Alcohol Abuse vs. Alcohol Dependence

1. Alcohol Abuse

Substance abuse experts make a distinction between alcohol abuse and alcohol dependence (also called alcoholism). 

Alcohol abuse is a maladaptive pattern of use leading to clinically significant impairment or distress, as manifested by one (or more) of the following, occurring within a 12-month period: 

• 1. Role impairment: Frequent intoxication leading to failure to fulfill major role obligations (e.g. at school, work, or home). Repeatedly neglecting your responsibilities at home, work, or school because of your drinking. For example, performing poorly at work, flunking classes, neglecting your kids, or skipping out on commitments because you’re drunk or hung over.
• 2. Hazardous Use: Recurrent Use when it is physically hazardous (e.g., driving while intoxicated). Using alcohol in situations where it’s physically dangerous, such as drinking under the influence, operating machinery while intoxicated, or mixing alcohol with prescription medication against doctor’s orders.
• 3. Legal Problems: Recurrent alcohol-related legal problems. Experiencing repeated legal problems on account of your drinking. For example, getting arrested for driving under the influence or for drunk and disorderly conduct.
• 4. Social Problems: Continued drinking despite knowledge of persistent or recurrent social or interpersonal problems caused or exacerbated by alcohol use. Continuing to drink even though your alcohol use is causing problems in your relationships. Getting drunk with your buddies, for example, even though you know your wife will be very upset, or fighting with your family because they dislike how you act when you drink. Drinking as a way to relax or de-stress. Many drinking problems start when people use alcohol to self-soothe and relieve stress. Getting drunk after every stressful day, for example, or reaching for a bottle every time you have an argument with your spouse or boss.

The path from alcohol abuse to alcohol dependence (alcoholism) 

Not all alcohol abusers become full-blown alcoholics, but it is a big risk factor. Sometimes alcohol dependence develops suddenly in response to a stressful change, such as a breakup, retirement, or another loss. Other times, it gradually creeps up on you as your tolerance to alcohol increases. If you’re a binge drinker or you drink every day, the risks of developing alcohol dependence are even greater.

2. Alcohol Dependence (Alcoholism)

Alcohol Dependence is the most severe form of problem drinking. It involves a maladaptive pattern of alcohol use, leading to clinically significant impairment or distress, as manifested by three (or more) of the following, occurring at any time in the same 12-month period: 

• 1. Tolerance: Tolerance as defined by either (a) a need for markedly increased amount of alcohol to achieve intoxication or desired effect; (b) markedly reduced effect when drinking the same amount; For example, do you have to drink a lot more than you used to in order to get buzzed or to feel relaxed? Can you drink more than other people without getting drunk? These are signs of tolerance, which can be an early warning sign of alcohol dependence. Tolerance means that, over time, you need more and more alcohol to feel the same effects.
• 2. Withdrawal: Signs of alcohol withdrawal; drinking to avoid or relieve withdrawal; Example, do you need a drink to steady the shakes in the morning? Drinking to relieve or avoid withdrawal symptoms is a sign of alcohol dependence and a huge red flag. When you drink heavily, your body gets used to the alcohol and experiences withdrawal symptoms if it’s taken away. These include: Anxiety or jumpiness, Shakiness or trembling, Sweating, Nausea and vomiting, Insomnia, Depression, Irritability, Fatigue, Loss of appetite, Headaches. In severe cases, withdrawal from alcohol can also involve hallucinations, confusion, seizures, fever, and agitation. These symptoms can be dangerous, so talk to your doctor if you are a heavy drinker and want to quit.

• 3. Using more or longer than intended: Recurrent drinking of larger amounts or for a longer period of time than intended. You’ve lost control over your drinking. You often drink more alcohol than you wanted to, for longer than you intended, or despite telling yourself you wouldn’t.
• 4. Quit/Cut Down/Control : Unsuccessful attempts or a persistent desire to quit, cut down, or control once drinking. You want to quit drinking, but you can’t. You have a persistent desire to cut down or stop your alcohol use, but your efforts to control it or to quit have been unsuccessful.
• 5. Much time spent using alcohol: Much time spent using, obtaining, or recovering from the effects of alcohol. Alcohol takes up a great deal of your energy and focus. You spend a lot of time drinking, thinking about it, or recovering from its effects. You have few if any interests or social involvements that don’t revolve around drinking.
• 6. Reduced activity: Important social or recreational activities given up or reduced in favor of alcohol use. You have given up other activities because of alcohol. You’re spending less time on activities that used to be important to you (hanging out with family and friends, going to the gym, pursuing your hobbies) because of your alcohol use.
• 7. Psychological/physical problems: Continued drinking despite knowledge of a recurrent or persistent psychological or physical problem caused or exacerbated by alcohol use. You drink even though you know it’s causing problems. For example, you recognize that your alcohol use is damaging your marriage, making your depression worse, or causing health problems, but you continue to drink anyway.

3. Solving Your Alcohol Abuse or Alcohol Dependence In 3 Steps: 

You have already taken the first step by admitting you have a drinking problem. It takes tremendous strength and courage to face alcohol abuse and alcoholism head on.

Reaching out for support is the second step. Support is essential. Recovering from alcohol addiction is much easier when you have people you can lean on for encouragement, comfort, and guidance. Support can come from family members, friends, co-workers, gym-buddies, other recovering alcoholics, or people from your faith community. Without support, recovery will most likely not be possible.

Getting Sober Is Only The Beginning

Your continued recovery depends on continuing mental health counseling, learning healthier coping strategies, and making better decisions when dealing with life’s challenges. In order to stay alcohol-free for the long term, you’ll also have to face the underlying problems that led to your alcohol dependence or alcohol abuse in the first place. This is the third step. Those problems could be depression, an inability to manage stress, an unresolved trauma from your childhood, or any number of issues. Such problems may become more prominent when you’re no longer using alcohol to cover them up. But you will be in a better position to finally address them and seek the help you need.