The Criteria for an Alcohol Use Disorder Diagnosis

Diagnosis Depends on the Drinker's Honesty

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Diagnosing alcohol use disorder (AUD) can be tricky since the diagnosis depends on the drinker being willing to honestly answer a series of questions about his or her drinking patterns and attitudes.

Denial Makes Diagnosis More Difficult

Getting an honest answer about alcohol use and its effects on your life is a problem because a common symptom of alcoholism is denial. An old adage about alcoholism is it's "the only disease that denies it exists and resists treatment."

If the drinker won't be honest about their drinking habits, it is difficult, if not impossible, to accurately diagnose AUD. 

Family and Friends See the Problem

Long before a health care worker gives an AUD diagnosis, friends and family of the drinker usually recognize the problem. 

They may try to talk to the drinker about the problem and encourage him/her to get help, but again, denial comes into play. Denial is so common in people with alcohol abuse problems that denial itself is a warning sign of alcoholism. The drinker simply does not see, or refuses to admit, that alcohol use is the source of problems.

Moreover, a health care professional is unlikely to give an AUD diagnosis during routine visits because this condition is misdiagnosed more than 70 percent of the time. 

Diagnostic Tools for AUD

There are many diagnostic tests to screen for and evaluate drinking problems.

To overcome denial, most don't ask direct questions about the number of drinks but ask questions about problems associated with drinking instead.

Shorter, four-to-five question alcohol screening tests, such as the FAST test, are effective in the initial screening to detect AUD, while longer, more elaborate tests do a more in-depth evaluation and assessment.

Symptoms of Alcohol Dependence

Medical professionals use the responses from the diagnostic test to determine how many of the 11 major symptoms of AUD the drinker is experiencing.

In order to receive an AUD diagnosis in accordance with the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) you must meet two of the 11 criteria within a 12-month period: 

  1. Drinking more or longer than intended.
  2. The desire to stop or modify your drinking habits more than once, but couldn't.
  3. Spending a lot of your time drinking or being hungover.
  4. Wanting a drink so badly you couldn't concentrate on anything else.
  5. Drinking and being hungover interfered with your responsibilities to your family, job and home.
  6. Continuing to drink even though it causes trouble with family and friends.
  7. Giving up important and enjoyable activities in order to drink.
  8. Getting into situations after drinking, such as driving or walking in a high-crime neighborhood, that increased your chances of injuring yourself.
  1. Continuing to drink even though it made you feel depressed, anxious, and/or blackout.
  2. Needing to drink more than you did before to get the same effect.
  3. Feeling withdrawal symptoms, such as nausea and sweating.

Once diagnosed with alcohol use disorder, you will receive an additional distinction of mild, moderate or severe, which is based on the number of criteria you meet.


American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

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