Alcohol Dependence vs. Alcohol Abuse

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There is a common trend among people that are accused of being alcoholics. Most of them deny that they have a problem. “I just like to have fun” and “I can stop drinking whenever I want” are just two of the phrases that people with alcohol dependence tend to say multiple times during their addiction.

Furthermore, alcohol dependence and alcohol abuse are often used hand in hand to describe alcoholics, but are they the same thing? Are they both present in alcoholism, or is one the end result and the other the cause?

To answer these questions, you must be familiar with the definitions of both alcohol dependence and alcohol abuse. Additionally, you must know how both of the terms relate to alcoholism and each other.

What is Alcohol Dependence?

One look at the term “alcohol dependence” will give you a brief explanation of what the term means – a dependence on alcohol. However, there is much more to know about alcohol dependence. The official definition of alcohol dependence syndrome is “a disorder characterized by a pathological pattern of alcohol use that causes a serious impairment in social or occupational functioning.” In short, alcohol dependence is what we commonly refer to as alcoholism.

What many people do not realize about alcohol dependence, or alcoholism, is that it is a genuine disease that is grounded in genetic, psychosocial, and environmental causes.  It is an addiction that almost always starts innocently in a person’s youth with their first drink and progresses until it can be all-consuming to the person and can even be fatal.

What is Alcohol Abuse?

Alcohol abuse is defined as “a spectrum of unhealthy alcohol drinking behaviors.” Unhealthy alcohol drinking behaviors include binge drinking, risky, or hazardous, drinking, and even alcohol dependence. The term alcohol misuse is also used at times and means the same thing as alcohol abuse.

Alcohol abuse is not only present within alcohol dependence, but it is often a precursor to the dependence. Alcohol abuse is the term typically used to describe binge drinking or hazardous drinking. Binge drinking is usually found among college-aged adults, most often women. Hazardous drinking can be found at any age, and it is simply characterized by drinking well over the amount needed to become inebriated.

Two Terms; One Disorder

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) combined alcohol dependence, alcohol abuse, and alcoholism into one disorder called alcohol use disorder in 2013. This suggests that all of the terms mean the same thing when it comes to diagnosing alcoholism, which is the accepted blanket term that encompasses all alcohol misuse.

In the past, alcohol dependence was believed to be the most extreme form of alcohol abuse. Now, all terms describing the misuse or abuse of alcohol are placed into the alcohol use disorder umbrella term which is then split into mild, moderate, and severe sub-categories. Mild alcohol use disorder presents with 2 or 3 symptoms of alcohol use disorder, while the moderate classification exhibits 4 to 5 of the symptoms and the severe classification exhibits 6 or more symptoms.

Symptoms of alcohol use disorder include the following:

  • Drinking more or longer than you want to
  • Constantly wanting to slow down or stop drinking but not being able to slow down or stop drinking
  • Spending a large amount of your time drinking and recovering from alcohol
  • Feeling extreme urges to drink
  • Neglecting to finish things at work, school, and home because of your drinking
  • Still drinking after it has caused issues with your loved ones
  • Putting your drinking ahead of more important life activities
  • Drinking even when you are in a situation that is made dangerous by drinking
  • Drinking in spite of the fact that alcohol worsens a physical or psychological problem you are facing
  • Having to drink much more alcohol to get drunk than you did before; building a tolerance
  • Experiencing withdrawal symptoms when you go without alcohol, like shakiness, nausea, and trouble sleeping, among others

Effects of Alcohol Dependence and Abuse

Most often, when you think of an alcoholic, you imagine an older, middle-aged unkempt person sitting in a bar alone until closing every night. That is a common misconception. In fact, in the United States, the age group that experiences the highest amount of alcohol misuse is 18 to 29-year-olds, with the lowest alcohol issues being founds among adults aged 65 and older. With the current lifestyle of young adults, it is hard to tell if there is true alcohol dependence forming or if they are “just partying.”

However, alcohol dependence does have symptoms that are both physical and emotional, withdrawals, and a large variety of health complications that can form with excessive use of alcohol. So, the danger of becoming an alcoholic is not the only thing that young drinkers have to worry about. Even if they eventually stop drinking heavily and consistently, they could have already permanently harmed their bodies.

Some of the withdrawal symptoms of alcoholism are: hand tremors, sweating, insomnia, rapid heart rate, anxiety, depression, fatigue, irritability, hallucinations, and seizures. These are not the only symptoms that can result from withdrawals, and if you have a pre-existing psychological or physical issue, the withdrawal symptoms can become very serious.

Some of the health issues that can arise because of alcohol dependence are:

  • Higher chance of getting cancer, specifically cancer of the larynx, esophagus, liver, and colon
  • Either acute or chronic (or both) pancreatitis
  • Liver issues, like cirrhosis of the liver
  • Alcoholic neuropathy, which is nerve degeneration
  • Alcoholic cardiomyopathy
  • High blood pressure
  • Nutritional deficiencies
  • Erectile dysfunction
  • No menstrual cycle
  • Fetal alcohol syndrome (in children born from pregnant women who abused alcohol)
  • Dementia brought on by alcohol abuse
  • Development of Wernicke-Korsakoff syndrome, also called Wernicke’s encephalopathy

It is important to understand that alcohol dependency has no good outcomes.

Causes of Alcohol Dependence and Abuse

Alcohol dependence does not have a single cause; instead, it is usually caused by a combination of factors like genetics and upbringing, mental health, and social interactions.

It is not known exactly how much influence genetics has over the development of alcoholism, but it is known that the child of an alcoholic parent is four times more likely to become an alcoholic. Scientists have not yet been able to identify an “alcoholic gene” to cement the genetics and alcoholism link, but the prevalence of alcohol dependence spanning generations cannot be ignored.

Upbringing also effects a person’s tendency to become an alcoholic. The combination of nature and nurture have always been said to have a dramatic effect on the kind of person someone turns out to be, and it is no different when it comes to developing alcohol dependence. Additionally, if someone is allowed to drink at a young age, they are more likely to develop alcoholism later in life. For instance, if someone drinks alcohol before the age of 15, he is 5 times more likely to become an alcoholic than if he would have waited to drink for the first time as a legal-aged adult.

A person’s mental health generally dictates how he lives his daily life. For example, someone with severe anxiety will not often be found in places that are crowded with tons of people like major shopping malls. So, if someone is depressed or not feeling like they are worthy of love, he can easily fall into the trap of drinking alcohol to attempt to feel nothing, which often backfires and makes the person feel even more hopeless and helpless. 37% of people that are alcohol dependent have at least one serious mental health disorder according to the National Alliance on Mental Illness.

The last, but possibly most influential, factor that can cause alcoholism to develop is a person’s social interactions. Most people experience their first taste of alcohol with their friends, and it is normally with their friends that they’ll continue to go out to clubs and bars. If a person is surrounded by drinking most of the time, he will most probably drink often himself. Peer pressure and social pressure are real and valid, which is a reason why young adults are at the highest risk of developing alcohol dependence without even realizing it.

Do I Have Alcohol Use Disorder?

If you fear that you may have developed alcohol dependence, it is imperative that you get help as soon as you can. You can go to your family doctor or general physician with your concerns, and you can also administer some self-tests to see if you have developed alcoholism.

Why self-test? Admitting that you may be an alcoholic is difficult and often comes with confusing emotions. Sometimes, it is easier to accept that you need outside help if you can fully convince yourself that you have a problem first.

Some questions for self-testing that are suggested by The Mayo Clinic are:

  • Do you drink more now to feel the same effects that you used to feel when drinking less?
  • Do you ever feel guilty for drinking?
  • Does drinking make you become angry or violent?
  • Has your drinking caused problems with your work, school, or home lives?
  • Do you think you would benefit by cutting back on your drinking?

If you answer “yes” to 2 or more of these questions, it is likely that you have developed a dependency on alcohol or are in the process of developing one. If your self-test points to alcoholism, it is crucial to see your doctor about your drinking habits.

Seeing a doctor about your alcohol dependency or abuse may seem frightening, but your doctor will usually only ask questions because it is a disease characterized more by behaviors than symptoms, especially if you are not in withdrawal. However, if your doctor notices signs of failing liver function, he or she may order bloodwork to check on the status of your liver.

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Getting Help with Alcohol Dependency

With the new DSM-5 definition of alcohol use disorder, you will first be diagnosed with either a mild, moderate, or severe version of the disorder. Usually, the severity of your disease will determine your treatment plan.

If you are simply on the verge of developing an alcohol dependency, you may be told to attend Alcoholics Anonymous meetings and following their Twelve Step programs in order to help guide you to sobriety. This may also be a suggestion for someone with mild alcohol use disorder, along with therapy.

Furthermore, there are more intensive treatment plans as well that involve rehabilitation programs, sober living homes, counseling and therapy, Twelve-Step programs, and even support groups all used together to help you reach and maintain your sobriety.

Getting Rid of Alcohol Dependency

Alcoholism – alcohol dependency, alcohol abuse, alcohol use disorder – is a major disease no matter which name it is called. The alcohol dependence syndrome has been researched and studied since 1976, when psychiatrist Griffith Edwards and his colleague Milton Gross began to study alcoholism in depth.

One of the most useful facts that Edwards and Gross discovered during their research is that the correct question to ask in alcohol dependent situations is not whether or not the person in question is dependent on alcohol but “how far along the path of dependence has the person progressed.”

This discovery has helped the both the medical community and the general public look at alcohol dependence differently, resulting in a more proactive approach to preventing the escalation of alcoholism instead of the old approach of trying to treat it once it has reached extreme levels.

In Conclusion…

Alcohol dependence and alcohol abuse may not be the exact same things, but they are both factors of alcohol use disorder – making them siblings. Both terms suggest addiction to alcohol, and if you consider yourself dependent on or an abuser of alcohol, it’s very important to seek help immediately. As you have read, alcohol use disorder is a disease that has stages – the further advanced you are in the stages, the harder it is to reach sobriety.

One of the best ways to reach sobriety and live an alcohol-free life is by undergoing treatment at a facility like The Hills. Here at The Hills, we focus on helping people dependent on or abusing alcohol detox and heal from addiction. Contact us now in order to find out how our facility can help you on the road to recovery!

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