Alcohol use disorder: how to spot it and what to do next

Alcohol use disorder (AUD) is more common than people admit. It ranges from drinking more than planned to full loss of control that harms work, relationships, or health. The sooner you recognize the signs, the sooner you can get help that actually works.

Watch for concrete signs: you need more alcohol to feel the same effect (tolerance), you can’t cut down even when you try, you spend a lot of time drinking or recovering, cravings feel intense, or drinking causes problems at home or work. Physical signs include shaky hands, sweating, insomnia, or nausea when you stop. If any of these match your experience, treat them as red flags—not reasons to hide it.

Safe first steps and withdrawal safety

If you or someone else plans to stop heavy drinking, don’t do it alone if withdrawal symptoms were ever present. Severe withdrawal can cause seizures or delirium tremens, which need urgent medical care. Call your doctor, local emergency number, or a crisis line if you notice confusion, severe shaking, high fever, or loss of consciousness. For planned quitting, a medical check-in can arrange monitored detox or medications to reduce risk.

Practical tip: write down how much and how often you drink for a week. Bring that info to your clinician—details help them decide if you need supervised detox, medicine, or outpatient support.

Treatment choices that actually help

Treatment isn’t one-size-fits-all. Options include: brief counseling and motivational interviewing for mild cases; outpatient therapy like cognitive behavioral therapy (CBT) to change drinking cues; medications such as naltrexone, acamprosate, or disulfiram that reduce cravings or make drinking unpleasant; and residential programs for people who need structured support. Peer groups (AA or SMART Recovery) help many people stay sober by offering routine and accountability.

Combining approaches usually works best: medication plus therapy and social support beats any single option on its own. If cost or access is a problem, ask about telehealth visits, community clinics, or sliding-scale programs—there are low-cost options.

Want to cut down rather than quit? Harm-reduction steps can still improve safety: set a daily drink limit, avoid binge patterns, don’t mix alcohol with sedatives or strong pain meds, stay hydrated, and plan sober friends or transport for risky times. Small, consistent changes reduce harm and build confidence.

If you’re unsure what to do next, call your primary care doctor or a local addiction service. If you feel unsafe, go to the emergency room. Asking for help is the strongest move you can make—there are clear, proven paths out of AUD and people ready to guide you through each step.