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Alcohol Abuse vs Alcoholism

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Key Takeaways

  • Alcohol use disorder (AUD) is a general term for alcohol abuse, alcoholism, alcohol dependence, and alcohol addiction.
  • An alcohol abuser typically drinks excessively but isn’t dependent on alcohol. However, alcohol abuse can turn into alcoholism with continued use. 
  • An alcoholic is a person who is physically and mentally dependent on alcohol. Withdrawal symptoms develop if they stop drinking abruptly.
  • Alcohol dependency means you rely on it to feel normal or cope with everyday life.
  • You can differentiate between alcohol abuse and alcoholism based on the symptoms, extent of use, and treatment approach.
  • AUD’s severity is clinically diagnosed using the Diagnostic and Statistical Manual of Mental Disorders (DSM–5).
  • Severe AUD requires medical assistance to manage unpleasant withdrawal symptoms.

Are Alcohol Abuse and Alcoholism the Same?

You may hear people use "alcohol abuse" and "alcoholism" in the same context. 

The terms sound synonymous, but they actually have different meanings. Their signs, symptoms, and effects on quality of life also differ.

Understanding the difference between alcohol abuse and alcoholism will help you determine the extent of your drinking problem. 

With the right knowledge, you’ll also be able to identify the best treatment approach for you or your loved one.

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Alcohol Abuse Definition

Alcohol abuse is a dangerous habit that can cause significant health problems. 

Drinking too much alcohol puts you at risk of dangerous behaviors such as drunk driving or unsafe sex. 

Abusing alcohol, however, doesn’t mean you’re addicted to or dependent on it. Long-term abuse can lead to addiction, though.

According to health experts, alcohol abuse is a milder form of alcohol use disorder (AUD).1

Alcoholism Definition

Alcoholism, sometimes referred to as alcohol dependence, is a brain disease characterized by excessive alcohol intake. Affected people are physically and mentally dependent on it. 

If you have a strong urge to drink and you're unable to stop despite the harm it causes, you might be an alcoholic.2 

Similarly, if you experience severe withdrawal symptoms when you decrease alcohol intake or stop drinking altogether, you might have a drinking problem.

Severe symptoms of alcoholism such as seizures and delirium tremens (DTs) can cause death. Call 911 immediately if you or someone you know experiences severe symptoms.

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Alcohol Abuse vs. Alcoholism: 3 Main Differences

You can determine the differences between alcohol abuse and alcoholism based on the symptoms, extent of use, and the necessary treatment approach.

1. Signs & Severity of Symptoms 

Alcohol abusers have less severe physical symptoms than alcoholics. 

For example, an alcohol abuser might experience a hangover after a night of drinking. They also often do things they regret while drinking. 

On the other hand, an alcoholic might experience severe withdrawal symptoms immediately as their blood alcohol concentration (BAC) decreases.3 

Some symptoms, such as seizures, can be fatal. Those who abuse alcohol frequently have a greater risk of increased tolerance and addiction.

2. Dependence Level 

A unique difference between alcohol abuse and alcoholism is the level of alcohol dependency.

While alcohol abusers drink irresponsibly, they usually can avoid drinking because they need to be sober for a specific reason or situation. 

Conversely, an alcoholic can’t control their urge to drink. Even if they decide not to drink because of something important, they frequently do it anyway. They rely on alcohol to feel normal.

3. Treatment Process 

Alcohol abuse treatment can differ from alcoholism treatment because of differences in severity.

If you're diagnosed with alcoholism, you'll most likely start treatment with medical detox

Detoxification is a safe way to eliminate alcohol from the body, only when it’s medically supervised. 

Alcohol abusers sometimes benefit from less-intensive treatments such as behavioral therapy and counseling.

Both alcohol abuse and alcoholism can be successfully treated using a combination of therapies, including medications, behavioral therapy, and support groups.

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How is Alcohol Use Disorder (AUD) Diagnosed & Treated?

Alcohol use disorder (AUD) is a general term for alcohol abuse and alcoholism.4

AUD can be mild, moderate, or severe.

According to the American Psychiatric Association (APA), you must meet certain criteria within a 12-month assessment period to be diagnosed with AUD. 

These include:

  • Drinking more alcohol for a longer time than intended
  • Needing more alcohol than usual to achieve the same effect
  • Being unable to cut back on the amount you drink
  • Experiencing prolonged alcohol sickness after heavy drinking
  • Struggling to focus due to strong alcohol cravings
  • Neglecting important family, school, or work duties to drink
  • Continuing to drink despite ruined relationships or adverse health effects
  • Decreasing participation in important activities and hobbies
  • Frequently finding yourself in trouble as a result of your drinking habits
  • Experiencing severe withdrawal symptoms after the effects of alcohol wear off

Your healthcare provider will ask you questions on the above criteria during your AUD diagnosis. 

AUD Severity Level

The number of symptoms identified will determine your severity level:

  • Mild AUD: Two to three
  • Moderate AUD: Four to five
  • Severe AUD: Six or more

The more symptoms you have, the more urgent treatment is needed.  

Different treatment options for alcohol use disorders are available. However, the most effective treatment for alcohol addiction may differ from person to person.5

Managing Alcohol Withdrawal Symptoms 

You might experience withdrawal symptoms regardless of your addiction severity. 

Symptoms usually occur between 24 to 72 hours after your last drink. Their severity can range based on the level of AUD:

Mild Symptoms

  • Headache
  • Dilated pupils
  • Restlessness 
  • Insomnia
  • Sweating
  • Appetite loss
  • Nausea
  • Vomiting

Moderate Symptoms

  • Low-grade fever
  • Anxiety/depression
  • Nightmares
  • Mood swings
  • Irritability
  • Rapid breathing
  • Tremors  
  • Profuse sweating

Severe Symptoms

  • Hallucinations
  • Pale skin
  • Extreme mental confusion
  • Convulsions or seizures 
  • Status epilepticus (long-lasting seizure)
  • Delirium tremens (DTs)6

Inpatient vs. Outpatient Addiction Treatment

If you're diagnosed with moderate to severe AUD, you’ll likely receive treatment in an inpatient or outpatient rehab facility.

In an inpatient setting, you’ll receive addiction treatment while residing in a facility. This approach is suitable for severe cases of addiction. These people aren't able to resist drinking if they aren’t continuously monitored in a controlled environment.

Outpatient treatment allows you to live a normal life while attending planned addiction treatment sessions. This approach is recommended for moderate alcohol addiction, sometimes following inpatient treatment. Those with more control or a structured home environment are also potential candidates.

During addiction treatment, your doctor can manage adverse symptoms through:

  • Alcohol detox: This is a medically supervised process that helps you eliminate alcohol from your system as you begin treatment. 
  • Prescription medications: Medications such as benzodiazepines, anti-seizure medications, and supplements may be used to relieve unpleasant withdrawal symptoms.
  • Cognitive behavioral therapy (CBT): These evidence-based programs focus on behavioral health conditions to manage triggers and prevent relapse. 
  • Twelve-Step Facilitation (TSF) programs: Alcoholic Anonymous (AA) is focused on providing peer-to-peer support among recovering alcoholics.7

Many experts agree that treatment for AUD lasts a long time. Few, if any, people are ‘cured’ after an initial course of treatment and don’t require long-term care and follow-up. 

The vast majority of ‘recovering alcoholics’ do well with informal peer-to-peer networking and meetings, such as Alcoholics Anonymous (AA).

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Updated on March 14, 2022
7 sources cited
  1. Alcohol Use Disorder (AUD),” National Library of Medicine, 26 Oct. 2021
  2. Understanding Alcohol Use Disorder,” National Institute on Alcohol Abuse and Alcoholism (NIAAA),  Apr. 2021
  3. Saitz R. “Introduction to Alcohol Withdrawal,” National Center for Biotechnology Information (NCBI)
  4. Alcohol Use Disorder: A Comparison Between DSM–IV and DSM–5,” National Institute on Alcohol Abuse and Alcoholism (NIAAA), Apr. 2021
  5. Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition),” National Institute of Drug Abuse (NIDA), Jan. 2018
  6. Delirium tremens,” National Library of Medicine, 30 Nov. 2021
  7. Kelly J. et al.,“Alcoholics Anonymous and other 12-step programs for alcohol use disorder,”  John Wiley & Sons, Inc 11 Mar. 2020

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