use disorder may devote substantial periods of time to obtaining and consuming alcoholic
beverages. 
Craving for alcohol is indicated by a strong desire to drink that makes it difficult to
think of anything else and that often results in the onset of drinking. School and job per-
formance may also suffer either from the aftereffects of drinking or from actual intoxica-
tion at school or on the job; child care or household responsibilities may be neglected; and
alcohol-related absences may o ccur from school or work. The individual may use alcohol
in physically hazardous circumstances (e.g., driving an automobile, swimming, operating
machinery while intoxicated). Finally, individu als with an alcohol use disorder may con-
tinue to consume alco hol despite the knowledge that continued consumption poses sig-
nificant physical (e.g., blackouts, liver disease ), psychological (e.g., depression), social, or
interpersonal problems (e.g., violent argume nts with spouse while intoxicated, child
abuse).
Associated Features Supporting Diagnosis
Alcohol use disorder is often associated wi th problems similar to  those associated with
other substances (e.g., cannabis ; cocaine; heroin; amphetamin es; sedatives, hypnotics, or
anxiolytics). Alcohol may be used to alleviate the unwanted effects of these other
substances or to substitute for them when they are not av ailable. Symptoms of conduct
problems, depression, anxiety, and insomnia frequently accompany heavy drinking and
sometimes precede it. 
Repeated intake of high doses of alcohol can affect nearly every organ system, espe-
cially the gastrointestinal tract, cardiovasc ular system, and the central and peripheral ner-
vous systems. Gastrointestinal effects includ e gastritis, stomach or duodenal ulcers, and,