Alcohol Use / Abuse / Dependence (Alcoholism) – What’s the Difference?

by Lisa Frederiksen

For ages (like 35 years), I’d always viewed drinking as either alcoholic or normal. You can imagine my surprise when I learned there’s a third level / stage to drinking and that is alcohol abuse, what we commonly think of as excessive drinking or problematic drinking. I am going to copy the answer to FAQ #1, here, so if you’ve already read it, skip to the comments section and add your thoughts.

Alcohol abuse is the term used to describe the various forms of excessive drinking that cause significant risk, harm and distress to the excessive drinker and to his or her family and friends (1) - risk, harm and distress that equals that which is most often associated with alcoholism. These include driving while intoxicated, relationship problems with a spouse, parent, boss, friend or child, suspension from school or absences from work and/or arrests.

For many who are grappling with what to do about a loved one’s drinking, it is helpful to understand the difference between alcohol use, alcohol abuse (excessive drinking) and alcohol dependence (alcoholism). Alcohol use is also known as “normal” or “moderate drinking.” Alcohol dependence (alcoholism) is an addiction, a chronic, often relapsing brain disease. Alcohol abuse is when a person continues to excessively drink in spite of the problems their drinking is causing. All alcoholics go through a period of alcohol abuse. Not all alcohol abusers become alcoholics.(2)

As for how you can tell…the World Health Organization (WHO) and the National Institute on Alcohol Abuse and Alcoholism (NIAAA) provide assessments. While a medical professional should be the one to conduct the assessment and make the determination, you can do it, too, from your perspective, to see where your loved one’s drinking falls. It is important to understand that you are assessing for your sake – not to get your loved one to “see the light.” But, it does help you to understand what you are dealing with and that can free you to learn more about what you can do about the situation.

And, while you’re going through the assessment, know that one drink in America is defined as:

• a 5 ounce glass of wine
• a 12 ounce beer
• 1.5 ounces (a shot) of 80-proof distilled spirits (scotch, gin, vodka)

As an FYI — the NIAAA defines alcohol use that’s not likely to cause problems as:

• no more than 3 drinks in a day AND no more than 7 in a week for women
• no more than 4 drinks in a day AND no more than 14 drinks in a week for men

Note: 4 or more drinks on one occasion for women and 5 or more drinks on one occasion for men is considered binge drinking. Binge drinking is not considered “normal” drinking.

As always, please share your comments. What struck you about this information? Does it help? Or????

________________________________

(1) Babor, Thomas F., John C. Higgins-Biddle, John B. Saunders and Maristela G. Monteiro, AUDIT (The Alcohol Use Disorders Identification Test), World Health Organization (WHO), page 5, <http://whqlibdoc.who.int/hq/2001/WHO_MSD_MSB_01.6a.pdf>

(2) Ibid