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Alcohol Abuse vs. Alcoholism

Learn the difference between alcohol abuse and alcoholism in this Howcast video featuring addictions specialist Paul J. Rinaldi, Ph.D.


Folks are often curious about what the difference is between alcohol abuse and alcoholism. We used to use those terms, diagnostically, as professionals. We use a diagnostic manual for diagnoses of psychological disorders and substance abuse disorders. And in the old diagnostic manual, which was called "DSM-IV-R", there was a category of alcohol abuse and alcohol dependence. Alcohol dependence was another word for alcoholism. Now, in the new diagnostic manual, which is called "DSM V", they've done away with those terms. And now we have what's called, "alcohol use disorder," which is now rated on a continuum from mild, moderate or severe in terms of your alcohol use. And that's all considered alcohol use disorders. People are really concerned often, that if they drink, they're automatically in a mild alcohol use disorder and that's not true because you need to meet certain criteria, a certain number of criteria, in order to gain the diagnosis.

There's 11 criteria under the alcohol use disorder diagnosis. And so, mild disorder is if you meet two to three of those criteria. And in the past, that was probably about the same as what was considered alcohol abuse. And what that means, generally, is that you drink more than you intend to at times. That doesn't mean that people drink all the time. It may be what we refer to also as binge drinkers, people who may drink on the weekend, what sometimes we call "weekend warriors" where they're fine during the week. They don't touch. They're teetotalers all week and then Friday comes and they go wild and they drink severe amounts. Binge drinking is generally referred to in males drinking five or more drinks in a single episode, and for females, four or more drinks in a single episode. So, that would be binge drinking.

But that also . . . people can drink daily and still not be considered a severe alcohol use disorder. They may drink daily, but only drink one drink daily and that would not have them fall into even a mild alcohol use disorder. Many people, in fact, cardiologists recommend that people have a glass or two of red wine per day. Sometimes people feel that they're getting mixed messages, but again, that's not a problem. It's only a problem when it becomes a problem, when you have some kind of consequences of your alcohol use. That really is the difference between alcohol abuse and alcoholism, would be again, alcohol abuse is in the mild category of alcohol use disorder and alcoholism would be analogous to the severe alcohol use disorder.

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