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What Are Serious Alcohol Problems?

Serious alcohol problems fall into two categories: alcohol dependence and alcohol abuse. Together, these behaviors are known among experts as alcohol use disorders. The American Psychiatric Association (APA) publishes standardized criteria for diagnosing each of these conditions according to the presence of certain symptoms. This calculator uses these criteria to estimate how many young people in the U.S. need treatment.

However, the APA developed these criteria for adults, not adolescents, which means they may miss many young people who would benefit from an intervention of some kind. Though serious alcohol problems can develop within a year or two after a young person has begun drinking,4 alcohol-related medical problems and withdrawal syndrome, which take years to develop, are symptoms that are much more likely to be found among adults. Nor do these criteria address factors unique to young people, whose bodies and minds continue to undergo profound changes throughout adolescence.

As a result, some researchers have suggested that serious alcohol problems should be assessed more broadly among young people to permit earlier and more targeted interventions along a continuum facilitated by more widespread use of screening. These assessments would be multidimensional and take a number of other factors into consideration, including:


Example: A 13-year-old who is binge drinking and smoking marijuana probably signals a more immediate need for intervention than an 18-year-old whose similar behavior, while dangerous and illegal, may be more typical of his age group.

The amount, frequency and context of alcohol and other drug use

Example: Any young person who drinks every day before going to school or during the school day.

The seriousness and nature of the problems being experienced by a young person

Example: A young person who fails a grade, runs away from home or comes into contact with the juvenile justice system.

The presence of a mental health problem

(see following section)

A family history of addiction

Example: Having a parent with an alcohol use disorder greatly increases the chances that an individual will develop one at some point in their life. Researchers have established that the risk for developing an alcohol use disorder is approximately 50 to 60 percent genetic.


4 Physician Leadership for National Drug Policy. 2002.