Signs of Alcohol Addiction: How to Recognize Them (And What to Do Next)

Knowing the clinical signs of Alcohol Use Disorder helps you spot problems early, when treatment works best and before consequences compound.

What You'll Discover:

• What clinicians mean by "alcohol addiction" and how Alcohol Use Disorder is diagnosed
• The three main clusters of warning signs: loss of control, compulsivity, and consequences
• Physical and mental health signs linked to heavy or hazardous drinking
• Quick self-screening tools you can use today (AUDIT-C and CAGE)
• Evidence-based treatment options, including therapy and medication like naltrexone
• Where to get immediate help if you or someone you care about needs support

If you're wondering whether your drinking (or someone else's) has crossed a line, you're not alone. Clinically, "alcohol addiction" is called Alcohol Use Disorder (AUD) in the DSM-5-TR, graded mild (2 to 3 criteria), moderate (4 to 5), or severe (6 or more) within 12 months, according to NIAAA.

The hallmark signs cluster into three groups: loss of control, compulsivity (craving, tolerance, withdrawal), and consequences (problems with roles, relationships, health, or safety).

All that said, short screens like AUDIT-C or CAGE can flag risk, but a clinical evaluation is needed for diagnosis. And here's what most people don't realize: there's no known safe level of alcohol for health. Risk rises with dose.

With that in mind, here's exactly how to recognize the signs of alcohol addiction, what screening tools work, and what evidence-based help looks like.

What clinicians mean by "alcohol addiction"

"Alcohol addiction" maps to Alcohol Use Disorder, a problematic pattern of use causing clinically significant impairment or distress. Severity is determined by the number of 11 DSM-5-TR criteria met in a 12-month period: mild (2 to 3), moderate (4 to 5), severe (6 or more).

The 11 symptoms (paraphrased) - Drinking more or longer than intended. Unsuccessful attempts to cut down. Spending a lot of time obtaining, using, or recovering. Craving. Role failure. Social or interpersonal problems. Giving up activities. Hazardous use. Continued use despite health or psychological problems. Tolerance. Withdrawal.

Two or more in the past year warrants a professional assessment.

Early, common, and often-missed signs

Loss of control - Plans for "just one" become many. Difficulty stopping once started. Repeated rules (only weekends, only wine) that don't hold.

Compulsivity (craving, tolerance, withdrawal) - Craving, a strong urge that crowds out other priorities. Tolerance, needing more alcohol for the same effect. Withdrawal, shaking, sweating, anxiety, nausea, or insomnia when alcohol is reduced or stopped. Seek medical advice before abrupt cessation if drinking heavily.

Consequences (functioning, health, safety) - Role impairment at work, school, parenting, or finances. Relationship strain, conflict about drinking, secrecy or broken trust. Hazardous use, drinking and driving, mixing with sedatives, operating machinery. Continued use despite problems, like hypertension, gastritis, sleep issues, depression or anxiety.

Physical and mental health signs linked to heavy or hazardous use

Excessive alcohol use (including binge and heavy patterns) is linked to injury, liver disease, heart disease, several cancers, and worsened mental health. Drinking less reduces risk. There's no known safe level for health.

Common health-related clues include:

Frequent hangovers - Sleep disturbance or morning "eye-openers" (a CAGE red flag).

Elevated blood pressure - Reflux, gastritis, pancreatitis flares.

Mood or anxiety worsening - Medication interactions or nonadherence.

Injuries or infections - Related to intoxication or risky environments.

"Is it really addiction?" - how clinicians decide

Clinicians consider patterns over time (the DSM-5-TR criteria) and may use validated screens:

AUDIT-C (3 questions) - A brief screen recommended by U.S. Preventive Services Task Force and NIAAA to flag unhealthy use and need for full evaluation.

CAGE (4 questions) - Two or more "yes" answers suggest clinically significant drinking problems and the need for further assessment.

If a screen is positive, or you recognize multiple signs, the next step is a clinical assessment to consider severity, safety (including withdrawal risks), and treatment options.

What AUD can look like across groups

Women and pregnancy - Any alcohol during pregnancy is unsafe. Women may experience harms at lower levels due to physiology.

Young people - Any under-21 drinking counts as excessive in U.S. guidance. Binge patterns are common and risky.

Older adults - Falls and drug-alcohol interactions raise risk even at lower amounts.

Family risk - Having close relatives with AUD elevates personal risk. Early screening helps.

Self-check you can try today (not a diagnosis)

AUDIT-C (3 items) - "How often do you drink?", "How many drinks on a typical day?", and "How often 6 or more on one occasion?" Higher totals suggest higher risk and the need to talk with a clinician.

CAGE (4 items) - Cut down, Annoyed, Guilty, Eye-opener. Two or more "yes" answers merit a professional assessment.

Important: Stopping suddenly after heavy use can be medically dangerous. Ask a clinician about safer withdrawal planning and supports.

Evidence-based treatment - what actually helps

Therapy and support - Core, guideline-supported elements include motivational interviewing, cognitive-behavioral therapy, and family-involved approaches. Care intensity (outpatient, intensive outpatient, residential, or inpatient withdrawal management) should match severity and medical risk.

Medication spotlight: naltrexone (oral tablet) - For many adults with AUD who are medically appropriate, naltrexone oral tablets can reduce heavy-drinking days and craving, especially when combined with counseling. Clinicians screen for contraindications (like current opioid use or dependence, acute hepatitis or liver failure) and check liver function before and during treatment. For a complete guide, see Naltrexone: What is it and how does it work? Discuss risks, benefits, and fit for your goals with your prescriber.

Managing withdrawal safely - People with moderate to severe dependence, past complicated withdrawals, or significant medical or psychiatric comorbidity may need medically supervised withdrawal. For details on what to expect during withdrawal, see How Long Does Alcohol Withdrawal Last? After stabilization, relapse-prevention strategies (therapy and, when appropriate, naltrexone oral tablets) should begin promptly.

What recovery can look like

Recovery has no single path. Some choose abstinence. Others pursue risk reduction on the way to abstinence. Many combine counseling plus naltrexone oral tablets plus peer support. People often report better sleep, mood, energy, relationships, and work consistency within weeks, with physical health gains accumulating as exposure decreases.

FAQ

Is any level of drinking "good" for health? - No. Best current evidence and public-health guidance indicate no known safe level. Risk increases with amount. If you choose to drink, less is better.

How do I know if I'm "dependent"? - Dependence features usually include tolerance and withdrawal, but diagnosis looks at all 11 DSM-5-TR criteria and life impact. A clinician can clarify severity and next steps.

Are there quick tests I can try? - Yes. AUDIT-C and CAGE are validated screening tools that guide whether to seek a full evaluation. They are not diagnoses.

What if I'm not ready to quit completely? - Talk with a clinician about harm-reduction goals (clear limits, trigger management, counseling) and whether naltrexone oral tablets fit your plan.

Where can I get help right now? - In the U.S., SAMHSA's National Helpline offers free, confidential 24/7 treatment referrals: 1-800-662-HELP (4357), or use their treatment locator.

Ready to understand where you stand?

Not sure if your drinking patterns warrant concern? Our quick, confidential alcohol assessment gives you a research-based readout you can share with your clinician, plus personalized guidance on safer next steps.

Start your 3-minute alcohol use assessment

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