Alcohol Use Disorder: Hope for Recovery

Alcohol Use Disorder: Hope for Recovery

Written by: Anton Bizzell

Alcohol use disorder (AUD) is often referred to as the hidden substance use disorder (SUD). With alcohol use legal and socially acceptable in many settings, the symptoms of AUD may initially go unnoticed. Yet individuals with AUD may experience significant difficulties in their relationships, work, and health.

In a newly released analysis, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) at the National Institutes of Health (NIH) found that over 70 percent of the adult population drank alcohol in 2017. Alcohol-related deaths more than doubled from 1999 to 2017. Overdoses of alcohol alone or in combination with other drugs accounted for 18 percent of the deaths in 2017; 31 percent of the deaths resulted from alcohol-related liver disease. Researchers note that the since this study examined only death certificate data, the actual number of lives lost may be significantly higher.

The death rates increased higher for women than for men, and gender differences persist in risks for alcohol-related cardiovascular disease, liver disease, and cancer. In addition, while prevalence of alcohol use and binge drinking remained stable for men, the prevalence of alcohol use increased by over 10 percent for women and binge drinking increased by over 23 percent among women.

The NIAAA screening tool for AUD includes questions a provider can use to diagnose whether an individual may have an AUD. Individuals who are struggling with their drinking, or families and friends concerned about their loved ones, can start by considering the following questions.

In the past year, have you:

  •  Tried to cut down or stop drinking more than once, but couldn’t?
  •  Found that drinking or being sick from drinking got in the way of you taking care of your home or your family, or caused problems at work or school?
  •  More than once gotten into situations while drinking that could be dangerous, such as driving, having unsafe sex, using machinery, walking in an unsafe neighborhood; or had a memory blackout?
  •  Kept drinking even though it was making you depressed or anxious, or adding to other health problems?
  •  Found that when the effects of alcohol were wearing off, you had withdrawal symptoms, such as trouble sleeping, shakiness, irritability, anxiety, depression, restlessness, nausea, or sweating?

In addition to peer-led support models such as Alcoholics Anonymous, there are many options for professionally-led treatment. Treatment for AUD often involves a combination of talk therapy and medication. Therapy can be for individuals, groups, or families, under the direction of a licensed counselor trained in substance use disorders. Medication to help individuals stop drinking and avoid relapse can be administered under the care of a licensed primary care provider or a board-certified addiction medicine physician. In addition, different levels of care and care settings are available to meet the needs of each situation, including outpatient, partial hospitalization, residential, or intensive inpatient.

Although the consequences of AUD can be devastating, hope for recovery is possible with evidence-based, timely intervention.

Reference: White, A. M., Castle, I. J. P., Hingson, R. W., & Powell, P. A. (2020). Using Death Certificates to Explore Changes in Alcohol‐Related Mortality in the United States, 1999 to 2017. Alcoholism: Clinical and Experimental Research.

The Bizzell Group (Bizzell) was founded by CEO Anton Bizzell, M.D., a substance use disorders expert and former Medical Officer at NIAAA. Our recent work includes systematic, integrated approaches designed to effect lasting change in the field of substance use disorders through projects with the National Institute on Drug Abuse (NIDA), the National Cancer Institute (NCI), the Food and Drug Administration (FDA), the Substance Abuse and Mental Health Services Administration (SAMHSA), and the United States Chamber of Commerce Foundation (USCCF). Learn more about how Bizzell advances data-driven, research-informed, innovative solutions to solve complex, real-world challenges. www.BizzellUS.com

National Alcohol Screening Day

National Alcohol Screening Day (NASD) is an initiative first launched in 1999 by the National Institutes of Health (NIH).  NASD is held annually on the first Thursday of the first full week of April. The purpose of this event is to increase public awareness that alcohol abuse and alcoholism are recognized disorders which can be treated. During this day, members of the public are encouraged to visit screening centers and asked to complete written self-assessments about their alcohol use.

According to The Community Guide, there are 2,000 alcohol poisoning deaths in the U.S. each year and alcohol abuse is higher in college students, who do tend to frequently drink in large volumes.  Excessive, fast consumption of alcohol is known as ‘binge drinking’, and this kind of alcohol abuse can lead to many recognized health problems such as anxiety, depression or sexual problems.  The long-term effects of alcohol abuse include an increased risk of developing certain cancers, liver cirrhosis, high blood pressure and heart problems.
National Alcohol Screening Day awareness continues to grow nationally, and the U.S. government is supporting programs and policies to reduce binge drinking and expand access through the Affordable Care Act to new health insurance plans to cover alcohol screening and brief counseling. The National Institute on Drug Abuse (NIDA) has launched two online screening tools that providers can use to assess for substance use disorder (SUD) risk among adolescents 12-17 years old.

Two Screening Options: Providers can select the tool that makes sense for their clinical practice.

CAGE Questionnaire  

The CAGE can identify alcohol problems over the lifetime. Two positive responses are considered a positive test and indicate further assessment is warranted.

The questionnaire takes less than one minute to administer and is often used in the primary care of other general settings as a quick screening tool rather than as an in-depth interview for those who have alcoholism.  The CAGE questionnaire does not have a specific intended population and is meant to find those who drink excessively and need treatment. The CAGE questionnaire is reliable and valid for assessment of alcohol abuse; however, it is not valid for diagnosis of other substance use disorders, although somewhat modified versions of the CAGE questionnaire have been frequently implemented for such a purpose.

AUDIT-C Overview 

The Alcohol Use Disorders Identification Test (AUDIT) can detect alcohol problems experienced in the last year. A score of 8+ on the AUDIT generally indicates harmful or hazardous drinking. Questions 1–8 = 0, 1, 2, 3, or 4 points. Questions 9 and 10 are scored 0, 2, or 4 only. The Audit-C is a 3-item alcohol screen that can help identify persons who are hazardous drinkers or have active alcohol use disorders (including alcohol abuse or dependence). The AUDIT-C is a modified version of the question AUDIT instrument.

Bizzell CEO Appointed to CSAP National Advisory Council

In recognition of his extensive expertise in substance abuse prevention and treatment, Anton Bizzell, M.D., CEO of The Bizzell Group (Bizzell), has been appointed by the Secretary of the U.S. Department of Health and Human Services (HHS) to serve on the Substance Abuse and Mental Health Services Administration’s (SAMHSA) Center for Substance Abuse Prevention (CSAP) National Advisory Council. Dr. Bizzell’s appointment is effective through November 2018.

CSAP leads the development of national substance abuse prevention policies and programming, promotes the adoption of proven, science-based substance abuse prevention approaches and helps states and communities build their capacity to implement these approaches. As a member of the CSAP National Advisory Council, Dr. Bizzell will support this mission by making recommendations on agency and center activities and policies, in addition to reviewing grant and cooperative agreement submissions. “It’s a great honor and responsibility to work at a national level to help states and communities find proven and practical ways to prevent substance abuse and reduce the impact this disease has on individuals, families and communities,” said Dr. Bizzell.

Since earning his Doctorate in Medicine from the University of Virginia, Dr. Bizzell has spent the majority of his career working to improve access and quality of care issues for people experiencing substance abuse, mental illness or complicating health issues. He has more than 20 years of combined clinical, research, health services, policy and management experiences with various private and public organizations, including his service as a Medical Officer at both the National Institute on Alcohol Abuse and Alcoholism, NIH, and the Center for Substance Abuse Treatment, SAMHSA. Dr. Bizzell has also provided leadership to projects of national significance including CSAP’s Prevention Fellowship Program, SAMHSA’s Federal Drug Free Workplace Technical Support contract, and SAMHSA’s Prescription Drug Misuse and Abuse project.

Bizzell CEO Appointed to COPE’s Governing Body

The Coalition on Physician Education in Substance Use Disorders’ (COPE) Executive Committee recently announced the appointment of Anton C. Bizzell, M.D., CEO of The Bizzell Group (Bizzell), to COPE’s governing body.  The designation adds to Dr. Bizzell’s rich history in the field of health education as he has served as a Medical Officer with the Substance Abuse and Mental Health Services Administration (SAMHSA), as well as in the Office of Translational Research and Education at the National Institute on Alcohol Abuse and Alcoholism (NIAAA), providing support for research and educational projects addressing physician and other allied health professions’ continuing education.

COPE was formed in 2010 to sustain and expand on the accomplishments of a series of White House Conferences on Medical Education in Substance Abuse, sponsored in 2003, 2006, and 2009 by the Office of National Drug Control Policy in the Executive Office of the President.  The organization’s overarching goal is to improve the education of medical students in the areas of alcohol, tobacco and other drug use disorders – ranging from problematic or risky use to addiction.  Another goal is to help medical students receive appropriate training to develop the skills they need to prevent, screen for, diagnose and manage substance use disorders in their patients, regardless of the location or specialty in which they ultimately practice.

As a member of COPE’s governing body Dr. Bizzell will have a hand in supporting the organization’s current activities including administration of medical school surveys and sponsorship of regional Medical Education Summits which are designed to identify specific needs and respond to opportunities for enhancing teaching about substance use disorders in the undergraduate years.  COPE also produces an e-newsletter, which is distributed to more than 3,000 readers, and maintains a website that offer news and resources to medical educators.

To learn more about COPE visit: www.cope-assn.org.