One drink with dinner becomes a bottle. An afterwork wind-down becomes a bender. A catch up with a friend becomes a two-day hangover. Drinking alcohol is socially accepted in society — around 43% of the world’s population drinks it — but a healthy relationship with alcohol looks very different to alcohol use disorder (AUD) [1].
The difficulty is being able to recognize when casual drinking has quietly transformed into addiction. For most people, they don’t know how far they’ve come until they’re in crisis.
Knowing the signs early can be life-saving and can mean getting treatment to address the deeper causes of addiction and to achieve lasting recovery. Let’s take a look.
What Is Alcohol Use Disorder (AUD)?
AUD is when someone is unable to stop or reduce the amount of alcohol they drink, despite the negative effects on their health and life. It’s a medical diagnosis, sometimes called alcoholism or alcohol addiction. In the U.S. alone, nearly 28 million people have AUD [2].
AUD can impact someone’s ability to function on a daily basis, it can negatively affect their performance at work, it can damage relationships, and it takes a big toll on physical and mental health.
People who have AUD often try to stop or cut back their drinking but can’t. The more they drink, the higher their tolerance becomes, which only leads to more drinking. And because AUD is an addiction, when someone does stop or dramatically lower their alcohol intake, they’re likely to experience cravings and withdrawal symptoms.
Signs of AUD
Shame tends to go hand-in-hand with AUD, so a person may hide how much they drink, secretly prioritize drinking over other plans, and consume alcohol in inappropriate settings, such as at work.
Someone with AUD may genuinely not realize they have a problem, or they may be in denial about the issue.
Signs of AUD are varied and depend on the person, but the main ones are:
- Spending lots of time drinking or recovering from drinking alcohol
- Having uncontrollable cravings for alcohol
- Trying to cut down on alcohol and failing multiple times
- Drinking alcohol even when it causes or contributes to physical, social, or relationship problems
- Underperforming at work or school because of alcohol
- Choosing to drink alcohol instead of doing hobbies or activities that once brought them joy
- Consuming alcohol in high-risk situations, such as when driving
- Needing higher amounts of alcohol to feel the same effects as before
AUD can hide among accepted societal norms around alcohol use. If you worry you or a loved one may have an addiction, start with a conversation. Relay the signs you’ve seen and then consider the following questions:
- Do you often drink more than you planned?
- Do you look forward to events when alcohol is present?
- Do you drink alone or secretly?
- Have you drank when you’ve been ill, when a partner or friend has asked you not to, or when you’ve had responsibilities that require you to be sober?
- Do you rationalize around alcohol? E.g. “it’s just one drink, it doesn’t make a difference”
- Do you regularly wake up hungover or impaired because of drinking?
Approaching the conversation with curiosity means bypassing judgment, which only fuels shame and doesn’t lead to productive outcomes.
Alcohol Use vs AUD
Alcohol use, more commonly referred to as casual drinking, is being able to control how you consume alcohol. AUD is when you cannot manage how or when you drink. According to the Centers for Disease Control and Prevention, moderate drinking is one alcoholic drink or less per day for women, or two alcoholic drinks per day for men. Heavy drinking is classed as 8 or more drinks per week for women, 15 or more for men [3]. Heavy drinking substantially increases your risk of developing AUD.
Research adds that casual drinking can be goal-oriented, such as to enjoy the taste of alcohol. AUD, on the other hand, is habitual alcohol-seeking, even when there’s no goal around drinking [4].
Casual drinking can be a road to AUD and can also be where AUD develops [5]. It’s also been associated with violence, sexual assault, and risky sexual behavior which can be markers of AUD [6].
Not everyone who is a casual drinker will develop AUD, but it can make AUD more likely because:
- Having an increased tolerance for alcohol drives more drinking
- Repeat drinking may lead to habit-forming behaviors that cause addiction
- Association with drinking (e.g. a stressful day or warm weather) can become triggers that justify drinking
Is There Treatment For AUD?
Yes, treatment for AUD is available and effective: in particular, medication and evidence-based therapies support people overcoming the disorder [7] [8].
Treatment involves joining a medical detox to safely withdraw from alcohol, and then attending structured care programs to address the roots of addiction and to build sustainable coping mechanisms. Cognitive behavioral therapy (CBT) and Dialectical behavioral therapy (DBT) are common approaches used in AUD treatment precisely because they help gain such insights.
Treatment not only alleviates withdrawal symptoms and encourages self-reflection, it lowers the risk of relapse and promotes long-term sobriety. It can also treat co-occurring mental health disorders such as depression and anxiety that often cause or exacerbate unhealthy drinking tendencies.
Keep in mind that any credible treatment should be personalized to the individual, factoring in how much alcohol they consume, how often, for how long, and other considerations such as their general health.
Take a Step Toward Sobriety at Trinity Wellness Group, Massachusetts
We understand that just confronting a drinking problem is scary. We offer a safe, calm space to help during your recovery journey.
At our center in Milton, we offer tailored addiction care, run by a team of licensed specialists. Our full and half day outpatient programs are suitable for anyone who is stable enough to live at home, but who still requires intense support.
We integrate evidence-based therapies in our programs, medication-assisted treatment (MAT), and a range of holistic activities. We take a trauma-informed approach, making sure that we treat addiction symptoms but also look at the driving forces and unprocessed experiences.
We’re empathetic and we work at a pace that suits you and your needs.
You can heal. Get in touch with our admissions team.
Sources
[1] Gallup. 2025. U.S. Drinking Rate at New Low as Alcohol Concerns Surge. news.gallup.com.
[2] National Institute on Alcohol Abuse and Alcoholism. 2025. Alcohol Use Disorder (AUD) in the United States: Age Groups and Demographic Characteristics. niaaa.nih.gov.
[3] CDC. 2025. Alcohol Use and Your Health. cdc.gov.
[4] Barker, J. Taylor, J. 2015. Habitual alcohol seeking: modeling the transition from casual drinking to addiction. Neuroscience & Biobehavioral Reviews.
[5] Fairbarn, C. Kang, D. 2025. Social Drinking and Addiction: A Social-Cognitive Model for Understanding Alcohol Use Disorder Risk. Current Directions in Psychological Science.
[6] Creswell, K. 2020. Drinking Together and Drinking Alone: A Social-Contextual Framework for Examining Risk for Alcohol Use Disorder. Current Directions in Psychological Science.
[7] Agabio, R. et al. 2024. Efficacy of medications for the treatment of alcohol use disorder (AUD): A systematic review and meta-analysis considering baseline AUD severity. Pharmacological Research.
[8] Witkiewitz, K. et al. 2019. Advances in the science and treatment of alcohol use disorder. Science Advances.