Alcohol Use vs. Alcoholism Demystified

Demystifying alcohol use vs. alcoholism: Understand the terminology, effects, and treatment options for alcohol-related concerns.

By Alis Behavioral Health Staff

April 5, 2024

Understanding Alcohol Use Disorder

Alcohol use disorder is a term used to describe a pattern of alcohol use that involves difficulties in controlling drinking, preoccupation with alcohol, continued alcohol use despite problems, increased tolerance, and withdrawal symptoms when alcohol consumption is reduced or stopped. It is important to understand this condition to recognize its impact and seek appropriate help.

Definition of Alcohol Use Disorder

Alcohol use disorder (AUD) is a chronic condition characterized by problematic alcohol consumption that can have severe effects on physical and mental health. It is diagnosed based on specific criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). These criteria include:

  • Drinking larger amounts or for a longer period than intended
  • Desire or unsuccessful efforts to cut down or control alcohol use
  • Spending a significant amount of time obtaining, using, or recovering from the effects of alcohol
  • Craving or a strong desire to drink
  • Continued use despite causing or exacerbating social or interpersonal problems
  • Giving up or reducing important occupational, social, or recreational activities due to alcohol use
  • Continued use despite physical or psychological problems caused by alcohol
  • Needing more alcohol to achieve the desired effect (tolerance)
  • Experiencing withdrawal symptoms when alcohol use is stopped or reduced

Prevalence of Alcohol Use Disorder

Alcohol use disorder is a significant public health concern. According to the 2022 National Survey on Drug Use and Health, an estimated 28.8 million adults ages 18 and older in the United States (11.2% of this age group) had alcohol use disorder in 2021. Among adolescents ages 12 to 17, approximately 753,000 individuals (2.9% of this age group) had alcohol use disorder during the same time frame. These numbers highlight the widespread impact of alcohol use disorder and the need for effective prevention and treatment strategies.

Risk Factors for Alcohol Use Disorder

Several factors contribute to the development of alcohol use disorder. These risk factors include:

  • Genetic predisposition: Family history of alcohol use disorder or other substance use disorders can increase the likelihood of developing alcohol use disorder.
  • Psychological factors: Mental health conditions such as depression, anxiety, or bipolar disorder may co-occur with alcohol use disorder, indicating a complex relationship between mental health and alcohol consumption.
  • Social and environmental factors: Peer pressure, a history of trauma or abuse, availability of alcohol, and cultural norms that encourage heavy drinking can contribute to the development of alcohol use disorder.
  • Age: Alcohol use disorder can start at any age, but it is more commonly observed in the 20s and 30s.

Understanding the risk factors associated with alcohol use disorder is critical for prevention efforts and early intervention. By recognizing these factors, individuals and communities can take steps to reduce the impact of alcohol-related problems and promote healthier choices.

In the next sections, we will delve deeper into the symptoms, diagnosis, treatment options, effects of alcohol on the body, and other important aspects related to alcohol use disorder.

Symptoms and Diagnosis of Alcohol Use Disorder

Understanding the symptoms and diagnosing alcohol use disorder (AUD) is essential for identifying and addressing alcohol-related problems. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), provides criteria for diagnosing AUD and categorizing its severity levels.

Diagnostic Criteria for Alcohol Use Disorder

Healthcare professionals utilize the diagnostic criteria outlined in the DSM-5 to assess whether an individual has AUD. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), a patient is diagnosed with AUD if they answer "yes" to two or more questions about their drinking behavior.

The DSM-5 identifies eleven criteria for AUD, including:

  1. Consuming alcohol in larger amounts or for a longer period than intended.
  2. Wanting to cut down or stop drinking but being unable to do so.
  3. Spending a significant amount of time obtaining alcohol, drinking, or recovering from its effects.
  4. Experiencing strong cravings or a strong desire to drink.
  5. Failing to fulfill major obligations at work, school, or home due to recurrent alcohol use.
  6. Continuing to drink despite causing relationship or social problems.
  7. Giving up or reducing important activities due to alcohol use.
  8. Engaging in risky behaviors while under the influence of alcohol.
  9. Continuing to drink despite experiencing physical or psychological problems caused or worsened by alcohol.
  10. Developing tolerance, requiring increased amounts of alcohol to achieve the desired effect.
  11. Experiencing withdrawal symptoms when attempting to stop drinking or reducing alcohol consumption.

Severity Levels of Alcohol Use Disorder

The severity of AUD is determined by the number of criteria that an individual meets within a 12-month period. The NIAAA categorizes AUD into three levels: mild, moderate, and severe

Assessing Alcohol Use Disorder

To assess AUD, healthcare professionals evaluate an individual's symptoms and determine the severity of their condition based on the number of criteria met. This assessment helps guide treatment decisions and interventions tailored to the individual's needs.

It's important to note that AUD is a medical diagnosis used to describe individuals with varying degrees of alcohol-related problems. In contrast, alcoholism is a non-medical term commonly used in everyday language and within Alcoholics Anonymous. The DSM-5 classifies alcohol abuse and alcohol dependence under the diagnosis of Alcohol Use Disorder (AUD), which can be categorized as mild, moderate, or severe based on the severity of the individual's condition [4].

By understanding the symptoms and employing diagnostic criteria, healthcare professionals can accurately diagnose AUD and provide appropriate treatment and support to individuals struggling with alcohol-related problems.

Treatment Options for Alcohol Use Disorder

When it comes to addressing alcohol use disorder, there are various treatment options available to help individuals on their path to recovery. These options include medications, behavioral therapies, and support groups.

Medications for Alcohol Use Disorder

Medications can play a crucial role in the treatment of alcohol use disorder. They are often prescribed to help individuals stop or reduce their drinking and prevent relapse. Some commonly used medications include:

These medications, approved by the United States, can be prescribed by healthcare professionals to support individuals in their journey towards sobriety. It's important to note that medication options may vary depending on the individual's specific needs and circumstances.

Behavioral Therapies for Alcohol Use Disorder

Behavioral therapies are an integral part of treating alcohol use disorder. These therapies aim to modify unhealthy behaviors, develop coping strategies, and support long-term recovery. Some commonly used behavioral therapies include:

  • Cognitive-Behavioral Therapy (CBT): Focuses on identifying and changing negative thought patterns and behaviors related to alcohol use.
  • Motivational Enhancement Therapy (MET): Encourages individuals to find internal motivation for change and set achievable goals.
  • Contingency Management: Provides incentives for abstaining from alcohol and adhering to treatment plans.
  • Family Therapy: Involves the individual's family members in the treatment process to improve communication and address any underlying family dynamics.

These therapies are typically conducted by licensed professionals and tailored to meet the specific needs of each individual. They can be delivered through individual counseling, group therapy, or a combination of both.

Support Groups for Alcohol Use Disorder

Participating in support groups is an essential component of the treatment journey for individuals with alcohol use disorder. Support groups provide a safe and understanding environment where individuals can connect with others who have similar experiences, share their challenges, and learn from one another. These groups can be invaluable in helping individuals cope with the disease, prevent or handle relapses, and maintain sobriety.

Healthcare providers or counselors can recommend suitable support groups based on an individual's specific needs. Examples of support groups for alcohol use disorder include Alcoholics Anonymous (AA), SMART Recovery, and Women for Sobriety. These groups offer a sense of community, encouragement, and accountability throughout the recovery process.

By combining medications, behavioral therapies, and participation in support groups, individuals with alcohol use disorder can access a comprehensive and multifaceted approach to treatment. It's important to consult with healthcare professionals to determine the most suitable treatment options based on individual needs and preferences. With the right support and resources, individuals can embark on their journey towards a healthier and alcohol-free life.

Alcohol Abuse vs. Alcoholism

When discussing alcohol-related issues, it's important to understand the distinction between alcohol abuse and alcoholism. While these terms are often used interchangeably, they have different meanings and implications.

Definition of Alcohol Abuse

Alcohol abuse refers to a pattern of drinking that leads to harmful consequences. It involves behaviors such as excessive or binge drinking, drinking in situations that are physically dangerous, or experiencing recurring problems in relationships, work, or other areas of life as a result of alcohol use. Alcohol abuse is characterized by the negative impact it has on a person's life, despite not meeting the full criteria for an Alcohol Use Disorder (AUD).

Definition of Alcoholism

Alcoholism, sometimes referred to as severe alcohol dependence, is a term commonly used in everyday language and within Alcoholics Anonymous. It is important to note that alcoholism is not a medical diagnosis, unlike Alcohol Use Disorder. Alcoholism generally describes a condition where an individual has a severe, chronic, and compulsive need to consume alcohol. These individuals often exhibit symptoms listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) criteria for Alcohol Use Disorder.

Differentiating Alcohol Abuse and Alcoholism

While alcohol abuse and alcoholism share similarities, the main distinction lies in the severity and impact of the condition. Alcohol abuse may involve harmful drinking patterns without meeting the full criteria for an AUD. On the other hand, alcoholism typically indicates a more severe and compulsive form of alcohol dependence.

The DSM-V identifies individuals as having an Alcohol Use Disorder (AUD) if they meet at least two of the eleven criteria within the same 12-month period, with the severity of the disorder determined by the number of criteria that apply to the individual. It is crucial to remember that the term "alcoholic" is commonly used within Alcoholics Anonymous and in everyday language, but it is not a medical diagnosis.

By understanding the difference between alcohol abuse and alcoholism, individuals can have a clearer understanding of their own relationship with alcohol and seek appropriate help or support. If you or someone you know is struggling with alcohol-related issues, it is important to consult with a healthcare professional or seek guidance from support groups specializing in alcohol-related concerns.

Effects of Alcohol on the Body

Alcohol consumption, whether in moderation or excessive amounts, can have significant effects on the body. Understanding the short-term and long-term effects of alcohol, as well as the associated health risks, is crucial for maintaining a balanced and informed approach to alcohol use.

Short-Term Effects of Alcohol

When consumed, alcohol rapidly enters the bloodstream and affects various organs and systems in the body. Some of the short-term effects of alcohol include:

  • Impaired judgment and decision-making abilities
  • Slowed reaction times and decreased coordination
  • Altered mood and behavior
  • Reduced inhibitions
  • Increased risk-taking behavior

Alcohol's effects on the brain can lead to altered perceptions, memory lapses, and in extreme cases, blackouts. It can also have a sedating effect, causing drowsiness and even unconsciousness in high doses.

Long-Term Effects of Alcohol

Prolonged or excessive alcohol consumption can lead to serious health consequences. Some of the long-term effects of alcohol on the body include:

  • Liver damage: Chronic alcohol use can result in liver diseases such as alcoholic hepatitis, cirrhosis, and liver cancer. The liver plays a crucial role in metabolizing alcohol, and excessive consumption can overwhelm its ability to process alcohol effectively.
  • Heart problems: Regular heavy drinking can increase the risk of developing cardiovascular diseases such as high blood pressure, irregular heart rhythms, and weakened heart muscles. These conditions can lead to heart attacks, stroke, and other cardiovascular complications.
  • Pancreatic issues: Alcohol abuse can cause inflammation of the pancreas, known as pancreatitis, which can disrupt digestion and lead to severe abdominal pain. Long-term pancreatitis can result in permanent damage to this vital organ.
  • Increased cancer risk: Alcohol consumption is strongly linked to an increased risk of developing alcohol-associated cancers. Regular and excessive alcohol intake is associated with an elevated risk of cancers such as mouth, throat, esophagus, liver, breast, and colorectal cancer. Even moderate alcohol consumption has been associated with a modestly increased risk of certain types of cancers.
  • Weakened immune system: Chronic alcohol consumption weakens the immune system, making the body more susceptible to infections such as pneumonia and tuberculosis. Even a single episode of heavy drinking can temporarily impair the immune system's ability to fight off infections for up to 24 hours after consumption.

Alcohol-Related Health Risks

Alcohol consumption is a major risk factor for various health problems and contributes to the global burden of disease. It is associated with a wide range of conditions, including infectious diseases, cancer, neuropsychiatric disorders, cardiovascular disease, liver and pancreas diseases, and unintentional and intentional injuries.

It's important to note that the effects of alcohol can vary depending on factors such as the amount consumed, frequency of consumption, individual tolerance, and overall health. While moderate alcohol consumption may have certain health benefits for some individuals, it is crucial to be aware of the potential risks and to make informed choices about alcohol use. If you have concerns about your alcohol consumption or its effects on your health, it is recommended to seek guidance from a healthcare professional.

Seeking Help for Alcohol Problems

When faced with alcohol-related issues, seeking help is an important step towards recovery. Recognizing the need for assistance, undergoing alcohol detoxification, and making lifestyle changes are key aspects of addressing alcohol problems effectively.

Recognizing the Need for Help

Recognizing the need for help is the first step towards addressing alcohol problems. It's crucial to acknowledge the presence of alcohol-related issues and the impact they have on one's life. Signs that may indicate the need for help include:

  • Frequent and excessive alcohol consumption
  • Inability to control or limit alcohol intake
  • Neglecting responsibilities and relationships due to alcohol use
  • Continued use of alcohol despite negative consequences
  • Experiencing withdrawal symptoms when attempting to stop drinking

If any of these signs resonate with an individual, it is important to seek professional guidance and support.

Alcohol Detoxification

For individuals with alcohol use disorder, detoxification is often necessary to safely manage withdrawal symptoms and cleanse the body of accumulated toxins. Abruptly stopping alcohol consumption can lead to severe withdrawal symptoms as the body adjusts to functioning without the substance. Alcohol detox helps the body manage these symptoms and begin the recovery process.

During alcohol detoxification, individuals may be provided with medical supervision, medications, and support to ensure a safe and comfortable withdrawal process. The duration and intensity of detoxification vary depending on the severity of alcohol use disorder and individual circumstances. It is important to undergo detoxification under the guidance of medical professionals to ensure safety and minimize potential risks.

Lifestyle Changes and Recovery

Recovery from alcohol problems often involves making significant lifestyle changes. These changes may vary depending on individual needs and circumstances. Some common lifestyle changes that can support recovery from alcohol use disorder include:

  • Avoiding Triggers: Identifying and avoiding triggers that lead to alcohol use can be crucial in maintaining sobriety. This may involve avoiding certain social situations, changing routines, and developing healthy coping mechanisms.
  • Participating in Behavioral Therapies: Behavioral therapies, such as cognitive-behavioral therapy (CBT) and motivational interviewing, can help individuals develop skills to overcome triggers and make positive changes in their behavior and thought patterns. These therapies are often provided by licensed professionals and can be instrumental in supporting recovery.
  • Medication-Assisted Treatment: In some cases, medications may be prescribed to help individuals reduce cravings and prevent relapse. Medications such as naltrexone, acamprosate, and disulfiram have been approved by the U.S. Food and Drug Administration for the treatment of alcohol use disorder and can be used in combination with behavioral therapies or support groups [2].
  • Participation in Support Groups: Support groups, such as Alcoholics Anonymous (AA) and SMART Recovery, provide a supportive community and a platform for individuals with alcohol problems and their families to share experiences, learn from others, and maintain sobriety. These groups can offer guidance, accountability, and a sense of belonging.

In addition to these lifestyle changes, it is important to work closely with healthcare providers, therapists, and support networks to develop an individualized recovery plan that addresses specific needs and goals. Recovery is a journey that requires ongoing commitment, patience, and perseverance. With the right support and resources, individuals can overcome alcohol problems and lead a healthier, fulfilling life.

Alcohol Use Disorder in Different Age Groups

Alcohol Use Disorder (AUD) can affect individuals of all ages, but its prevalence and impact may vary across different age groups. In this section, we will explore the occurrence of AUD in adults and adolescents, as well as the impact of alcohol on youth.

Alcohol Use Disorder in Adults

According to the 2022 National Survey on Drug Use and Health, approximately 28.8 million adults aged 18 and older, which is equivalent to 11.2% of this age group, had Alcohol Use Disorder in 2021. This highlights the significant prevalence of AUD among adults.

Alcohol Use Disorder in adults can have a range of consequences, including physical health problems, relationship difficulties, and impaired occupational performance. Seeking treatment and support is crucial for individuals struggling with AUD to regain control over their alcohol consumption and improve their overall well-being.

Alcohol Use Disorder in Adolescents

Alcohol Use Disorder is not limited to adults; it can also affect adolescents. The same National Survey on Drug Use and Health estimates that around 753,000 adolescents aged 12 to 17, comprising 2.9% of this age group, had AUD in 2021.

The prevalence of AUD among adolescents is concerning, as it can have long-lasting effects on physical and mental health, academic performance, and future risk-taking behaviors. Early intervention and prevention efforts are crucial in addressing alcohol-related issues among adolescents and promoting healthy habits.

Impact of Alcohol on Youth

Alcohol abuse is particularly common among young adults and college students. This age group often engages in binge drinking at parties and bars, which can have serious consequences. The impaired judgment and motor skills resulting from alcohol abuse can lead to dangerous situations, such as driving under the influence, increasing the risk of harm to themselves and others. Legal consequences may also arise from these behaviors.

It is important to educate and support young individuals in making responsible choices regarding alcohol consumption. Prevention programs, peer support, and access to resources can play a significant role in reducing the negative impact of alcohol on youth and promoting healthier behaviors.

Understanding the prevalence of Alcohol Use Disorder in adults and adolescents, as well as the impact of alcohol on youth, highlights the need for awareness, early intervention, and support systems to address alcohol-related issues across different age groups. By providing education and resources, we can foster a healthier relationship with alcohol and promote overall well-being.

Alcohol Use Disorder and Mental Health

Alcohol use disorder (AUD) often co-occurs with mental illnesses, creating a complex and intertwined relationship between alcohol and mental health. Understanding this connection is crucial for effective diagnosis, treatment, and recovery.

Alcohol Use Disorder and Co-Occurring Mental Illness

AUD is frequently associated with co-occurring mental illnesses, such as depression, anxiety disorders, bipolar disorder, and post-traumatic stress disorder (PTSD) [1]. These mental health conditions can contribute to the development of AUD and vice versa. It is important to recognize that the presence of one condition can exacerbate the other, making the treatment more challenging.

Alcohol Use Disorder Treatment for Individuals with Mental Health Disorders

Individuals with co-occurring AUD and mental health disorders may require integrated treatment that addresses both conditions simultaneously. This approach, known as dual diagnosis or integrated treatment, can improve treatment outcomes and reduce the risk of relapse.

The treatment plan for individuals with AUD and mental health disorders may involve a combination of medications, behavioral therapies, and support groups. It is important to tailor the treatment approach to address the specific needs and challenges of each individual. Integrated treatment aims to address the underlying factors contributing to both conditions, promoting overall well-being and recovery.

The Link Between Alcohol and Mental Health

The relationship between alcohol and mental health is intricate. While alcohol may initially provide temporary relief from symptoms of mental health disorders, excessive and prolonged alcohol use can worsen mental health symptoms and contribute to the development of new mental health problems.

Alcohol can disrupt the balance of chemicals in the brain, affecting mood, emotions, and cognitive function. It can also interfere with the effectiveness of medications used to treat mental health disorders. Therefore, individuals with mental health disorders should exercise caution when consuming alcohol to prevent exacerbation of their symptoms and potential negative interactions with prescribed medications.

Understanding the complex connection between alcohol and mental health is crucial for individuals with AUD and co-occurring mental health disorders. Seeking professional help from healthcare providers specializing in addiction and mental health is essential to develop a comprehensive treatment plan that addresses both conditions. With proper support and treatment, individuals can work towards recovery, improving their overall well-being and quality of life.

Statistics on Alcohol Use Disorder

Understanding the prevalence and impact of alcohol use disorder (AUD) is crucial in addressing this public health concern. In this section, we will explore the prevalence of alcohol use disorder in the United States, its global impact, and its occurrence in different populations.

Prevalence of Alcohol Use Disorder in the United States

According to the 2022 National Survey on Drug Use and Health, in 2021, an estimated 28.8 million adults aged 18 and older in the United States, representing approximately 11.2% of this age group, had alcohol use disorder (AUD). Additionally, during the same time frame, it was estimated that approximately 753,000 adolescents aged 12 to 17, or 2.9% of this age group, had AUD. These statistics highlight the significant impact of AUD on individuals across different age groups in the United States.

Global Impact of Alcohol Use Disorder

Alcohol consumption is a major risk factor for various health problems worldwide, contributing to the global burden of disease. It is a necessary underlying cause for more than 30 conditions and a contributing factor to many others, including infectious diseases, cancer, diabetes, neuropsychiatric diseases (including alcohol use disorders), cardiovascular disease, liver and pancreas disease, and unintentional and intentional injury.

Alcohol consumption ranks as the third-most disabling disease category in high-income countries and the fourth-most disabling disease category in low- to middle-income countries. The detrimental impact of alcohol use disorder extends beyond physical health, affecting mental well-being, social relationships, and overall quality of life.

Alcohol Use Disorder in Different Populations

Alcohol use disorder can affect individuals from all walks of life. However, certain populations may be more vulnerable to the development of AUD due to various factors such as genetics, cultural norms, and socioeconomic conditions.

It is important to note that alcohol use disorder does not discriminate based on age, gender, or socio-economic status. It can affect individuals of all backgrounds. However, it is worth highlighting that certain populations may be at a higher risk for AUD.

Further research is needed to understand the specific factors contributing to the varying prevalence of alcohol use disorder within different populations. By recognizing the unique challenges faced by these populations, targeted interventions and support can be implemented to address and prevent the harmful effects of AUD.

Understanding the prevalence and impact of alcohol use disorder is an essential step in addressing this complex issue. By raising awareness, promoting education, and providing access to effective treatment and support, we can work towards reducing the burden of alcohol use disorder on individuals, families, and communities.


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