaking, AUD is 50–60% genetically determined. Gene interactions are complex, so there are many genes that shape how someone ends up developing alcohol use disorder, and to what degree. The range of severity comes down to how these genes are expressed.
The American Psychiatric Association put together a manual called the Diagnostic and Statistical Manual, Fifth Edition (DSM-5) to help define and diagnose the severity of conditions like AUD. Per the DSM-5, AUD is broken down into 11 points of criteria. The severity of AUD depends on the number of symptoms present. A mild AUD diagnosis means 2–3 symptoms are present, a moderate condition means 4–5 symptoms are present, and a severe condition means 6+ symptoms are present. Understanding where you fall on the AUD spectrum can be a helpful indicator of the level of care that makes sense for you, and if you’ll be able to moderate your alcohol intake, or if you should stop drinking entirely.
To take the DSM-5 alcohol assessment and learn about your treatment options, you can sign up for Monument.
‘Can I moderate my drinking, or should I aim for sobriety?’
The choice to moderate or quit drinking altogether is a very personal decision, and one that might evolve over time. Some people prefer to start moderating their alcohol intake with an end goal of sobriety, others quit drinking with aspirations for reintroducing controlled drinking down the road, others decide sobriety is their only option, and everything in between. So, what’s right for you?
At Monument, we connect you to a specialized physician and therapist to set attainable goals based on your medical history, lifestyle, and preferences. Goal setting is an important step in defining what success looks like, and putting together an action plan to get there. To start reflecting on if moderation or sobriety is best for you, check out these questions from a licensed therapist.
‘How does alcohol use disorder vary by age & severity?’
AUD displays itself to varying degrees and during different stages of life. No one’s diagnosis looks identical to another. For example, some develop symptoms of AUD earlier in life, and others much later. Oftentimes, those who develop symptoms at a younger age aim to quit drinking alcohol in their twenties, and for those whose symptoms develop in their thirties and forties, AUD can easily go undetected. Stress hormones, which are common while navigating parenting, marriage, work, finances, and more, can be catalysts for worsening someone’s drinking habits and potentially developing AUD. Someone who falls in this category may be asking themselves, Do you see what I have going on? Who wouldn’t develop a drinking habit! And that’s fair! But that doesn’t mean it’s not a problem and one that deserves attention. Partaking in heavy drinking can lead to an increased risk of alcohol poisoning, liver disease, and other health complications. There is no shame in acknowledging when your alcohol consumption has become unhealthy and getting support to make a change.
If you’re feeling like your drinking habits have gotten out of control, it’s always good to check in with yourself and a physician and therapist specialized in treating AUD. At Monument, you can do that completely anonymously, and entirely online.
‘How does alcohol use disorder coexist with other medical conditions?’
It is incredibly common that people who are diagnosed with AUD experience other mental health conditions. According to Monument Advisor Laura Diamond, LMHC, EdM, MA:
Learning to manage negative or uncomfortable emotions is one of the fundamental components of this journey, and you don’t have to do it alone. One of the most useful steps to take during your recovery process is committing to a therapy program that is specifically tailored to you and your needs. In addition to addressing excessive alcohol use, therapy can also treat co-occurring mental health conditions. Understanding the connection between alcohol and depression, and alcohol and anxiety is a crucial part of many people’s treatment journeys. That’s why personalized therapy that addresses all components of mental health is a core component of Monument treatment plans.
If you’re interested in accessible and affordable alcohol therapy, that’s what we’re here for.
‘What if I’m not on the spectrum for alcohol use disorder?’
It’s important to note that while the above criteria can serve as a helpful tool to evaluate your drinking behaviors, you do not have to check any boxes or identify with any labels to make a healthier choice for yourself and start online alcohol treatment.If your drinking feels out of control, you deserve support to make a change. At Monument, our goal is to get you from where you are to wherever you want to be, no matter the starting point.
‘What does medical treatment for a medical issue mean?’
Making the choice to change your drinking habits is a courageous decision, and you deserve to get results. That’s why we use evidence-based treatment methods, and connect you to expert clinical care.
After signing up for a Monument plan, you’ll work with a Care Team to build a treatment program tailored to your needs and goals. Depending on your plan, you’ll meet with either a licensed physician or a licensed physician and licensed therapist who are specialized in helping people change their relationship with alcohol, whether that means cutting back on drinking or stopping drinking altogether. They use tools like cognitive behavioral therapy and FDA-approved medication options to empower you to reach your goals. Medication is always optional. Read more about medication to stop drinking, with information on physician-prescribed options like disulfiram and naltrexone. (Wondering, “what is naltrexone and disulfiram?” We have resources for how disulfiram works and what drinking on naltrexone is like, too.)
You can also sign up for additional resources like this one, virtual therapist-moderated support groups, and an anonymous community forum.
Regardless of your path forward, know that:
- You are not defined by your drinking habits
- You can change your drinking habits
- You don’t have to change your drinking alone (it’s hard!)
- Making the choice to change your drinking is something to be proud of. And we’re proud of you.
Important Safety Information
Naltrexone has the capacity to cause hepatocellular injury (liver injury) when given in excessive doses. Naltrexone is contraindicated in acute hepatitis or liver failure, and its use in patients with active liver disease must be carefully considered in light of its hepatotoxic effects. In the treatment of alcohol dependence, adverse reactions include difficulty sleeping, anxiety, nervousness, abdominal pain/cramps, nausea and/or vomiting, low energy, joint and muscle pain, headache, dizziness and somnolence. This is not a complete list of potential adverse events associated with naltrexone hydrochloride. Please see Full Prescribing Information for a complete list
The most common side effects of Disulfiram may include drowsiness, tiredness, headache, acne, and metallic-like taste in the mouth. Call your doctor if you have signs of serious side effects such as decreased sexual ability, vision changes, numbness of arms or legs, muscle weakness, mood changes, seizures, or confusion. Do not take Disulfiram if you are allergic to any of the ingredients. If you begin to have signs of an allergic reaction, then seek immediate medical attention. Avoid consumption of alcohol while taking this medication, as it may lead to adverse side effects. Talk to your doctor about the history of your medical conditions including if you have or have had diabetes, underactive thyroid, brain disorders, liver or kidney disease, personal or family history of regular use/abuse of drugs. Certain drug interactions may lead to serious adverse side effects. Let your doctor know about any other medications you are taking. This is not a complete list of potential adverse events associated with Disulfiram. Please see Full Prescribing Information for a complete list.