DSM-5 Alcohol Use Disorder Diagnostic Criteria

Diagnostic Criteria

The American Psychiatric Association recommends that alcohol use disorder (AUD) is diagnosed when a patient meets at least 2 of 11 specific criteria within a 12-month period, with severity graded as mild (2-3 criteria), moderate (4-5 criteria), or severe (6 or more criteria) 1
The diagnosis requires a problematic pattern of alcohol use leading to clinically significant impairment or distress, with at least 2 of the following 11 criteria occurring within a 12-month period, as supported by the Journal of Hepatology and Clinical and Molecular Hepatology 1, 2

The severity grading is straightforward and based solely on criterion count, with mild AUD defined as 2-3 criteria met, moderate AUD defined as 4-5 criteria met, and severe AUD defined as 6 or more criteria met, according to the Journal of Hepatology 1, 2

The American Psychiatric Association eliminated the previous distinction between "alcohol abuse" and "alcohol dependence," combining them into a single dimensional disorder with severity specifiers, as reported in the American Journal of Psychiatry 4, 5
The legal problems criterion from DSM-IV was removed, and craving was added as a new criterion, based on extensive factor analyses showing that all criteria formed a single unidimensional continuum rather than two separate disorders, as supported by the American Journal of Psychiatry and the American Psychiatric Association 4

The World Health Organization (WHO) developed the AUDIT (Alcohol Use Disorders Inventory Test) as the gold standard screening instrument, with proven sensitivity and specificity across clinical settings and countries, as reported in the Journal of Hepatology 1
For patients using substances under medical supervision, tolerance and withdrawal alone should not count toward diagnosis if no other criteria are met, as recommended by medical guidelines 3