How Alcohol Use Disorder Is Diagnosed – and What It Actually Means

AUD vs Alcoholism – Are They the Same Thing?

Yes. “Alcoholism” is the everyday term; alcohol use disorder (AUD) is the formal clinical diagnosis. In 2013, the DSM-5 merged what used to be two separate diagnoses, “alcohol abuse” and “alcohol dependence,” into one spectrum disorder. Mild AUD starts at just two criteria sustained over 12 months.

The 11 DSM-5 Criteria for Alcohol Use Disorder

A clinician checks for these 11 criteria over the past 12 months:

1. Drinking in larger amounts or for longer than you intended
2. A persistent desire or unsuccessful attempts to cut down or control your drinking
3. Spending a lot of time drinking, getting alcohol, or recovering from its effects
4. Cravings, or a strong urge to drink
5. Drinking that gets in the way of your obligations at work, school, or home
6. Continuing to drink despite ongoing relationship or social problems it’s causing
7. Giving up or cutting back on activities you used to enjoy because of drinking
8. Drinking in situations where it’s physically hazardous, like before driving
9. Continuing to drink even knowing it’s making a physical or mental health problem worse
10. Tolerance — needing more alcohol to get the same effect, or getting less effect from the same amount
11. Withdrawal symptoms when you stop or cut back, or drinking specifically to avoid them

There’s no drinks-per-week threshold. Meeting 2–3 criteria is mild AUD, 4–5 is moderate, and 6 or more is severe.

What the AUDIT Screening Test Is

The AUDIT (Alcohol Use Disorders Identification Test) is a 10-question screening tool developed by the World Health Organization. Each question is scored 0–4. A total of 0–7 suggests low risk, 8–14 suggests hazardous or harmful use, and 15 or higher suggests likely dependence. It’s a screener, not a diagnosis on its own — see what an in-between score actually means if you’ve already taken it.

Why AUD Often Goes Undiagnosed

• Shame. Feeling ashamed about how much you drink, or what it’s led to, can keep people from being honest about it, even with a doctor.
• Being high-functioning. When you’re still able to meet your responsibilities, it’s easy to assume that rules out a real problem.
• Not knowing what it actually looks like. There are a lot of misconceptions about what alcohol use disorder is supposed to look like, and real cases often don’t match the stereotype.

What a Diagnosis Actually Changes

A diagnosis is often what opens the door to treatment and insurance coverage, since most insurers require a diagnostic code to cover care. It also removes the question of whether you’re “bad enough” to deserve help: meeting 2 or more criteria qualifies you for treatment. The number of criteria you meet also helps clinicians recommend the right level of care — mild AUD is often suited to outpatient treatment, while severe AUD usually calls for a higher level of support.

Talk to Someone at GBAC

A free, confidential assessment with our clinical team in Needham, MA can help you understand where you stand and what your options are. Call (877) 920-6583, or verify your insurance online.

Frequently asked questions