Nonpathological use of alcohol. The key element of alcohol use disorder is the use of heavy doses of alcohol with resulting repeated and significant distress or impaired func- tioning. While most drinkers sometimes consume enough alcohol to feel intoxicated, only a minority (less than 20%) ever develop alcohol use disorder. Therefore, drinking, even daily, in low doses and occasional intoxication do not by themselves make this diagnosis.
Sedative, hypnotic, or anxiolytic use disorder. The signs and symptoms of alcohol use disorder are similar to those seen in sedative, hypnotic, or anxiolytic use disorder. The two must be distinguished, however, because the course may be different, especially in rela- tion to medical problems.
Conduct disorder in childhood and adult antisocial personality disorder. Alcohol use disorder, along with other substance use disorders, is seen in the majority of individuals with antisocial personality and preexisting conduct disorder. Because these diagnoses are associated with an early onset of alcohol use disorder as well as a worse prognosis, it is im- portant to establish both conditions.
Bipolar disorders, schizophrenia, and antisocial personality disorder are associated with a markedly increased rate of alcohol use disorder, and several anxiety and depressive disorders may relate to alcohol use disorder as well. At least a part of the reported association between depression and moderate to severe alcohol use disorder may be attributable to temporary, al- cohol-induced comorbid depressive symptoms resulting from the acute effects of intoxication or withdrawal. Severe, repeated alcohol intoxication may also suppress immune mechanisms and predispose individuals to infections and increase the risk for cancers.
A. Recent ingestion of alcohol.
B. Clinically significant problematic behavioral or psychological changes (e.g., inappropri- ate sexual or aggressive behavior, mood lability, impaired judgment) that developed during, or shortly after, alcohol ingestion.
C. One (or more) of the following signs or symptoms developing during, or shortly after, alcohol use:
Slurred speech.
Incoordination.
Unsteady gait.
Nystagmus.
Impairment in attention or memory.
Stupor or coma.
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D. The signs or symptoms are not attributable to another medical condition and are not better explained by another mental disorder, including intoxication with another substance.
Coding note: The |CD-9-CM code is 303.00. The |CD-10-CM code depends on whether there is a comorbid alcohol use disorder. It a mild alcohol use disorder is comorbid, the |CD-10-CM code is F10.129, and if a moderate or severe alcohol use disorder is comorbid, the |CD-10-CM code is F10.229. If there is no comorbid alcohol use disorder, then the |CD-10-CM code is F10.929.