Alcohol Abuse Vs. Dependence: When Is Drinking a Problem?

Prescription drugs and alcohol are two of the most challenging drugs to determine if use has turned into a problem. For example, with prescription drugs, a person who is prescribed is under the illusion these drugs are safe, and problems can’t occur because a physician deemed them worthy of using them. For that reason, it’s easy to start abusing the drug(s) and become addicted without knowing a problem has occurred.

Albeit different, and it’s not considered a medication to treat an ailment, alcohol faces similar issues because of its legality and not knowing when the lines are crossed. It may start as a glass of wine with dinner or drinks on the weekends with friends, but you might find yourself needing more and more to experience the desired effect or start drinking to get through the day.

What makes alcohol even more challenging to resist is the constant reminders – you can walk through a grocery store and see an entire aisle dedicated to the substance, and when you leave, you’ll see billboards of happy people drinking or hear an advertisement on the radio. As you can imagine, an individual battling alcohol addiction faces unique challenges. 

According to the U.S. Centers for Disease Control and Prevention (CDC), excessive alcohol use is responsible for more than 95,000 deaths in the United States, translating to 261 deaths a day. The same study shows that these deaths shorten the lives of the people that die by an average of nearly 29 years, which equals 2.8 million years of potential life lost. Alcohol is the third preventable cause of death in the country and costs the nation $249 billion in 2010. 

Those who drink might wonder about the difference between alcohol abuse and dependence. On occasion, it’s common for a person to go out and binge drink and abuse the substance, but does that constitute becoming dependent? When does drinking become a problem?

Until the publication of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorder (DSM-5), those who used substances were typically divided into dependence and abuse. The DSM-5 combines both of these categories into a single substance use disorder, which is measured from mild to severe. 

The change was implemented to update the idea that abuse was an early phase of the illness and dependence was something more severe. However, realistically speaking, abuse can also be severe. 

What Is Alcohol Abuse?

addiction versus dependence

The Harvard Medical School reports that alcohol abuse is the second most common form of substance abuse in the United States. When a person’s drinking causes harm or distress, it’s considered an alcohol use disorder. An estimated five percent of women have an alcohol use disorder and an estimated ten percent of men. Their alcohol use can lead to troubles at school, work, or home, health problems, and issues with the law. Many of them lose control of their drinking, and they can’t cut down or stop despite adverse health consequences or losing relationships. 

Why some people abuse alcohol, and others don’t isn’t entirely understood, but families with a history of alcohol addiction will place a person at higher risk. Children of parents with alcohol troubles have a fourfold risk of increasing the disorder.

Heavy drinking will cause damage to the heart, stomach, liver, brain, and nervous system. It also increases the risk of mouth, larynx (voice box), throat, and esophagus cancer. Women who drink heavily increase their risk of developing osteoporosis and breast cancer. Also, those who drink heavily may not eat well, leading to vitamin and mineral deficiencies. 

An alcohol abuse disorder is a progressive and severe condition. However, it’s treatable. Early symptoms of alcohol abuse include drinking alcohol despite the concerns of others, drinking more than planned, and frequent attempts to cut down or stop drinking with no results. The individual will continue drinking alcohol to get the desired effect, which will increase over time as the tolerance gets higher. 

Who Is Alcohol Dependent?

As was mentioned above, alcohol abuse could be a person who binge drinks one day in a month. Although they aren’t addicted or have a tolerance to alcohol, binge drinking, which is defined by the U.S. Centers for Disease Control and Prevention (CDC) as five or more drinks consumed by men or four or more consumed by women in two hours, could be fatal due to alcohol poisoning or an accident caused by drinking. The piece goes on to say that most people who binge drink don’t have a severe alcohol use disorder. 

Binge drinking is most common for adults between the ages of 18 and 34, but more than half of the total binge drinks are consumed by adults aged 35 and older. One in six adults binge drinks an estimated four times a month, consuming on average seven drinks per binge. The figure translates to 17 billion total binge drinks consumed by adults. 

Binge drinking is more common among men than women, and four out of five total binge drinks are consumed by men. An estimated 90 percent of adults in the United States who drink excessively reported binge drinking in the previous 30 days. 

Those who become alcohol-dependent will exhibit either some or all of the characteristics listed below, including:

  • Alcohol tolerance: Tolerance refers to the need to increase the amount of alcohol consumed over time to achieve desired effects. For example, a person who drank one beer a night might need two or three to become intoxicated.
  • Withdrawal symptoms: Alcohol withdrawal can be dangerous, and it refers to experiencing physical symptoms, such as tremors, insomnia, or mood swings after a brief period without drinking. 
  • Drinking solely to relieve withdrawal symptoms: When a person drinks to cure their hangover or stop the shakes,
  • Awareness of their compulsion to drink: The person is aware of their cravings whether they admit it to others or not. 
  • Consuming too much at one time: As was mentioned above, binge drinking can be dangerous even if a person isn’t addicted to alcohol. When you drink more than intended and fail to cut down, it’s a sign of dependency. 

Those with moderate-to-severe alcohol use disorders must seek professional help to stop drinking, including medical detox, professional rehab, medical treatment, or counseling. If you’re ready to stop drinking, you shouldn’t risk your life in the process. Alcohol withdrawal can lead to seizures or delirium tremens (DTs), which can lead to fatalities.

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