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Alcohol use disorder is defined as repeated alcohol-related difficulties in at least 2 of 11 life areas that cluster together in the same 12-month period (Table 202-1).

TABLE 202-1Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Classification of Alcohol Use Disorder (AUD)


Lifetime risk for alcohol use disorder is 10–15% for men and 5–8% for women. Typically, the first major life problem from excessive alcohol use appears in early adulthood, followed by periods of exacerbation and remission. The course is not hopeless; following treatment, between half and two-thirds of pts maintain abstinence for years and often permanently. If the alcoholic continues to drink, life span is shortened by an average of 10 years with leading causes of increased death stemming from enhanced rates of heart disease, cancer, accidents, or suicide.

Screening for alcoholism is important given its high prevalence. Standardized questionnaires can be helpful in busy clinical practices including the 10-item Alcohol Use Disorders Identification Test (AUDIT) (Table 202-2).

TABLE 202-2The Alcohol Use Disorders Identification Test (AUDIT)a

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