For laypeople, the person who has a drinking problem is often referred to as an alcoholic or as a person who suffers from alcoholism. These terms are general and encompass a wide range of problem drinking behaviors. The word alcoholic can mean different things to different people. That is because they are not diagnostic terms but everyday terms.
When psychologists and other experts refer to people struggling with problems related to alcohol use, they use terms that are much more specific. The terms alcohol abuse and alcohol dependency may sound interchangeable to the common man, but there is a distinct difference in the meaning behind the terms.
Though the terms alcohol abuse and alcohol dependency both point to a person’s problematic alcohol use, they are specific diagnostic terms used to describe discrete types of drinking problems. The term alcoholism has come into common parlance through association with 12 step drinking recovery programs like Alcoholics Anonymous and is not a clinical term. Clinicians use precise terminology to describe different stages of disordered alcohol use. Alcohol abuse describes one stage of an alcohol use disorder, and alcohol dependency describes another.
Alcohol abuse is defined as a pattern in a person’s life of at least one, but perhaps several, negative consequences related to alcohol use. Alcohol abuse can be best thought of as the early phase of alcohol dependency. The diagnosis has fewer definable symptoms but actually lays the foundation for later alcohol dependency. Some of the negative consequences associated with alcohol abuse include:
- Repeated failure to meet responsibilities or obligations at home, at work, or within the family due to the use of alcohol
- Repeated alcohol use in potentially dangerous situations such as driving a car or operating heavy or dangerous machinery
- Repeated problems with the law, either such as driving under the influence of alcohol, being inebriated in public, or disorderly conduct
Clinicians assign a diagnosis of alcohol abuse when one or more of these consequences are repeated in a person’s life over the course of a one-year period. A person may also be diagnosed with alcohol abuse because they continue drinking alcohol despite the occurrence of these negative consequences in their life.
Alcohol dependency describes a more chronic and complex condition. Dependency is actually considered to be an illness related to alcohol use that produces physiological symptoms. The criteria for an alcohol dependency diagnosis include:
- Symptoms of withdrawal (shakes or tremors, hangovers)
- A desire to cease drinking
- Failed efforts to cease drinking
- A preoccupation with drinking
- Negative consequences associated with drinking
- Continuation of drinking in spite of a desire to cease and/or associated negative consequences
Clinicians assign a diagnosis of alcohol dependency when there is evidence of alcohol tolerance and when one or more of the abovementioned criteria are met. The person with alcohol dependency may cease drinking but will always be considered alcohol dependent. The disorder is described as either in full or partial remission once a person ceases to drink. Full remission describes an alcohol-dependent person who shows no symptoms of dependency for a minimum of 30 days but less than a full year.
In both instances, whether alcohol abuse or alcohol dependency, the treatment will center upon abstaining from drinking. Since alcohol abuse describes an early stage and more behavior-centered diagnosis, it is possible to receive treatment and put the diagnosis of abuse behind you. By contrast, alcohol dependency is a diagnosis that remains and is further defined throughout a person’s life as either active or in remission. The person who has developed alcohol dependency will need to combat the temptation of alcohol misuse long after they have ceased from the problem drinking itself.