Alcohol Dependence vs. Alcohol Abuse: What's the Difference?

Table of ContentsView AllTable of ContentsWhat Is Alcohol Dependence?What Is Alcohol Abuse?What Is Alcohol Use Disorder?How Much Is Too Much?Alcohol Withdrawal SymptomsTreatments That Can Help

Table of ContentsView All

View All

Table of Contents

What Is Alcohol Dependence?

What Is Alcohol Abuse?

What Is Alcohol Use Disorder?

How Much Is Too Much?

Alcohol Withdrawal Symptoms

Treatments That Can Help

Until the publication of the 5th edition of the"Diagnostic and Statistical Manual of Mental Disorders" (DSM-5), problems with substance use were generally divided into “abuse” and “dependence.” The DSM-5 combined these categories into a single diagnosis of “substance use disorder,” measured on a continuum from mild to severe.

This change was made to challenge the idea that abuse was a mild and early phase of the illness and dependence was a more severe manifestation. In reality, abuse can be quite severe.

At a GlanceAlcohol dependence causes people to keep drinking to avoid experiencing withdrawal symptoms. Alcohol abuse, on the other hand, involves drinking excessively without having a physical dependence. Both have serious health risks.While the two are no longer differentiated in the DSM, understanding their original definitions can still be helpful. This article discusses alcohol dependence, alcohol abuse, and the key differences between them.

At a Glance

Alcohol dependence causes people to keep drinking to avoid experiencing withdrawal symptoms. Alcohol abuse, on the other hand, involves drinking excessively without having a physical dependence. Both have serious health risks.While the two are no longer differentiated in the DSM, understanding their original definitions can still be helpful. This article discusses alcohol dependence, alcohol abuse, and the key differences between them.

Alcohol dependence causes people to keep drinking to avoid experiencing withdrawal symptoms. Alcohol abuse, on the other hand, involves drinking excessively without having a physical dependence. Both have serious health risks.

While the two are no longer differentiated in the DSM, understanding their original definitions can still be helpful. This article discusses alcohol dependence, alcohol abuse, and the key differences between them.

People who have a dependence on alcohol exhibit some or all of the following characteristics.

RecapAlcohol dependence refers to being unable to stop drinking without experiencing symptoms of withdrawal. People often continue drinking to alleviate these unpleasant symptoms.

Recap

Alcohol dependence refers to being unable to stop drinking without experiencing symptoms of withdrawal. People often continue drinking to alleviate these unpleasant symptoms.

Alcohol abuse was defined as a condition in which a person continues to drink despite recurrent social, interpersonal, health, or legal problems as a result of their alcohol use.A person who abuses alcohol may also be dependent on alcohol, but they may also be able to stop drinking without experiencing withdrawal symptoms.

According to a study published in the journalPreventing Chronic Disease, 90% of people who abuse alcohol are not alcohol dependent.

This included people who engaged in excessive drinking andbinge drinking. However, the study did find that people who engaged in binge drinking more often were also more likely to be alcohol dependent.

RecapAlcohol abuse refers to continuing to use alcohol, often excessively, even though it creates problems in a person’s life, including health, relationship, and work-related consequences.

Alcohol abuse refers to continuing to use alcohol, often excessively, even though it creates problems in a person’s life, including health, relationship, and work-related consequences.

Alcohol DependenceRefers to an inability to stop drinking without experiencing withdrawal symptomsInvolves developing an alcohol toleranceAlcohol AbuseRefers to excessive alcohol useThe person continues to drink despite legal, social, or health problems

Alcohol DependenceRefers to an inability to stop drinking without experiencing withdrawal symptomsInvolves developing an alcohol tolerance

Refers to an inability to stop drinking without experiencing withdrawal symptoms

Involves developing an alcohol tolerance

Alcohol AbuseRefers to excessive alcohol useThe person continues to drink despite legal, social, or health problems

Refers to excessive alcohol use

The person continues to drink despite legal, social, or health problems

People who use alcohol excessively may havealcohol use disorder. Signs of the condition include characteristics that were previously labeled as either abuse or dependence. Some common symptoms include:

Those with moderate to severe alcohol use disorders generally require outside help to stop drinking. This could includedetoxification, medical treatment,professional rehabor counseling, and/or self-help group support.

Changing Terminology

Research has shown that the terminology used does, in fact, influence how people with a substance use disorder view themselves as well as how others view them.

For example, " abuse " may imply that the behavior is intentional and controllable and, therefore, a personal failure rather than a disease symptom. Referring to this condition as alcohol use disorder is more accurate and less stigmatizing.

It also emphasizes that the condition is a diagnosable, chronic, and relapsing brain disease, not a moral or personal failure.

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Are your drinking habits safe, risky, or harmful? Could your alcohol use be a sign of abuse or dependence? Looking at the symptoms mentioned above can give you an idea of how your drinking may fall into harmful patterns and indicate whether or not you have a drinking problem.

What Is Moderate Drinking?

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) suggests that heavy alcohol use involves drinking four or more drinks a day (or more than 14 a week) for men and more than three drinks a day (or more than seven drinks a week) for women.

NIAAA defines binge drinking as consuming five or more drinks for men and four or more drinks for women in two hours or less.

If you or a loved one are struggling with substance use or addiction, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat1-800-662-4357for information on support and treatment facilities in your area.For more mental health resources, see ourNational Helpline Database.

If you or a loved one are struggling with substance use or addiction, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat1-800-662-4357for information on support and treatment facilities in your area.

For more mental health resources, see ourNational Helpline Database.

What Does Having an “Alcohol Problem” Mean?

If you have developed alcohol dependence and decide to quit drinking, you can expect to experience withdrawal symptoms. According to information from the National Institutes of Health, these discomforts usually peak 24 to 72 hours after your last drink, but they may last for weeks.

Those with mild to moderate symptoms may receive treatment in an outpatient setting. You should ask a loved one to stay with you during this process, and you may need to visit a clinician for daily monitoring.

If you have moderate to severe symptoms of alcohol withdrawal, you may require inpatient treatment at a hospital or substance abuse facility. Symptoms of severe alcohol withdrawal include:

Common Alcohol Withdrawal Symptoms

A doctor may alsoprescribe medicationsto help you manage withdrawal symptoms and support you in your effort to stop drinking.Benzodiazepinescan help alleviate withdrawal symptoms, whilenaltrexonemay help you manage alcohol cravings.

Before you decide to stop drinking, talk to a healthcare provider to determine what treatment options are available and whether you would benefit from medical supervision during detox.

If you have been consuming alcohol heavily for an extended period, quitting on your own has the potential to be dangerous.

Delirium tremensis a symptom of severe alcohol withdrawal that can be potentially fatal. Contact emergency services immediately if you experience symptoms such as fever, involuntary muscle contractions, seizures, delusions, hallucinations, or rapid mood swings as you withdraw from alcohol.

Summary

Alcohol dependence and alcohol abuse were two designations previously recognized in the DSM-IV. Today, they have been combined and are known as alcohol use disorder. While no longer separate diagnoses, it can be helpful to understand the differences between the two. “Dependence” refers to being unable to stop drinking without experiencing withdrawal symptoms while “abuse” refers to continuing to consume alcohol despite adverse consequences.

What This Means For YouIf you think you might have an alcohol problem, discuss it with a healthcare provider. They can offer advice on how to approach your treatment and assist you with the process of detoxing, withdrawing, and recovering from alcohol use disorder. Everyone’s experience with alcohol is different, but effective treatments are available, whether your condition is mild, moderate, or severe.

What This Means For You

If you think you might have an alcohol problem, discuss it with a healthcare provider. They can offer advice on how to approach your treatment and assist you with the process of detoxing, withdrawing, and recovering from alcohol use disorder. Everyone’s experience with alcohol is different, but effective treatments are available, whether your condition is mild, moderate, or severe.

What an Alcohol Use Disorder Diagnosis Means

8 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institute on Alcohol Abuse and Alcoholism.Alcohol use disorder: A comparison between DSM–IV and DSM–5.Esser MB, Hedden SL, Kanny D, Brewer RD, Gfroerer JC, Naimi TS.Prevalence of alcohol dependence among US adult drinkers, 2009-2011.Prev Chronic Dis. 2014;11:E206. doi:10.5888/pcd11.140329U.S. National Library of Medicine.Alcohol withdrawal.National Institute on Alcohol Abuse and Alcoholism.Understanding alcohol use disorder.Kelly JF, Westerhoff CM.Does it matter how we refer to individuals with substance-related conditions? A randomized study of two commonly used terms.Int J Drug Policy. 2010 May;21(3):202-7. doi:10.1016/j.drugpo.2009.10.010National Institute on Drug Abuse.Words matter - terms to use and avoid when talking about addiction.USDA.Dietary Guidelines for Americans, 2020-2025.National Institute on Alcohol Abuse and Alcoholism.Drinking levels defined.

8 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institute on Alcohol Abuse and Alcoholism.Alcohol use disorder: A comparison between DSM–IV and DSM–5.Esser MB, Hedden SL, Kanny D, Brewer RD, Gfroerer JC, Naimi TS.Prevalence of alcohol dependence among US adult drinkers, 2009-2011.Prev Chronic Dis. 2014;11:E206. doi:10.5888/pcd11.140329U.S. National Library of Medicine.Alcohol withdrawal.National Institute on Alcohol Abuse and Alcoholism.Understanding alcohol use disorder.Kelly JF, Westerhoff CM.Does it matter how we refer to individuals with substance-related conditions? A randomized study of two commonly used terms.Int J Drug Policy. 2010 May;21(3):202-7. doi:10.1016/j.drugpo.2009.10.010National Institute on Drug Abuse.Words matter - terms to use and avoid when talking about addiction.USDA.Dietary Guidelines for Americans, 2020-2025.National Institute on Alcohol Abuse and Alcoholism.Drinking levels defined.

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

National Institute on Alcohol Abuse and Alcoholism.Alcohol use disorder: A comparison between DSM–IV and DSM–5.Esser MB, Hedden SL, Kanny D, Brewer RD, Gfroerer JC, Naimi TS.Prevalence of alcohol dependence among US adult drinkers, 2009-2011.Prev Chronic Dis. 2014;11:E206. doi:10.5888/pcd11.140329U.S. National Library of Medicine.Alcohol withdrawal.National Institute on Alcohol Abuse and Alcoholism.Understanding alcohol use disorder.Kelly JF, Westerhoff CM.Does it matter how we refer to individuals with substance-related conditions? A randomized study of two commonly used terms.Int J Drug Policy. 2010 May;21(3):202-7. doi:10.1016/j.drugpo.2009.10.010National Institute on Drug Abuse.Words matter - terms to use and avoid when talking about addiction.USDA.Dietary Guidelines for Americans, 2020-2025.National Institute on Alcohol Abuse and Alcoholism.Drinking levels defined.

National Institute on Alcohol Abuse and Alcoholism.Alcohol use disorder: A comparison between DSM–IV and DSM–5.

Esser MB, Hedden SL, Kanny D, Brewer RD, Gfroerer JC, Naimi TS.Prevalence of alcohol dependence among US adult drinkers, 2009-2011.Prev Chronic Dis. 2014;11:E206. doi:10.5888/pcd11.140329

U.S. National Library of Medicine.Alcohol withdrawal.

National Institute on Alcohol Abuse and Alcoholism.Understanding alcohol use disorder.

Kelly JF, Westerhoff CM.Does it matter how we refer to individuals with substance-related conditions? A randomized study of two commonly used terms.Int J Drug Policy. 2010 May;21(3):202-7. doi:10.1016/j.drugpo.2009.10.010

National Institute on Drug Abuse.Words matter - terms to use and avoid when talking about addiction.

USDA.Dietary Guidelines for Americans, 2020-2025.

National Institute on Alcohol Abuse and Alcoholism.Drinking levels defined.

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