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Alcohol Use Disorder, Alcohol Dependence & Alcoholism: What’s the Difference?

Alcohol use disorder, formally referred to as alcohol abuse, is a common term. Alcohol dependence and alcoholism refer to struggles that patients have with substance use.

Alcohol use disorder, formally referred to as alcohol abuse, is a common term. Alcohol dependence and alcoholism refer to struggles that patients have with substance use. And while they all may seem like multiple ways to describe alcohol addiction, they refer to different experiences. 

Knowing the difference between these terms is a great entry point into understanding how substance use disorders work. In this piece, we’ll outline the meaning of these labels and explore how they’ve evolved with time.

What is Alcohol Use Disorder (formerly Alcoholism)?

Alcoholism is an outdated term used to refer to Alcohol Use Disorder (AUD). With the introduction of the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), a classification handbook that helps professionals diagnose mental health disorders, in 2013, alcohol abuse, alcohol dependence, and alcoholism were integrated into a singular diagnosis. This was done because healthcare officials wanted to reduce stigma around the condition, which can cause feelings of guilt and shame, preventing a person from seeking help.

The DSM-V categorizes the intensity of a patient’s AUD as either mild, moderate, or severe, depending on the amount of symptoms they experience. A person with mild AUD has 2 to 3 symptoms, a person with moderate has 4 to 5, while severe has 6 or more. These symptoms match the ones listed for alcohol dependence and abuse, as it is referred to in the DSM-IV (the prior edition of the DSM-V). These symptoms include:

  • Trouble sleeping
  • Shakiness
  • Restlessness
  • Nausea
  • Sweating
  • Racing heart
  • Seizures
  • Sensing things that aren’t there

However, the DSM-V also adds cravings, in which a person’s urge to have alcohol overrides anything else

It is important to note that AUD is connected to poor mental health, which can be a risk factor for substance use or arise as a result of it.

What Is Alcohol Abuse?

According to the DSM-IV, alcohol abuse is when drinking begins to interfere with a person’s normal life. With the introduction of alcohol use disorder in the DSM-V, the term has become outdated. However, it may still be useful to know.

A person struggling with alcohol abuse would find that drinking, and even being sick from drinking, would prevent them from taking care of their home and family. Drinking would also cause problems at work or school. A person dealing with alcohol use disorder might find themself getting into harmful situations while, during, or after drinking, like swimming, driving, using machinery, walking in a dangerous area, or having unsafe sex. They continue to drink, even if the behavior is causing trouble with friends and family.

The DSM-IV adds that a patient is likely experiencing alcohol use disorder if they have been arrested, held at a police station, or dealing with other legal problems as a result of drinking. However, its following edition, the DSM-V, does not include this criteria.

Essentially, alcohol abuse means that a person has begun to misuse alcohol in a way that interferes with their daily life, but in the short term. Though they may drink excessively, it doesn’t follow that they are necessarily dependent. However, alcohol abuse is part of an unhealthy pattern that has room to escalate to dependence.

What is Alcohol Dependence?

According to the Centers for Disease Control and Prevention (CDC), alcohol dependence is a chronic medical condition that typically includes a current or past history of excessive drinking and a strong craving for alcohol. Also, a person with alcohol dependence will continue to use despite a pattern of problems with drinking and will be unable to control alcohol consumption.

The DSM-V let go of this term along with alcohol abuse.

With alcohol dependence, the substance negatively impacts a person’s health. For example, a person with alcohol dependence experiences symptoms of withdrawal when the effects of alcohol wear off.

The DSM-IV states that when dependent on alcohol, a person will be unable to cut down on or stop drinking and may drink more or longer than intended. They will spend a lot of time drinking or feeling sick as a result and will even sacrifice pleasurable or important activities in order to drink. 

A person with alcohol dependence may continue to drink despite a negative effect on health. This can mean drinking through memory blackouts and adding to existing health problems. This can also include feelings of depression or anxiety

“AUD is connected to poor mental health, which can be a risk factor for substance use, or arise as a result of it.”

Alcohol Use Disorder and Mental Health

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), AUD and mental health disorders are frequently interrelated. Mental health problems can lead to alcohol or drug misuse when a person uses the substance to self-medicate. Simultaneously, substances can cause people with AUD to experience symptoms of a mental health problem.

More than 1 in 4 adults has both a serious mental health and a substance use disorder. People with depression, anxiety, schizophrenia, or personality disorders are more likely to experience AUD. When a person has both AUD and mental health disorders at once, this is called co-occurring or Dual Diagnosis.

Because these issues are related, it is crucial to treat AUD and mental disorders at the same time. By addressing the relationship between these separate diagnoses, a person will be able to recover. 

Stay on Track with Purposes Recovery

As awareness of stigma and its effect on recovery has grown, the way we discuss AUD has changed. Alcohol abuse, alcohol dependence, and alcoholism may not be used anymore, but they are still useful for understanding AUD and mental health.

If you or a loved one is struggling with AUD or other forms of substance use disorder, there is no need to feel ashamed. With luxury rehab in Los Angeles, Purposes Recovery offers inpatient mental health programs to help you get on track. Call our toll-free number today to learn more about our luxury detox center in Los Angeles and see how we can help you.


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If you or a loved one are struggling with substance use disorder, request a confidential call from our addiction treatment center in Los Angeles CA. Our team is ready to guide you through understanding your treatment options in a supportive and understanding environment. Taking this step is a sign of strength and the beginning of your path to a healthier, brighter future.

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