Many people don’t realize they have an alcohol problem. Yet early indicators of alcohol issues show that if attention were paid, excessive drinking might be headed off before alcoholism develops. For example, experts now recognize a pre-addiction stage of alcohol use disorder (AUD). If a person is identified with pre-addiction before alcohol issues become entrenched and then receives treatment, major emotional and physical pain could be averted. This post covers the range of problematic alcohol use from pre-addiction to AUD. It also describes existing and potential treatments.

The National Institute of Alcohol Abuse and Alcoholism (NIAAA) encourages medical providers to screen patients for alcohol consumption and initiate interventions aimed at harm reduction. Yale’s Joel Gelertner studied heavy drinking and compared it to lower levels of alcohol use, alcohol dependence, and relationships with mental and physical health. Habitual heavy drinking is genetically similar to AUD -an important risk for developing alcohol dependence.

Most heavy drinkers do not have AUD but may benefit from feedback leading to their making healthy changes. All heavy drinkers need counseling from physicians—called a brief intervention—to reduce risks for alcohol-related harm. Sadly, fewer than 10% of individuals needing treatment for AUD receive treatment. In addition, less than 2% receive one of the three FDA-approved and effective medications for AUD. Teresa Rummans, MD, Professor and Chair at Mayo Clinic, says, “We see too many patients whose lives have been changed because of their drinking. We need to intervene and start treatment earlier. We have excellent treatments for AUD, but few patients taking them. More patients take MATs [Medication-assisted treatment] for OUDs [opioid use disorders] than people taking medications for their AUDs, even though more deaths are associated with AUD."

With pre-addiction, there is a high risk of developing a substance use disorder (SUD), but the person isn’t there yet. The person in the pre-addiction phase is starting to experience social, psychological, or physical impairments due to alcohol, but these outcomes are not yet severely........

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