Alcohol Abuse vs. Alcoholism

How does Alcohol Abuse differ from Alcoholism?

Alcohol abuse, also called problem drinking, occurs when drinking alcohol becomes an issue that creates negative consequences for a person.

Alcoholism, medically known as alcohol use disorder (AUD), occurs when a person has formed a mental reliance on (addiction to) and/or a chemical dependency on alcohol.

Essentially, alcoholism is the point at which alcohol abuse becomes alcohol addiction.

Here are the key differences between alcoholism and alcohol abuse.

The Difference in Drinking Habits

If a person abuses alcohol, they are drinking more than the recommended amount for safe drinking habits by the Centers for Disease Control and Prevention (CDC).

Alcohol abuse may look like any form of drinking that is more than these safe drinking limits:

• 2 drinks or less per day for men
• 1 drink or less per day for women

There are several forms of abuse, with varying degrees of drinking with each.

Binge drinking is a pattern of alcohol abuse in which a person quickly consumes a lot of alcohol.

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), binge drinking is defined as:

• 5 or more alcoholic drinks on one occasion for men
• 4 or more drinks on one occasion for women

Heavy alcohol use is a form of alcohol abuse in which a person drinks a lot of alcohol over a longer period of time—or binging at least five or more days in the past month.

Per the National Institute on Alcohol Abuse and Alcoholism (NIAAA), heavy alcohol use is:

• Men: more than 4 alcoholic beverages on any day OR more than 14 drinks per week
• Women: more than 3 alcoholic beverages on any day OR more than 7 drinks per week

A person with alcoholism may drink every day, multiple times a day, may start their day with alcohol, end it with alcohol, and may not be able to go a day without drinking.

Presence of Alcohol Withdrawal Symptoms

Alcohol withdrawal is a symptom of AUD or alcoholism. Someone with an alcohol abuse problem may not experience withdrawal symptoms.

In fact, experiencing alcohol withdrawal syndrome is one of the first signs of alcoholism for those who may not have previously seen their drinking habits as a problem.

Alcohol withdrawal symptoms include:

• Alcohol cravings
• Excessive sweating
• Increased heart rate
• Hand tremors (shaking hands)
• Body shakiness
• Nausea
• Vomiting
• Restlessness
• Agitation
• Hallucinations
• Anxiety
• Seizures (with a severe form of withdrawal known as delirium tremens or DTs)

Effects of Alcohol

People may drink for its depressant effects or the feelings of calm, relaxation, and well-being it produces.

However, with both alcohol abuse and alcoholism, these feelings are less effective over time as a person’s drinking habits increase.

As drinking becomes a pattern, it may take greater and greater amounts of alcohol to produce the same effects. This condition is known as tolerance. Tolerance is often one of the driving factors of alcohol addiction. People may try to overcome their tolerance whenever they drink by consuming more alcohol.

With time, this means they increase the overall amount they drink in each instance and over a period of time. Before they know it, alcohol abuse has turned into alcoholism.

Alcoholism May Cause Alcohol Dependence

Those abusing alcohol (or simply drinking too many drinks at one time or over a set period) may not develop alcohol dependence if they cut back on drinking.

Alcohol dependence, also called physical dependence, happens when a person’s body begins to rely on alcohol to function.

This health condition is what’s responsible for a person experiencing alcohol withdrawal.

According to the CDC, most people who drink too much are not alcohol-dependent, and 9 out of 10 adults engaging in alcohol abuse do not have alcohol dependence or alcoholism.

Here’s the difference: When a person must drink every day to avoid withdrawal symptoms, this is a sign of physical dependence.

And alcohol dependence is a known component of alcoholism.

Is Alcohol Misuse the Same as Alcohol Abuse?

Alcohol misuse and alcohol abuse are two terms for the same condition: a pattern of drinking that is unhealthy and against safe drinking guidelines.

Misusing alcohol in one instance may not lead to an alcohol use disorder. However, continuing to abuse alcohol over a period of time will likely lead to an alcohol problem. It’s for this reason that you should strive to avoid alcohol abuse and seek to help people who are battling this issue.

Alcohol misuse or abuse can lead to alcohol use disorder, a condition difficult to overcome without proper help, support, and treatment.

When Does Alcohol Abuse Become Alcohol Use Disorder (Alcoholism)?

Alcohol abuse becomes alcohol use disorder (AUD) or alcoholism at the point when a person can no longer control their drinking.

They may begin thinking about having their first drink as soon as they wake up, which is not normal drinking behavior for people without AUD.

A person with alcoholism may spend a lot of time thinking about drinking or how to hide their drinking. They may not feel comfortable at social events if alcohol is not available.

There are many signs of alcohol use disorder, but you will know your loved one has developed this condition if you can no longer get through the day or week without drinking.

Warning Signs of Abuse

Since abuse may take many forms, it will look different in each person. Some common signs of alcohol abuse include:

• Binge drinking
• Heavy drinking
• Thinking about drinking (e.g., looking forward to drinking after work, at the end of the day, etc.)
• Ensuring you have alcohol on hand
• Avoiding social outings that don’t include alcohol
• Starting to hide drinks or instances of drinking due to shame or guilt
• Intentionally drinking to get drunk
• Feeling unable to relax or have fun without alcohol
• Experiencing blackouts (memory lapses) during drinking

Warning Signs of Alcoholism

It may be hard to identify when alcohol use becomes problematic for some folks. But identifying when abuse turns into the actual disorder may be more clear-cut.

Here are some of the top symptoms of alcoholism (alcohol use disorder):

• Excessive drinking habits: Heavy drinking or bring drinking often
• Missing work or school due to a hangover
• Experiencing alcohol intoxication
• Experiencing withdrawal symptoms when trying to stop drinking
• Becoming tolerant to the side effects of alcohol
• Drinking more than intended
• Drinking more often than intended
• Rearranging/shirking life obligations to make time for drinking
• Showing disinterest in hobbies
• Drinking at risky times, such as before driving, working, or operating machinery
• Being unable to control drinking, even when it causes issues with work, school, or relationships

Treatment Options for Alcohol Abuse and Alcoholism

As alcohol abuse and alcoholism differ, so do the right treatment options for people with these conditions.

If a person has mild abuse issues, they may be able to join a support group, such as Alcoholics Anonymous (AA). They may need accountability to reduce drinking and avoid developing an AUD.

However, if abuse has become a dangerous pattern, a person may need more intensive treatment.

With alcoholism, the most important component for alcohol treatment is usually time. A person may need varying levels of care with ‘step-down’ levels to foster long-term sobriety.

Some of the most effective treatment programs for alcoholism include these levels of care:

• Detoxification: Alcohol detox can come with dangerous or even life-threatening symptoms, so detox programs are safest and most effective under medical supervision.
• Medication-assisted treatment (MAT): Medications like naltrexone (Vivitrol) can help people avoid drinking since it produces negative effects when a person drinks alcohol.
• Partial hospitalization programs (PHP): These outpatient programs provide highly structured care for AUD without the need to stay overnight
• Intensive outpatient programs (IOP): Slightly less intensive than a PHP, IOPs are rehab programs that provide outpatient services for AUD.
• Inpatient rehab programs: Residential and inpatient alcohol rehab programs offer 24-hour care in rehabilitation centers or medical facilities, usually paired with detox.
• Aftercare: Counseling, group therapy, rehab alumni groups, and other continuing care options can support a person after they complete their treatment program.
• Sober living homes: Sober living allows people recovering from drugs to be surrounded by sober communities in early recovery.

Getting Help for Someone Facing an Alcohol Use Disorder

You can find the alcohol rehab program you or a beloved family member need to overcome alcohol use disorder at all levels, from alcohol abuse to alcoholism. Here are some actionable steps to take to get help.

1. Take an online alcohol self-assessment

The World Health Organization created the Alcohol Use Disorders Identification Test (AUDIT) based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria for identifying AUD.

An alcohol assessment will give you a quick idea of whether you or your loved one should seek help.

2. Speak to your primary healthcare provider

While this may be a difficult conversation, they can provide further testing to determine whether you need professional help for alcohol and drugs.

3. Visit the Alcohol Treatment Navigator web page (located on the NIAAA website) when you’re ready to search for a treatment provider.

The Alcohol Treatment Navigator provides a wealth of treatment resources, including tips on finding a quality treatment center and a toolkit for your search. You can also visit the SAMHSA site to search for alcohol and drug rehab centers anywhere in the United States.

4. Find an Alcoholics Anonymous (AA) support group

This system has local chapters nationwide and a subchapter of Al-Anon for family members of those facing AUD.

Whatever stage of alcohol misuse you face, know that help is available and that lasting recovery is possible!