This disorder is only diagnosed when these behaviors become persistent and very disabling or distressing. There is often craving for alcohol that makes it difficult to think of anything else until drinking resumes.
Alcohol Intoxication causes significant psychological and social impairment (e.g., inappropriate sexual or aggressive behavior, mood lability, impaired judgment, impaired social or occupational functioning).
This intoxication has one or more of the following physical signs: slurred speech, incoordination, unsteady gait, nystagmus, impairment in attention or memory, stupor or coma.
Alcohol Intoxication is similar to Benzodiazepine or Barbiturate Intoxication.
Alcohol Makes Anxiety Better, Then Worse:
Many alcoholics state that they started drinking "to calm their nerves" and this led to their addiction as their anxiety got worse. This is actually a misinterpretation of what actually happened.
Alcohol initially reduces anxiety; only to increase it a few hours later. In the first hour or two after drinking, alcohol has a sedative, antianxiety effect. Thereafter, alcohol actually increases anxiety, and this prompts the individual to ingest more alcohol.
Thus the more the individual drinks alcohol to "decrease anxiety"; the more alcohol causes increased anxiety. This is why alcohol is a bad treatment for insomnia since it only sedates the person for a few hours; then alcohol increases anxiety and arousal, which wakes the person up. The longer the individual can stay "dry" off alcohol; the less problem they will have with anxiety and insomnia.
Alcohol Withdrawal only occurs after the cessation of (or reduction in) heavy and prolonged alcohol use. This withdrawal syndrome includes two or more of the following: autonomic hyperactivity (e.g., sweating or pulse rate greater than 100); increased hand tremor; insomnia; psychomotor agitation; anxiety; nausea or vomiting; and, rarely, grand mal seizures or transient visual, tactile, or auditory hallucinations or illusions.
This withdrawal syndrome can be relieved by administering alcohol or any other brain depressant. These withdrawal symptoms usually begin within 4-12 hours of abstinence, and peak on the second day of abstinence. The Alcohol Withdrawal improves markedly by the 4th or 5th day of abstinence; however, symptoms of anxiety, insomnia, and autonomic dysfunction may persist for up to 3-6 months at lower levels of intensity.
Complications
School and job performance may suffer either from hangovers or from actual intoxication on the job or at school; child care or household responsibilities may be neglected; and alcohol-related absences may occur from school or job.
The individual may use alcohol in physically hazardous circumstances (e.g., drunk driving or operating machinery while intoxicated). Legal difficulties may arise because of alcohol use (e.g., arrests for intoxicated behavior or for drunk driving).
Individuals with this disorder may continue to abuse alcohol despite the knowledge that continued drinking poses significant social or interpersonal problems for them (e.g., violent arguments with spouse while intoxicated, child abuse). Alcohol intoxication causes significant intellectual impairment (and stupid behavior).
Once a pattern of compulsive use develops, individuals with this disorder may devote substantial periods of time to obtaining and consuming alcoholic beverages. These individuals continue to use alcohol despite evidence of adverse psychological or physical consequences (e.g., depression, blackouts, liver disease, or other complications).
Individuals with this disorder are at increased risk for accidents, violence, and suicide. It is estimated that 1 in 5 intensive care unit admissions in some urban hospitals is related to alcohol and that 40% of people in U.S.A. experience an alcohol-related accident at some time in their lives, with alcohol accounting for up to 55% of fatal driving events.
More than one-half of all murderers and their victims are believed to have been intoxicated with alcohol at the time of the murder.
Severe alcohol intoxication also contributes to disinhibition and feelings of sadness and irritability, which contribute to suicide attempts and completed suicides.
Comorbidity
Individuals with Alcohol Use Disorder are at increased risk for Major Depressive Disorder, other Substance Use Disorders (e.g., drug addiction), Conduct Disorder in adolescents, Antisocial and Borderline Personality Disorders, Schizophrenia, and Bipolar Disorder.
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