Aims: This manuscript aims to provide a review of historical movements within the United States (U.S.) surrounding alcohol consumption and consequences, including sociopolitical discourse and shifts in alcohol research and treatment priorities. We also examine correspondence between historical movements in the U.S. and processes by which alcohol use disorder (AUD) diagnostic criteria were established. This historical review will focus only on movements and criteria within the U.S. and the Diagnostic and Statistical Manual for Mental Disorders published by the American Psychiatric Association, given a recent review focused on the evolution of the International Classification of Diseases published by the World Health Organization. Through a critical evaluation, we also elucidate future directions for the conceptualization and diagnosis of AUD. Methods: We conducted a review of the literature on AUD definition, terminology, and classification. There were no restrictions on publication type, publication date, or peer-review status. Results: Manuscripts were reviewed and integrated by the respective time frame and movement they described. This resulted in coverage of five main movements including colonialism, temperance, alcoholism/dispositional disease model, public health/continuum beliefs, and the brain disease model. Within each movement, we identify and describe the relevant diagnostic influences and criteria at that time and how they influenced later construals. Conclusions: Conceptualization of AUD continues to be rooted in previous traditions, thwarting progress towards evidence-based diagnostic criteria and treatment of AUD. We offer a roadmap forward to direct future efforts towards improved diagnosis of AUD.