01 Jan Alcohol Abuse vs. Alcohol Dependence
You may hear a lot of different terms when referring to addiction and substance abuse. Those are two of them. You might also hear terms like alcoholism, alcohol abuse, alcohol dependence and alcohol use disorder. Are there differences between these terms? Do they all refer to essentially the same thing? Not quite. Let’s take a closer look.
What Is Alcoholism?
Alcoholism is used to describe a person who has advanced alcohol dependence. However, some people use the term more casually to describe someone that they think drinks too much. A person who has alcoholism is often referred to as an alcoholic.
The description of alcoholism by Alcoholics Anonymous uses the following signs:
• You sincerely want to quit drinking, but you can’t
• You have little to no control over the amount you drink
Alcoholics Anonymous also says that they cannot tell you if you have alcoholism, but that it’s a decision you have to make on your own. Another definition of alcoholism is continuing to drink despite any negative consequences. Essentially, alcoholism is the chronic and usually uncontrollable consumption of alcohol in spite of the negative effects on your life and health. A professional addiction treatment specialist can make a more accurate diagnosis when you seek help.
What Is An Alcohol Use Disorder?
Alcohol use disorder is defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM). The DSM is used by mental health professionals to diagnose people seeking treatment for conditions that include alcohol use disorder. In 2013, the DSM combined alcohol abuse and alcohol dependence into alcohol use disorder. The previous two designations were considered deviant use of alcohol.
Alcohol use disorder (AUD) is separated into three different classifications:
The DSM diagnosis for alcohol use disorder is defined by how many designated symptoms a person has experienced in the last 12 months.
The symptoms are as follows:
• Drinking more alcohol for a longer duration than intended
• Being unable to cut back on the amount of alcohol consumed
• Getting sick from the amount of alcohol you consume
• Difficulty concentrating due to cravings for alcohol
• Inability to uphold your responsibilities due to drinking too much
• Continuing to abuse alcohol despite the problems it’s causing
• Withdrawing from hobbies and interests
• Ending up in risky situations due to drinking
• Continuing to drink despite compounding health problems
• Drinking more due to alcohol tolerance
• Withdrawal symptoms
If you have experienced at least two of these symptoms, it’s likely that you have an alcohol use disorder. In terms of what level of AUD you have, it depends on the number of symptoms from the above list. Your alcohol use disorder is likely mild if you have two to three symptoms. If you have four or five symptoms, then you have moderate AUD. Six or more symptoms means that you have severe AUD.
What Is Alcohol Dependence?
As previously mentioned, alcohol abuse and dependence were combined into alcohol use disorder for diagnostic use. However, it’s useful to discuss what dependence is when it comes to alcohol abuse. In simple terms, dependence is when your body has adapted to a particular substance and needs more to have the same effect. It also means that your body will experience withdrawal symptoms when you stop using a substance or cut back. It’s possible to develop a physical dependence on something and not be addicted. You can also form a dependence on alcohol without necessarily taking part in alcohol abuse. Alcohol abuse can lead to dependence, but the two conditions are not exactly the same.
You can also have a psychological dependence on alcohol. For example, feeling like you need alcohol in order to function in a social setting, or feeling like you need a drink as soon as you get back from work to cope with stress and relax.
The following are some symptoms of dependence:
• Developing a tolerance so that you need more for the same effect
• Physical symptoms like chills, nausea, headache, etc. after the effect wears off
• Psychological symptoms like irritability, anxiety or depression if you can’t drink
• Denying that you have an alcohol abuse problem
• Trying to quit drinking and failing
What Is Alcohol Abuse?
If dependence is having a physical and/or psychological need and tolerance for alcohol, then what is alcohol abuse? Abuse is generally defined as problematic use of a substance that causes harm to the user and/or people around them. As previously mentioned, alcohol abuse can lead to dependence. Alcoholism is essentially chronic alcohol abuse where you’re both dependent on alcohol and abusing it despite negative effects on your life and the life of others.
The following are some distinct behavioral signs of alcohol abuse:
• Missing work regularly due to drunkenness or the need to drink
• Forgetting to pick your kids up at school because you’re too drunk to drive
• Getting arrested for behavior related to alcohol abuse
• Regularly driving drunk
• Arguing with your spouse or separating due to your alcohol abuse
• Drinking alone, drinking in secret, or drinking all day
• Drinking to deal with stress or to feel normal
There are also some physical signs of alcohol abuse, including the following:
• Blackouts or forgetting things that happened the night before
• Flushed face and broken capillaries
• Trembling hands
• Husky voice
• Chronic diarrhea and bloody stools
• Headache, nausea or insomnia when you stop drinking
Treatment Differences For Alcohol Abuse vs. Dependence
Chronic abuse of alcohol is considered alcoholism, but not everyone with alcoholism is dependent. If you do have alcoholism and a dependence on alcohol, then you will have to go through a detox period before further treatment. It’s very important to seek detox treatment if you have a dependence on alcohol as withdrawal symptoms can be fatal. After a period of detox, you can enter into the next phase of treatment, which involves group therapy, individual counseling and possibly other types of therapy.
Treatment for alcoholism doesn’t always require detox if you don’t have a dependence. However, it does require education and counseling to help you find the underlying problem. Many people with alcoholism have underlying mental health issues that cause them to use alcohol as a form of self-medication. For example, you may not realize that you’re drinking heavily to assuage undiagnosed anxiety. Treatment for alcoholism gives you the skills you will need to lead a sober life going forward.
New Method Wellness provides comprehensive treatment for alcoholism and alcohol abuse, including dual diagnosis treatment for those with alcoholism and another mental disorder. We have a professional and caring staff as well as a range of holistic and evidence-based treatments. If you or a loved one is struggling with alcoholism, contact us today to find out how we can help.