Is it alcoholism? How can you tell?
Fear of the labels, alcoholism and alcoholic, often keeps people from looking at their drinking patterns. Yet more often than not, the real problem is alcohol abuse. Alcohol abuse can lead to alcoholism, but in and of itself, it is not alcoholism. Here’s information that can help.
There’s a common belief that drinking is either “normal” or “alcoholic,” when in actuality, there’s a third stage of drinking. It’s called alcohol abuse. And it’s during the stage of alcohol abuse that a person’s brain starts the chemical and structural changes that make their brain more susceptible to the five key risk factors for developing the disease of alcoholism.
Alcohol abuse can be stopped, IF a person changes their drinking patterns to fall within “low-risk” levels (see below) and finds they no longer experience the emotional, physical and relationship issues associated with alcohol abuse. Alcoholism, on the other hand, can be entirely, successfully treated, however successful treatment means a person cannot drink any amount. Period. Why? Because of the nature of the brain disease of alcoholism.
These are bold statements, to be sure, and likely confusing. So to help you better understand that alcoholism is a brain disease (no drinking) and alcohol abuse is a condition (low-risk drinking may be possible), please consider watching these two short videos.
AT-RISK Drinking Patterns Defined (the kind of drinking that leads to Alcohol Abuse)
The Difference Between Alcoholism and Alcohol Abuse
And if you are wondering whether your or a family member or friend’s drinking has crossed the line from alcohol abuse to alcoholism, consider assessing your drinking patterns using the World Health Organization’s 10 question Alcohol Use Disorders Identification Test (AUDIT). You might also visit the National Institute on Alcohol Abuse and Alcoholism’s (NIAAA) website, Rethinking Drinking. There you will find assessments, tips for cutting down, drink calculators, and resources for more help and information.
Bottom line: Alcoholism is a brain disease (one of the brain diseases of addiction). It is not alcohol abuse. To treat alcoholism, drinking must be stopped entirely due to the nature of the brain disease, itself. To stop alcohol abuse, on the other hand, a person may be able to curtail their drinking by staying within “low-risk limits,” which are defined by NIAAA as:
- no more than 7 standard drinks/week or 3 on any day for women
- no more than 14 standard drinks/week or 4 on any day for men
- a standard drink = 5 ounces of table wine; 1.5 ounces of “hard liquor,” such as 80-proof vodka, bourbon, scotch or gin; 12 ounces of regular beer; or 8-9 ounces of malt liquor, such as ale or lager beers.
And one more thing… It’s important to understand that sometimes a person who drinks way beyond “low-risk” limits decides it’s just easier to stop drinking all together. This does not make them an alcoholic. Additionally, some people who drink at “low-risk” limits may still experience physical, emotional or relationship problems, in which case, the best course of action may be to stop drinking all together.
35% of American adults ages 18 and older do not drink any alcohol [NIAAA]. Sometimes it helps to know, not everybody drinks.
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Great post that clarifies the differences between alcohol use and alcoholism. Often the focus is on the extremes of addiction which is why we need to understand that there are different stages of drinking.
Interesting to know that 35% of adults age 18 and over don’t drink at all. It’s good to have that perspective!
It often helps people to know that statistic — it helps teens, as well, to know that the “norm” is not “everybody.” Thanks for reading and adding your comment!
Lisa, I am not American but I am one of those people who don’t drink at all…a decision that I made in my early teens, so have not had to experience any issues with alcohol. Some of my extended family members did though, and it is a tough road for people…there is a lot of damage. I appreciate that you have outlined the differences between alcoholism and alcohol abuse.
You are so right — there can be a great deal of damage — especially to those who are on the receiving end of the drinking behaviors. Thank you so much for reading and adding your comment!
Great videos and post Lisa! I was not aware of the “standards”. My husband and I like to enjoy a drink every now and then, so it’s good to know what the actual limit is!
It’s wonderful that there is a “target” now. Thanks so much for reading, watching and commenting!
Amazing article and something many people need to hear. I am in that 35% of non-drinkers. For me, it is a pointless endeavor and a waste of money. That is my opinion mind you based on my experience. In my mind, drinking is for one reason only and that is to alter your body and mind. Otherwise, what is the point? Drink some great tea! lol I prefer to know that I’m always thinking, talking and responding as I always would. If I “alter” me then I am no longer authentic.
This is simply my personal view. 
Good for you! Here’s another statistic from NIAAA — 37% of Americans ages 18 and older always stay within low-risk limits. Thanks for reading and adding your comment!
What an informative post Lisa, thanks for sharing and clarifying. Alcohol abuse is so often overlooked or forgotten.
You are so right — alcohol abuse is so often overlooked — mostly because people don’t want to label or be labeled an alcoholic. Hopefully understanding the difference and knowing there’s a low-risk drinking target can help those who do abuse alcohol change their drinking patterns. Thanks for reading and your comment!
oh my…such great information. I migt have told you already that my sister died as an alcolholist; she had many symptoms and it was very sad to look at!! I like to drink a glas of wine so now and then, I don’t feel guilty about it, because I also heard that drinking a glass of wine is good for your heatlh, do you agree??
For some people, drinking at low risk limits (e.g., a glass of wine) can be good for their health, but researchers are also finding that for some, even low-risk limits are not healthy (generally there are other health concerns and/or medications that don’t interact well with alcohol in these instances). I’m so sorry about your sister — the new research on the brain disease of alcoholism is sure helping people better understand how alcohol hijacks the brain, why alcoholism is a brain disease, and how it can be treated effectively, which offers great hope for the future. Thanks so much for reading and adding your comment.
Our family lost one in every generation to alcohol – it never occurred to us that there was a difference between alcohol abuse and alcoholism. Very interesting and helpful information!
Not knowing there was a difference had been my experience as well. As it turns out, there are far more alcohol abusers than there are alcoholics — so that’s really the bigger problem from the standpoint of drinking behaviors, impacts on the health of heavy drinkers, and impacts on the health of those who try to cope with the chaos that occurs when a person loses control of their normal brain functioning as a result of drinking too much. Thanks so much for reading and adding your comment!
Very interesting! Glad to know the statistics on non-drinkers. Will pass that along to my sons, who sometimes feel they are the lone rangers if they say no.
That’s great and how wonderful they are staying strong in their decision not to drink! Thanks for reading and adding your comment!
Lisa, for me too the distinction between alcohol abusers and alcoholics (based on impact on the brain) was fascinating. Charlie Rose’s TV program has a series on the brain, with a new segment every so often, and the advances in knowledge in the past 10-15 years due to technology are remarkable. So I’m not surprised that the understanding of alcoholism has grown as well. I have watched alcoholic friends stop drinking and now understand better why it has to be forever. Eye-opening!
Thank you, Sharon! I know from my own experiences with loved ones and friends who either abuse(d) or were dependent on alcohol, it was this new research that made all the difference. I could finally let go of believing that those who were alcoholics (had the brain disease of alcoholism) could learn to re-drink if they wanted to badly enough and then feeling hurt and angry when that didn’t happen. That’s when I could also start looking at what I needed to do to make my life better regardless of whether they stopped their drinking. I so agree with you that Charlie Rose’s series is excellent. 60 Minutes had a recent program with Dr. Nora Volkow (Director of NIDA) on addiction that was also fascinating. Exciting times!!
Love how you explain the science behind alcoholism, I learn something new from you every week!
Thanks so much, Sherry — so glad it’s helpful!
Alcoholism and alcohol abuse is a great debate as well as disease…genetics and all the other information we are now given. I am always interested to hear others take on it. Thanks for sharing your thoughts
Thank you for reading and adding your comment, Anita! It’s now understood that alcoholism is a developmental disease, and the five key risk factors contributing to a person developing the disease are genetics, social environment, mental illness, early use and childhood trauma. It all starts, however, with alcohol abuse, which is what sets up the chemical and structural brain changes that makes a person more susceptible to their risk factors. Childhood trauma, mental illness and brain development ages 12-25, for example, are all brain changers, which is where, in part, the susceptibility comes in…. Exciting times for better understanding and therefore more effectively treating all of this.
Very informative videos, Lisa. I even ask that question on my massage intake forms because it makes a difference on how I may do certain massage techniques. I sometimes get lots of conversation around that question in people asking what is too much. Wonderful resource and thanks!
That’s so interesting that you assess alcohol use as part of your massage techniques — makes total sense! Thanks so much for reading, watching and adding your comment!
I love this article.. I have seen many life affected by alcohol and the abuse of it! Thanks for sharing the difference and saying hey it’s okay not to drink!
You’re so welcome! Thanks for reading and adding your comment.
This has ruin many a marriage.. and i have to see ugly things because of it. Thanks for sharing Lisa.. this is very Educational.
It does ruin so many marriages and so many children’s childhoods. Thanks so much for reading and adding your comment!
It is interesting how 35 % of the population doesn’t drink, that means that 65% of the population does, I would like to hear some of the reasons behind why those 35 % don’t and why the 65% do, just to know.
Another NIAAA statistic is that 37% always stay within low-risk limits. As for reasons – I don’t a research study of reasons, but what I’ve read and been told, the reasons people don’t drink have to do with concerns about what happens to their behaviors when they do drink, don’t feel a need to drink, never wanted to drink, don’t see the point… as for why people do – generally, it’s because they enjoy the relaxing feeling they get when they drink…. Thanks for reading and adding your comment.
Very interesting article Lisa. My parents were both heavy drinkers, and reading this I can see now where one was an alcoholic and didn’t touch the stuff, and the other was actually an alcohol abuser. Definitely sheds light on a few things. Thanks!
You’re so welcome, Helena! Thanks for reading and adding your comment.
Great information as always Lisa! Great to share that “35% of American adults ages 18 and older do not drink any alcohol…” We often forget that. Take care.
Yes — and the other statistic, too — 37% always stay within low-risk limits. Thanks so much for adding your comment, Cathy!
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Great article. Thanks for the information. This will make a lot of people realize and consider their choices as they can become addictions that could affect the quality of life. There are people who do not acknowledge their faults. To recover from addiction, treatment starts with the acceptance that you are an addict who needs help.
You’re absolutely right, Jason – to recover from an addiction, a person has to admit they can no longer control their brains (therefore their behaviors) if they consume any amount of their substance of choice. For those who are not addicted but do abuse a substance and thereby change their behaviors, it is possible to change drinking patterns to fall within low-risk limits (or prescription drug use patterns to fall within prescribed limits). But that takes dedication and a deep commitment to change, as well. Thanks so much for your comment – glad you liked the article!